Friday, February 02, 2007

Shortage of midwives puts mothers and babies at risk

A shortage of midwives is putting mothers and babies at risk, in spite of a Labour manifesto pledge to increase the numbers so that every pregnant woman would be cared for throughout by the same nominated midwife. Research shows that many baby units are failing to meet targets for the number of midwives and that Labour’s promise is far from being achieved.

The Royal College of Midwives has issued a warning of cuts to services, stress on staff, fewer home visits, less chance of a home birth for those who want it, and a shrinking workforce — at a time when the number of births is increasing.

The college’s assessment is supported by the healthcare analysis company Dr Foster. It examined the numbers of births and the numbers of midwives across England to see how close the NHS was to meeting the informal but generally accepted target of 32 births per full-time midwife per year. More than 62 per cent of trusts in England, and more than 56 per cent in the UK as a whole, were failing to meet this target.

The company also found that shortages of midwives often led to maternity unit closures. In the past year, units in England were closed for almost 4,000 hours, or 165 days. This meant that women expecting to give birth at a particular hospital were transferred elsewhere at the last minute.

The Healthcare Commission has investigated one unit, at Northwick Park Hospital in northwest London, where ten mothers died between 2002 and 2005. Although a midwife shortage was not to blame, the report said that the trust was too reliant on agency and part-time staff. The trust has since recruited 20 more midwives.

The commission is now conducting a review of maternity units throughout the country, and the King’s Fund has also announced a review of safety in maternity units, to start next month.

Training budgets for midwives are being cut, in some cases by 75 per cent or even 100 per cent. Fewer midwives are being employed than was the case a year ago, even though the number of births is rising at about 6,000 a year.

Three years ago the Government urged nursing students to become midwives, but now the college says that there is no money to employ them. Louise Silverton, the college’s deputy general secretary, said: “The midwifery shortage is getting worse at a time when we are experiencing a significant increase in the number of births. Graduates can’t get jobs and it has cost the taxpayer £45,000 to train each one.”

The college published a survey this month in which two thirds of midwifery heads said their units were understaffed.

Women who want to have babies at home are often denied the opportunity because of the shortage. As times2 reports today they can be let down at the last minute if there is no midwife available.

The Dr Foster figures show that staffing problems are greatest in the East Midlands, the East of England, and London, all areas where more than 80 per cent of units exceed the target of 32 births per midwife. In the East Midlands the average figure is more than 41.

The best area is Wales, with under 23 births per midwife and Scotland also does well, at just under 24. The Department of Health has admitted that improvements are needed. On the home births commitment, a spokesman said: “Nobody claims it will be easy, but the manifesto commitment is there. We would expect that home births would be a realistic option for women with an uncomplicated pregnancy.”


£13bn hospital plans 'at risk from incompetent managers'

Dozens of privately financed hospital projects could face meltdown if the Government does not take a firmer grip, the Public Accounts Committee has said. Millions of pounds were wasted by “amateur and incompetent” NHS managers who tried to rebuild three hospitals on a single site in Paddington, West London, without a proper plan or sufficient land. The same could happen in other places if the Department of Health does not improve supervision and continues to depend on local NHS managers who are out of their depth in managing huge building projects.

The Paddington Health Campus collapsed after almost £15 million had been paid to consultants, lawyers and architects, the PAC says in a report. The Department of Health sat by while the project unravelled and the participants argued among themselves.

The parliamentary committee said that with PFI programmes worth £13 billion being planned, some could go the way of Paddington. The department admits that it blundered in not terminating the Paddington project sooner, but claims that the same will not happen again.

Edward Leigh, the chairman of the committee, said: “The collapse of the ambitious Paddington Health Campus project after five years was the direct result of appalling planning and forecasting of costs by the NHS trust partners, rows between them over the way forward and uncertainty over the Department of Health’s degree of support for the scheme.

“The department, in effect, left this £900 million construction project to local NHS staff who were rapidly out of their depth and floundering.”

The plan was to combine St Mary’s Paddington with the Royal Brompton and Harefield hospitals on a single site. But the Brompton and Harefield (itself the product of a merger) never agreed to merge with St Mary’s. Indeed, it made it a condition of its participation that it would not do so.

The department and local NHS managers nevertheless let the plan go ahead, incurring costs, for five years. What began in 2000 as a £300 million project had by May 2005 ballooned to £894 million. The completion date, set for last year, had slipped to 2013.

The failure of the plan can be traced to “ill-informed decisions taken by the NHS in northwest London”, the report says. When the scale of the problems became evident in 2002-03, there was a lost opportunity to pull the plug.

Mr Leigh said: “The department must look long and hard at whether its private finance unit is really up to the task of supporting local NHS trust procurement teams.”

The report sharply criticises the trusts for failing to put together a proper business case for the project, failing even to consult doctors and nurses over what facilities they needed. It then took “several years” for the partners, hampered by “insufficient manpower and capability”, to reach a clear position on the costs, planning issues, land required and afford-ability, it said.

The MPs criticised the North West London Strategic Health Authority for failing to halt it in 2003, but said that the Department of Health itself was also to blame. Eventually it was the Treasury, and not the DoH, that terminated the project.

The department is reviewing £13 billion of PFI hospital-build-ing plans, and aiming to reduce the total spend to between £7 billion and £9 billion. In evidence to the committee, Hugh Taylor, Permanent Secretary of the DoH, said it was “regrett-able” that the project had not been terminated sooner. But he was confident that it would not happen again, a confidence not universally shared by the committee, which concluded: “It remains to be seen whether this action will be sufficient to get a grip on a programme which continues to be managed by the NHS locally.”



Judge halts trial of the chip shop owners who seized tearaway in a citizen's arrest. The politically correct British police love to prosecute anybody but the real offender

A chip-shop owner thought he was doing his public duty when he carried out a citizen’s arrest on a 12-year-old delinquent who spat at his customers and smashed a window. But overzealous police officers turned the tables on Nicholas Tyers, 46, and his son Lee, 20, treating them as criminals and taking their fingerprints after the boy complained. Mr Tyers and his Royal Marine son were charged with kidnap for holding the boy for up to six minutes and told the maximum sentence was life in prison. During the six months that followed, Mr Tyers was forced to sell his shop and lost his faith in justice.

His nightmare ended yesterday when a judge halted the trial, which has cost taxpayers £60,000, and derided the police and the Crown Prosecution Service for bringing the case. Judge John Dowse told the men at Hull Crown Court: “I began this case asking whether it was in the public interest, whether it should have been pressed, and the result is it has not been in the public interest. I raise the question of whether or not there are far more serious cases to bring.”

The judge told the court the men had reasonable grounds to make a citizen’s arrest and there were doubts over the reliability of the boy’s evidence.

Mr Tyers, the former owner of Queensgate Fisheries, in Bridlington, East Yorkshire, said later that the case had led him to give up the business that he had run for ten years. “I have faced six months of hell waiting to prove my innocence,” he said. “The case should never have been brought. I am now looking for a full-time job. This lad spat at a customer. We had a look around for him, that night, but he ran away. I didn’t see him again until the next day.” He said that after his window was smashed his wife saw the boy and, with his son, they went looking for him. They found him with two other boys.

“We went back to the house, rather than the police station, to call the police from there. Nine times out of ten, Bridlington police station is unmanned and you have to speak to someone on the telephone.” said Mr Tyers. “When we got to the shop a police car was passing so I flagged him down and told him we had got the lad.”

The court that heard the boy regularly played truant from school. The judge said that evidence had been heard of how the boy made obscene gestures after spitting and that there was talk of his brothers fire-bombing the shop. Mr Tyers’ son, who is part of a Royal Marines unit deployed to Afghanistan, had been held back until the trial ended.

After the case, Nigel Cowgill, Chief Crown Prosecutor for Humberside, said: “This was a difficult case which the CPS considered very carefully in accordance with the code for Crown prosecutors.” A spokesman for Humberside Police said: “The arresting officer was faced with a situation in which a distressed boy alleged he had been forced into a car. It was right for that officer to act and for a police investigation to commence.” [Pathetic comment. The issue is whether the "investigation" should have CONTINUED!]


So Britain is weak on rape? Think again

Rape is not something that any of us likes to think about. It is a vile crime. But this week’s headlines have been hard to ignore. They tell us that only 1 in 20 rape victims will see their attacker convicted. That 30 years ago it was 1 in 3. That the number of reported rapes has soared, from 5,136 in 1995 to 14,002 in 2005. That we are living in a world in which huge numbers of evil men get away with violating women because the police are useless and juries think that women are “asking for it” by wearing short skirts. But it is not so simple. I first started looking at this issue because something jarred with me. The figures were shocking, and getting worse despite a decade of effort by police and prosecutors. And the Government was using them to justify a steady dismantling of defendants’ freedoms.

The first thing I found was that the “conviction rate” of one in twenty, the rate cited by every authority on the issue, is not the conviction rate at all. It is the number of convictions secured out of the total allegations made, not the number of convictions secured out of the cases tried. I can think of no other crime where conviction is so routinely confused with attrition. The attrition rate in rape cases is very high: only about 12 per cent of allegations reach court. The true conviction rate in rape cases is closer to 50 per cent than 5 per cent. That does not suggest that juries are weak: quite the opposite.

The next thing I found was that more people are being found guilty of rape: up from 655 in 2002 to 728 in 2005. Conviction rates are falling only because allegations have jumped by 40 per cent in that period.

What explains this staggering increase in allegations? Women seem more willing to report, now that many police forces have become more sensitive. Much good work has been done, with purpose-built sexual assault referral centres, the option of prerecording testimony and the end of cross-examination by the defendant. But there are two other factors. The Sexual Offences Act 2003 changed the definiton of rape to include oral sex, something that the Criminal Bar Association says has greatly boosted allegations. And the culture of binge drinking has blurred boundaries. More than four out of five rape allegations are made against friends or acquaintances; more than half of those are fuelled by alcohol and/or drugs.

Two years ago a judge threw out the case of a woman who admitted that she had been too drunk to remember whether she had consented to sex or not. She then claimed that her consent would have been meaningless anyway, because she was so inebriated. This case created waves of outrage among victim groups. But instead of treating it as a watershed, one that demonstrated the law could go no further, the Government ran scared. It had already redefined consent, to mean agreement rather than the absence of a refusal. Now it wants to ensure that no agreement can be taken as consent if it is given under the influence of alcohol. In our zeal to protect women, are we going to legislate so that a drunken man is accountable for his deeds, but a drunken woman is not? Why do we encourage women to see themselves as victims? This week I met a mother whose teenage daughter and friend had gone out on the razzle. The friend went to bed with a man and the next day was full of regret. She called: would her friend go with her to the police? The mother was horrified. “They were drinking to lower their sexual inhibitions,” she said. “The girls have to take responsibility too, for abdicating their responsibility to stay sober.” The girl was genuinely distressed. But the mother had a point.

I do not wish to trivialise acquaintance rape. There is no doubt that it can be just as traumatic as stranger rape, the cold-blooded and cold-sober attack that many people imagine, but which accounts for relatively few cases. But there is a good reason why acquaintance rapes are much harder to prosecute. With no witnesses and no circumstantial evidence, only one person’s word against another, the law must navigate tricky territory. Juries are the best people to do so — and they do convict, contrary to what we keep being told. The Government’s new definition of consent would skew the law out of their hands; and that would be quite wrong.

It is important to ask why so few of these cases come to court. Yesterday’s report by the Inspectorate of Constabulary and the Crown Prosecution Service Inspectorate makes clear that there are still huge variations in the way that different police forces deal with rape. And some women are still having to endure outrageously long delays and incompetent legal and medical advice. The report shows that more can be done with forensic doctors and specialist prosecutors. But it also states that no new policies are needed.

I wonder whether the unquestionable horror of rape has simply clouded people’s minds. In rape cases a dramatic growth in allegations, of which very few lead to convictions, is taken as proof that justice system has failed. In cases of alleged teacher assault, it is taken as proof of the opposite. There has been an enormous growth in allegations made against teachers, and fewer than 1 in 200 lead to a conviction. Yet the consensus is that most of those allegations are groundless.

I am the last person to claim that all men are blameless victims of predatory women. I have no doubt that some are still getting away with horrendous crimes. I merely ask that we go back to the data before rushing to dismantle defendants’ rights further. And that we stop portraying juries as weak when they seem to be precisely the opposite.


Britain: Homosexual tourist hotels fear equality law

They want right to refuse heterosexuals. Rules change will hit the 'pink' market

Hoteliers chasing the pink tourist pound have joined criticism of a law outlawing discrimination against homosexuals. The hotels, which cater for the thriving “exclusively gay” tourism market, say that they should be exempt from the Sexual Orientation Regulations as they will be forced to accept heterosexual guests.

Some say that a ban on “gay only” advertising could put them out of business. There were also concerns that some heterosexual couples might be unhappy if they unwittingly booked into a gay hotel.

John Bellamy, who runs Hamilton Hall, in Bournemouth, described the new laws as “discrimination against gays”. He said: “We are a unique venue and we only admit gay and bisexual men. Under this law, we would go out of business. This so-called anti-discrimination law is actually discriminatory as it discriminates against gays.”

Another hotelier, Mark Hurst, co-owner of the exclusively gay Guyz hotel, in Blackpool, said that his gay clientele would feel uncomfortable mixing with straight customers. The hotel had been catering for the gay market for the past 20 years, but only went “exclusive” last year because of customer demand. He said: “It’s not all good news at all. I don’t welcome it one little bit. We intend to stay ‘men only’ exclusively for as long as we can.

“When we had a mixed environment, with gay, bi and heterosexual customers, people didn’t behave as they naturally would.

“Here in the hotel now we have gays who cuddle up when they’re watching a film but that never happened before. If this law is introduced it will deprive gays of a place where they can be themselves.”

Mr Hurst added that if the law was passed, he would apply for an exemption. He said: “At the end of the day, this is our home and as a landlord we have the right to refuse entry to anyone without giving a reason.”

According to figures from Visit Britain and Out Now Consulting, the gay market is now worth £3.5 billion a year and represents a significant slice of the tourist industry.

In 2005, about 146,000 gay and lesbian visitors came to Britain from the United States alone, and internationally it is a top ten tourist destination for gays. A survey by Visit Britain states: “The brand-loyal gay and lesbian market is a key niche. Traditionally gays and lesbians are well-educated, have an above-average income and a high propensity to travel off-season as well as during the peak holiday months.”

The concerns have been dismissed by the gay rights group Stonewall, which says that equality is more important than the right to be exclusive. A spokeswoman said: “What gay people gain through having an equality law is much more than whether we can just run gay hotels.”


More British schools fail to make the grade

A quarter more primary schools were failed by inspectors last term under tougher inspections, according to Ofsted. Overall, the number of England’s schools judged not to be giving children a decent education rose by almost a fifth between last August and December. By the end of last year, inspectors had put 243 schools into special measures, Ofsted’s worst category, which threatens a school’s closure unless it improves.

The latest figures were released after Christine Gilbert, chief inspector of England’s schools, said that one in eight secondaries and one in twelve schools overall was inadequate. Of the 2,942 inspections last term, the results were particularly bad for primary schools, with 171 in special measures — a rise of 25 per cent since the end of the summer term. Another 367 schools in England were found to be inadequate and served with notice to improve, the education watchdog said. It noted that 82 new schools had been put into special measures, and a further 113 were given a “notice to improve”. Another 91 schools had “serious weaknesses”.

Ofsted put the rise down to inspectors asking more of schools. “Ofsted has been clear, since a new inspection framework was introduced in September 2005, that we have raised the bar of expected performance for schools because what was considered good ten years ago is not be considered good any longer,” a spokesman said.

Jim Knight, Minister for Schools, said that the number of schools in special measures still remained below 1 per cent of the total, half the number that were in special measures in 1998. He said: “The number normally increases at the end of the autumn term when there are more inspections, before returning to previous levels in the summer. But we’re not complacent and are turning these schools around more quickly.”

“We have raised the bar, so that schools which previously would have avoided attention now find themselves in special measures. We make no apology for this tough stance against failing or coasting schools.”

Alan Smithers, director of education and employment research at Buckingham University, said that the rise in the number of primary schools in special measures should be a serious cause for concern. “At the very least it indicates that the Government’s natural wish to improve primary education has stalled,” Professor Smithers said, adding that a shortage of primary head teachers could be contributing.

Teaching unions said that ministers had scored a “a spectacular own goal” but that it was not surprising schools were struggling with the bureaucratic burdens heaped on them. “In ‘raising the bar’ the Government has given the impression that standards of education in schools are going down, whereas the reverse is true,” Mick Brookes, of the National Association of Head Teachers, said.


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