Tuesday, August 05, 2008

The British Left loves criminals and hates ordinary people

Families who overfill rubbish bins are to face bigger fines than those imposed on drunks or shoplifters, the government has told local authorities. New guidance instructs councils to impose fixed penalties of "not less than $150" and up to $220 in what the opposition has attacked as a "new stealth tax". The offences for which householders can be fined include leaving ajar the lid of a wheelie bin, putting out a bin the evening before collection or leaving the bin in the wrong place.

Although the government has previously claimed that it leaves local councils to decide on the level of fines, the Fly-capture Enforcement manual, produced by the Department for Environment, Food and Rural Affairs, stipulates that fixed penalties for offencesinvolving "waste receptacles" must range from $150 to $220. It suggests a standard fixed penalty of $200, adding that "if a notice is not paid, it is essential it is followed up". The penalties are higher than the o80 on-the-spot fines levied by police for offences ranging from being drunk and disorderly to shoplifting.

Local councils have been sharply criticised for taking harsh measures against trivial misdemeanours. Earlier this year, Gareth Corkhill, a Cardiff bus driver, was given a criminal conviction after being taken to court when he refused to hand over a $220 on-the-spot fine by council inspectors who found the lid of his wheelie bin open by 4in.

Eric Pickles MP, the shadow local government secretary, said Labour was creating "an army of municipal bin bullies hitting law-abiding families with massive fines while professional criminals get the soft touch". He added: "It is clear Whitehall bureaucrats are instructing town halls to target householders with fines for minor breaches. "Yet with the slow death of weekly collections and shrinking bins, it is increasingly hard for families to dispose of their rubbish responsibly. It is fundamentally unfair that householders are now getting hammered with larger fines than shoplifters get for stealing."

The environment department, headed by Hilary Benn, said on-the-spot fines were "intended to be an alternative to prosecution". A spokesman said: "Local authorities wanted flexible fines that they can relate to the severity and frequency of the offence and offender. Ultimately the fines are there to act as a deterrent." According to Phil Woolas, the environment minister, local councils face extra costs of $6.4 billion over the next five years to fund recycling measures, which would equate to a $300 council tax increase.

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Huge monetary costs of NHS negligence

Despite the fact that most Brits are effectively discouraged from claiming and despite the fact that awards in Britain are usually only a tiny fraction of the equivalent in the USA

For Dr Spencer at his Norfolk surgery, the whoops-a-daisy moment came when he dosed a woman with bismuth. Startled by her dyspeptic response, and eager to reassure her increasingly agitated husband, he swallowed a spoonful of the stuff himself. "See? Perfectly safe!" Two things then happened: Dr Spencer vomited, fell down and lay writhing on the floor. His patient died.

The explanation was simple. As the doctor explained to the coroner, bismuth and strychnine look remarkably similar in the bottle and, well, mistakes do happen. At the subsequent trial for manslaughter, Mr Justice Willes agreed. A simple blunder, he said, was not in itself a criminal act. To secure a conviction, the crown would have to prove that the doctor's medicines were in such chaotic disorder that it was impossible for him to know which was which. Not guilty, said the jury.

That was in 1867. Legal actions against clinical killers then were exceedingly rare, and would remain so. By 1989 only six more doctors had been fingered for manslaughter - an average of one every 20 years. Then something changed. In the 1990s, 17 were prosecuted, and since 2000 there have been 11 more. One or two of them, like the Spencer case, were tales of startling improbability. A woman under anaesthetic was connected to an oxygen cylinder instead of to a ventilator and inflated like a balloon (the anaesthetist got six months' jail, suspended for 18 months). Mostly, however, they were mundane tragedies of misread notes, wrong drugs or lethal doses administered by exhausted, inexperienced or occasionally negligent practitioners who failed in the most basic of their responsibilities.

This relatively small number of headline cases, however, was only the tiny tip of a legal iceberg. It wasn't just the police and Crown Prosecution Service who were taking a more critical look at wards and clinics - it was the patients themselves. In England between 1990 and 1998, the rate of civil negligence claims against hospitals doubled, reaching a peak in 1998-9 of 6,168. If we didn't know them to be true, the numbers would strain credibility. The cost to the NHS of claims settled in 2006-7 was 579.3m pounds. In the same year it was hit by 5,426 new cases. The NHS Litigation Authority (NHSLA) estimates that the combined cost of settling all outstanding claims, including incidents so far unreported, will be 9.09 billion pounds.

Some of the settlements are whoppers - the actress Leslie Ash made headlines in January this year when she was awarded 5m pounds for the paralysing effects of the hospital "superbug" MRSA. The all-time record is the 12.4m paid last year to a professional dancer, Kerstin Parkin, who suffered brain damage from a heart attack during childbirth. Others by comparison are trifling - "a few hundred pounds for someone scratched during an operation" is one example offered by the NHSLA. But there is an important common factor, and it affects us all.

Paralysing tentacles of fear are now putting the squeeze on medical practice, and changing the way we are treated. Type the words "clinical negligence" or "no win, no fee" into Google and you'll see why - a clamorous pack of legal agencies and law firms who trade on the idea that every accident must be someone's fault. Some websites even provide interactive body maps showing the value of everything from an injured finger (1,000 to 75,000 pounds) to serious brain damage (millions). The come-on to patients is the promise of "no win, no fee". If the lawyer wins your case for you, he collects his fee in costs from the other side and you walk away with your damages in full. If he loses, he charges nothing. So, come on! What are you waiting for? Sue the doc!

Many cases in the past have been the medical equivalents of the time-honoured "slips and trips" actions against local authorities with bumpy pavements. Anyone coming out of hospital with a bruise or a sore eye they didn't go in with was encouraged to call a solicitor. The result was that lawyers' fees were often higher than the damages they won, and these in turn could be eroded by extra costs - medical reports by independent experts, for example - so that even successful litigants wound up out of pocket. According to the National Audit Office, legal and administrative costs exceed money paid to victims in most claims under 45,000. This is why Citizens Advice in 2004 published a 59-page report on personal-injury compensation under the title No Win, No Fee, No Chance.

As so often with the NHS, vice is the bastard child of virtue. "No win, no fee" deals, known in law as conditional-fee arrangements, were introduced by an amendment to the Courts and Legal Services Act in 1995. It was meant to be a double benefit. The courts would be opened up to those in the income trap who were ineligible for legal aid but unable to afford lawyers. The government itself would save money by effectively privatising legal aid. On the surface it looked like the long-overdue democratisation of civil justice.

But law firms are not charities. Working for nothing - pro bono - is not unknown, but it hardly stands as an ideal business model. If lawyers were to drop their fees when they lost, then they would need a bonus when they won. Recognising this, the law allows a "success fee" of up to double the normal scale. In clinical- negligence cases, when judgment favours the patient, this must be paid by the NHS, otherwise known as the taxpayer.

Given all this, the one surprise is that the number of cases each year is actually going down, albeit very slowly. The cost to the NHS nevertheless continues to rise. How can this be? Ironically, it is due in part to improvements in medicine that allow seriously damaged people - especially children - to survive for near-normal life spans. For this reason, courts are awarding much higher damages. Thirty years ago, for example, children suffering cerebral palsy in birth accidents might be expected to die. Now they can reach late middle age. Damages in such cases, which account for 60% of all claims the NHSLA faces, can run to 5m or more....

Walsh does not buy into the idea that avaricious lawyers alone are to blame for the escalating costs of clinical negligence, or even that the costs are excessive. "They come to well under 1% of the NHS budget," he says, "so the notion that claims are bleeding the NHS dry doesn't hold water." Furthermore, it's entirely reasonable for claimants' solicitors to charge more than their opponents do.

Apil's Amanda Stevens agrees. "It's much more costly to prepare evidence to prove a claim than it is to assemble evidence to knock it down," she says. The British public, too, is very far from the writ-happy mob of gold-diggers that the headlines often suggest. "They do not like making a claim." Every year, she says, around 800,000 "adverse clinical events" are recorded in the NHS, and many more - at least 20% - go unreported. Yet only 1% of the victims make a claim, and only 10% of these - ie, 0.1% of the total - get damages.

Thus if the NHSLA believes it is shelling out too much in costs, the remedy is in its own hands. It is a legal catch-22. The NHSLA is duty-bound to keep expense to a minimum, and therefore to challenge costs awarded against it. This means that more cases go to appeal and legal costs escalate. Peter Walsh invites the NHSLA to draw the obvious conclusion. "Stop arguing, admit fault and settle earlier without drawn-out legal wrangling," he says. "That alone would save millions of pounds."

Of all the ways to cut the costs of medical negligence, one stands out way above the others: avoid being negligent in the first place. The NHS needs literally to clean up its act. Here are some figures reported by Sir Liam Donaldson in 2003: 10% of hospital admissions may result in something going wrong; 5% of the entire population report "some adverse effects" of medical care; 18% of patients say they have been victims of "medication error" within the past two years. On top of all the traditional foul-ups - missed diagnoses, poor or inadequate treatment, slipped scalpels and lethal drug doses - now looms the utterly modern phenomenon of the drug-resistant hospital infection. As recently as February, the Department of Health thought it necessary to launch a national campaign against the over-prescription of antibiotics. "The more we take antibiotics when they are not necessary," said Donaldson, "the more bacteria will become resistant to them." Yet patients with runny noses still think they can be cured by them, and - for all that they know better - some doctors still go on doling them out.

The other thing that bacteria love is filth, and the ideal place to look for it is in an NHS hospital. The result is that there are now law firms claiming to specialise in hospital "superbug" cases, and the number of claims is multiplying like bacteria on a Petri dish. One of the most notorious cases involved the three hospitals administered by the Maidstone and Tunbridge Wells NHS Trust where, between April 2004 and September 2006, more than 1,170 patients were infected with Clostridium difficile. According to the Healthcare Commission's official report, about 90 people "definitely or probably died as a result of the infection". The commission's inspectors found that the hospitals were epidemics waiting to happen. Supposedly clean bedpans were contaminated with excrement. Nurses were not washing their hands, emptying commodes, cleaning mattresses and equipment, or wearing aprons and gloves. If there was a parlour game called "pass the bacteria", this is how you'd play it. The health secretary, Alan Johnson, described the episode as "scandalous", and Kent police are still weighing the possibility of prosecution.

Another NHS trust in trouble was Bromley, against which the commission issued an "improvement notice" in February. Inspectors found an absence of routine cleaning around beds in the wards; sterilising equipment not being properly used; dirty commodes marked clean and ready for use; a blood-culture bottle trolley thickly covered in dust, and more. One is always wary of generalising from the particular, but there is no reason to suppose that these two trusts are wholly out of the ordinary. In fact, there is every reason to think otherwise. In June the Healthcare Commission reported that 103 of the 391 primary-care and hospital trusts in England were not meeting statutory hygiene standards - a failure rate of over 25%. The nurses might not be washing their hands, but the lawyers sure as hell are rubbing theirs.

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Pesky British navy logbooks upset Greenies

Britain's great seafaring tradition is to provide a unique insight into modern climate change, thanks to thousands of Royal Navy logbooks that have survived from the 17th century onwards. The logbooks kept by every naval ship, ranging from Nelson's Victory and Cook's Endeavour down to the humblest frigate, are emerging as one of the world's best sources for long-term weather data. The discovery has been made by a group of British academics and Met Office scientists who are seeking new ways to plot historic changes in climate.

"This is a treasure trove," said Dr Sam Willis, a maritime historian and author who is affiliated with Exeter University's Centre for Maritime Historical Studies. "Ships' officers recorded air pressure, wind strength, air and sea temperature and other weather conditions. From those records scientists can build a detailed picture of past weather and climate."

A preliminary study of 6,000 logbooks has produced results that raise questions about climate change theories. One paper, published by Dr Dennis Wheeler, a Sunderland University geographer, in the journal The Holocene, details a surge in the frequency of summer storms over Britain in the 1680s and 1690s. Many scientists believe storms are a consequence of global warming, but these were the coldest decades of the so-called Little Ice Age that hit Europe from about 1600 to 1850.

Wheeler and his colleagues have since won European Union funding to extend this research to 1750. This shows that during the 1730s, Europe underwent a period of rapid warming similar to that recorded recently - and which must have had natural origins. Hints of such changes are already known from British records, but Wheeler has found they affected much of the north Atlantic too, and he has traced some of the underlying weather systems that caused it. His research will be published in the journal Climatic Change.

The ships' logs have also shed light on extreme weather events such as hurricanes. It is commonly believed that hurricanes form in the eastern Atlantic and track westwards, so scientists were shocked in 2005 when Hurricane Vince instead moved northeast to hit southern Spain and Portugal. Many interpreted this as a consequence of climate change; but Wheeler, along with colleagues at the University of Madrid, used old ships' logs to show that this had also happened in 1842, when a hurricane followed the same trajectory into Andalusia.

The potential of Royal Navy ships' logs to offer new insights into historic climate change was spotted by Wheeler after he began researching weather conditions during famous naval battles. Later, as global warming moved up the scientific agenda, he and others realised that the same data could shed light on historic climate change. He said: "British archives contain more than 100,000 Royal Navy logbooks from around 1670 to 1850 alone. They are a stunning resource."

Most of these earlier documents contain verbal descriptions of weather rather than numerical data, because ships lacked the instruments to take numerical readings. However, Wheeler and his colleagues found early Royal Navy officers recorded weather in consistent language. "It means we can deduce numerical values for wind strength and direction, temperature and rainfall," he said. The information will ultimately contribute to the International Comprehensive Ocean-Atmos-phere Data Set, a global database maintained by the National Oceanic and Atmospheric Administration, a US government agency.

Wheeler makes clear he has no doubts about modern human-induced climate change. [He would be out on his ear if he said otherwise] He said: "Global warming is a reality, but what our data shows is that climate science is complex and that it is wrong to take particular events and link them to CO2 emissions. These records will give us a much clearer picture of what is really happening."

The Met Office has also set up a project, part-funded by Defra, the environment ministry, to study 900 logbooks kept by the East India Company on voyages between Europe and the Far East between 1780 and 1840. Its vessels carried thermometers and barometers so the data is of higher quality.

Faced with logs taken over so many voyages, the researchers have had to be selective. One of the most avid recorders of such data was Nelson himself, whose personal logbook records the air pressure and other readings he took up to several times daily.

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A new British "university of life"

It is not so much a school for scoundrels as an academy to turn hooray Henrys into smart Alecs. A new "university of life" will teach its students how to talk at the dinner table, what books to read and how to sneer at British holidaymakers. A group of philosophers, actors, wits and businessmen has been assembled to offer courses on everything from sparkling table talk to French philosophy.

The School of Life, whose faculty includes Alain de Botton, the philosopher and author, and Luke Johnson, chairman of Channel 4, may appear to critics to be an attempt to bolt intellectual pretentiousness onto old-fashioned snobbery. Its backers, however, insist it will help clients who have been too busy in the pursuit of money to develop their social skills and intellectual depth. De Botton, author of How Proust Can Change Your Life, will offer students an insight into ways to revive a relationship, choose a good doctor, enjoy a holiday, make friends and respond to an insult.

Those who would be welcome to attend evening and weekend classes include Katie Price, the model and bestselling author also known as Jordan. Price said she was barred from part of the Cartier polo tournament at Windsor last weekend out of "pure snobbery".

The school, which opens in Bloomsbury in central London next month, was founded by Sophie Howarth, 33, a former curator at Tate Modern. "It is not a finishing school. Nor is it conventional evening classes," Howarth said. "We are going to be teaching essential stuff to bright people and acting as a travel agent for the mind. We are pitching at bright, busy people who want to make the most of their careers and lifestyles and limited time off. The etiquette lessons will not be about which spoon to use or how to fold a napkin but more a menu to good conversation."

Lessons in politics will examine the theories of philosophers from Plato to Karl Marx but will also look into whether it would be more politically effective to become a billionaire than prime minister.

Learning courses - which include lessons in love, work, family and play - will cost $400 a term, starting in September. Meals will cost $90 for three courses. There is also the opportunity for a "one-to-one" with an expert for $100 an hour and a chance to listen to a "sermon" from a guest speaker or go on specialised holidays with a guest lecturer. The "sermons" are not religious but will discuss modern ethics.

Experts such as Susan Elderkin, author of Sunset Over Chocolate Mountains, will give students a spot of "biblio-therapy" with tailored reading lists. Students will also be invited on field trips. De Botton will teach them the meaning of travel at Heathrow airport for two days for $600 a head; and Martin Parr, a photographer, will lead an expedition to the Isle of Wight to observe "the vulgarity, nostalgia and brashness of British holidaymaking in its full glory".

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