Monday, September 15, 2008

Free speech punished by senior NHS doctors

The NHS is just another nasty bureaucracy

A junior doctor made a rude comment on a doctors' only forum about one of the top bananas who masterminded the plan to 'improve' doctors' training and 'career paths'. 'Modernising Medical Careers', as it's called, is very widely disliked. Its benefits seem to be mostly for employers and the government - not doctors or patients.

Our Dr Scot Jnr, who works in a Highlands hospital, made some forthright comments (which included some 'Anglo-Saxon' words) about one of the MMC architects who is a career medical politician.

He was immediately suspended from work: a high-powered London close friend of the top banana architect had seen the comment and called another chum, another big tamale medical woman, up in the Highlands. A plot - allegedly unlawful - was hatched between them, Chinese-whisperish, to silence and punish Dr Scot Jnr forthwith.

This summary activity has deep implications for the freedom of doctors to speak out against diktats they don't agree with, and it demonstrates how bullied and harassed clinical staff are. One in four junior doctors report being bullied and intimidated by senior doctors (figure from BMA report). Ultimately it has deep implications for the quality of care and treatment doctors are allowed to give patients.

Fundamentally, this silencing and intimidatory activity is an onslaught on freedom of speech for all of us. In the NHS particularly, this toxic culture is so deeply entrenched that it goes barely noticed by most, it's part of the environment like targets or management suite shagpile. This hidden culture of intimidation and fear is also the reason that so many patients are not able to get the treatment they need or the apologies they deserve when things go wrong.


British middle school graduates with the spelling skills of seven-year-olds

Pupils can gain a good GCSE in English despite being unable to spell basic words, according to a report. Many were awarded at least a C grade - considered a decent pass - even though scripts were littered with errors, it is claimed. Some teenagers were unable to spell there and where - words the average pupil is expected to master at the age of seven. Pupils were also awarded B grades despite spelling words such as finally with one "l" and failing to appreciate the difference between woman and women.

Researchers from Cambridge Assessment - one of the country's biggest exam boards - analysed spelling in 60 English papers. Three per cent of all words were wrong, rising to one-in-14 among teenagers awarded a G grade, they said. Some words were so badly spelt that researchers had problems working out what they meant. In one script, gorgeous was spelt "gourges", anxious came out as "angshuse" and familiar became "formiler". In other examples, nervous was spelt "nufse", thought became "faunt" and talk "torck".

The disclosure comes just days after a leading academic called for an overhaul of the English spelling system to allow irregularities to be accepted. Professor John Wells, from University College London, said that forcing pupils to memorise irregular spellings was holding many back in the classroom.

But Ian McNeilly, of the National Association for the Teaching of English, said too many schools were forced to ignore bad spelling in tests to inflate pupils' overall marks. "I am not saying that we make spelling a huge priority over understanding, analysis and interpretation," he told the Times Educational Supplement. "But students should be able to spell securely. It's an ongoing battle that isn't helped by wider society."

In the latest study - presented to the annual conference of the British Educational Research Association - academics analysed papers taken by students in 2004. They were able to present a detailed breakdown of the number of spelling mistakes by grade. Around four per cent of all words in papers graded an F were incorrect and more than two per cent of spellings by C-grade candidates were wrong.

Most common mistakes surrounded uncertainty over double letters. Spellings such as "allways", "quiettly", "untill" and "stoped" were common errors. Many pupils confused new and knew - and failed to spot the difference between too and to. Some teenagers were unsure about when "h" followed "w", using phrases such as "I whant", "he whas" and "we where".

Basic rules of primary school spelling were also forgotten by GCSE candidates. This led to misspellings such as "slightley", "angrey" and "comeing". Researchers said many errors came down to pupils' speech patterns, with some substituting -ing for -ink, producing words such as "somethink" and "nothink".

It comes amid on-going concerns over spelling standards among young people. Last month, one academic said that standards of spelling among university students were now so bad that lecturers are being urged to turn a blind eye to mistakes.


Girls at British single-sex schools outperform co-education pupils

There have been a lot of findings elsewhere to this effect but socio-economic differences might be part of the explanation

GIRLS attending single-sex schools far outperform their contemporaries in mixed education, an analysis of government data have found. The research by the independent Girls' Schools Association (GSA) shows that this year 56.7% of their member schools' A-level results were at grade A, compared with 48.9% at coed independent schools. At GCSE the margin was wider still, with 68.5% marked A or A* compared with the mixed figure of 54%.

The research, based on figures from the Department for Children, Schools and Families, reflects a trend that has been apparent for at least the past four years. In recent decades single-sex education has declined in popularity, with the number of schools falling from nearly 2,500 30 years ago to about 400. In the past decade alone, some 120 independent schools have gone co-educational.

Some of the best-known former boys' schools, such as Wellington and Uppingham, are now mixed, although others, including Eton and Winchester, have remained boys-only.

Girls' schools have been more likely to resist going co-educational. Advocates of the system believe that in mixed classes girls are more likely to be inhibited and reluctant to voice their opinions openly. Girls in single-sex schools are also more likely to take A-level subjects which in mixed schools have traditionally been seen as the preserve of boys, such as science and maths.

Last year, 72.5% of pupils in the GSA schools won A grades in maths A-level while the figure was 64.9% for girls in their mixed equivalent. The national figure was nearly 30 percentage points lower. Separate research by the Girls' Day School Trust, an independent chain, has found that the proportion of their pupils taking science subjects at A-level is more than double the national average. Vicky Tuck, president of the GSA and principal of Cheltenham ladies' college, said girls schools "have a brilliant track record in helping pupils attain".

However, Richard Cairns, headmaster of the mixed Brighton college, said boys and girls complemented each others' learning. "Boys will focus on what's going on in the killing fields, and girls will think, `What's the impact [over] the next 40 years when there's no father at home?' "

Rebecca Ogilvie-Smith, from Oxfordshire, who last month scored top grades in all her AS-levels at Cheltenham - while also winning top grades in her French A2- said attending a single-sex school had taken off "a certain pressure" which the presence of boys can bring. "There is a very intense feeling of community and it is not judgmental," said Ogilvie-Smith. "Your focus is not on how you look."


Revealed: UK's first official sharia courts

ISLAMIC law has been officially adopted in Britain, with sharia courts given powers to rule on Muslim civil cases. The government has quietly sanctioned the powers for sharia judges to rule on cases ranging from divorce and financial disputes to those involving domestic violence. Rulings issued by a network of five sharia courts are enforceable with the full power of the judicial system, through the county courts or High Court. Previously, the rulings of sharia courts in Britain could not be enforced, and depended on voluntary compliance among Muslims.

It has now emerged that sharia courts with these powers have been set up in London, Birmingham, Bradford and Manchester with the network's headquarters in Nuneaton, Warwickshire. Two more courts are being planned for Glasgow and Edinburgh. Sheikh Faiz-ul-Aqtab Siddiqi, whose Muslim Arbitration Tribunal runs the courts, said he had taken advantage of a clause in the Arbitration Act 1996. Under the act, the sharia courts are classified as arbitration tribunals. The rulings of arbitration tribunals are binding in law, provided that both parties in the dispute agree to give it the power to rule on their case.

Siddiqi said: "We realised that under the Arbitration Act we can make rulings which can be enforced by county and high courts. The act allows disputes to be resolved using alternatives like tribunals. This method is called alternative dispute resolution, which for Muslims is what the sharia courts are."

The disclosure that Muslim courts have legal powers in Britain comes seven months after Rowan Williams, the Archbishop of Canterbury, was pilloried for suggesting that the establishment of sharia in the future "seems unavoidable" in Britain. In July, the head of the judiciary, the lord chief justice, Lord Phillips, further stoked controversy when he said that sharia could be used to settle marital and financial disputes. In fact, Muslim tribunal courts started passing sharia judgments in August 2007. They have dealt with more than 100 cases that range from Muslim divorce and inheritance to nuisance neighbours. It has also emerged that tribunal courts have settled six cases of domestic violence between married couples, working in tandem with the police investigations.

Siddiqi said he expected the courts to handle a greater number of "smaller" criminal cases in coming years as more Muslim clients approach them. "All we are doing is regulating community affairs in these cases," said Siddiqi, chairman of the governing council of the tribunal.

Jewish Beth Din courts operate under the same provision in the Arbitration Act and resolve civil cases, ranging from divorce to business disputes. They have existed in Britain for more than 100 years, and previously operated under a precursor to the act.

Politicians and church leaders expressed concerns that this could mark the beginnings of a "parallel legal system" based on sharia for some British Muslims. Dominic Grieve, the shadow home secretary, said: "If it is true that these tribunals are passing binding decisions in the areas of family and criminal law, I would like to know which courts are enforcing them because I would consider such action unlawful. British law is absolute and must remain so." Douglas Murray, the director of the Centre for Social Cohesion, said: "I think it's appalling. I don't think arbitration that is done by sharia should ever be endorsed or enforced by the British state."

There are concerns that women who agree to go to tribunal courts are getting worse deals because Islamic law favours men. Siddiqi said that in a recent inheritance dispute handled by the court in Nuneaton, the estate of a Midlands man was divided between three daughters and two sons. The judges on the panel gave the sons twice as much as the daughters, in accordance with sharia. Had the family gone to a normal British court, the daughters would have got equal amounts.

In the six cases of domestic violence, Siddiqi said the judges ordered the husbands to take anger management classes and mentoring from community elders. There was no further punishment. In each case, the women subsequently withdrew the complaints they had lodged with the police and the police stopped their investigations. Siddiqi said that in the domestic violence cases, the advantage was that marriages were saved and couples given a second chance.

Inayat Bunglawala, assistant secretary-general of the Muslim Council of Britain, said: "The MCB supports these tribunals. If the Jewish courts are allowed to flourish, so must the sharia ones."


Wanted: Pretty woman flatmate who will cook and clean

A finance worker has been disciplined after sending an email to female colleagues asking them to recommend a lady flatmate who would cook and clean for him and be "reasonably nice to look at"

Paul Eley, 30, told colleagues he was looking for a woman to share his apartment rent free as long she was aged 18 to 26, attractive and happy to do his washing and ironing. He emailed 12 female co-workers asking if anyone needed a room and would be prepared to clean the whole flat once a week and the kitchen every day. Mr Eley said the new tenant would have to cook for him if he worked late, adding: "Nothing difficult, something like sausage and mash." She would "sometimes" be allowed to watch what she wanted on television and would be allowed friends around "as long as they are women". Mr Eley also stipulated that the lady would have to leave at a month's notice if he suddenly found a "serious" girlfriend who wanted to move in.

The fiduciary administrator made his comments in two emails sent to colleagues at investment company Concept Group Limited in Guernsey. Some of his appalled female colleagues forwarded the emails to friends and they were soon being read by hundreds of people on the island. After several complaints about his conduct Mr Eley was disciplined by company directors and warned the comments were sexist.

One colleague said: "Nobody was sure if he was trying to be funny or not. It was either a bad joke or the most sexist thing ever written. "Most women in the office didn't see the funny side and he was hauled in to the boardroom and given a proper dressing down for sexist behaviour. His bosses definitely didn't see the funny side."

Mr Eley insisted the emails had been a joke and he had not meant to cause offence. He said: "It was only meant as a joke and was not meant to be anything serious." Mr Eley sent his first email at 2.13pm on September 9 under the heading "New Flatmate" It said: "I am looking for a girl flatmate between 18 years old and 26 years old. Preferably someone who is very tidy and reasonable nice to look at." He then listed a series of cooking and cleaning jobs the new flatmate would have to do instead of paying rent.

Mr Eley is the latest person to have an embarrassing email proliferate unexpectedly. In 2000 public relations officer Claire Swire sent her boyfriend, Bradley Chait, an intimate email which went around the world after he forwarded it to friends.


Easy ways to cut immigration and still get the work done

A great comment from Minette Marrin in Britain

It is a great relief to know that though the British Establishment may be unforgivably slow in recognising the obvious, it isn’t absolutely incapable of it. Last week the powers that be – the forces of conventional wisdom and political correctness – finally saw the light on immigration. They didn’t exactly admit it, of course. They merely stood by quietly and allowed others to tell the truth about immigration, without trying to shame them into silence. In its quiet way it was a remarkable cultural moment – a national tipping point.

On Monday a cross-parliamentary group led by Frank Field, the former Labour minister, called for a limit to immigration. There were no howls of outrage, merely a few squeaks. In a report called Balanced Migration, accompanied by a poll by YouGov, the parliamentary campaigners made the obvious point, accompanied by painstakingly gathered facts, that immigration cannot continue at its present uncontrolled rate. The country cannot stand it. At current levels, (mostly immigration from outside the European Union) 7m people will come to live here by 2031; that is the equivalent of seven cities the size of Birmingham. By now only bigots against the truth deny the pressure that recent immigration imposes on schools, hospitals, prisons, housing and infrastructure.

All this ought to have been obvious long ago. It’s what the vast majority here think. What’s new is that it’s possible to say so without being accused of playing the race card or the numbers game; I’m not sure why, but it must have something to do with the fact that many ethnic minority people now think so too. The YouGov poll showed that 85% of all people think immigration is putting too much pressure on public services, 76% that Britain is overcrowded and 81% that the government should greatly reduce immigration to Britain. Sixty per cent of Asians and 45% of blacks think the same, so such thoughts are not necessarily racist; ironically, it is their agreement that has made discussion possible.

The Balanced Migration group is calling for a stop to net immigration: it proposes that the number of immigrants (from outside the EU) who are given permission to settle here should be kept to roughly the same as the number of British citizens who are emigrating. This wouldn’t affect temporary work permits or family reunion, but it would significantly cut the population explosion here.

Part of the point of this launch is the usual invitation to a national debate. I have a couple of suggestions to offer. One of the many standard arguments in favour of immigration is that we need the workers. Even if immigrants make a net contribution of only a few pounds a year (62p a week, according to the exhaustive House of Lords economics committee investigation this year into the economic impact of immigration) or even if they are a large net cost, we’d be lost without them because they do essential work. They do all the care work, the unskilled work and the seasonal work. Who else would do it?

The answer is simple. There are already plenty of British citizens here to do it. I don’t mean the unemployed Britons here, though some of them might be suitable as well. I mean two other groups. One consists of state sector workers. The Labour government, while in office, has created well over 800,000 public sector jobs, most of them unnecessary. Not only is this make-work, it is make-waste. All those functionaries do not merely sit at desks, consuming heat and light and waiting for their pension. They create other costs and other work. Such is the mindless power of bureaucracy that one outreach worker with an absurd brief such as advising Irish people in Birmingham about sex (I didn’t make that one up) can call upon new initiatives, new meetings, new groups, new funding, new employees and more expense. Meanwhile the old and the lonely are neglected, unless a Filipino or a Somali immigrant can be found for them.

This vast army of state sector workers should be redeployed. They should be allowed to keep their job security, salaries and pensions, but they should become social care workers. They should, in person, look after the old, the sick, the mentally ill and the displaced; we are all capable of social care – looking after a bedridden pensioner, or feeding a sick child in hospital, giving a worn-out carer a respite break, working in a women’s shelter, or advising a desperate family about debt. We don’t have enough citizens doing this. It is supremely valuable work, far more so than checking the ethnicity of people parking cars.

This important work is not exactly skilled, but it is responsible and demanding. It is not right to give this work to low-paid, poorly educated immigrants who speak little English, when we have plenty of people here already who could do it.

Similarly with work that is more obviously unskilled, or low-skilled, like looking after parks and streets and countless other essential jobs, we need not depend so heavily on immigrants when we have huge numbers of citizens who could do it, yet they are often denied the opportunity. I mean people with learning disabilities.

Learning disability is an awkward term. It has nothing to do with mental illness. It means a significant intellectual impairment, or – crudely – a low IQ. Clearly a person with a mild or moderate learning disability couldn’t usually expect to do a skilled job. But for many doing an unskilled job can be a great joy, a source of pride and independence, as well as useful to all concerned, whether it’s stacking shelves in a friendly supermarket, assisting a park keeper, working on a building site, in a hotel laundry or picking strawberries. And according to government estimates, between 580,000 and 1.75m people here have mild to moderate learning disabilities; that is a huge source of willing workers. Yet despite the known wishes of people with such disabilities, despite the pressure of various lobby groups on their behalf, they find it difficult to get jobs.

Immigrants have brought great things to this country. One of them, rather oddly and recently, is the opportunity at last to talk more openly as a society about the costs and benefits of immigration, without being denounced as a heartless xenophobe or closet racist. Enoch Powell is at last being proved wrong.


AIDS epidemic? It was a `glorious myth'

The author of 1987's "The Truth About the AIDS Panic" welcomes two new whistleblowing texts on the opportunism of the AIDS industry.

There is a widely accepted view that Britain was saved from an explosive epidemic of heterosexual AIDS in the late 1980s by a bold campaign initiated by gay activists and radical doctors and subsequently endorsed by the government and the mass media. According to advocates of this view, we owe our low rates of HIV infection today largely to the success of initiatives such as the `Don't Die of Ignorance' leaflet distributed to 23million households and the scary `Tombstones and Icebergs' television and cinema adverts (though they are always quick to add that we must maintain vigilance and guard against complacency).

Now former AIDS industry insiders are challenging the imminent heterosexual plague story and many of the other scare stories of the international AIDS panic. James Chin, author of The AIDS Pandemic: The Collision of Epidemiology with Political Correctness, is a veteran public health epidemiologist who worked in the World Health Organisation's Global Programme on AIDS in the late 1980s and early 1990s. Elizabeth Pisani, a journalist turned epidemiologist and author of The Wisdom of Whores: Bureaucrats, Brothels and the Business of AIDS, spent most of the past decade working under the auspices of UNAIDS, which took over the global crusade against HIV in 1996. Once prominent advocates of the familiar doomsday scenarios, both have now turned whistleblowers on their former colleagues in the AIDS bureaucracy, a `byzantine' world, according to Pisani, in which `money eclipses truth'.

For Chin, the British AIDS story is an example of a `glorious myth' - a tale that is `gloriously or nobly false', but told `for a good cause'. He claims that government and international agencies, and AIDS advocacy organisations, `have distorted HIV epidemiology in order to perpetuate the myth of the great potential for HIV epidemics to spread into "general" populations'. In particular, he alleges, HIV/AIDS `estimates and projections are "cooked" or made up'.

While Pisani disputes Chin's claim that UNAIDS epidemiologists deliberately overestimated the epidemic, she admits to what she describes as `beating up' the figures, insisting - unconvincingly - that there is a `huge difference' between `making it up (plain old lying) and beating it up'. Pisani freely acknowledges her role in manipulating statistics to maximise their scare value, and breezily dismisses the `everyone-is-at-risk nonsense' of the British `Don't Die of Ignorance' campaign.

Chin's book offers a comprehensive exposure of the hollowness of the claims of the AIDS bureaucracy for the efficacy of their preventive campaigns. He provides numerous examples of how exaggerated claims for the scale of the HIV epidemic (and the risks of wider spread) in different countries and contexts enable authorities to claim the credit for subsequently lower figures, as they `ride to glory' on curves showing declining incidence. As he argues, `HIV prevalence is low in most populations throughout the world and can be expected to remain low, not because of effective HIV prevention programmes, but because. the vast majority of the world's populations do not have sufficient HIV risk behaviours to sustain epidemic HIV transmission'.

By the late 1980s, it was already clear that, given the very low prevalence of HIV, the difficulty of transmitting HIV through heterosexual sex and the stable character of sexual relationships (even those having multiple partners tend to favour serial monogamy), an explosive HIV epidemic in Britain, of the sort that occurred in relatively small networks of gay men and drug users, was highly improbable, as Don Milligan and I argued in 1987 (1).

As both Chin and Pisani indicate, high rates of heterosexually spread HIV infection remain the exceptional feature of sub-Saharan Africa (and parts of the Caribbean) where a particular pattern of concurrent networks of sexual partners together with high rates of other sexually transmitted infections facilitated an AIDS epidemic. Though this has had a devastating impact on many communities, Chin suggests that HIV prevalence in sub-Saharan Africa and the Caribbean has been overestimated by about 50 per cent. The good news is that, contrary to the doom-mongering of the AIDS bureaucracy, the rising annual global HIV incidence peaked in the late 1990s and the AIDS pandemic has now passed its peak.

Most significantly, the sub-Saharan pattern has not been replicated in Europe or North America, or even in Asia or Latin America, though there have been localised epidemics associated with gay men, drug users and prostitution, most recently in South-East Asia and Eastern Europe.

Many commentators now acknowledge the gross exaggerations and scaremongering of the AIDS bureaucracy. It is clear that HIV has remained largely confined to people following recognised high-risk behaviours, rather than being, in the mantra of the AIDS bureaucracy, a condition of poverty, gender inequality and under-development. Yet they also accept the argument, characterised by Chin as `political correctness', that it is better to try to terrify the entire population with the spectre of an AIDS epidemic than it is to risk stigmatising the gays and junkies, ladyboys and whores who feature prominently in Pisani's colourful account.

For Chin and Pisani, the main problem of the mendacity of the AIDS bureaucracy is that it leads to misdirected, ineffective and wasteful campaigns to change the sexual behaviour of the entire population, while the real problems of HIV transmission through high-risk networks are neglected. To deal with these problems, both favour a return to traditional public health methods of containing sexually transmitted infections through aggressive testing, contact tracing and treatment of carriers of HIV. Whereas the gay activists who influenced the early approach of the AIDS bureaucracy favoured anonymous and voluntary testing, our whistleblowers now recommend a more coercive approach, in relation to both diagnosis and treatment.

Pisani reminds readers that `public health is inherently a somewhat fascist discipline' (for example, quarantine restrictions have an inescapably authoritarian character) and enthusiastically endorses the AIDS policies of the Thai military authorities and the Chinese bureaucrats who are not restrained from targeting high-risk groups by democratic niceties. The problem is that, given the climate of fear generated by two decades of the `everyone-is-at-risk nonsense', the policy now recommended by Chin and Pisani is likely to lead to more repressive interventions against stigmatised minorities (which will not help to deter the spread of HIV infection).

Chin confesses that he has found it difficult `to understand how, over the past decade, mainstream AIDS scientists, including most infectious disease epidemiologists, have virtually all uncritically accepted the many "glorious" myths and misconceptions UNAIDS and AIDS activists continue to perpetuate'. An explanation for this shocking betrayal of principle can be found in a 1996 commentary on the British AIDS campaign entitled `Icebergs and rocks of the "good lie"'. In this article, Guardian journalist Mark Lawson accepted that the public had been misled over the threat of AIDS, but argued that the end of promoting sexual restraint (especially among the young) justified the means (exaggerating the risk of HIV infection): as he put it, `the government has lied and I am glad' (2).

This sort of opportunism is not confined to AIDS: in other areas where experts are broadly in sympathy with government policy - such as passive smoking, obesity and climate change - they have been similarly complicit in the prostitution of science to propaganda. It is a pity that Chin and Pisani did not blow their whistles earlier and louder, but better late than never.


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