Monday, December 15, 2008

Gross incompetence: NHS hospitals forced to close wards as winter bug spreads

They can't even handle a predictable flu outbreak

Hospitals are facing a winter crisis as a sharp rise in cases of flu and other viruses forces some to close wards to new patients. Several hospitals are already struggling to cope with a sudden rise in admissions and the spread of a virulent winter vomiting bug. Figures from NHS Direct's telephone help line show that the number of calls about colds, flu, coughs and fever has trebled in the past three months.

The figure tends to rise as winter draws in, but in the same period last year the increase was only two-fold, not three-fold. NHS Direct received 10,512 calls between September and December this year, compared to 3,435 calls for the previous three months, while more than 25,000 people have visited NHS Direct's flu symptom checker website.

The vomiting bug norovirus - the most common gastrointestinal illness in the UK, affecting up to a million people every year - is causing particular problems, with NHS chiefs forced to warn sufferers to stay away from doctors' surgeries and hospitals for fear of spreading it further. Affected hospitals include Addenbrooke's in Cambridge, Norfolk and Norwich Hospital, Worcestershire Royal Hospital and York Hospital. Several trusts said the knock-on effect was making it difficult to meet the Government's target of admitting, or dealing with, 98 per cent of emergency patients within four hours.

One of London's three major trauma centres, St George's in Tooting, was issued a 'black alert' and closed its doors to emergencies for a number of hours on Monday after experiencing a 14 per cent surge in demand compared to the same period last year. Staff at St George's reported that up to 20 patients requiring urgent admission had to be kept on beds in A&E as wards were full. Some were diverted to neighbouring hospitals, including Mayday in Croydon, Kingston Hospital and St Helier in Sutton, all of which reported pressure on their own capacity.

The Royal Devon & Exeter Hospital closed its doors to all visitors last week after 12 of its 49 wards were infected, forcing it to postpone about 60 non-urgent operations. It faced extra pressure from emergency admissions caused by falls on ice, with nearly 100 people going into the emergency department with ice-related injuries on Monday alone.

In Carlisle, two elderly care wards at the Cumberland Infirmary were closed last week in a bid to isolate the norovirus bug. Nearby Wigton cottage hospital was closed to all admissions and non-emergency transfers for the second time in a fortnight.

Two wards at East Surrey Hospital closed, while five at the Queen Elizabeth Hospital in King's Lynn were shut or under observation.

At the University Hospital of North Staffordshire, six wards were closed, reducing the number of beds available to patients by 130. Sarah Byrom, the chief nurse, said: "While norovirus is common for this time of year, we have seen a big increase in the number of people coming into the hospital with symptoms."

Affected wards can usually be reopened after a few days, following routine disinfecting. But campaigners claim that cuts in bed capacity have left hospitals ill-equipped to cope with seasonal flu, accidents and respiratory complaints at the same time as having to close wards to cope with norovirus. Geoff Martin, head of campaigns at Health Emergency, called the situation at St George's "deeply worrying" and said: "We are calling on the Government to make cash available to open additional beds and draft in extra staff to cope with the growing crisis on the wards."

Norman Lamb MP, Liberal Democrat spokesman for health, said too many hospitals where operating at 90 to 95 per cent capacity, despite experts recommending no higher than 85 per cent in order to allow hospitals to cope with a sudden influx of patients or an emergency. He said: "There is a minority of hospitals around the country already operating under impossible pressure and when you add to that winter viruses such as norovirus you get a crisis. It has an impossible impact on staff, putting them under enormous strain, and it clearly affects patient care."

A spokesman for the Department of Health said: "Winter crises used to bedevil the NHS. Thanks to record investment and better organisation we have not had a major winter crisis for several years. However, we constantly update our contingency plans in the light of events." [Translation: Reality does not exist]


Porkie pies about the dioxin threat

The recall of Irish pork products exposes the opportunism and hysteria of Ireland and Britain's food standards bodies. ("Pork pies" is Cockney rhyming slang for "lies")

If there's no problem that panicked authorities cannot turn into a crisis, then there's no crisis that indecision cannot exacerbate. So it was on Saturday afternoon that the Food Safety Authority of Ireland (FSAI) discovered it had just such a problem on its hands. Dioxins - the synthesis of chlorinated organic compounds formed, in this case, as a by-product of a manufacturing process - had been found at 80 to 200 times the safe `maximum level' in Irish pork products. This sounds a lot, but, as countless experts have stated, the risk to the public is virtually nil. Not only that, the culprit - an oil used by a particular animal feed producer in a machine used to dry animal feed - affected just 49 out of the Irish Republic's 400 pig farms. And of the nine linked in Northern Ireland, none currently, it has since emerged, have any pigs.

Such facts were not about to inhibit the FSAI, however. Any pork product, it decided - be it bacon, ham, sausages, white pudding or certain pizzas produced since 1 September - was to be recalled and destroyed. Whatever the response lacked in good sense it more than made up for in haste. And with the cost to the Republic's pig industry likely to be in the region of _100million, it is a decision that is likely to have a disastrous effect on Ireland's already ailing pig industry.

The response of the Food Standards Agency in the UK - a country that is the biggest single importer of Irish pork, taking around 68,000 tonnes a year - has been far more ambiguous. Its knee has certainly jerked with the same alacrity as its Irish counterpart: `The FSA is currently advising consumers not to eat pork, or products where pork is the main ingredient, that are labelled as being from the Irish Republic or Northern Ireland.' (1) But despite that message, it has taken no action, leaving it to the supermarkets themselves to decide whether to keep Irish pork produce on the shelves. So while the FSA echoes FSAI's fears, it then shirks all responsibility.

The result has been sheer confusion. Newspapers have been quick to follow the authorities' panic-stricken suit. `Deadly contaminant found in Irish pork', said The Times. `Shoppers told: don't eat toxic Irish pork', informed the Daily Mail. If bald statements such as these weren't frightening enough, the Guardian went a step further by helpfully highlighting the most famous individual case of dioxin poisoning: `The scarred face of Ukranian president Viktor Yushchenko.' (2) The implication seems to be that everyone is but a string of Irish sausages away from a complexion like the surface of the moon.

But while some sections of the press have been more than happy to stoke toxic nightmares, the FSA's unwillingness to do anything drastic betrays its underlying reticence about the reality of the risks posed. So just last night, Tesco announced that it will continue stocking Irish and Northern Irish pork products regardless of the FSA's advice to consumers. This is not surprising given the FSA's own scientific experts have been at pains to emphasise just how negligible is the health risk. Professor Alan Boobis, a toxicologist at Imperial College London and an adviser to the FSA, said: `Even the levels detected in these pigs are extremely low and present no immediate cause for concern.' (3)

So just what is the health risk? The key thing to emphasise here is that the risk posed depends above all on long-term exposure. Dioxins, getting into our system through our food, are stored in body fat, and, with only a small percentage of this excreted each day, the amount gradually builds up over many, many years. The Tolerable Daily Intake, according to which the maximum level of dioxins is determined, is calculated in terms of the amount of a dioxin that experts recommend can be eaten every day over a whole lifetime without causing harm. Or as Alan Reilly of the FSAI put it, `you'd have to be eating these products containing these levels for 40 years before you'd show any signs of illness' (4). And when you take into account that the average British citizen's dioxin intake has fallen by 85 per cent since 1982, the difference some relatively dioxin-heavy pork will make right now is tiny (5).

It is unhelpful, then, that instead of keeping their heads when the FSAI were culling theirs, the FSA decided it was best to appear similarly vigilant. Far from calming anxieties, the FSA's back-covering advice merely heightened them. And if FSA officials thought the precautionary pose would appease those, like Labour MP Michael Meacher, who are intent on waging war against anything that looks like a chemical in the food chain, their inaction just confirms the food-safety zealots' worst suspicions (6). But that is what happens when you foster a climate in which porkies about Irish pork can appear perfectly plausible.


Turn the heat on a cold: Warmed-up fruit cordial really does ease your sniffles

Granny was right. A nice hot fruit drink really can help you overcome the misery of colds, claim researchers. It turns out the tender loving care traditionally dispensed to relieve sniffles and sore throats has its basis in science. A steaming mug of fruit cordial not only tastes nice but actually helps reduce the symptoms of common colds and flu, compared with a cooler drink.

The common cold strikes 930,000 Britons, on average, on any day in winter, with levels of sickness already starting to climb rapidly as Christmas approaches. Experts at Cardiff University's Common Cold Centre carried out what they believe is the first scientific research of its kind into non-medical remedies. They compared the effects of a commercially produced apple and blackcurrant cordial drunk either hot or at room temperature by 30 volunteers with common cold symptoms. And they found that the hot version provided 'immediate and sustained relief from symptoms of runny nose, cough, sneezing, sore throat, chilliness and tiredness'.

The study was published in the December edition of the clinical journal Rhinology. Centre director Professor Ron Eccles said: 'With temperatures falling, cold viruses love this time of year. A bottle of fruit cordial in the cupboard could help fight off the symptoms. The big advantage of this type of treatment is that it is cheap as well as safe and effective.' He said the advantage of hot fluids is a soothing effect.

Little research has been carried out into 'old wives' remedies' for colds, but research last year showed the herbal remedy echinacea is effective. Taking supplements of the plant also known as purple coneflower cut the chances of catching a cold by more than half and when used as a treatment reduced the length of a cold by one and a half days on average, according to the journal Lancet Infectious Diseases. Zinc lozenges can also help shorten the duration of symptoms, says the Common Cold Centre, but most people will not benefit from large doses of vitamin C to ward off colds.

Professor Eccles said it was worth trying to reduce the impact of a cold by eating more fresh fruit and vegetables, taking exercise and smiling to cut stress levels.


Class hatred at Stansted Airport

Posh Plane Stupid insists that it is not picking on poor people. So why is it so madly obsessed with cheap flights?

The contrast between the protesters at Stansted Airport and the people who were delayed by their protest could not have been more stark. On one side there were the well-to-do moaners of Plane Stupid, a campaign group that counts the grandson of a peer, the granddaughter of a baronet, and numerous privately educated young people amongst its most visible cadre. On the other side, the `cheap flyers' hoping to fly abroad from an airport that specialises in no-frills flights, and which has been labelled by snooty observers as Britain's `chief chav airport' because its main airlines include Ryanair and easyJet (1). On one side, eco-elitists; on the other, everyday holidaymakers.

The protest - which forced Stansted to close for five hours and delayed more than 50 flights - provided a striking snapshot of the snobbish, masses-attacking streak in environmentalism. Plane Stupid and other anti-flying groups insist that they're not only concerned with `poor people' who take `cheap flights'; in response to an article I wrote in 2007, Joss Garman, the founder of Plane Stupid, said `cheap flights haven't made it easier for poorer people to travel for the first time; they've just made it easier for the wealthy to travel more often'. So, he said, laying into cheap flights is actually a way of laying into `the privileged' (2). Yet no amount of fact-twisting can disguise the fact that, again and again, the eco-worthies of the anti-flying lobby are drawn towards attacking and delaying those flights taken by the lowest-income communities; by `cheap people'. Why?

It is no accident that the Plane Stupid protesters chose Stansted for their biggest demo yet. They said their aim was to `draw attention to CO2 emissions from the aviation industry'. Yet Stansted, being the smallest of London's major airports, does not emit nearly as much CO2 as a Heathrow or a Gatwick. In Heathrow there are 481,476 aircraft movements a year, and 68million passengers. Gatwick has 266,550 aircraft movements a year, and 35million passengers. Stansted comes a low third, with 208,462 aircraft movements a year and 24million passengers (the New Labour government has now given the go-ahead for the expansion of passenger numbers at Stansted). Even Manchester Airport, far away from the Big Three airports in London, has more annual aircraft movements than Stansted: 222,703 (3).

The Plane Stupid protesters targeted Stansted not because it is particularly polluting, but because it is the home of that apparently most reckless and pointless and destructive form of flying: the no-frills variety. Stansted is, as one website puts it, the `hub for Europe's low-cost carriers' (4). Ryanair, the bete noire of anti-flying groups, flies to 109 destinations from Stansted; easyJet flies to 23. It is not surprising that Ryanair, which is described by Plane Stupid as `Lying-Air', its Irish bosses mocked by the well-to-do, well-educated anti-flying activists for not attending university and being `clearly very stupid' (5), suffered most as a result of yesterday's protest: it had to cancel 52 flights. And because it is the least frilliest airline of all, its stranded passengers were not offered hotel or meal vouchers; they squeezed themselves into uncomfortable chairs and tried to get some shut-eye as their better-educated peers on the runway kept Stansted in shutdown.

Indeed, Stansted is a gleaming symbol of the opening up of flight to lower-income communities. Stansted has been used as a commercial airport since 1966, but its business has grown exponentially over the past 10 years as a direct result of the rise and rise of low-cost airlines. As one government report says, `Stansted has grown very rapidly in recent years, particularly in the leisure market'. In 1998, Stansted was handling seven million passengers a year; in 2003, that rose to 19million passengers; today it handles 24million passengers. This `rapid expansion of passenger numbers' has come `on the back of the boom in low cost air travel' (6). If the growth of Heathrow and Gatwick in the 1960s and 70s spoke to the expansion of air travel for the middle classes, then the growth of Stansted since the 1990s is a result of the expansion of air travel even to the lower middle classes, working-class families, young single people, and others. This is the main reason why Stansted, more than any other British airport, riles the anti-flying lobby: because it symbolises the expansion of flight to nearly all members of British society.

Largely in response to spiked's critique of their eco-misanthropy, and of their seemingly unshakeable focus on `cheap flights', the anti-flying lobby argues that targeting Stansted and Ryanair is not about targeting `poorer people'. `The average income of people using Stansted Airport is 47,000 pounds per year - and it's supposed to be a budget airport!' scoffs Plane Stupid. In an article attacking me for being a Gap jacket-wearing Marxist (the Gap? Oh please.), Joss Garman added a few extra thousand quid to this estimate, arguing that `the Civil Aviation Authority's own data shows that the average person flying in or out of Stansted, a budget airport, earns in excess of 50k' (7).

These bandied-about figures are highly disingenuous. The CAA did not find that the `average person' who uses Stansted earns 50,000 a year - it found that the average household income of people who use Stansted as leisure passengers is 47,000 a year. This includes the earnings of everyone living in a single household before it is taxed and squeezed by various other outgoings. This hardly makes them wealthy, and certainly not part of `the privileged'. They could not, for example, afford to send their children to schools such as Westminster (26,000 a year), as attended by leading Plane Stupid activist Tamsin Omond, or Godolphin and Latymer (15,000 a year), as attended by Plane Stupid's spokesperson on yesterday's demo, Lily Kember. [Two posh protesters in the pic below. Kember on the right]

In their rush to mock the supposedly `privileged' people who take cheap flights from Stansted, Plane Stupid neglects to point out that, according to the CAA's figures, the average household income of 47,000 at Stansted is the lowest for London's major airports. At London City airport, the average household income of leisure passengers is 78,000 a year; at Heathrow it is 58,000; at Gatwick it is 54,000; and at Luton it is 48,000 (9). So, no, those who take cheap flights from Stansted are not `poor' (what the aloof, ivory-tower activists of Plane Stupid fail to realise is that most working-class families, while far less well-off than the public-school crowd, are not `poor' in absolute terms; they frequently earn fairly decent wages, would never define themselves as `poverty-stricken', and like to spend their disposable income on enjoyable things); however, in terms of average household income, Stansted is the `poorest' of London's major airports. However much Plane Stupid tries to comfort itself with the delusion that it is attacking `the privileged', in truth it continually targets the least wealthy of Britain's flyers.

Again and again, almost despite themselves, despite their defensiveness about coming across as wealthy snobs - the real privileged - attacking those chavs and slags who fly abroad on the cheap, Plane Stupid and its supporters return to the `scandal' of cheap flights. They cannot help themselves. It really is cheap flights that they find most foul and offensive. Before yesterday's closure of Britain's `chief chav airport', Plane Stupid forced the HQ of easyJet in London to shut down, on the basis that `binge-flying' - a phrase that sounds deliciously like `binge-drinking', that other famous pastime of `cheap people' - is `choking the planet to death' (10).

Plane Stupid has also spent thousands of pounds taking out a newspaper ad attacking Ryanair; it was a spoof advert with Ryanair boss Michael O'Leary saying: `Let's beat the climate to death. Book Ryanair today to ensure a real climate disaster.' (11) The dripping snobbery of Plane Stupid's campaign comes through in its attacks on the kind of uncultured oiks who take Ryanair and easyJet flights from Stansted: `There's been an enormous growth in binge-flying with the proliferation of stag and hen nights to Eastern European destinations chosen not for their architecture or culture but because people can fly there for 99p and get loaded for a tenner.' (12)

When you consider that aviation contributes only five per cent to Britain's total carbon emissions, and that a tiny proportion of that five per cent is caused by Ryanair, easyJet or Stansted itself, it becomes clear that there is something seriously skewed about Plane Stupid's focus on cheap flights. This is not about reining in CO2 per se; it's about reining in the slovenly, destructive behaviour of the lower orders. The shutting down of Stansted and the relentless attacks on Ryanair and easyJet are driven by the most pernicious snobbery, by a view of `cheap flyers' as ultimately destructive, noxious, wanton and foul. These posh activisits, descended from baronets, lords, inventors and aristocrats (13), are keeping up a long tradition in which `mass tourism' has attracted the `class-contempt of killjoys who conceived themselves superior by reason of intellect, education, curiosity and spirit' (14). What we saw at Stansted yesterday was not remotely radical or edgy - it was unabashed, undiluted, unattractive class hatred.


Global cooling hits Britain

Raw Arctic winds have left Britain shivering in its coldest start to winter for three decades. According to the Met Office, the average temperature for the first third of December has been 1.7C (35F), well down on the long-term average for this time of 4.7C (40.5F). The bitter cold is a rude reminder of what winter used to be like and in stark contrast to the recent run of remarkably mild winters, when trees hung on to their leaves well into December and frogs were seen spawning in ponds. An early taste of winter came with the freakish snows of October, and this month could prove to be the worst month of the year for underpar temperatures. The last time that the country suffered such an outrageous early winter bout of cold was in December 1976, when the average temperature was a bonechilling 0.8C (33.4F).

Much of the driving force behind this recent cold is the jetstream, a ribbon of winds a few miles high that blow eastwards around the globe and are generated by a battle between Arctic air col-liding with warm subtropical air. Because the jetstream has swung south around the UK, it has left the country under a mass of frigid air.This pattern has been locked in for some time, and although there will be some respite this weekend, with an intrusion of milder, wetter Atlantic air, the cold is expected to return next week. The jetstream is believed to be behaving like this because of events thousands of miles away, in the Pacific Ocean. For more than two years, the tropical waters of the Pacific have turned unusually cool, a phenomenon called La Ni¤a. This has upset the pressure systems across the Pacific and knocked the jetstream off course.

Like a wave rolling around the world, the jetstream was shunted farther south than usual around Britain. This gave us the past two soaking-wet summers. The same jetstream pattern tends to produce a cold, dry start to the winter but ends much milder and wetter in late winter and early spring. Hence the Met Office is sticking by its seasonal forecast, which predicted the cold start to the winter, followed by milder conditions during January and February, although interspersed with cold snaps at times. And for the past two years its winter long-range forecasts have proved correct.

"This has been an unusually long episode of La Nina, and could last well into spring," Adam Scaife, of the Met Office, explained. "It pushes the probabilities towards a drier, colder early winter and a warmer, wetter end to winter - but can't guarantee it because all these signals can be outweighed by atmospheric chaos." In other words, the day-to-day weather throughout winter can still blow hot and cold.


Road congestion scheme knocked on the head

It was the "Green" alternative to road improvement. It had already failed in London

Road pricing, the Government's favoured policy for dealing with congestion, has been roundly rejected in a referendum in Manchester. There now appears little chance of any pay-as-you-drive schemes being introduced for the next decade at least. Manchester's proposal for peak-time tolls of up to 5 pounds a day was defeated by 4 to 1. The scheme was rejected in separate votes held in all ten Greater Manchester boroughs. Just over a million people voted, 53 per cent of the 1.9 million balloted. Electors were not persuaded by the promise of 1.5 billion of government money for public transport and 10,000 extra jobs.

The result is undoubtedly a severe embarrassment for the Government, which has created a 2 billion Transport Innovation Fund to reward councils that introduce pricing schemes to reduce congestion. The Department for Transport said last night that the rules of the fund would remain. They state that any council bidding for a share of the fund would have to introduce a form of "demand management", such as congestion charging or a levy on workplace parking spaces. Other authorities that had been considering charging schemes distanced themselves from the policy after hearing the Manchester result.

Andrew Carter, leader of Leeds City Council, said: "We are doing a survey but we are a million miles from having any recommendations. I don't like the blackmail and the bullying. The Government must rethink its policy of making the funding conditional on demand management."

Cambridgeshire County Council, which has proposed a charge of up to 5 pounds to drive into Cambridge in the morning at peak times, also retreated.Matt Bradney, the council's cabinet member for infrastructure, said: "Now that congestion charging has been proven so unpopular, we think the Government should not be putting the handcuffs on us. We are urging it to change the rules of the fund." The West of England Partnership, representing four councils in the Bristol area, said it was still considering a charging scheme but the Manchester result "highlights certain challenges we might have".

Labour politicians in Manchester, working closely with the DfT, had tried everything they could to make the congestion charge attractive to the majority. Charging would not have started until 2013, by which time 80 per cent of the public transport improvements would have been completed. There would have been discounts for the low-paid and exemptions for areas that would have to wait longer for improved public transport. Only one in ten people would have paid the charge and no drivers would have been affected in two thirds of households. A spokesman for the "yes" campaign blamed the downturn in the economy for the strength of the "no" vote. "People were not willing to embrace an additional charge when they were worried about their jobs," he said, "even though only a small minority would have paid."


Mediocre teachers + jargon = low standards

Huge numbers of British 11-year-olds can't read, write or do basic sums. The latest curriculum rehash will not help in the least

But what about the teachers? I feel like the child who had to point out that the emperor isn't wearing any clothes. What we got this week, from the Government's primary schools adviser, was a rehashed curriculum in fine new garb, and a rather verbose way of setting out what good teachers do already - but not a word about what really matters: the quality of the teachers.

Sir Jim Rose's report is a tragic missed opportunity. If this is the limit of ministers' ambition for primary schools then they might as well go home early, clutching those little prizes which schools award the slower pupils for "effort". There certainly won't be any progress. Sir Jim is in danger of giving bad and mediocre teachers even more jargon and curricular complexity to hide behind. The Independent Review of the Primary Curriculum is itself smothered in it. Sir Jim sums up his ideas: "The report explores a curriculum design based on a clear set of culturally derived aims and values, which promote challenging subject teaching alongside equally challenging cross-curricular studies." You what?

This sort of jargon filters down through teachers to the classroom, with lessons wrapped in equally incomprehensible verbiage. "Are we doing reading now?" I asked one primary school teacher recently. "Oh no", she replied, "this isn't reading - this is literacy." Er...

There is something wrong with the teaching profession. Not all of it, but some of it - and presumably the part that curriculum reviews are intended to reach. The teachers have turned insular and defensive; even their language has become alien. It's as if they inhabit a different world.

So spelling isn't spelling any more (there is but one mention of "spelling" in Sir Jim's 73-page report): it has become "decoding" and "encoding". Is it really necessary for an educational adviser to write out the following: "Children may know how to decode and encode print but must then apply that knowledge and skill to understanding the words on the page." You mean, children should be taught to read, sir? Good teachers - even barely competent teachers - do not need to be told that. Good teachers will already apply the best of the ideas in Sir Jim's report, while good schools will do some of what he recommends already, such as using specialised teachers in certain subjects. Good teachers do not hide behind jargon.

The problem is with the bad schools and the bad teachers, who rigorously apply the rules handed down by ministers and officials to groups of baffled children. Like the chilling Ofsted official who described Baby P as a collection of data last week, they can talk the strange talk, but they cannot walk the walk.

So children unable to write their alphabet sit in circles parroting the definitions of "phoneme" and "grapheme": "sound" and "letter" to you and me. "It's in the curriculum," shrugs a teacher. "Silly, isn't it?"

Incompetent teachers, or those lacking in confidence, and afraid of the authorities, stick rigidly to any script they are given, carefully ticking all the little boxes. And Sir Jim is about to hand them quite a script. Take the idea of a "theme" uniting all the primary subjects. This could be done well, so that a Second World War theme for the term incorporates European geography as well as a spot of French, and the mathematics of how many planes in a squadron returned if seven were shot down - that sort of thing. But it could be done badly, like the early-years teacher I saw writing down "a" for "aeroplane" in a child's first reading lesson - "because the theme this term is travel".

It's all very well trying to make the curriculum "relevant" but the fundamental purpose of education must be that the basic building blocks are taught well first. "Relevance" can crowd out education. Take mathematics: Sir Jim issues a familiar warning that children are not being taught how to apply their mathematics skills to the real world. Teachers have heard this complaint many times before. So keen are they to listen that many have overcorrected, asking a child, for instance, how he would hand out 12 chocolate bars among four children, but not teaching him that 12 divided by 4 is 3.

"What is that?" a six-year-old asked me the other day, pointing to a minus sign. He knew how to "count back two from five" (although he couldn't read the words; they had to be read to him) but he was unable to decipher 5 - 2 = 3. A seven-year-old state school child taking a maths exam for private school entry asked his mother of the multiplication questions: "Why were there kisses all over the paper?"

There will be many teachers who insist this does not matter; that children are picking up the concepts or themes, or developing understanding, or some such. But it does matter. So hard are educationists trying to keep the attention of every child with "varied and matched learning", to use some more jargon, that education has become frighteningly dumbed down. Middle-class flight from state schools is directly attributable to this happy-clappy, thematic, lowest-common-denominator, "entire planned learning experience" approach. Some kids enjoy learning times tables.

Listen to this terrifying sentence in the Rose report: "The teacher who once said: `If children leave my school and can't paint, that's a pity but if they leave and can't read, that's a disaster' was perhaps exaggerating to make a point." Exaggerating? It's appalling that the man reviewing the primary curriculum considers that an exaggeration.

Children are leaving primary schools unable to read and write and do basic sums - a fifth failed English this year, a fifth maths and almost four in ten failed in combined reading, writing and arithmetic - and they tip into the secondary system already five years behind their peers, too late for many ever to catch up. It is absolutely essential to get this right. Yet nowhere in Sir Jim's report (because it wasn't in his remit drawn up by the Schools Secretary Ed Balls) is there anything about improving the quality of teachers.

A McKinsey study last year, conducted by Tony Blair's former policy adviser Sir Michael Barber, examined school systems around the world to see what made the difference in the best. The absolutely key element, beyond new buildings and class sizes, the curriculum or the structure of the system, was the quality of teachers. Yet Britain is still stuck in a rule-bound, jobs-for-life education system that rewards laziness and mediocrity as highly as real talent and drive. The gulf between the public and private sectors gets wider and wider. Sir Jim is in danger of pulling up the drawbridge.


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