Saturday, December 01, 2007

Incompetent and negligent killer doctor OK for NHS

What the hell does it take for someone to be found too incompetent to work for the NHS?

A doctor convicted of killing a patient through gross negligence has been told that he can return to work in the NHS. Amit Misra, 37, fled to India after being found guilty of the manslaughter of Sean Phillips, a 31-year-old sales executive, who died from a common infection while recovering from routine knee surgery. A court was told that the trainee surgeon had failed to diagnose the infection and was “too proud” to ask senior doctors for help until it was too late. He was suspended from working for a year and avoided a jail term after his barrister pleaded that his career was in ruins.

Yet despite failing to prove himself in a series of medical assessment tests, the General Medical Council has ruled that Dr Misra should now be allowed to return to Britain to work, seven years after Mr Phillips’s death. Under the law all cautions and convictions given to doctors have to be examined by the governing body, but in many cases the GMC allows those convicted of serious crimes or unprofessional conduct to work again.

The case comes two years after the Shipman inquiry called for a radical overhaul of the GMC, which was accused of “looking after its own” and failing to protect patients. A fitness-to-practise panel of the GMC announced a series of conditions that Dr Misra will have to adhere to over the next three years.

But the family of Mr Phillips said yesterday that there was no way that the doctor should be allowed to work in Britain again. The father of one from Southampton had been expected to leave hospital the day after the operation on June 23, 2000. Four days later he was dead, after developing toxic shock syndrome from staphylococcus aureus, a common but virulent bacterial infection. Southampton University Hospitals Trust was fined 100,000 pounds over failures in his care. Dr Misra and a fellow doctor, Rajeev Srivastava, 40, were convicted of manslaughter due to gross negligence at Winchester Crown Court in April 2003 after it was found that they had failed to monitor the patient’s abnormal temperature and pulse. Despite checking on the patient at least four times, Dr Misra, a senior house officer with nine years’ experience, made only one note of the problems in Mr Phillips’s records, the court was told.

In an interview last year, Mr Phillips’s former partner, Annabel Grant, 33, who lives in Southampton with the couple’s son, Mitchell, 9, said that the doctors had never apologised. Ms Grant said: “I feel I deserve an apology from both doctors. Sean was everything I could have wished for – a soulmate, best friend and a fun-loving, caring partner. Losing him has torn my life apart but what makes the pain still harder to accept is knowing that his death was so unnecessary.”

Dr Srivastava, 40, of Invergowrie, Dundee, is understood to be working as a trainee registrar at Ninewells Hospital in the city, but has no contact with patients. Dr Misra sparked outrage when he began working at the Freeman Hospital in Newcastle upon Tyne just nine months after his conviction. He was banned from working in Britain for a year in November 2005. The doctors were given 18-month suspended sentences but not struck off.

Last year Dr Misra was ordered to undergo a performance assessment, but a team of senior doctors declared that many elements of his practice were still “unacceptable”. Speaking at a hearing to adjudge Dr Misra’s fitness to practise this week, Brian Gomes da Costa, its chairman, said: “It notes that knowledge gaps were identified in three out of the four areas of Dr Misra’s assessed professional performance. “The Panel has noted the gross negligence in postoperative care that led to Dr Misra’s conviction for manslaughter, but it has also heard of efforts that Dr Misra has made with his mentors in India to rectify the deficiencies in his clinical skills. “The overall conclusion of this assessment is that Dr Misra’s core clinical skills are at a minimum but acceptable level.”

The conditions on the doctor’s registration include informing the GMC as soon as he is back in the country, taking a course in basic surgical skills, working with a senior doctor and applying only for trainee posts. Dr Misra must also inform all future employers of the findings against him, is not allowed to do any private work and is not allowed to do any out-of-hours work or on-call duties.

The GMC is set to review the case in 18 months. A spokeswoman for the GMC said: “Our primary concern is not protecting doctors but patient safety. There are indicative sanctions that we refer to when doctors have a criminal conviction and in this case these have been taken into account.”


British Stealth curriculum is `threat to all toddlers'

This is rather hysterical but imposing a single uniform government requirement on every kid in the country, regardless of mental age or maturity, is nonetheless objectionable. It actually makes the Hitler Youth look tolerant. You could opt out of that. Applying the system to State-educated children only would be some improvement

A new national curriculum for all under-5s will cause untold damage to the development of young children, a powerful lobby of academics says today. The highly prescriptive regime for pre-school children, which is due to become law next year, has been introduced by stealth, they say. It will induce needless anxiety and dent children's enthusiasm for learning, according to the group of experts in childhood development. They say that the severity of the compulsory measures, which will apply to an estimated 25,000 nurseries across the private and state sectors, has gone virtually unnoticed and risks an array of educational and behavioural problems for the country's children.

A letter signed by the group, and seen by The Times, is highly critical of the Government's drive to make children aged 3 and 4 write simple sentences using punctuation, interpret phonic methods to read complex words and use mathematical ideas to solve practical problems. The group, including the leading child psychologists Richard House, Dorothy Rowe and Penelope Leach, and Sue Palmer, author of Toxic Childhood, are today launching a campaign called Open Eye to promote the message that babies and young children learn most naturally and effectively through free play, movement and imitation, rather than formal teaching.

"An overly formal, academic and/or cognitively biased `curriculum', however carefully camouflaged, distorts this learning experience," they say. "An early `head start' in literacy is now known to precipitate unforeseen difficulties later on - sometimes including unpredictable emotional and behavioural problems."

The new early-years foundation stage framework (EYFS), which becomes law next autumn, will affect all nurseries and kindergartens in England. The system requires children to be continually assessed according to 13 different learning scales, including writing, problem solving and numeracy. It could also have profound implications for thousands of non-mainstream preschool organisations, such as Steiner kindergartens, where formal learning is not introduced until children reach 6«. Montesorri schools, which also have a less academic approach, will also be affected.

Richard House, senior lecturer in psychotherapy and counselling at Roehampton University, southwest London, said that the element of compulsion surrounding the new legislation been introduced "by stealth". Unlike the national curriculum for schools, which does not apply to independent schools, the framework will apply to all pre-school settings - state, private and voluntary. "What is most objectionable is that the framework is compulsory. The central State is defining what child development is. It means that a pre-school would have to pursue the Government's defined view of healthy child development, even if it contradicts their own view," Dr House said. "Some people do not want their children doing synthetic phonics or quasi-formal learning at 3 or 4 but they could be left with little choice. There would be a very strong case for mounting a legal challenge under the human rights legislation," he said.

Experts believe that the legislation will impose a system of "audit and accountability" on children that will profoundly affect the way in which teachers interact with them. Margaret Edgington, a leading independent early-years consultant, said: "We are going to end up with lots of children who can read and decode print but who haven't got the skills to understand what the words mean."


We've been robbed of our Englishness

Says Jeremy Clarkson

As the nation settled down on Wednesday night to watch England play Croatia, I sensed an air of optimism in the land. A feeling that all would be well. I mean hey, England were holding their own against Brazil when Croatia didn't even exist as a nation state. So what chance would these swarthy-looking Yugo-ruffians have? They were minnows in a tank of sharks. They weren't going to be beaten. They were going to be eaten.

Hmmm. I'm afraid I knew we were going to lose moments before the match began. I looked at our players mumbling their way through the national anthem and realised they didn't really care about playing for England. Because they don't really know what England is. And truth be told, neither do I.

When I was their age it was crystal clear. Newspapers would report: "Fog in the Channel: Europe cut off." Peter Ustinov would arrive at JFK airport and, having studied the signs saying "US citizens" and "Aliens", he'd ask a security guard where the British should go. We were separate, different, better.

We had hardback dark blue passports with a personal message from the Queen on the inside cover "requiring" that foreign border guards allow the bearer to do whatever he or she pleased without let or hindrance. Slap one of those down on a Frenchman's desk and the crack of invitation grade cardboard would have the greasy little oik sitting up straight; that's for sure.

We had saved the world from tyranny so often we'd lost count; we'd brought decency, truth and cricket to every continent and every coral pinprick. We'd sailed iron steamships into America when they were still using coracles. We were defined by our brilliance, our superiority, our technical know-how.

Today, things are rather different. Mention the war and you'll be told by an outreach counsellor that we must empathise with the Germans, who are coming to terms with their mistakes of the past. "And you know, children, it was actually the British who invented concentration camps . . ."

Empire? When I was at school, teachers spoke with pride about how a little island in the north Atlantic turned a quarter of the world pink, but now all teachers talk about is the slave trade and how we must hang our heads in shame.

Right. So we must forgive Germany for invading Poland. But I must beat myself to death every night because my great-great-great-grandad moved some chap from a hellhole in Ghana to Barbados. In fact I can't even say we're British any more because then all of Scotland would rush over the border, pour porridge down my trousers and push a thistle up my bottom.

I believe people need to feel like they're part of a gang, part of a tribe. And I also believe we need to feel pride in our gang. But all we ever hear now is that we in England have nothing to be proud about. In a world of righteousness we are the child molesters and rapists. Our soldiers were murderers. Our empire builders were thieves. Our class system was ridiculous and our industrial revolution set in motion a chain of events that, eventually, will kill every polar bear in the Arctic.

And it gets so much worse. Because if you say you are a patriot, men with beards and sandals will come round to your house in the night and daub BNP slogans on your front door. This is the only country in the world where the national flag is deemed offensive. Small wonder the England players were disinclined to sing the national anthem with any gusto. It's in English and that's offensive too. Unless it's simultaneously translated into Urdu, for the deaf.

Then there's our national character. In the past, boys were told in school assembly that their mothers had died and were expected to get over it in a nice game of rugby. Crying only happened abroad. Not any more. We were ordered to weep like Americans when Diana died, and no local news report is complete today without some fat oik sobbing because his house has fallen over. I sometimes get the impression Kate McCann is being hounded precisely because she has a stiff upper lip.

Every day we read obituaries about men who pressed on with the attack on a German machinegun nest even though their arms and legs had been blown off. Today disabled people get a statue in Trafalgar Square just because they got pregnant. Tomorrow all the obituaries will be for those who saved others from certain death by insisting they wear high visibility jackets. Cowardice is the new bravery.

As for that wounded soldier seen recently sporting a T-shirt that said: "I went to Afghanistan and all I got was this crappy false leg," I call that typically English. But not any more. It's appalling. A slight on disabled people. And you shouldn't have been in Afghanistan in the first place, you baby killer.

Do you see? We can't be proud of our past because it's all bad, we can't use British humour because it's offensive and we can't use understatement to deal with a crisis because the army of state-sponsored counsellors say we've got to sob uncontrollably at every small thing.

I want to end with a question. It's addressed to all the equal opportunity, human rights, diet carbon, back room, bleeding heart liberals who advise the government: "I am English. Why is that a good thing?" I bet they don't have an answer. And until they can come up with one, chances are we'll never win at football again.


British farms kiss goodbye to stiles and gates to allow wheelchair access

Stiles and kissing gates are the latest aspects of country life to fall victim to political correctness. They have been a familiar feature of the landscape for centuries, but local authorities now believe that installing them along footpaths and rights of way is a breach of the Disability Discrimination Act 1995. This law requires public services to make "reasonable adjustments" to allow disabled access.

A number of councils have identified stiles and kissing gates as obstructions for people with mobility problems or with visual impairments. Some want stiles banned and kissing gates replaced by larger ones that allow wheelchair access. The move is also part of the Government's attempt to encourage more people to visit the countryside and to learn more about farms and the provenance of food.

Some parish councils are concerned about the look of new gates and about losing long-established stiles over fences, walls and hedgerows. Farmers are questioning why they should pay for new access points when some are used just three or four times a year.

Suffolk County Council is looking at replacement gates that will allow wheelchair access but keep livestock secure. Guy McGregor, the Conservative council member responsible for roads and transport, said: "We have an obligation to provide access to footpaths for everyone. The problem is that many kissing gates are virtually impossible to use if you are in a wheelchair. Stiles are no use for people in wheelchairs and are just as difficult for parents with children in buggies.There are landowners who are not interested in any access at all and so where there are rights of way it is down to the council to pay and install gates. The larger kissing gates cost 250 pounds and there are hundreds that need replacement throughout the county. Yet our transport grant has been cut by 1.5 million pounds this year."

John Collen, a cattle farmer and chairman of the National Farmers' Union in Suffolk, is concerned about the risk of animals escaping. "Kissing gates do a splendid job keeping livestock secure and allowing public access. It is difficult to see what alternatives there could be," he said.

He added: "A lot of footpaths crossing fields are unsuitable for wheelchairs. Are we going to see paths across fields hard-surfaced so they can be used by wheelchairs at any time?" The Department for Environment, Food and Rural Affairs said that it did not expect all gates to be replaced overnight. It said: "Where a kissing gate or stile is an historic feature there is no reason why it could not be left in place alongside a structure that is easier to use for those with mobility problems."


UK population 'to double in one lifetime'

The UK’s population could almost double within a lifetime to more than 100 million, new figures have shown. A combination of record immigration, high fertility rates and longer life expectancy could push the numbers to 108 million by 2081. The extraordinary estimate issued by the Office for National Statistics yesterday came as a parliamentary committee heard evidence of the growing impact on schools and hospitals. One teachers’ leader said some schools were ''struggling to cope” because they had not been given enough money to deal with the influx.

The most likely forecast based on current trends is that the population will rise to 71m in 2031 and to 85m in 2081, but if birth rates grow more quickly than expected, immigration remains high and people live longer this could reach 108 million - nearly twice today’s 60m. High immigration is also fuelling a baby boom because new arrivals tend to be younger and to have larger families than the indigenous population.

David Davis, the shadow home secretary, said: 'This confirms what we have been telling the Government all along. ''Labour needs to wake up and understand the factors driving population change as well as the solutions.”

Sir Andrew Green, the chairman of Migrationwatch, said: “Our country is already facing massive changes as a result of the government’s failure to control our borders. ''These population projections are a sharp reminder of what could well happen if they continue to fail to take firm and effective action to bring a halt to the mass immigration which they have stimulated.”

Liam Byrne, the immigration minister, said: "These projections show what might happen in 75 years’ time unless we take action now. "Frankly, it underlines the need for the swift and sweeping changes we are bringing to the immigration system in the next 12 months, which will include the introduction of an Australian-style points-based system, so only those that Britain needs can come to work and study.”

The figures were published as representatives of teachers, doctors and nurses spoke of the impact of migration on the public services. In evidence to a House of Lords committee inquiry into the impact of immigration, Steve Sinnott, general secretary of the National Union of Teachers, said a phenomenon once limited to urban areas was now affecting rural primary schools which needed more expert staff and specialist books for pupils who speak no English. "We do have schools where we have had significant, large numbers of youngsters appearing very quickly,” he said. "We have had schools in London where on a Friday afternoon the head has arrived with seven or eight youngsters and taken them to a GCSE English class and none of the youngsters can speak English. '’The teachers have been pulling their hair out,’’ he said.

Mick Brookes, general secretary of the head teachers’ union NAHT, said the education of both migrant and local pupils was at risk in some schools. "Some schools are struggling to cope,’’ he said. "The capacity to do the best they can for the local children - and the children who are coming in - is being stretched.’’

An analysis by the union suggested that extra Government funding for each immigrant child would only pay for about three weeks of a teaching assistant’s time. Josie Irwin of the Royal College of Nursing said there was only anecdotal evidence about the impact of immigration on hospitals but there were ''particular difficulties” in the inner cities.

Prof David Blanchflower, a member of the Bank of England’s monetary policy committee, predicted a second wave of migration from eastern Europe as the current well-educated arrivals gain new skills and get better jobs. He believed the flow from the east was ''inexorable” and probably had not peaked. Prof Blanchflower expected another inflow of Poles and other EU nationals from Ireland, which has seen a greater number of arrivals proportionately than the UK but where work is drying up. There would be a new migration to help London prepare to the Olympics in 2012, he added. Prof Blanchflower said there was evidence that the high levels of immigration were depressing wages among low-skilled workers, something the Government has disputed.


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