Friday, October 24, 2008

'Police are unable to visit 40% of crime victims because of a fog of administration', says British chief constable

Four in ten victims of crime are not visited by a police officer, a chief constable has admitted. Matt Baggott, who is the country's most senior officer for neighbourhood policing, blamed a 'fog of over-supervision and administration'. The Leicestershire chief constable said: 'We do not have the time to do our jobs properly. 'There are no excuses about money. This is about leadership.' He believes every victim should receive a police visit. But critics say many forces no longer attend the scenes of minor crimes, such as theft or vandalism.

Mr Baggott is the first officer to place a figure on the number of incidents that are simply investigated over the phone, with the victim being handed a crime number to give to their insurer. He told a conference in London: 'At the moment we do not visit 40 per cent of crime victims. 'We are not dealing with the moment of misery in their life thoroughly.'

He fears that this approach will make it harder to find out how crimes were able to take place and whether there were any other problems in the neighbourhood. This has a knock-on effect on public trust in policing. According to research conducted for Mr Baggott, for every negative experience of the police, officers must do 14 positive acts locally to repair the damage to their reputation.

He urged officers to free themselves from red tape and targets by engaging in 'structured anarchy' - challenging excessive bureaucracy to persuade policy-makers to scrap it. He wants constables to have the same freedoms as GPs, who do not need permission from superiors to write prescriptions or decide how to treat patients. At present, junior officers have to check their actions with sergeants.

Mr Baggott also wants all criminals to be met at the prison gates to dissuade the 70 per cent who reoffend from doing so. He said they should be placed under such close supervision that they could not commit any more crimes. Former Police Federation chairman Jan Berry, who now works as a red tape tsar for the Home Office, backed Mr Baggott's comments. She said: 'We have got too many people complying with sets of rules that are doing nothing for neighbourhood safety.' She added there was a danger of 'losing the momentum' in tackling red tape and targets since a report into slashing bureaucracy by Sir Ronnie Flanagan, the Chief Inspector of Constabulary, was published earlier this year.

Mr Baggott's comments follow a damning report by the Civitas thinktank warning that the middle classes have lost confidence in the police. The study found responses to crimes such as burglary were slow and statements given by victims of serious crime were often left lying idle for months.

Last month, it emerged that complaints against police officers in England and Wales had risen to record levels. Accord to the Independent Police Complaints Commission there were 48,280 complaints in the year to March, up five per cent on the previous year and the highest total since independent investigations began more than 20 years ago. Most of the complaints concerned alleged failures to investigate or record crimes properly.


The desperate British medical bureaucracy

Family doctors paid bonuses to NOT send you to hospital. It could cause you to have an avoidable amputation but who cares?

GPs are to be paid cash bonuses in return for not sending patients to hospital, raising concerns that financial gain will be put before patients' needs. Doctors' practices stand to earn thousands of pounds extra under the initiative, already said to have been adopted by health authorities across the country. In a variety of schemes, which differ from region to region, GPs are said to have been offered unprecedented cash incentives for deciding not to refer a patient for specialist treatment. Surgeries are given a target of how many patients they should refer to hospital each year and will receive a windfall payment if they meet the quota. Conversely, the money is lost if the surgery sends more patients to hospital than allowed for under the health authority target.

The Mail on Sunday has established that in Oxfordshire each surgery will be given a target of how many patients it should refer to hospital every year. If it meets those quotas, it will be eligible for a bonus payment of up to $20,000. GPs in the region will be paid a similar amount to set aside additional time to review decisions on whether patients should be given hospital appointments. It was reported last night that under another local scheme, doctors in Torbay in Devon could make $120 for every patient not referred. Practices in London, Essex and Wiltshire were said to be in line for $9 for every patient on their list if they meet targets which include a curb on the number of referrals.

The bonus money will be paid into the coffers of GPs' practices, from which they draw their income, giving clinicians for the first time a direct financial incentive to refuse further treatment to patients.

The initiative will cause deep unease, even among doctors who could profit from it. Commenting on the Oxfordshire scheme, Dr Laurence Buckman, chairman of the British Medical Association's GP Committee, told The Mail on Sunday it was `morally dubious, ethically disturbing and quite wrong'.

The schemes are seen as an attempt by NHS managers to direct patients away from the overloaded hospital system towards cheaper health workers, such as physiotherapists. But Stephen Cannon, a consultant surgeon at the Royal National Orthopaedic Hospital, said last night that potentially fatal tumours had already gone undiagnosed because of the scheme.

He said: `I recently encountered two cases in which patients referred to physiotherapists later turned out to have a malignant tumour. In one, a young man was referred to a physiotherapist because of sudden knee pain. Had he come to a specialist the symptoms should have been recognised and he should have been urgently referred to an oncologist. In this case, after the delays, the outcome was amputation. It was devastating for the patient and his family.' ....

Dr Buckman said: `The idea that we should pay doctors to behave in a particular way is worrying. There is a huge difference between paying GPs to increase vaccination levels - which is public health policy and therefore perfectly reasonable - and rewarding them for not referring a patient. `Many patients are referred for further investigation rather than treatment and it would be incredibly dangerous if these patients failed to get hospital appointments simply because GPs decided they weren't sure if a referral was strictly necessary. `The reason for a rise in referrals is very complicated and this isn't the way to deal with it. We should be trying to understand the reason for the referrals.'

Oxfordshire Primary Care Trust insisted it is not paying GPs not to refer but to review their practices, and that every patient who needs to be referred to hospital will get an appointment. Alan Webb, director of commissioning, said the Trust hoped the savings made would go back into patient care.


Immigration to Britain continues unabated amid financial crisis

The growth of immigrant workers holding jobs in Britain has not been halted by the economic slowdown, according to official figures

The number of foreign workers rose by 10,000 between April and June according to the Department for Work and Pensions, despite a fall in the total UK workforce of 15,000 over the same period. The rise took place despite a new points-based immigration system, introduced at the beginning of March, which was supposed to make it harder for foreign nationals from outside the EU to obtain work permits. More than half of foreign workers have been given permission from the government because they are from outside the EU.

Tory MP James Clappison, a member of the Commons home affairs committee, said: "This is in no small part down to Labour's work permit policy."

A Home Office spokesman said: "Government and independent research continues to find no significant evidence of negative employment effects from migration. "The points system, plus our plans for newcomers to earn their citizenship, will reduce overall numbers of economic migrants and the numbers awarded permanent settlement. "It also ensures British jobseekers get the first crack of the whip and only those foreign workers we need - and no more - will be able to come to the UK."

The figures emerged as former minister Frank Field highlighted the issue in the House of Commons, claiming more than 20,000 new National Insurance numbers were issued to foreign nationals last year in the London borough housing the 2012 Olympic Village. He said: "When is the Government going to try and deliver on the Prime Minister's promise of British jobs for British workers?"


New drug raises hope of reversing multiple sclerosis in early stages

Sounds good. Might work on Alzheimers too

A step change in the treatment of multiple sclerosis is heralded today by the first study to suggest that a drug can stop the disease in its tracks and even reverse its progress. A trial of the medicine, known as alemtuzumab, has found that it offers benefits that are “better by a country mile” than other treatments for MS, and that it is effective for a much wider cross-section of patients.

The results offer hope that thousands of people who suffer from MS will eventually be able to control the condition, which causes nerve damage, loss of mobility, blindness and cognitive decline.

Scientists cautioned, however, that alemtuzumab will not be available outside clinical trials for about five years, and that it is suitable only for patients with early-phase MS. Those in whom the disease has already been diagnosed are unlikely to benefit.

When people with early-stage MS were treated with alemtuzumab, their condition improved significantly more than those on beta interferon, the best treatment available now, across three standard clinical indicators.

The drug reduced the number of MS attacks by 74 per cent, and the progression of disability by 71 per cent, when compared with beta interferon. Patients on alemtuzumab also showed recovery of brain function, so that they were less disabled at the end of the three-year study than at the beginning, while those on beta interferon continued to decline. Almost every patient taking alemtuzumab improved, whereas about half of MS patients show no response to beta interferon.

Scientists behind the research said that if the findings were repeated in a larger sample it would promise a revolution in MS care within five years, though only for patients who had yet to develop much nerve damage. “It is a landmark, a step change,” said Alistair Compston, Professor of Neurology at the University of Cambridge, who led the study. “It is more effective than beta interferon by a country mile, and the efficacy is so high that we hope it will represent the definitive treatment if used in the right people.”

Alasdair Coles, another member of the team, said: “It is our view that alemtuzumab offers the most effective treatment for relapsing-remitting multiple sclerosis described to date. The ability of an MS drug to promote brain repair is unprecedented. We are witnessing a drug which, if given early enough, might effectively stop the advancement of the disease and also restore lost function by promoting repair of damaged brain tissue.”

The study, which is published in The New England Journal of Medicine, was a phase 2 trial, conducted on 334 patients as the first test of the drug's efficacy. Two phase 3 trials, of 600 and 1,200 patients, are now under way and positive reports will be needed from these before it can be licensed. Alemtuzumab was also shown to have some potentially serious side-effects, which means that patients who take it will have to be monitored by their doctors. One patient taking the drug died of a brain haemorrhage after developing an autoimmune condition that destroys a clotting agent in the blood, and two others were successfully treated for the same disorder.

Lee Dunster, head of research at the MS Society, said that the charity was delighted at the results. “This news will rightly bring hope to people living with the condition day in, day out.”


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