Wednesday, June 27, 2007

British mother denied cancer drug -- has to sell her house

It's very pesky trying to cash in on your health insurance when the government is the insurer. What if she did not have a house to sell? Tough luck!

A mother has been forced to sell her home to pay for private treatment with a cancer "wonder drug" after funding for it was denied. Debbie Mitchell, 39, said she was "left to sit in the corner and die" after her local primary care trust refused to pay for Sutent for her stomach cancer. The drug costs 2,500 pounds a month and to pay for it she and her partner John Forrester have now had to sell their 340,000 four-bedroom detached home in the Staffordshire village of Derrington.

"It's heartbreaking," she said. "We built the house ourselves from scratch - it's our dream home. "We love the house, we love the village, we love the people, but we've been left with no alternative. "I can't believe it's come to this. We live in such a cruel world."

Miss Mitchell was diagnosed with cancer in 1999, and had 40 per cent of her stomach removed. In May last year she received the devastating news that the disease had returned in the form of GIST (gastrointestinal stomal), a rare mutating cancer. South Staffordshire PCT paid for her to be put on the drug Glivec, even funding a double dose for her which would cost 58,000 for a year's treatment. But in February, cancer specialists treating her said her tumours were still growing and recommended Sutent, which has been shown to shrink tumours dramatically and can prolong life for two years or more.

The drug, which is widely prescribed throughout Europe and the U.S., has already been licensed for use in Britain. But it has yet to be approved by the Government's drugs watchdog, the National Institute for Health and Clinical Excellence (NICE). Until NICE guidelines are introduced, it is up to primary care trusts to decide whether to fund treatment with Sutent. It is funded in parts of Britain, but Miss Mitchell's PCT refused to pay for it on the grounds of cost and clinical effectiveness.

Its decision came even though, at 29,000 a year, it is cheaper than the double dose course of Glivec. Some experts also estimate Sutent has a 50 per cent chance of working on tumours whereas Glivec has only five per cent. "I can't take it, there's no logic there," said Miss Mitchell. "It is a postcode lottery whether you receive Sutent or not. "We all put money into the NHS pot and therefore we should all be allowed the same treatment. "My oncologists have written to the PCT, saying that I should be given the drug. Yet the PCT has not bothered to look into the circumstances of my condition, despite all the evidence. "What's the point in developing these drugs if they're not going to be used?"

She and Mr Forrester, 37, who co-own a limousine hire company, will move next month with her 18-year- old daughter Amy to a smaller 240,000 pound house they have bought in nearby Stafford. Mr Forrester's four children stay with the couple every other weekend. Miss Mitchell said: "We'll still have a mortgage because the money we've made off our house is going toward the cost of the treatment. "We've got enough money for a couple of years of the drug at the moment. After that we'll have to remortgage the new house."

In a letter sent to Miss Mitchell, the PCT defended its decision saying: "The request for treatment was turned down due to lack of evidence of clinical and cost-effectiveness."


Hijacking education in Britain

From global warming alarmism dressed up as Geography to 'happiness teaching' through yoga: the classroom has been hijacked by zealous campaigners who care little for pedagogy

Over the past two decades, the school curriculum in Britain has become estranged from the challenge of educating children. Pedagogic problems still influence official deliberations on the national curriculum, of course. But increasingly, educational matters are being subordinated to the imperative of social engineering and political expediency.

As I write this essay I receive word that the Equal Opportunities Commission has just dispatched 40 pages of guidance to head teachers and governors in England about how they should go about tackling inequality between the sexes. The guideline, The Gender Equality Duty, is the product of an imagination that regards the curriculum as principally a political instrument for changing attitudes and behaviour. `The gender equality duty presents a fantastic opportunity for schools to make a coordinated effort to tackle inequality and ensure that all pupils are able to fully achieve their potential' declares the Commission. (1)

Instructions to schools about how to close the gender gap compete with directives that outline how children should be taught to become more sensitive to cultural differences. Everyone with a fashionable cause wants a piece of the curriculum. The former national chair of the Professional Association of Teachers wants pupils to `learn about nappies' and has demanded the introduction of compulsory parenting classes for 14- to 16-year-olds. (2) Others insist that teachers spend more time talking to their class about sex or relationships or climate change or healthy eating or drugs or homophobia or Islamophobia.

The school curriculum has become a battleground for zealous campaigners and entrepreneurs keen to promote their message. Public health officials constantly demand more compulsory classroom discussions on healthy eating and obesity. Professionals obsessed with young people's sex lives insist that schools introduce yet more sex education initiatives. Others want schools to focus more on black history or gay history. In the recent widespread media outcry over the sordid scenes of moral and cultural illiteracy on Celebrity Big Brother, many demanded that schools should teach Britishness. The government hasn't yet announced any plans for introducing Appropriate Behaviour on Reality TV Shows into the curriculum. But nevertheless, Alan Johnson, the current education secretary, is a very busy man. Not only is he introducing global warming studies, he has also made the instruction of Britain's involvement in the slave trade a compulsory part of the history curriculum.

For Johnson, the subject of history, like that of geography, must be subordinated to the task of transmitting the latest fashionable cause or value. Johnson is indifferent to the slave trade as part of an academic discipline with its own integrity; rather he sees slave trade studies as a vehicle for promoting his version of a multicultural Britain. `This is about ensuring young people understand what it means to be British today' (3), he said in defence of his reorganisation of the history curriculum.

Johnson's title, education secretary, is something of a misnomer. He seems to have no interest in education as such. His preoccupation is with using the classroom to transmit the latest and most fashionable prejudices. He can't even leave school sports alone, recently announcing that PE lessons will now stress the importance of a healthy lifestyle and will raise awareness about the problem of obesity. So after children have received instruction on how to behave as green consumers, learned crucial parenting skills and feel very British, they'll be taught how and why to lose weight. A curriculum devoted to a total makeover has little energy left for dealing with such secondary issues as how to gain children's interest in real education.

Increasingly, the curriculum is regarded as a vehicle for promoting political objectives and for changing the values, attitudes and sensibilities of children. Many advocacy organisations that demand changes to the curriculum do not have the slightest interest in the subject they wish to influence. As far as they are concerned they are making a statement through gaining recognition for their cause in the curriculum. The government, too, is in the business of statement-making. It may lack an effective drugs policy but at least it can claim that schools provide drugs education.

In recent months the politicisation of the curriculum has acquired a powerful momentum. Back in February climate change emerged as the new Big Theme for the curriculum. According to proposals published by the Department of Education, cautionary tales about global warming will become integral to the British school curriculum. This instruction about global warming will masquerade under the title `geography lessons'. As Alex Standish argues in his essay Geography Used To Be About Maps published in the CIVITAS report The Corruption of the Curriculum, this subject has been transformed into a crusade for transmitting `global values'. And global values usually mean the latest Hurrah Causes championed by the cultural elites through the media.

This was the intention behind Alan Johnson's announcement in February 2007 that `we need the next generation to think about their impact on the environment in a different way'. This project, aimed at manipulating how children lead their lives, is justified through appealing to a higher truth. Johnson claims that `if we can instil in the next generation an understanding of how our actions can mitigate or cause global warming, then we lock in a culture change that could, quite literally, save the world' (4). Literally save the world! That looks like a price worth paying for fiddling with the geography curriculum.

This ceaseless attempt to instil in schoolchildren fashionable values is symptomatic of a general state of moral confusion today. Instead of attempting to develop an understanding of what it means to be a good citizen, or articulate a vision of public good, Britain's cultural elites prefer to turn every one of their concerns into a school subject. In the classroom, the unresolved issues of public life can be transformed into simplistic teaching tools. Citizenship education is the clearest example of this corruption of the curriculum by adult prejudices. Time and again, school inspectors have criticised the teaching of citizenship, which is not really surprising considering that leading supporters of citizenship education seem to have little idea what the subject is or ought to be about.

Nick Tate, former chief executive of the Qualifications and Curriculum Authority, argued that citizenship education was `about promoting and transmitting values', `participation' and `duties'. But the obvious question, `values about what?', was carefully avoided. Instead, those advocating citizenship education have cobbled together a list of unobjectionable and bland sentiments that have been rebranded as values. Alongside fairness, honesty and community, even participation and voting have been turned into values.

A few years down the road and the meaning of citizenship is even less clear than when schools started teaching it as a subject. Back in January 2007, a review of how schools teach citizenship found that the subject failed to communicate any sense of what it means to be British. Anyone with the slightest grasp of pedagogy will not be surprised by the failure of successive social engineering projects in the classroom. The absence of any moral consensus in Britain today will not be solved through subjecting children to sanctimonious platitudes. Those who are genuinely interested in educating children and inspiring them to become responsible citizens will instead look to real subjects, which represent a genuine body of knowledge. Propaganda campaigns around the latest fashionable `value' only distract children from learning. Values-led education has helped create a situation where children learn that the Holocaust was awful, but do not know which country suffered the greatest number of casualties during the Second World War. It will produce children who know that the slave trade was bad, but who are ignorant about how the right to vote was won in Britain.

The essays by Michele Ledda, Alex Standish, Chris McGovern, Shirley Lawes, Simon Patterson and David Perks in The Corruption of the Curriculum deal with different school subjects. But they all point to similar problems that afflict their area of specialty. Their accusation about the corruption of the school curriculum is not made in the spirit of polemical excess. Corruption in these cases refers to the erosion of the integrity of education through debasing and altering its meaning. As a result some subjects such as geography and history no longer bear any resemblance to what they were in the past. At least the new dumbed-down happy versions of science and mathematics bear some relation to their subjects. But history without chronology is like learning maths through skipping over the multiplication table.

The uniqueness of twenty-first century philistinism

Of course there is nothing new about attempts to influence the values and beliefs transmitted through the school curriculum. Competing claims made on the curriculum reflect confusion and an absence of consensus about how to socialise children. At least in part, the `crisis of education' is symptomatic of an absence of consensus about the basic values of society.

Back in the early 1960s the social philosopher Hannah Arendt recognised the tendency to confuse the lack of moral consensus in society with the problem of schooling. There had to be a measure of consensus about the past before a system of education could affirm its virtues. `The problem of education in the modern world lies in the fact that by its very nature it cannot forego either authority or tradition, and yet must proceed in a world that is neither structured by authority nor held together by tradition' she wrote in 1961. (5) In other words, the crisis in education is often a symptom of a more fundamental erosion of authority and tradition. The diminishing relevance of the values of the past is a constant theme that underpins debates about education.

Arendt was one of the few observers to note that in a changing world society finds it difficult to establish a creative balance between the achievements and legacy of the past and the provision of answers to new questions and challenges thrown up in the present. It is because it is so difficult to mediate between old and new that educators continually experience their profession as facing a crisis. The challenge of sustaining respect for the past and being open to change can provide important insights about how to go about the business of teaching and learning and developing new knowledge. Unfortunately, in recent decades the British education establishment has become estranged from this challenge. It has distanced itself from the past and devotes itself to searching for and inventing values `appropriate' for our times. Indeed, one of its distinct characteristics is its obsessive search for novelty.

There is nothing unique about the experience of an education system in crisis. What is distinct about our time is the reluctance of educators to attempt to develop a system of schooling that can mediate between the old and the new. The growing tendency to reinvent subjects, modernise them or make them more relevant is driven by the objective of inventing a new tradition. Unfortunately traditions cannot be cobbled together out of thin air. If they lack an organic relationship to people's lived experiences they will lack a capacity to inspire. That is why every initiative taken to improve citizenship education falters and creates a demand for a new idea!

However, it would be wrong to perceive today's crisis of education as simply the contemporary version of an old problem. For a start, education has become far more politicised than at any time during the past two centuries. When Blair made his famous `education, education, education' speech what he really meant was `politics, politics, politics'. In the absence of a consensus of what it means to be British and what are the fundamental values that society wishes to convey to young people, the curriculum has become subject to constant partisan disputes and political experimentation.

The contemporary crisis of education is subject to three destructive influences that are in many ways unique to our time. Firstly contemporary pedagogy has lost faith in the importance of knowledge and the search for the truth. Increasingly educators insist that there is no such thing as the truth and children are instructed that often there are no right or wrong answers. The relativistic turn in pedagogy has important consequences for epistemology and the quality of intellectual life in the west. (6) It also has profound implications for the way that the curriculum is perceived. If the meaning of the truth and the status of knowledge are negotiable, then so is the curriculum.

Studying a subject or body of knowledge is rarely perceived as a good thing in itself. More importantly, the diminished status assigned to knowledge has encouraged a relativistic orientation towards standards. That is why officials have been so pragmatic about the way they wheel and deal about the content of school subjects. From their perspective, lowering standards has become the default position when confronted with a problem. Of course they rarely promote new initiatives through acknowledging that they have made the curriculum easier. Instead they suggest that the changes introduced make the subject more relevant and appropriate for our times. The recent announcement that delivery of education will become more personalised represents the logical outcome of this trend. Personalised learning displaces the idea that there is a coherent body of knowledge that needs to be assimilated in favour of the principle of teaching what works for the individual. Such a promiscuous attitude towards knowledge creates a situation where there are no real pedagogic barriers against pressures to politicise the curriculum.

The second destructive trend haunting education is the enthronement of philistinism in pedagogy. The striving for standards of excellence is frequently condemned as elitist by apparently enlightened educators. Forms of education that really challenge children and which some find difficult are denounced for not being inclusive. There have always been philistine influences in education but it is only in recent times that anti-intellectual ideals are self-consciously promoted by educators. The corrosive effects of anti-elitist sentiments are evident in all the subjects discussed by the authors in Corrupting the Curriculum.

The third important influence that is distinct to our times is a radically new way that educators perceive children. In recent decades it has become common to regard children as fragile, emotionally vulnerable things who cannot be expected to cope with real intellectual challenge. It was in this vein that in April 2007 Alan Johnson instructed teachers to routinely praise their pupils. According to guidelines, teachers ought to reward children five times as often as they punish them for disrupting lessons. (7) That this inane formulation of the relationship between praise and punishment is circulated through the institution of education is a testimony to the impoverished intellectual and moral climate that prevails in this domain. But the exhortation to institutionalise the praising of children is not an isolated attempt to flatter the egos of young people. Increasingly the therapeutic objective of making children feel good about themselves is seen as the primary objective of schooling.

The consequences of this tendency to infantilise children have been enormously destructive. At a time when Britain's schools face serious difficulties in providing children with a good education, they are to be charged with providing happiness lessons. This initiative is the latest technique adopted in a futile attempt to tackle the crisis facing the classroom through the management of children's emotions. Making children feel good about themselves has been one of main objectives of US schools during the past three decades. By the time they are seven or eight years old, American children have internalised the prevailing psychobabble and can proclaim the importance of avoiding negative emotions and of high self-esteem. Yet this has had no perceptible impact on their school performance.

In Britain, too, educators who have drawn the conclusion that it is easier to help children feel good than to teach them maths, reading and science, have embraced the cause of emotional education. During the past decades they have also adopted a variety of gimmicks to improve classroom behaviour through helping children to relax. Some schools have opted for yoga, others use aromatherapy or chill-out music to improve concentration and learning.

Perversely, the more we try to make children feel good about themselves, the more we distract them from engaging in experiences that have the potential for giving them a sense of achievement. These programmes encourage a mood of emotionalism in the school. I can predict with the utmost certainty that an expansion of the resources that schools devote to managing the emotional life of children will encourage pupils to turn inward and become even more preoccupied with themselves. Emotional education will have the unintended consequence of encouraging children to feel that they have a mental health problem. The branding of this therapeutic project as emotional education attempts to convey the impression that new forms of behaviour management possess educational value. They don't.

There are no easy magical solutions to the problems facing education. In one sense the system of education in a modern society will always be subject to new problems and challenges, but there are a number of steps that can be taken to restore a curriculum fit for our children. Firstly, education needs to become depoliticised: politicians need to be discouraged from regarding the curriculum as their platform for making statements. Secondly, society needs to challenge the tendency to downsize the status of knowledge and of standards. Anti-elitist education is in reality a masquerade for social engineering and needs to be exposed for its destructive consequence on school standards. Thirdly, we need to take children more seriously, uphold their capacity to engage with knowledge and provide them with a challenging educational environment. Children do not need to be made to feel good nor praised but to be taken seriously.


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