Sunday, September 07, 2008

Mythical NHS maternity money

Funding promised by the Government to improve poor standards of care for mothers and newborn babies is failing to reach maternity units, The Times has learnt. A survey of NHS trusts has showed that nine out of ten cannot identify their share of the $660 million pledged by ministers. Leading midwives and doctors say the money could be lost on the NHS balance sheet or spent on other services because it has not been properly ring-fenced. Despite record increases in spending on the health service by Labour, critics maintain that the money is still not reaching the areas most in need of reform.

Alan Johnson, the Health Secretary, announced the extra spending over the next three years in January, following several critical reviews of maternity services by the Healthcare Commission, which is the NHS regulator. "From April 2008, trusts have access to this additional money," he said.

Rising birth rates and a shortage of midwives have put huge pressure on the system, meaning mothers are often left without care during labour.

The Times submitted questions under the Freedom of Information Act to all 152 Primary Care Trusts (PCTs) in England, the local bodies that distribute 70 per cent of the total NHS budget. Of 85 trusts who responded, only eight claimed to have received additional funding for maternity this year as Mr Johnson promised. The extra money was for the implementation of "Maternity Matters", a policy that recommends that every woman giving birth in England should have one-to-one care from a dedicated midwife. Ministers also aim to give greater choice over where babies are born, with more home births and deliveries in local units staffed by midwives rather than hospital consultants expected as a result.

One head of midwifery in the South West, who did not wish to be named, said: "Despite all of the Government's announcements, we have not seen any of this additional funding. "All the staff are aware of this additional funding and expecting to see changes and improvements in maternity service provision, but I have not seen any of the money." Instead, healthcare staff have to bid for the extra funds and have had no reassurances on how it would be spent.

Louise Silverton, deputy general secretary of the Royal College of Midwives (RCM), said that new mothers would still face a postcode lottery in the quality of care as a result. "It is not enough for the Government to say they have put money into maternity services, but then fail to make sure the money actually goes where it is supposed to. "Women keep hearing these excellent policy statements, such as one-to-one care from a midwife, but they are not getting that sort of treatment in many areas." Overall, NHS spending on maternity in England was cut by $110 million in 2006-07, while the birth rate has risen 16 per cent since 2001, she said. "Some trusts have managed to increase their spending but for the most part we don't know what PCTs are spending the money on, there's a lack of transparency."

Sabaratnam Arulkumaran, president of the Royal College of Obstetricians and Gynaecologists, added: "Extra funds have been promised to improve maternity services and it is important for these to be ring-fenced within each trust. "NHS managers, clinical directors and head of services must present a case to their PCTs in order to secure more funds for their units." The RCM estimates that 5,000 extra midwives need to be recruited urgently, but the Government has promised only 3,400 full-time posts.

Of those surveyed, 33 trusts (38 per cent) could specify a figure for their projected spending on maternity services in 2008-09, but this was estimated from increases in their total budgets or from local plans agreed prior to the Government's investment. Asked what the money was being spent on, trusts' answers varied from specific numbers of posts for midwives and maternity support workers to more general promises to "increase midwifery capacity" or programmes such as sexual health services, breast-feeding support or smoking cessation for pregnant women.

"These are softer areas of care that do not address the core issue of staffing shortages," Miss Silverton added. "Large numbers of midwives are due to retire in the next few years and maternity support workers should not be used to substitute for them."

Anne Milton, a Conservative MP, added: "This Government has been more concerned with getting a good headline than delivering the services that patients need. It is unacceptable that at a time when the NHS is reporting record surpluses of nearly $4 billion that this funding is not reaching the front line, where it is so desperately needed by new mothers and their children."


Waiting in pain

For women like Clare Payne, who experience complications during pregnancy, childbirth can be an agonising experience. Mrs Payne, 23, gave birth to her first son Harry in 2006 with few problems, but his brother Finley's birth last September was delayed repeatedly owing to a shortage of staff and beds.

At 18 weeks she developed SPD, a condition that causes pressure on the pelvis and extreme pain. Doctors said that she should be induced at 37 weeks, but when she arrived at hospital she was promptly sent home because there were not enough staff. "I was told I was a priority case, but every time I contacted the ward I was told I would have to wait hours, if not days."

Mrs Payne, a sales assistant from St Leonards, East Sussex, returned to hospital at least three more times. Finally she elected to have a Caesarean section after waiting for more than two weeks. "It was a totally disgusting way to treat a heavily pregnant woman," she said.


British Soldier forced to sleep in car after hotel refuses him a room

A hotel that refused an injured soldier a room, forcing him to spend the night in his car, was backed into issuing a grovelling apology yesterday after receiving a barrage of abusive phone calls. The Metro Hotel, in Woking, Surrey, called the police as its phone lines were flooded with angry and threatening calls from the public. The attack on the switchboards came after it emerged that Corporal Tomos Stringer, 24, had been told that it was company policy not to accept members of the Armed Forces.

A soldier since the age of 16 and veteran of multiple tours in Northern Ireland, Iraq and Afghanistan, Corporal Stringer had travelled to Surrey to help with funeral preparations for a friend killed in action. The corporal, who was not in uniform, presented his warrant card when asked by the hotel for proof of identity. After being refused a room, he had to bed down in his car, with his wrist, broken during a convoy ambush, encased in plaster.

Corporal Stringer's MP, Hywel Williams, Derek Twigg, the Defence Minister, and Bob Ainsworth, the Armed Forces Minister, have all written to the hotel. After a resolute silence, the hotel, owned by a company called American Amusements, finally issued a statement: "The Metro Hotel, Woking, sincerely regrets any upset caused towards Corporal Stringer and his family . . . The hotel management has always had an open-door policy to all its visitors and guests, including members of the military and Armed Forces." The receptionist had made a mistake, it added.

Corporal Stringer, of 13 Air Assault Support Regiment, The Royal Logistic Corps, has returned to Afghanistan. His mother, Gaynor Stringer, from Criccieth, North Wales, told The Times: "I'm very, very angry. It's discrimination. They would never get away with it if it was against someone of ethnic origin." She added: "In America, they treat soldiers as heroes. We went to Disney World with Tomos and the whole family was moved to the front of the lines. Everybody was clapping and cheering. Here, soldiers can't even get a bed for the night."


Environment Minister for Northern Ireland calls global warming fears 'hysterical psuedo-religion'

The Environment Minister Sammy Wilson has angered green campaigners by describing their view on climate change as a "hysterical psuedo-religion". In an article in the News Letter, Mr Wilson said he believed it occurred naturally and was not man-made. "Resources should be used to adapt to the consequences of climate change, rather than King Canute-style vainly trying to stop it," said the minister. Peter Doran of the Green Party said it was a "deeply irresponsible message."

Mr Wilson said he refused to "blindly accept" the need to make significant changes to the economy to stop climate change. "The tactic used by the "green gang" is to label anyone who dares disagree with their view of climate change as some kind of nutcase who denies scientific fact," he said. The minister said he accepted climate change can occur, but does not believe the cause has been identified. "Reasoned debate must replace the scaremongering of the green climate alarmists."

John Woods of Friends of the Earth said Mr Wilson was "like a cigarette salesman denying that smoking causes cancer". "Ironically, if we listen to him Northern Ireland will suffer economically as we are left behind by smarter regions who are embracing the low carbon economy of the future."

It is the latest clash between Mr Wilson and green groups since his appointment as environment minister in June.


White students 'avoid maths and science'

Thousands of high-flying white youngsters are giving up maths and science at 16 because they think they are not clever enough to succeed atA-Level, according to a report published today. The report reveals that white children who achieve A* and A grade passes at GCSE are far less likely than other ethnic groups to pursue the subjects to A-Level.

According to what is being billed as a "state of the nation" report on maths and science by The Royal Society, white youngsters are "known to develop the idea that success in mathematics comes from being naturally gifted". By contrast, Asian and Chinese youths, says the report, are more likely to believe that success comes from hard work.

It also warns that overall take-up of the subjects has fallen during the past decade. That means ministers are unlikely to reach targets they have set for qualified scientists and mathematicians to enable the UK to compete with other countries. "In chemistry, Pakistani students are 7.2 times more likely and Indian students 4.3 times more likely than white students with the same level of attainment at GCSE to progress toA-Level," the report says. "Bangladeshi, black and Chinese students are also more likely than white students with the same attainment to progress to A-Level. "A similar pattern can be seen in mathematics, with Chinese students being 4.7 times more likely to progress, Indian students 3.4 times more likely and Pakistani, Bangladeshi and black students also more likely to progress."

The report warns that - despite rises in the take-up of maths and science subjects in recent years - numbers are still well down on a decade ago. "Between 1996 and 2007, the proportions of 17-year-olds in each of the four UK nations taking chemistry, physics and mathematics have actually shrunk," it says. "In England, Northern Ireland and Wales no more than 6 per cent of 17-year-olds took A-Level physics in any one year. For chemistry, the figure was 7 per cent and for biology and mathematics it was 12 per cent."

Government attempts to reform the curriculum during the past 12 years to make the subjects more attractive have, the report adds, "had worryingly little impact on increasing the number of students taking maths and science in post-compulsory education". Those include rewriting the maths syllabus to make it more accessible - or "easier" as some critics would have it.

The report says that children's attitudes towards science become "less positive" at secondary school, with the lack of specialist teachers being cited as one reason pupils are put off the subject. "There is enduring concern that students do not find the science and mathematics they encounter at school as interesting as might be hoped. "Negative attitudes are linked to a view of the science curriculum in England as overly full, fact-laden and hard. The situation is worrying, given the needs of industry for science, technology, engineering and mathematical (STEM) skills, the Government's stated desire to increase the number of STEM graduates, and the need for more science and mathematics teachers." The Government, it says, wants at least 80 per cent of all pupils to take the equivalent of two science GCSE's. This figure has not been met since 2005.

Professor Michael Reiss, director of education at the Royal Society, said last night: "Science and mathematics education, particularly in England, has been assaulted by reform over the last 20 years. "Unless we break the cycle of politically motivated knee-jerk reactions and constant change, we are in danger of never giving reforms the time they need to bed in. "Therefore [we are] not getting to grips with what works and what doesn't."

A spokeswoman for the Department for Children, Schools and Families said: "Recent exam results tell a different story and show that our reforms are having a positive effect. The number of young people taking maths and science A-Levels continues to increase and this year the number of young people taking maths A-Level was at its highest for a decade."


Handwriting standards blamed as pupils ask for exam 'scribes'

Thousands of teenagers need "scribes" to help them write their A-level and GCSE papers because they are incapable of answering questions in longhand themselves, a study has revealed. The number of requests for "ghost writers" to help pupils do exams rose from 28,324 in 2005 to 40,215 last year, while the number of students asking to use a word processor or computer also soared by more than 50 per cent, to 21,713. Requests for practical assistance short of a "scribe", such as a teacher sitting in to help a pupil to write legibly, also increased.

Experts say more scripts than ever are illegible because the email and text generation are unable to write properly by hand. Teachers marking this summer's English, drama and citizenship GCSEs for the Edexcel exam board reported: "Some handwriting is a pleasure to read but an increasing minority is bordering on the illegible." They added: "Centres [where examinations are held] are asked to emphasise to candidates the importance of writing answers that are not only legible but coherent. Centres might wish to consider the use of scribes or word processors in more cases - especially for those candidates with known handwriting difficulties." In a report on this year's English exam, Edexcel added: "Centres should continue to stress to candidates the importance of clear handwriting which is not too small ... The actual quality of handwriting in some instances is such as to make responses virtually illegible."

Their concerns mirror those expressed by Scottish examiners, who have called for handwriting classes to be reintroduced because so many pupils cannot write longhand. They say teenagers who spend hours each week sending emails and text messages have lost the ability to work with pen and paper. As a result, a large number of Higher exams in English could not be marked because of illegible handwriting.

The latest report from exam assessors says "markers are increasingly concerned about handwriting that is difficult to read" and that dedicated classes should be held for "candidates whose handwriting is seriously weak or known to become so under pressure".

Nick Seaton, of the Campaign for Real Education, said yesterday: "This suggests to me that youngsters should be spending less time on computers and more on improving their handwriting skills. "Examinations are supposed to be a test of basic skills and, if they can't do the basics, they shouldn't be getting someone else to do them for them. Emails and text messaging have their place but not at the expense of basic skills."

The rise in requests for handwriting has prompted Ofqual, the new regulator of exams in England, to promise it will monitor the position. "The number of candidates approved for access arrangements has increased this year," it said. "This could be due to a greater awareness amongst exam officers in schools and colleges of what candidates are entitled to. As the regulator, we will closely monitor the situation to ensure that the system remains fair for all students." Exam boards pointed out that the figures related to the total number of scripts with which a pupil had asked for help - saying that a candidate might require help with more than one exam.

However, sources said the requests were only likely to be made in subjects which required detailed writing, such as English, history and citizenship, and it was unlikely that a single candidate would need help with more than three exams. To satisfy examiners that a request for a scribe is valid, a candidate must either have a physical disability, a sudden injury or be assessed by a qualified psychologist or specialist teacher. They are eligible for a scribe if they can prove they cannot write more than 10 words a minute.


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