Proper sentences

Everyone knows Guido is campaigning for a return of the death penalty.

We petition the government to review all treaties and international commitments which may inhibit the ability of Parliament to restore capital punishment. Following this review, the Ministry of Justice should map out the necessary legislative steps which will be required to restore the death penalty for the murder of children and police officers when killed in the line of duty.

The findings of the review and the necessary substantive legislation to be presented to House of Commons for debate no later than 12 months after this petition passes the acceptance threshold.

But of course many sentences are too lenient.

For instance, Inspector Gadget writes about a tragic family. One male involved

In 2004 ... broke a Met policewoman’s jaw and received a suspended sentence.

This just isn't good enough.

Sylvia Knight and Boston's Pilgrim Hospital

About 100 student nurses have been removed from Boston's Pilgrim Hospital after the Nursing and Midwifery Council expressed "serious concerns" about it.

Sylvia Knight, director of nursing and patient services at United Lincolnshire Hospitals Trust (which runs the hospital), said

We are seeking further clarification from the NMC regarding the reason for their actions.

If she truly, really doesn't know, maybe should read the local Boston paper, which quotes Prof Patrick Callaghan, Director of Research in the School of Nursing, Midwifery and Physiotherapy:

Yesterday I took an urgent call from the Nursing and Midwifery Council requesting the urgent withdrawal of students on the basis of serious concerns which had been raised by the Care Quality Commission.

Our primary concern is for the quality of the students’ learning and welfare and concerns were raised so that is why we took the action we have to safeguard the quality of learning.

That seems clear enough. If Sylvia Knight doesn't get that, just maybe she's not the right person to sort out the hospital's problems.

Indeed, it's not going well. The CQC had ordered the trust to make improvements after an inspection in February. However, in June it voiced dissatisfaction with the progress the trust had made, and was dissatisfied with its ability to identify and address problems.

The CQC is also working with the police and local authority over “several” safeguarding investigations currently under way, relating to allegations of abuse and neglect at the trust.

You simply shouldn't train nurses in an unsatisfactory hospital. So what's the mystery?

I suppose the problem for Sylvia Knight is that it brings her failing back into sharp, public focus. For the CQC report was pretty damning. In summary

We found that Pilgrim Hospital was not meeting one or more essential standards. We have taken enforcement action against the provider to protect the safety and welfare of people who use this service.

And last month the CQC reported that

Following an inspection in February, CQC ordered the trust to make improvements. However, the Commission was not satisfied with the speed with which the trust responded, or with the trust’s ability to proactively identify and address problems.

In addition, there are currently several safeguarding investigations in progress relating to abuse and neglect allegations at the trust. CQC is working closely with the police and local authority with regard to these.

As a result of all of these issues CQC is now investigating what systems and procedures are in place at the trust to ensure people are protected against the risk of inappropriate or unsafe care and treatment.

Certainly not the sort of environment for training our future nurses in.

So is Sylvia Knight trying to muddy the waters to hide the continuing incompetence? Or is she just too stupid to get it?

Disengaging from the EU

Doubtless much to the scorn of the eurosceptic blogging community, John Redwood has posted an interesting proposal (worth reading in full) about disengaging from the EU.

The simplest way to fix the problems in the UK’s relationship with the EU would be to restore a modified UK veto over all matters. The new veto would allow us to say No to to any law or proposal emanting from Brussels, but would not allow us to stop them doing it for themselves without us. This would take much of the pressure out of the situation.

Then we could disengage gradually from EU measures we didn't like, and the EU could move forward to closer integration if it chose.

Of course this would require strategic direction, which our present excuse for a government doesn't have.

Meanwhile, Cyprus has suddenly popped up as the latest eurozone problem economy flagged as having problems. Where did that come from? Well, it seems their banks have - surprise, surprise - a lot of Greek debt. And wouldn't you know it, growth in this club med country has slumped to zero.

Amusingly, no sooner is Madame Lagarde installed at the IMF than it warns France it could be stripped of its high credit rating without ‘more efforts’ to tackle its debts. Sarko will be delighted.

But it seems a bit rich of the media to highlight the likelihood that Italy will show little or no growth this quarter. What was ours again? Oh yes, 0.2%. And our government is front-loading tax rises while back-loading spending cuts.

Augurs well, doesn't it. Good to know we have firm strategic direction.

Vince flops

Vince Cable wants applause for abolishing what he describes as ridiculous business regulations.

You get no kudos for abolishing silly, trivial regulations which it would have been easy to dump years ago.

Business groups met the announcement with scepticism, calling on the Government to tackle the bigger regulatory burdens rather than tinkering with less important rules.

One said

It is evident that hefty regulatory changes in pensions, flexible working and maternity and paternity are still going to hit small firms hard.

Some of these regulation cuts being announced today will have no tangible impact on small firms at all as they are outdated and unused anyway.

That's exactly it. The smug Cable wants credit for doing something trivial, while other measures are making business regulation more burdensome.

Do ministers really believe this announcement makes a significant difference to business - a worrying misunderstanding? Or is this guff announcement pure cynicism?

Anyway, from the tone of their puffery it seems this is the best they can do. Which makes them deregulation failures.

Fortress NHS again

Sky News has a jaw-dropping story about secrecy in dealing with disciplining of paramedics:

An NHS trust has apologised after a Sky News investigation uncovered a culture of secrecy surrounding incompetent paramedics.

The North East Ambulance Trust was accused of criminal behaviour by a widow for "hiding" evidence that her husband might still be alive if he had been properly treated in an ambulance.

The Department of Health denounced the secrecy as "completely unacceptable" and insisted that NHS trusts must apologise to those affected.

They had no idea this was happening.

Sky News discovered that relatives of patients who die are not routinely informed about disciplinary procedures by ambulance trusts or the paramedics' regulator, the Health Professions Council (HPC).

Sixty-four-year-old Marion Giles, from Warkworth in Northumberland, was not told that her husband Grahame's death in 2008 followed a catalogue of failures by a paramedic from the North East Ambulance Service.

The HPC heard that three junior doctors and two nurses at Wansbeck Hospital in Ashington thought Mr Giles "could have survived" a heart attack if he had been given the correct treatment.

Mrs Giles only learned the truth after Sky News found clues to her husband's identity buried in a heavily-redacted transcript of an HPC misconduct hearing.

With proper treatment, Mr Giles might have survived a heart attack

In line with its standard practice, the regulator had not ensured that the hearing was publicised locally, Mr Giles' name had not been mentioned, and his wife had not been invited. The HPC's response is here.

"It's criminal really, that all this went on, hidden, and they didn't have the guts to tell me and to be honest about what had happened," she said.

"It's left me horrified to think that I'd put my trust in medical staff and now it's made me feel they've let me down, they haven't told me the truth and it's very hurtful."

In response, the Department of Health said:

It is completely unacceptable for relatives not to be informed when a mistake, error or unprofessional behaviour has caused serious harm to a loved one.

We expect the NHS to be open about mistakes, apologise to those affected and ensure that lessons are learned to prevent them from being repeated.

This is easy to understand and surely everyone in the NHS knows is the official policy. But it doesn't seem to be hard to get away with flouting it.

Less than six hours after Mrs Giles' comments were first broadcast on Sky News, and more than three years after her husband's death, the chief executive of the North East Ambulance Service, Simon Featherstone, apologised and pledged to look for other cases where families may not have been told the full facts.

We wish to apologise to Mrs Giles and we genuinely have now learned the lessons from this case.

Our policy now is to ensure that [when] any serious incident happens we will inform the family of the patient concerned and we will inform the coroner if there has been an unexpected death.

Is informing the coroner not a legal duty? So where have they been all this time? They've been caught out, haven't they.

Sky News has learned that the coroner for North Northumberland, Tony Brown, has written to the ambulance trust after launching his own investigation into Sky's findings.

"Further information which it seems was not available to the previous coroner, is being clarified before deciding whether to review the case or to hold an inquest [into Grahame Giles' death]," he said in a statement.

Solicitor Mary-Ann Charles, from Shaw and Company in Newcastle, says the secrecy has prevented victims' families from seeking justice and compensation.

"It sounds like a cover-up, it smells like a cover-up, and it really is acutely concerning that people can't find out what's going on, especially when it could be of such significance to them," she said.

Peter Walsh, a campaigner for greater transparency in the NHS and chief executive of the charity Action against Medical Accidents said Sky's findings demonstrate a "staggering" lack of ethics.

"Action [should be] taken to ensure that any NHS body that is complicit with this unacceptable behaviour is held to account," he said.

This means sackings.

Sky News studied documents from a handful of the 95 HPC misconduct hearings since 2005 that led to paramedics being struck off.

In the case of Grahame Giles, paramedic Brian Jewers had refused to follow a doctor's telephone instruction to administer a potentially life-saving drug and failed to carry out two other vital procedures.

Wansbeck Hospital, which raised the alarm, told Sky News it assumed the ambulance service would inform his family.

At his home in Shilbottle, Northumberland, Jewers declined to answer questions, saying: "That was three years ago, I've forgotten about it."

Earlier this year, the North East Ambulance Service paid £40,000 in compensation to James and Kerry-Ann Hopper after failing to tell them that Jewers had given "incompetent" treatment to their mother.

Their solicitor Ms Charles had discovered by chance that Jewers was disciplined over the death of 40-year-old Denise Hopper in 2007.

In another case, the truth was deliberately withheld from an elderly man in Greenock, near Glasgow, whose wife had died in 2006 following misconduct by two paramedics.

A general manager for the Scottish Ambulance Service told the HPC that he "didn't really see any benefit to us" in telling the unidentified man the truth.

The manager said if the man was told he could have concluded that his 72-year-old wife "might still have been here if someone else had come and done a different job".

"He is more comfortable thinking that everything that could have been done was done,"he said.

The HPC panel member replied: "OK, thank you very much. I have no further questions."

A spokesman for the Scottish Ambulance Service could not say if the man had subsequently been informed and could not locate the trust's policy on contacting the relatives of negligence victims.

The London Ambulance Service did not inform the family of a man who died in New Malden in 2007 that a paramedic was being disciplined for failing to give him prompt treatment.

The trust's first contact was made when relatives wrote a letter two years later. The trust confirmed that no compensation claim was made, but refused to discuss the correspondence.

A trust spokeswoman said they contact relatives if they have made the complaint that leads to disciplinary action, "in line with the Department of Health’s 'Being Open' policy".

In August 2010 a paramedic from the Yorkshire Ambulance Service was struck off over his treatment of three patients, including a seven-year-old girl who died on 17 June 2008.

The paramedic pronounced the girl dead without giving her advanced life support treatment - but the complaint was not made by the girl's family.

The Yorkshire Ambulance Service will not say whether the girl's parents know about what happened to their daughter, citing patient confidentiality.

The HPC issued a statement confirming it was aware of "some instances" where families are not told that misconduct hearings are being held:

We are taking steps to ensure that they are informed of the hearing, where appropriate and in-line with patient confidentiality.

A spokeswoman clarified the statement, saying there is no guarantee that families will be informed, and no attempts will be made to contact relatives of victims where the case has already been heard.

Marion Giles says the HPC's response has made her lose faith in the National Health Service.

"I just don’t know how they could go down that line. I don't know why they're doing that, for what reason? Just to cover their own backs, I presume," she said.

Why would an ambulance trust think this secrecy is acceptable? Perhaps more seriously, why does the regulator seem to think it's perfectly fine? And how come the Department of Health seemingly knows nothing of this at all?

Well, we know why. The NHS is a huge fortress for those inside it. It's too big to manage, and too big to be accountable.

Damned if they blow the whistle, damned if they don't

Health regulators should warn nurses, doctors and midwives they may be investigated if they fail to report concerns about colleagues, MPs say.

The call comes from members of the cross-party health select committee.

But the MPs said NHS whistle-blowers sometimes end up facing disciplinary action themselves from employers if they do raise concerns.

Damned if they do and damned if they don't. Their professional medical ethics collide with the convenience of an over-mighty management.

The General Medical Council (GMC), which regulates doctors, said it was committed to doing more in this area.

The committee says a clear signal should be sent by the GMC and the Nursing and Midwifery Council (NMC) that staff who fail to report concerns are at as much risk for being investigated as they are from any poor practice of their own.

The committee's chairman, the Conservative MP Stephen Dorrell, said:

This is an underdeveloped part of the regulators' work.

We regard the principle behind this wider obligation as an important safeguard for patients.

We're not suggesting a new doctrine for staff. It's part of the professional obligation - being aware of the practices around them is in the professional codes.

There have been examples of people raising concerns, and then facing inappropriate or heavy-handed action from their employer.

We intend to follow up and to examine what is appropriate and what isn't, in terms of how employers respond.

The GMC is currently investigating doctors at Stafford Hospital whose own work was blameless, but who allegedly failed to report colleagues.

The GMC said that in the past five years it had investigated more than 80 doctors over allegations that they did not report, or did not report soon enough, their concerns about the risk a colleague posed.

The NMC was unable to give details of any similar investigations.

Peter Walsh, who heads the charity Action against Medical Accidents (AvMA), said:

Many whistle-blowers are affected by threats and bullying. They lack independent help and support.

If there are doctors or nurses who unreasonably fail to report serious concerns, they should be held to account.

However, the management who make it so difficult for staff to raise concerns must also be held to account.

The GMC's chief executive, Niall Dickson, said:

The committee rightly challenges us, as well as all health professionals, to speak up if they are aware of poor patient care.

We know there is more we can do in this area and we are committed to doing it.

The important point is that doctors are aware of these issues and act appropriately. We will be working with the profession to take this forward.

The Department of Health has held a consultation about strengthening safeguards for whistle-blowers. It closed in January, with no response published yet.

The dilemma for a whistleblower is that your colleagues and management can make things difficult for you quickly. Any protection - from publicity or through a professional body - will be slower to engage, and less certain in its effects.

It's all very fine the Select Committee fingering medical professionals and their supervisory bodies.

But who is going to turf repressive managements out on their ear?

CQC locks the stable door

NHS regulator CQC has belatedly taken notice of Winterbourne View, where they had previously ignored a whistleblower, who then went to Panorama.

The CQC have now reported and - stand by to be amazed and shocked - found a "systemic failure to protect people".

The BBC news report today summarises the findings and then reminds us

Winterbourne View closed down in June.

And we pay for the CQC.

The Commons found its voice? Not impressed

One of the outcomes of the News International story so far is to show how stupid many MPs are.

Before the Milly Dowler revelation, the campaign had been driven by Chris Bryant and Tom Watson, both from the camp of Gordon Brown, who were voicing his hugely simmering resentment built up since the Murdoch press had turned away from him.

The media fed on a diet of revelations about the voicemails of politicians and slebs being hacked, but the public was giggling rather than concerned. Brown's former lieutenants weren't succeeding.

But then came the Milly Dowler revelation. MPs were deluged with public indignation. As Charles Kennedy said, there are some times when MPs have to act as lightning conductors. This was one.

Most MPs then followed the trail which Watson and Bryant had already laid. Bercow revelled in the chance to put the Commons in the spotlight with an emergency debate and allowed Brown to go on and on. This should have been a key point in his revenge campaign, but we all know he blew that too.

No word that the Information Commissioner had written two reports several years ago highlighting the possible scale of offending by journalists, and that the Labour government had done - precisely nothing.

Nonetheless, the hounds were now baying, and the oleaginous Vaz and his unselect committee questioned police and ex-police. Some of the police made idiots of themselves, but many of the MPs' questions were embarrassingly stupid.

Evidently few of them have worked in a large organisation. They didn't understand there will always be questions of priorities, because resources aren't infinite. In the Commons, one backbencher even asked Cameron if he would consider telling the police to increase the resources allocated to the new investigations!

The unselect committee didn't seem to like Peter Clarke, because he explained succinctly why the original hacking investigation hadn't seemed top priority at the time, and was brief with MPs whose questions showed they hadn't grasped when he'd retired. None of the MPs would have been capable of holding down his job, but boy are they great at hindsight.

They did like Sue Akers. She massaged them with her answers, and fairly subtly made them feel jolly important. They nodded at her decision that her team would visit everyone who might have been hacked, even though this will add years to her investigation. She said a judicial enquiry could start now and read itself in (they liked the idea of an immediate start) but would then have to wait until anyone charged had been through the courts. One MP then even asked if this delay would be weeks? months? years? Commendably, Sue Akers kept a straight face.

She seems a good choice to do a slow, thorough job, while not upsetting any politicians. There was no sense that she would be a good choice for something fast-moving, or even seriously important.

So far the laborious process seems only to be looking at News International. But as Guido points out, the figures on suspected blagging suggest that News International may not have been the chief offenders.

David Leigh suggested on The World at One that tabloids' malpractices were perpetrated just to satisfy sleazy curiosity, whereas the serious press only stooped to those levels reluctantly and in the public interest, so the serious press wasn't an issue. This would be serious papers like The Guardian, whose journalists have breakfast with Gordon Brown, copy out his allegations on to the front page, and then have to retract a few days later - on the back page.

No MP is coming out of this well, and there is plenty more to emerge. Most backbenchers think they understand the outlines of the issues, but they don't. They think events are a sign of backbench power, but they're not. MPs have been led by the nose by Brown's team, and then forced forward by public disgust. And it's not just backbenchers. Cameron has adopted it as an article of faith that the first investigation was flawed. Given that a judge had considered another case not worth the cost of a long trial, and given the competing resource pressures on the Met, this is beyond glib. Cameron's method of operation becomes transparent, making it easier to despise him. Miliband meanwhile has to guard against not going overboard on this issue. There are far greater scandals.

If MPs can't even get their heads round this issue, there's no hope of them understanding why the EU is a bad thing, or why ruinous AGW legislation is also bound to fail.

Better to remain silent and be thought a fool than to speak out and remove all doubt.

NHS's attitude to taxpayers' money

The Royal Brompton Hospital has won the right to challenge a consultation which it claims has threatened the closure of its children's heart surgery unit.

So what's happened? Have they protested to Andrew Lansley? Er, no.

The hospital has been given permission to seek a High Court judicial review against what it says was a deeply flawed process. Mr Justice Burnett said there was "an arguable case" that should be heard, and directed that the full hearing should take place over three days in September.

The hospital's claiming that the review wasn't based on objective evidence, and that the decision making process wasn't transparent.

So presumably the review team robustly said the hospital was wasting taxpayers' money? You've probably guessed that they didn't.

Jeremy Glyde, director for Safe and Sustainable, an NHS review of children's heart services, said: "We welcome the opportunity to present its evidence and will do so robustly.

"The rationale for change is supported by medical experts, professional associations and leading national heart charities."

The BBC adds that this is believed to be the first legal challenge of its kind to be brought by one NHS body against another.

At what point should ministers say Enough is enough, and stop NHS bodies throwing our money at lawyers in competitions with each other?

If ministers believe in their decision making processes, they should of course do that now. Going to law is a recipe for hospitals to defend their vested interests, while the taxpayer gets shafted. Again.

Now it's blood clots

A few days ago the spotlight was on bed sores, which were described as totally preventable.

Now Sir Bruce Keogh, the NHS's medical director, has said it is “absolutely disgraceful” that so many patients die every year after developing Deep Vein Thrombosis (DVT) on hospital wards.

Some 25,000 people die in England each year – more than the combined toll from breast cancer, Aids and traffic accidents – after developing DVT and a pulmonary embolism in hospital.

In addition, NHS trusts have paid out £110million in compensation to sufferers of hospital-acquired DVT over the past six years.

Many suffer because fewer than half of trusts assess inpatients’ risk level when they are admitted, despite the threat of Department of Health fines.

So we are going to have yet another exercise to name poorly performing hospitals.

Too big to be accountable - and what will happen to this lot of under-performers?

Trapped in the EU against our will

Guido highlights two polls reporting this.

A YouGov/PoliticsHome poll showed that if there was an in/out referendum tomorrow, 50% would vote to leave and just 33% to stay. But 55% think it likely the UK will still be in the EU in 10 years time, while 32% think we will have left.

Obviously there's a democratic disconnect here. And that explains why the powers that be won't give the voters an EU referendum.

Lib Dems would vote 45% to 40% to stay in, while Labour supporters would vote 42% in and 42% out. But among Conservative supporters 66% would vote to leave, and only 21% to stay in.

All age groups would vote to leave except for the 18-24s, where 43% would vote to stay in, and 36% to leave. After that, the margin in favour of leaving rises with age.

The second poll has 49% saying they would vote to leave the EU in a referendum, while 25% would vote to stay in.

The political establishment is trapping the UK in the EU against our will. Which is a far greater scandal than hacking of slebs' and MPs' phones.

Bedsores again

The Telegraph's junior doctor picks up the recent report on bedsores (see here).

He writes that bedsores are always preventable. So "NHS bosses and the Department of Health should adopt a zero tolerance policy for bedsores".

Given that with proper nursing and medical care they are preventable, in every case, it should be viewed as a case of professional negligence. The managers responsible for the ward or nursing home should face disciplinary procedures and if someone dies, instant dismissal. When faced with this kind of threat, I suspect that very quickly, the problem would start to improve.

Well of course he's right. That would be happening if the NHS was rigorous about always putting patients first.

But that régime's not there - which demonstrates the NHS's priorities.

Even more worryingly, there are no official figures for bedsores in care home residents, yet in every patient I have seen with them, this is where they have developed. Severe financial penalties might force owners of these homes to invest in ensuring they never occur.

CQC, anyone?

By their deeds shall ye know them. The tolerance of bedsores demonstrates the priorities of the healthcare industry as no words can.

Too big to be accountable.

Commissioner Reding lays down the law

That would be the unelected Commissioner Reding. She's the Justice Commissioner, by the way.

Henk Kamp, Holland's minister for social affairs and employment, recommended expelling EU migrants from the newer member states who had been unemployed for more than three months, and cutting benefits for those who failed a Dutch language test:

We need to avoid migrants who decide to live here for a longer period of time not being able to integrate and ending up on the margins of society

What does Unelected Commissioner Reding think of this view - stated by someone who has actually been elected?

The Commission has a number of concerns about the proposed Dutch measures. All EU citizens must be treated equally, and there can be no discrimination based on nationality.

That's core to the doctrine of the EU.

There can be no discrimination based on nationality.

Remember that next time a UK manufacturing contract goes to Germany. Don't blame a drafting error by the officials who drew up the contract.

If you support EU membership, you agree that nationality is outmoded.

Now go and defend that on the doorsteps. Not keen?

You may find people agreeing more with the Dutch MEP who said

We don't want jobless Poles, Romanian beggars and people from North Africa or Turkey in Europe.

(For an MEP he seems hazy about where Europe's borders are, but you get his point.)

BBC institutional bias continues

Jenny McCartney welcomes what she sees as a mea culpa at the BBC.

What Mr Thompson has admitted ... is that before 2010, our national broadcaster became a hostage to the insidious culture of the unsayable, which established itself across so much of British life during the Labour years, and left a legacy of widespread damage.

So things are changing?

Not so long ago, to voice the opinion that there should be a re-examination of immigration policy, that qualifications were ebbing in value, or even that the ideal of the European Union was expensive and unworkable, would be to outrage several bien-pensant orthodoxies at once. Today, they all sound like simple common sense.

So the view that the "ideal" of the EU is expensive and unworkable now sounds like simple common sense.

Good.

Any sign that the BBC is treating it this way? It's passed me by.

Let's add to that list "man made climate change" and look at a story on the front page of the BBC News website this very day.

"Australia to tax worst polluters" says the front page headline. Not "Australia to tax 'worst polluters'". See what the "impartial" BBC is doing?

Let's look at the "impartial" BBC's story in more detail.

The Australian government has unveiled plans to impose a tax on carbon emissions for the worst polluters.

That's the opening paragraph. Now notice that this so called pollution isn't sulphur that can choke you. Nope. It's carbon dioxide. A few paragraphs later:

Australia is one of the world's worst emitters of greenhouse gases per head of population.

Just what is the word "worst" doing there from our "impartial" broadcaster? If they want to weave their prejudices into news, let them go write for The Guardian, which isn't supported by a licence fee.

Sorry, casual bien pensant bias remains deeply rooted in BBC coverage.

The nannies are out

Mortality from heart disease in England is highest in the North West, primary care trust figures indicate.

Richer areas in the south have lower death rates from heart disease than poorer areas in the North.

An author of what the BBC calls "a landmark report" on health inequalities says

We know that many health conditions relate to social and economic status and these largely explain the variations in life expectancy and health status that we see across England between regions and within smaller areas.

It is still the case in England, as in most other countries, that the richer you are the healthier you are likely to be and the longer you will live.

Heart Research UK's "lifestyle manager" says that

People living in deprived communities, in particular, are at greater risk of developing heart disease due to several risk factors such as poor diet, lack of exercise and access to health education and advice.

Eh? This is no longer the nineteenth century. Anyone with access to a supermarket can eat reasonably healthily and cheaply. It's the same main supermarkets in every PCT area. If people choose to eat a poor diet, it's a choice they've made.

Lack of exercise? In a few council estates walking about may be dangerous, but even there people can still exercise in their front rooms.

And access to health education and advice? I haven't noticed any locally at all. Just the media. The same media which broadcast to the north west of England.

The nannies should just face it. Some people ignore information and make stupid choices. Not that the government doesn't keep trying. Pupils in one local school have just sat through their fourth viewing at the school of the television film Supersize Me.

Maybe more children from comprehensive schools would get to a good university if the schools educated their pupils rather than repeatedly force fed them the same health advice.

Imagine how fee paying parents would react if their children were treated that way. Deaths from stress in southern England might shoot up.

What happened to personal responsibility? If it's ignorance, it's wilful.

It's Europe, stupid

John Redwood writes an interesting post with this title.

The main reason Conservative MPs are rebellious, he writes, is the EU. Many of the issues which anger or annoy Conservative MPs are ones where EU law now "has a considerable impact on what any Minister is allowed to do".

Carbon taxes, renewables and dearer energy, fortnightly bin collections, votes for prisoners, higher spending to fuel the EU budget, bail outs of Euroland countries, immigration rules, human rights requirements for political correctness – all these matters are determined by the EU or are areas where Ministerial action is very circumscribed by the EU or the ECHR.

He sees that "the EU has induced a dishonesty in UK politics over the years". And he lists some inconvenient truths.

Conservatives in the government say they wish to limit immigration. Yet we all know that they cannot impose controls on EU immigration, including migrants from outside the EU who have spent some time in another EU country, unless EU law is changed. The government says it wishes to deregulate industry and commerce, yet much of the regulation is now baked into the European system and cannot be repealed. Ministers say they are establishing a new UK system of financial regulation, yet in reality they are agreeing to the EU undertaking more and more of the controlling functions in financial regulation.

John Redwood gets it, but his commenters get that the anti-EU MPs in the Commons are still a tiny minority. He suggests that

It might be wise ... for the government to amend its rhetoric on issues where the EU is in charge, and admit it.

But there's no sign at all that the government is going to do that, and no political argument is provided which might convince the government to change its ways.

Sadly, Redwood is spitting in the wind. I and many others feel disfranchised. But his leaders (they're not mine) don’t care.

Nonetheless, it's useful every time an MP takes the trouble to set out just what a devious game of concealment the political élite are playing week in, week out.

Bring on citizens' initiatives.

Misreading the news

Are the BBC and The Guardian afraid that Murdoch is planning to turn Sky News into a UK Fox News if he gets full control of Sky?

Not unless they are very ill-informed. Part of the proposal for his takeover of Sky is that he will divest Sky News and provide funds to keep it running for several years.

This blog is against Murdoch getting control of Sky (and added its voice to Jeremy Hunt's consultation in-tray, on the basis that it's a civic duty to help slow down the consideration process). But not for that reason.

While we're at it, is it hypocritical of The Guardian to applaud Julian Assange for publishing US government information while giving a thumbs down to The News of The World for its hacking?

Of course not. Publishing state information is one thing. No one is criticising The Telegraph for its exposé of MPs' expenses.

The issue for the NoTW is that it hacked the phones of a murder victim, and maybe of the families of war victims too. As for the phones of slebs and politicians, I don't give a fig.

Was hacking Milly Dowler's phone - and deleting messages on it - acceptable because she seemingly hadn't changed her PIN?

Of course not.

An unpleasant lot

Oborne's Philippic today against Cameron's consorting with News International worthies manages to be too harsh. Every PM has tried to win the good opinion of Rupert Murdoch and his senior people. Cameron was no exception.

Not that this blog has any time for the practices revealed at The News of the World, which apart from anything else must be a deeply unpleasant place to work. Coulson's and Brooks' denials of responsibility look increasingly thin, and no one has denied that News International lied to the Press Complaints Commission when it claimed that hacking was the work of one rogue reporter. How high up the organisation would that decision have been taken? Who in News International decided to treat an MPs' Select Committee hearing with barely concealed contempt?

Nor does this blog have any time for Cameron, a cynical political manipulator with scant regard for voters' views on overseas aid, or the EU, or global warming, or practically anything that comes to mind.

Meanwhile, it's good to see rational discussion of the case against overseas aid aired here and here.

They provide a case to answer, but of course Mr Cameron has not condescended to argue against it.

The blog has a clear view on this too. In the spirit of the Great Society, overseas aid donations should come from individuals and businesses, with tax relief. Not from government.

Cameron, Osborne and co of course enjoy the warm glow of spending other people’s money. What they never argue is why they think it’s better spent on overseas aid rather than on potholes.

Or maybe the people the money belongs to should keep it and decide for themselves how to spend it.

Now that might be an interesting question for a national referendum.

Oh no, it's referism again

Yesterday Douglas Carswell wrote

The House of Commons will today approve the government spending £ 48.875 Billion of your money for the Home Office, Foreign Office and Department of Communities and Local Government. This is part of a total Estimates approval for the year ending March 2012 of £221,086,166,000. Even today, that is a serious amount of money.

Richard North in a comment here has claimed that his research into local referenda undermines criticisms of his referism proposal - the idea that there should be annual national votes on the government's budget.

In the local votes, the electors were presented with clear choices. In Croydon, for instance

Of the 4,190 council tenants responding to the rents referendum (24.1 percent turnout), just over 58 percent voted for a rent freeze, keeping average rents at £65 a week. On offer to the tenants had been a community patrol service, community grants, money advice and debt counselling services – all of which were rejected.

Here it's quite clear what the choices are for you. You pay more, you get more services. Your vote will affect what happens in a clear way.

By comparison the numbers quoted by Douglas Carswell are mind boggling. National votes on them would also be meaningless, because all the departments have so many lines of spending. I'm not offered a choice at the margin directly affecting me which I can easily understand, it's a Yes/No vote on unimaginably big numbers.

That's why turnouts in local votes are irrelevant to a national referism proposal. That's why national incomprehensible votes would probably received apathetically. It would be unclear what a Yes or a No vote actually meant - whereas the council tenants' view was crystal clear.

Local votes - fine. National referenda on specific questions - fine. Annual votes on the national budget - waste of everyone's time and taxpayers' money. I'll vote No.

Incontinence and the supreme court

We can have every sympathy with former ballerina Elaine McDonald having to wear incontinence pads at night.

But the courts are not the place to decide these issues.

Some 557,000 adults in England and Wales currently receive care at home, and in Chelsea an overnight carer costs £22,000 a year.

Should local residents pay more so that more local people can receive overnight care? Or should spending on schools or libraries or leisure facilities be trimmed?

These are decisions to be made locally, through the democratic process, not by judges.

Doubtless she received legal aid. Not a good use of taxpayers' money.

Charities are evidently outraged. Then they should persuade local taxpayers of the need for more spending. Or they could appeal for donations, and fund the costs themselves.

Otherwise, they should keep their righteousness to themselves.

The harm in the NHS

Phil Hammond and Andrew Bousfield have a site medicalHARM. They write that

We think that in order to do no harm, first you have to count the harm.

On the right is a link to their latest stories.

As they say in the current Private Eye

Healthcare is an industry that causes significant harm while bringing enormous benefits. Overall, one in 10 patients are harmed by their healthcare; but if you're sick and over 75, the risk rises to 1 in 3.

Any other industry would be shut down with such an appalling safety record; but healthcare has an ingrained culture of denial. Errors are hidden, rather than owned up to; and many more pass unnoticed because nobody bothers to pick them up.

The cases discussed in Private Eye show managements which are unaccountable, usually safe in the huge fortress that is the NHS and readily using taxpayers' money to protect themselves, sometimes at the expense of medical staff and - far more importantly - patients.

A review in 2009 showed that NHS organisations were subject to 35 different regulators, auditors, inspectorates and accreditation agencies that demanded information from the various parts of the system.

The NHS is too big to be managed, and too big to be accountable.

Politicians have no chance of managing this vast empire effectively, especially as its commanding heights are staffed by managers who have risen from within the fortress.

It is too big and too powerful to be accountable. As the Private Eye report shows, even recommendations from expensive public enquiries do not get implemented. The empire is too vast to be changed quickly and effectively, and its capacity for inertia overwhelms pressures from outside.

No amount of changes at the top will ever ensure that the NHS as an organisation becomes responsive and patient-focused. It's just too big.

That's why the NHS has to be broken up.

Bedsores an NHS disgrace

Yes, the NHS has a bedsores crisis.

Hospitals are being "named and shamed" in an effort to end the bedsore crisis which is costing the NHS £4 billion a year.

It's serious, then.

Bedsores kill almost as many patients as the MRSA superbug, and health chiefs warn the cost of treating sufferers uses 4% of the entire NHS budget.

We've heard a lot more about MRSA than bedsores. Could it be because they're less dramatic? - this crisis seems to be a failure of basic nursing care.

The sores cause hundreds of deaths a year, taking hold when bed-bound patients are not regularly turned over or given special mattresses by nurses.

The worst hospitals had bedsore rates four times higher than the national average.

A union leader argues for the status quo:

Thousands of nurses are losing their jobs and this could lead to a rise in the number of patients with bedsores.

Yes, we noticed the could. But the point is that many nurses aren't doing their job already. Action Against Medical Accidents seem to be on the button, saying bedsores are completely avoidable.

Its down poor nursing care and there should be zero tolerance of bed sores. But sadly they are accepted and it leads to a lot of misery and suffering for patients and their relatives.

These are highly preventable. Stopping them is not rocket science. But in many hospitals they happen too easily.

Many of the shamed hospitals, we are told, have said they are taking action. That's what they always say. They issue an emollient statement and wait for public attention to move on.

These are the managements who tolerated bedsores in their hospitals. Why should we think they are the right people to deal with this negligent nursing?

Just don't expect anyone in the NHS to be held accountable.

NHS bleeding money

Two mothers who gave birth on the NHS in extraordinary circumstances have provoked a furious ethical row.

The first case centres on a British 39-year-old who had a £4,000 cycle of IVF funded by the taxpayer after she claimed it was her ‘human right’ to receive it. She is unemployed and on benefits.

Her son will grow up without a father. Since 2008 health trusts do not have to take a child’s need for a father into account when considering treatment.

The second case relates to a Nigerian who flew to Britain purely to give birth to quintuplets conceived in Africa after she swallowed a course of high-dose fertility tablets.

Her bill to the taxpayer is already £200,000 and she is fighting Home Office moves to return her to her home country.

MPs and campaigners say an apparent fertility free-for-all is unacceptable at a time when the NHS is under unprecedented financial pressure.

And they're right.

More

NHS accused of more anti-age discrimination

Hundreds of thousands of elderly people are being denied basic access to medical treatment simply because they live in care homes, a report warns.

Health service executives and residential home managers are failing to ensure that elderly patients are seen by GPs, receive the therapy, out-of-hours care and specialist dementia treatments that they need, it said.

Doctors often simply tell staff that residents should go to straight to hospital, while some state-funded medics are reluctant to help privately-run care homes for ideological reasons, the report suggested.

Eh? We pay them to provide a service. Why do they feel entitled to foist their ideologies on us?

The British Geriatrics Society, which conducted the inquiry, condemned the “betrayal” of elderly residents by an NHS that is “ageist” and treats patients in care homes as a “low priority”.

The report called on ministers to set clear national rules for doctors and hospitals on the services they must provide to care home residents.

The findings follow a series of highly critical reports from health inspectors at the Care Quality Commission into the neglect of the elderly in NHS hospitals. The watchdog found problems at a quarter of hospitals inspected, with dehydrated elderly patients being prescribed water and others left without being fed.

There are an estimated 400,000 older people in British care homes.

The report said: “Healthcare for residents remains a ‘Cinderella’ service in the NHS. This is a betrayal of older people, an infringement of their human rights and is unacceptable in a civilised society.”

The study found that there were “unacceptable” variations in the health services provided to residents from one home to the next, while the quality of medical care provided by the NHS was “often poor”.

The report blamed a range of factors for the breakdown in health services for elderly care home residents. These included “ageism”, a failure by health executives to prioritise services for care homes, and cuts to funding for NHS services for care home residents.

The report also warned that too many medics still believe in the “myth” that private care homes are making large profits out of their residents and want to use the NHS “to avoid providing care and equipment they have been paid to provide”.

“This myth persists in tainting working relationships and affects residents’ access to health care,” the report said.

Money no object

A cardiologist is believed to have cost a cash-strapped NHS trust more than £1million after being suspended six years ago.

Hospital bosses have been probing claims of incompetence against consultant cardiologist Sisiresh Chakrabarty since November 2005.

How long can that take?

It is believed Ipswich Hospital paid him between £415,980 and £560,823 and has had legal costs on top.

Ipswich MP Ben Gummer described the case as ­“scandalous” saying: “They should able to sack him without an outrageous bill, now more than £1million.”

Dr Chakrabarty was hauled before the General Medical Council in 2009. It allowed him to work again but only under strict conditions.

The trust said it was “continuing its dialogue” with Dr Chakrabarty under ­national guidelines.

Clearly the national guidelines are wrong.

Millions of medical records lost by the NHS

Is your medical data safe with the NHS? Probably, but not necessarily.

Millions of personal medical records have been lost by NHS trusts and hospitals, in the latest of a long series of data breaches which include staff losing laptops and memory sticks, and in one case faxing details of patients’ operations to the wrong number.

The Information Commissioner will impose fines of up to £500,000 on hard-pressed NHS trusts and hospitals in order to counter what he called a “disturbing” culture in the health service.

Five more health organisations have agreed to undertakings to improve security after breaches of data protection. In February, Ipswich Hospital NHS Trust misplaced 29 records after a member of staff took them home to update a training log and then lost them. In the same month, a medical practice in Durham sent out details of patients’ operations to the wrong fax number. Other breaches were recently committed by East Midlands Ambulance Service NHS Trust, Lancashire Teaching Hospitals NHS Foundation Trust and Basildon and Thurrock NHS Trust.

The Information Commissioner is investigating how the NHS North Central London Trust managed to lose a laptop containing an estimated 8.3m patient records.

Over 8 million records on one laptop!

It also recently emerged that thousands of notes belonging to cancer patients have gone missing from the abandoned Belvoir Park hospital in Belfast, which closed in 2006.

And the Information Commissioner cited a recent case in Bury where information on accident victims was being provided to a claims management company:

It’s all too easy for information to be blagged from the doctor’s surgery. You can ring up, pretend to be somebody else and you are not very often challenged by the questions you would face if you were ringing up your bank. You don’t have to prove who you are.

Slapdash. But even fines wouldn't affect the individuals responsible.

Again NHS staff get away with it.

Iraq torture doctor working in NHS hospital

A doctor involved in torture by Saddam Hussein’s henchmen is working in British hospitals, reports The Mail.

In an astonishing immigration scandal, border officials have allowed the suspected war criminal to treat thousands of British patients.

Dr Mohammed Kassim Al-Byati was given a permit to work as a doctor in the NHS by the Labour government in 2004.

Checks failed to uncover his history of working for the notorious Iraqi Intelligence Agency, which ran the country in a reign of terror during the Saddam years.

His job was to patch up torture victims so that they could be subjected to more appalling treatment.

In 2007, Al-Byati contacted the Home Office to confess to his horrific past so that he could claim asylum.

But, incredibly, this did not prevent him from carrying on earning tens of thousands of pounds working at a hospital in Wales.

More

Putting heart patients' lives at risk

As we now know, back in 2008 staff at University Hospital of North Staffordshire turned down the volume of a heart monitoring alarm, leading to the death of David Bough.

As Mr Bough’s relatives sobbed in the gallery, the coroner ruled that he died of natural causes ‘exacerbated by an act of omission causing alerts from the heart monitoring to not be seen or heard’.

JuliaM discusses the staff's attitudes and asks, "Why not call it what it was – criminal negligence?"

But the admirably detailed account on This Is Staffordshire makes it look worse.

No one will be brought to account. The NHS fortress looks impregnable again.