Wednesday, June 18, 2008

Many NHS trusts fail to meet hygiene standards

More than a quarter of health trusts in England are failing to meet basic hygiene standards, official figures show today. The Healthcare Commission reports that no improvement has been made on a year ago. In total, 103 out of 391 trusts admitted they did not achieve the minimum requirements, brought in by the Government to help combat the hospital superbugs, MRSA and Clostridium difficile.
Patients groups and politicians said that it was "shocking" that one in four still did not meet the standards, despite ministers' pledges to tackle cleanliness.

More than 8,000 deaths were related to MRSA and C. diff. The report shows that 26 per cent of trusts failed to keep facilities clean, did not have adequate infection control or follow guidelines on decontaminating reusable equipment. Only 40 per cent of trusts claim to have met all the Governments standards, which include patient care and confidentiality as well as hygiene, a slight fall on last year.

The commission warns that even fewer trusts may be deemed to have met all the criteria by the time it finishes spot checks this year. The failings come despite a [stupid] 50 million pound "deep clean" of every hospital in England, designed to curb superbugs.

Despite the critical reaction, Ben Bradshaw, the health minister, said that he welcomed the fact that the number of trusts failing to comply with more than seven standards had fallen from 15. "This improvement is a great tribute to the hard work of NHS staff," he said. "We are also pleased that infection control is showing significant improvement."


The British are still lovers of liberty

But let's not forget the EU is as much a threat to our freedom as the surveillance state

By William Rees-Mogg

My wife, Gillian, is the chairman of the trustees of St John's Smith Square. Last Thursday evening, the hall was being used for the BBC's Question Time. We were watching the discussion from the balcony; David Dimbleby kindly invited us to supper after the show. The last time I had seen Question Time live is now 25 years ago, when Robin Day was in the chair.

On Thursday evening, the Irish had voted on the Lisbon treaty, but we did not yet know the result. David Davis had announced that he was going to resign his seat in order to fight a by-election on issues of liberty. Only one member of the panel seemed to regard the Davis story as really important; that was Shirley Williams, the former leader of the Liberal Democrats in the House of Lords. She spoke of Mr Davis's decision with considerable sympathy, more sympathy than I would have expected. Not for the first time, her judgment of a political issue was better than mine. The British people feel very strongly about the current issues of liberty; I admit that I think that Baroness Williams underrates their concern about liberty in Europe.

After supper, we drove down to Somerset late in the evening. Friday was, for me, a very enjoyable day. I had not expected the Irish to vote "no" to the Lisbon treaty; that seemed too good to be true after every other democratic defence against a bad treaty had failed. Only last Wednesday, the House of Lords had voted down Britain's promised referendum by 280 votes to 218. I found myself voting for the referendum in the same lobby as Margaret Thatcher, just as I had when I voted for a referendum on the Maastricht treaty. I thought it was shameful that the Labour and Lib Dem peers would not honour the manifesto commitments of the 2005 general election. But, then, I had thought it shameful when Tory peers tamely obeyed their whips and voted down a referendum for Maastricht.

Saturday was a perfect Somerset day; we sat in the garden from lunch to tea. Two of our grandchildren were staying with us and two more had come across in the morning. Our youngest daughter, Annunziata, who is the Conservative candidate for Somerton & Frome, went off to canvas in villages near Bruton, including Pitcombe, where our eldest daughter lives, and Shepton Montague, where a lot of our ancestors are buried. Annunziata was able to bring back to us a fresh and up-to-date report on public opinion in southeast Somerset.

As I expected, the Irish vote had been greeted with delight. Earlier in the year, we had a local referendum in Somerset & Frome on the Lisbon treaty. Eighty-seven per cent wanted a referendum on the treaty and 88 per cent stated that they would vote "no" if a referendum were given. The local MP, David Heath, resigned from the Lib Dem front bench in the Commons rather than follow Nick Clegg's three-line whip to abstain.

What I had not foreseen was the impact of the Davis resignation. Annunziata found that Lib Dem voters identified most strongly with the Davis campaign, to the point at which Mr Davis seemed to be validating the Conservatives as a party prepared to fight on liberal issues. There seems to have been a similar reaction among Labour rebels, some of whom say they will go up to Haltemprice and campaign for him. Pragmatists may have failed to recognise the impact of his personal declaration or the strength of public feeling on libertarian issues.

For the Libs Dems themselves, there is a snag in this, or perhaps two snags. The first, as Lady Williams immediately saw, is that Mr Davis is not campaigning on right-wing issues, but on traditional issues of personal liberty. The second snag is that Europe is itself a liberal issue, but one on which the Liberal Democrats as a party are on the anti-liberal side. If the Lib Dem peers had voted with the Conservatives in the Lords, the Lisbon Bill would have gone back to the Commons with a clause providing for a British referendum. We would not have had to leave our liberties for the Irish to protect.

The origin of the Lisbon treaty was the constitutional treaty, which was drafted by the European Constitutional Convention, which was controlled by Val‚ry Giscard d'Estaing as its chairman. In the Convention, the democratic deficit, which was supposed to be eliminated, was deepened and entrenched. The constitutional treaty was put to the vote in several European countries. Spain voted "yes", but France voted "no", as did the Netherlands. The European people do not want to transfer further powers away from their elected parliaments to the unelected bureaucracy in Brussels.

The EU responded to the French and Dutch votes not by recognising the public concerns about liberty and democracy, but by trying to avoid any public votes in the future. In every country except Ireland, this policy of avoiding democracy was successful, though there are still a few to come. The avoidance of a referendum was even successful in Britain, where all the major parties had committed themselves to a vote. Only the Conservatives honoured their commitment.

What may happen next? There will be an attempt to rescue the substance of the Lisbon treaty in some form or through some subterfuge. Brussels, like the Clintons, is extremely reluctant to recognise defeat. The European politicians want their legal identity, their extended powers, their president, their foreign minister. They want the status of a national state. But referendums will go against them, as the referendum went against them in Ireland.

The Prime Minister has no feeling for these developments in public opinion. He is creating an ever larger surveillance state and accepts the European democratic deficit. There is now no national consensus to ratify the Lisbon treaty and it would be a grave blunder to do so.



The "apocalyptic visions" of environmentalists are not justified by the evidence about global warming, according to a Midland MP. John Maples (Con Stratford) told the House of Commons he did not believe scientists really understood what was happening to the earth's climate. He sounded a note of scepticism in a debate which highlighted the lack of consensus among Britain's politicians about the environment.

Black Country MP Rob Marris (Lab Wolverhampton South West) told colleagues to "wake up and smell the coffee" and accept the world was not going to stop creating the pollution believed to cause global warming. Most MPs and staff failed even to turn the lights off in the Commons toilets, he said. Britain should focus on how it was going to cope with global warming, instead of hoping it could avoid the problem by cutting back on carbon emissions, he said.

They were speaking during a debate on the Climate Change Bill, which will set a legally binding target for reducing UK carbon dioxide emissions by at least 26 per cent by 2020. Mr Maples said: "Until a couple of months ago, I was happily riding this consensus and accepted the received wisdom. I thought it was probably being exaggerated a bit, but then people usually do that. However, I then made the mistake of reading a few books and quite a lot of analysis ... that has led me to a couple of conclusions that trouble me a lot.

"I do not believe that the science is anything like as settled as the proponents of the Bill are making out. In fact, the scientists hedge their predictions with an awful lot of qualifications and maybes that those who invoke them often omit. "The science is a bit like medicine in the 1850s. The scientists are scratching the surface of something that they do not really understand, but no doubt will. "They are probably on to something, but nothing like the whole story. What they say does not justify any of the apocalyptic visions that we have heard set out."

He said none of the models scientists had developed to predict how carbon emissions might affect the environment could account for the climate change that had actually taken place. "The record shows that the climate warmed from 1920 to 1940, cooled from 1940 to 1975, rose again from 1975 to 2000, and since 2000 ... has not risen at all. In the past seven years, global temperatures have not increased."

Mr Marris was also sceptical about plans to reduce carbon emissions, but for different reasons. He said: "I welcome the Bill and I accept that human activity is affecting the climate adversely. I am not a flat-earther." But he did not accept the "cosy consensus" that everything would be fine if plans were made to cut carbon dioxide emissions, he said. Emissions were currently going up rather than down, he added.

Some MPs were calling for an 80 per cent cut, he said. "I say to honourable members, `wake up and smell the coffee'. We are not going to achieve 80 per cent - it will be hard to reach 60 per cent, if we consider the number of air trips our constituents make."

Global warming would affect Britain's plans, wildlife and food production, he said. "They will affect issues such as building design and planning regulations; roads and railways, with rails buckling in the heat; water supply, with a need for new reservoirs; what we have to do about coastal defences with rising sea levels; inland flooding, which we saw dramatically last year and which will only get worse; possible civil unrest and its security implications, which other countries and, potentially, we will face; and international development."



There has been a mixed reaction to East Antrim representative Sammy Wilson's appointment as Environment Minister, following a reshuffle of the DUP's Stormont team. Amid the back-slapping over the Assemblyman and MP's elevation to the Executive has come sharp criticism from leading environmentalists over the local politician's "sceptical" views on climate change.

Mr. Wilson, who replaces DUP colleague Arlene Foster in the post, said he was "very happy" to take on a job in which he could deal with issues affecting the people of East Antrim. He cited in particular the planning system which had caused "much frustration for many people". Mr. Wilson added: "I am also keen to ensure that we protect the beauty of Northern Ireland and keep it in its current state for future generations to enjoy. "There is also an important job be done with local government: I want to see efficient councils in Northern Ireland which provide good services and are accountable for what they do." ...

Mr. Wilson's promotion brought a less favourable response from other quarters. The Green Party expressed disappointment at Mr. Wilson's "climate change sceptic views" and urged him to refrain from commenting on the subject until he has acquainted himself with the findings of the Inter-governmental Panel on climate change.

Said Green Party MLA Brian Wilson: "Sammy Wilson has a duty to the people of Northern Ireland and the environment to ensure that his comments are evidence-based and not the uninformed babble of someone who should be spending more time reading his First Day briefs." He urged the East Antrim politician to attend UN talks on climate change, adding: "No serious scientist has attributed all climate change to human activity. "Even the school children of Northern Ireland understand the distinction."

Mr. Wilson's appointment also caused raised eyebrows within environmental group, Friends of the Earth. Describing the move as "a mistake," the organisation's Northern Ireland director, John Woods, commented: "Mr Wilson is well known for his sceptical views on climate change. "It is difficult to see how a Minister who holds such views in the face of overwhelming scientific evidence could be a credible protector of our environment. But the test will be how Sammy Wilson approaches his new responsibilities. "The jury is out on this appointment - he has a good deal to prove."

Responding to the criticism, the new Environment Minister said: "I am not convinced and I don't think that there is any firm evidence to show that all climate change is due to CO2 emissions. "I think we have to make sure we do not allow the agenda for NI to be dominated by the people who can sometimes be described as green fanatics."

More here

What schools need most is a motivated principal who is left alone by the bureaucrats

The item hardly made the morning news. [British] Government inspectors had discovered 14 "failed" schools that had suddenly become successes. Some bright spark thought it worth asking why. The answer came as a bolt of lightning: that all had benefited from something called leadership. It was the one common thread.

When stuck for an answer to a problem, I turn to the maxim known as Ockham's razor. It states: "Frustra fit per plura quod potest fieri per pauciora," or do not apply many things to a task that can be done with few. It was brilliantly "razored" by the American marines to KISS, "keep it simple, stupid".

In modern state education, Ockham's razor is tantamount to knife crime. It lacks bureaucratic complexity. Its application demands no expertise, no grand staff, no research budget, no office blocks with atriums. Its mere mention endangers thousands of nonjobs, threatening to send former teachers now screwing up the school system back where they belong, in the schools.

Not a week passes without these people inventing for ministers a new and expensive quick fix for bad schools, an academy, a foundation, a trust, a "please look at me, I'm a minister" initiative. There is not a shred of evidence that any of these upheavals work, but each has its dedicated bureaucracy, its budget and its spin doctor.

Now along comes Ofsted, the schools inspectorate, and lets the cat out of the bag. If you want a good school, get the right head. Sack bad heads and appoint good ones. Give them the money and leave them alone. If they do not work, sack them again. Good heads are not made, except in the forge of experience. Mostly they are born.

In his charming novel Mister Pip, Lloyd Jones tells of an educated man living on a Polynesian island from which civil war has driven all public servants. The islanders plead with him to teach their children, for which he has no skills, books or equipment. All he has is an old copy of Great Expectations, which becomes his sole teaching aid. He requires nothing but his own personality, and that of Dickens.

The answers to most institutional problems are that simple. Ofsted approached 14 schools that were so dysfunctional as to be under "special measures". Each had shown dramatic improvement in 2003-7, in both exam performance and pupil behaviour. There had been a calculated programme of discipline, school uniform and subdivision into houses, and a promoting of school pride and identity.

While the report's jargon was close to gibberish, the message was clear: only a highly motivated staff would deliver "a whole-school identity and sense of belonging . . . an evident pride in recognising collective achievement". Then came the sting. The inspectors found that all depended on the courage, risk-taking and autonomy of one person, the head teacher, and on that person being left alone. Indeed, "outside help can actually make things worse . . . with a potential to create more problems and slow the pace of improvement". Local councils do best to disengage or, as the report put it, "manage robust exit strategies".

This finding echoes a 2006 report that found one in five English schools did not have a permanent head at all, and one in three vacancies had to be readvertised. The reason was that targetry and crushing paperwork had greatly reduced the appeal of running a modern state school and teachers were just not interested. The chief task of an English school head is to man the battlements to fight off marauding bands of ministers and officials. As one said to me: "They make the hoodies at the school gate look like a bunch of patsies."

Hansard reported that in one year under Labour the schools ministry sent out 3,840 pages of instructions to head teachers. Back in 2005 the "head teacher of the year" publicly attributed her success to "ignoring all government strategies". In March 2006 the chief examiner, Ken Boston, confessed that at British schools the "assessment load is huge . . . far greater than in other countries and not necessary for the purpose".

The centralisation of school administration has clearly not worked. The schools secretary, Ed Balls, admitted recently that we have "gone backwards" compared with the rest of Europe. He seemed bereft of any solution, other than yet more central initiatives.

Finding good leaders and then leaving them alone runs counter to Balls's entire outlook and Treasury upbringing. As he and his schools minister, Andrew Adonis, showed last week in yet another reorganisation of secondary education, their preferred route to improvement is through targets, regulations, inspections and the humiliating threat of closure. Balls publicly listed 638 schools on his hitlist, an act of mass demoralisation worthy of the Inquisition.

Towards the end of his career as a management pundit, the late C Northcote Parkinson retreated into what many saw as his least original phase. His famous "laws" had passed into the language, but none had had any effect. Paperwork still proliferated, work expanded to fill the time available and staff hired to do half-jobs still needed assistants. The one common trait that Parkinson could detect in all management success was that will-o'-the-wisp, leadership. An inspirational and determined leader defied his laws and moved bureaucratic mountains. Nothing else could do the trick. Parkinson's fans were contemptuous. How banal, they said. The genius had met old age.

The same response was given by the BBC to the Ofsted report on failing schools. Informed that the key lay in leadership, the interviewer remarked coldly: "But isn't that a statement of the blindingly obvious?" and turned to the next item. The BBC worships at the shrine of management consultancy and gorges on complexity. It cannot handle Ockham's razor. It loathes the simple answer.

Ofsted's discovery is of wider application than just to schools. As we watch the agony that Alan Johnson and his predecessors have inflicted on the National Health Service, we see the same syndrome. When anything is wrong with a hospital or health centre, the cure lies in reorganisation. There must, to use the prime minister's motto, be "solution through change". I think not. Public services are supplied by humans led by humans.

Whenever a hospital has in some sense failed, the cry is heard, "Bring back the matron", and some eager minister promises it. He then appoints 10 administrators over her head. These administrators have to be paid "incentive bonuses" just to do their jobs, defined as not to lead but to meet an external target. Nothing works.

We eulogise the simplistic managerial skills of an Alan Sugar, yet refuse to apply the lesson to the public sector. Top-down public administration in Britain is now obsessively complex. Last week it was announced that "popular schools will be allowed to take up to 26 extra pupils a year above their official limit, ministers propose". What on earth has such a detail to do with ministers? Such meddling reflects a lack of confidence in people to do good work. It ranks with the bonus fixation and targetry as a sure way of destroying professional self-esteem.

The cult of leadership was derided in the last century by the countervailing cult of management as shrouded in ugly connotations of superiority. The managerialists implied that running a human institution was a matter of technical skill, one that could be quantified, incentivised and taught. This appealed to the control tendencies of Whitehall. It reflected a lack of faith in the ability of democrats to hold institutions to account, be they schools, hospitals, care homes, police forces or even prisons - despite such accountability operating across the rest of Europe to general public satisfaction. Not a single cabinet minister to my knowledge has ever run an institution and thus known what it is like to deal with a cabinet minister on the rampage.

Leadership is notoriously indefinable and therefore hard to ordain from above. It lies in unexpected and untutored places, possessed for instance by Tony Blair but sadly not by Gordon Brown. It is unpredictable but essential to the running of institutions, often revealed only by trial and error. Ofsted has detected it in 14 lucky schools. Will the rest get the message?


British PM comes through on Iran sanctions, Afghan troop increase: "There were questions surrounding Gordon Brown when he became Great Britain's Prime Minister. Taking office with echoes of "lap dog" following his predecessor Tony Blair, many wondered just how committed Brown would be to the "Special Relationship" between the US and Great Britain and whether he would initiate a more independent course in foreign affairs. Brown may yet eschew supporting the US on many issues. But on increasing sanctions on Iran and sending additional troops to Afghanistan - two things the US devoutly wished Brown would accede to - the British Prime Minister has come through."

No comments: