Editorial
And now for something slightly different. Keith is
enjoying a well earned break and so you have me,
Andrew Dawson guest editing. Its been quite a
week. NHS emergency services failing our children;
an enormous pensions black hole there too. And
then there is the government being castigated in the
High Court for rejecting the Parliamentary
Ombudsman’s findings of maladministration and
injustice in the Department of Work and Pensions.
We have a government U-turn on hybrid-embryo
research – probably just as well with the frightening
statistics on the prevalence of Alzheimer’s disease
both now and projected over the next 50
years. Incidentally I’ve resisted putting in an article
about “coughs and sneezes spreading disease” –
that was too much nanny state even for me! Look
out for the startling consequences of having two
scoops of ice cream and guess what, garlic makes
you smell!
Please send me your comments and feedback
andrew.dawson@bruswicks.eu
regards
Andrew Dawson
Guest Editor
Parliament
26 Feb 2007 (HoL) - Report stage of the Mental
Health Bill (day 2)
27 Feb 2007 (HoL) - Questions: the NHS pension
scheme
Abuse
1. £20,000 victimisation award
27 February 2007 – The Times
A woman received an award of £20,000 after being
victimised by her manager at a children’s centre after
she exposed a colleague as a sex offender. The
woman ordered a CRB check after noting the friendship
the offender had struck up with two 11 year old
boys. The offender had a conviction for indecent
assault. The Al Ghazali Centre reputedly refused to
sack the offender as he had converted to Islam. The
woman who reported the issue was called a “bad
muslim”. Other staff were banned from talking to
her.
2. Abuse victim boosts pupil safety
22 February 2007 – BBC News
Bill Jenkins, from Surrey has developed software to
enable pupils to be protected from bullying and paedophile
grooming. Mr Jenkins’ software, Securus,
has been introduced into 800 schools, with the backing
of the Department for Education and Skills. Mr
Jenkins was abused at a care home in the 1950’s.
For full report click here
3. (CEOP) Sought - John Richard Murrell the
Child Exploitation and Online Protection
Centre's latest 'most wanted' offender
20 February 2007 – GNN
West Mercia Constabulary are urging members of
the public to visit the CEOP as a new offender has
been identified.
The latest addition is 38 year old John Richard
Murrell, last seen in the Worcestershire area. His
photo and details can be found on http://
www.ceop.gov.uk/wanted.
Business News
4. Castlebeck Group Limited has announced
that Chief Operating Officer, Tony McLean, has been
appointed the company’s new Chief Executive. He is
taking over from David Cole who in turn is taking up a
number of positions as chairman and non-executive
director within the Lydian Group of companies which
bought Castlebeck last year from HG Capital.
Since 2006 Tony McLean has been Chief Operating
Officer at Castlebeck. This company operates care
facilities for people with learning disabilities across
the UK. He began his career as a Registered General
and Psychiatric Nurse and Registered Health
Visitor in the North East of England before becoming
Chief Executive of Essex and Herts NHS Trust. He
joined Castlebeck from PFI (Private Finance Initiative)
consortium RMPA Services Plc where he was
Chief Executive. RMPA Services was behind the
£2.2bn Colchester Garrison redevelopment.
He takes over at Castlebeck as the company begins
the development of a number of new specialist health
care facilities for adults and young people with learning
difficulties and complex needs.
David Cole’s new role will involve helping to coordinate
strategy and drive growth across a number
of companies within the Lydian portfolio. He remains
a non-executive director of Castlebeck whilst joining
the boards of other companies on the threshold of
their own growth plans.
Care Homes
5. Care homes share £1.26m windfall
22 February 2007 – BBC News
Norfolk’s care homes are being invited to apply for a
share of a £1.26m windfall earmarked to improve living
conditions for the elderly. Funding must benefit
the maximum number of residents to be entitled to
the Department of Health award.
Norfolk County Council wants homes to submit details
of improvement schemes of more than £5,000 by
9 March and the council will then submit details to the
Department of Health of how and where the money
will be spent.
For full report click here
6. Japan probes 'man kept in cage'
20 February 2007 – BBC News
Japanese officials are investigating allegations of restraint
and in one case, caging of elderly residents in
a Tokyo nursing home. A former employee has told
of residents being tied or handcuffed to their beds on
a regular basis, with a physically and mentally disabled
man being shut in a metal pet cage for at least
three months.
For full report click here
Case Reports
Law Reports
7. Ombudsman’s findings of fact are binding
on Ministers
27 February 2007 – The Times Law Report
R (Bradley & Others) –v- Secretary of State for
Work and Pensions
Queens Bench Division
In a case brought by individuals who had been found
to have suffered both maladministration and injustice
at the hands of the Department for Work and Pensions
by the Parliamentary Ombudsman Mr Justice
Bean quashed the decision of the present Secretary
of State to reject all but one of the Ombudsman’s
findings. The court held that a finding of maladministration
was binding on the authority against whom
that finding had been made save in the case where
the findings were objectively flawed, irrational or peripheral
to the issue at hand or where there was
genuinely fresh evidence to be considered.
Ed – this case is startling whether one looks at
the plight of the pensioners involved who have
suffered loss , or the refusal of the government to
compensate them for the losses suffered by their
misinformation. This is the first time an Ombudsman’s
findings have been rejected.
Disciplinary cases
8. Pathologist guilty of misconduct
20 February 2007 – BBC News
Dr Kenneth Shorrock, pathologist, who admitted
changing a medical report which led to a surgeon
being accused of manslaughter will be keeping his
job. Dr Shorrock left out part of a report into the
death of a woman on an operating table which
cleared her doctor of any blame.
Urologist Hurais Ramis Syed was originally charged
with manslaughter but later acquitted.
For full report click here
Cases in the news
9. Appeal over care home fire verdict
24 February 2007 – The Herald
Prosecutors have launched an appeal yesterday
against a High Court judge's decision to dismiss
criminal charges against the owners of a care home
where 14 elderly residents died in a fire.
Fourteen residents died and several others were injured
when a fire broke out in a downstairs cupboard
at the care home on January 31, 2004.
Mr and Mrs Balmer and their son were accused, as
partners of the firm running the home, of a total of 12
charges which included breaches of the Health and
Safety at Work Act 1974, the Health and Safety at
Work Regulations 1999, and of the Electricity at Work
Regulations 1989. (Previously reported in BHCR, Vol
1, Issue 23—item 8 and this issue—below).
10. Rosepark fire charges dismissed
21 February 2007 – BBC News
Rosepark’s nursing home owners have had the
charges against them dropped due to the way the
charges on the indictment had been framed by the
Crown Office. The fire killed 14 people in 2004.
At the High Court, Lord Hardie said the decision did
not mean there would be no further proceedings as a
result of the fire in Uddingston in 2004 and it was a
matter for the Lord Advocate to decide what further
action should be taken.
For full report click here
11. GP appeals verdict over asthma boy
24 February 2007 – Evening Times
Dr Julie Mallon has launched an appeal on a ruling
that she was guilty of serious professional misconduct
for sending home an eight-year-old asthma sufferer
who later died. She also claims that the threemonth
suspension imposed on her by the General
Medical Council was “inappropriate and unnecessary”.
Children
12. Child dental scheme 'fails poor'
22 February 2007 – BBC News
Government experts are calling for the UK-wide programme
to screen school children for tooth decay to
be scrapped after a trial of 17,000 children found that
those from poor backgrounds benefit least from
screening despite having much higher rates of dental
disease.
Experts said that adding fluoride to drinking water
would have more impact.
For full report click here
Conferences & Courses
13. Reconfiguration: Designing and implementing
major service change
Tuesday 13 March 2007, King's Fund, London
The conference will encourage debate and the sharing
of practical knowledge and experience to help
support managers and clinicians in their local areas,
as well as policy-makers and managers regionally
and nationally. Speakers will consider what a reconfigured
service might look like and what system
changes are needed to facilitate this. They will also
identify how commissioners and providers could best
work across a health economy and how constructive
public, staff and political engagement can be facilitated.
Keynote speakers:
Professor Sir George Alberti, National Clinical Director
for Emergency Access, Department of Health
Mark Britnell, Chief Executive, South Central Strategic
Health Authority
Professor Paul Corrigan, Prime Minister's Special
Adviser on Health
Spaces at this event are limited so we recommend
that you reserve a place as soon as possible by
downloading a registration form from our website or
booking online. For further information, please visit
our website or email us and we will be happy to provide
you with more details.
If your organisation is interested in having a higher
profile at the event, we also have a range of sponsorship
opportunities available. Please email us for further
information.
14. Local Government PPP Finance Forum
15 March 2007, 76 Portland Place, WIB
www.centaurconferences.co.uk/finance.ashx
This conference will explore the local government
bill, the autumn budget and look to the comprehensive
spending review to set the scene for the future
of local authority PPPs.
If you haven't received a copy of the brochure or
would like further information, please email me directly
on anna.knight@centaur.co.uk or download
the brochure here.
To register your place at the event, simply call +44
(0) 20 7970 4770 or download the booking form and
fax the back to +44 (0) 20 7970 4799.
For further information, please call us on the number
above or email anna.knight@centaur.co.uk
Kind Regards
Anna Knight
Marketing Manager
Local Government PPP Finance Forum
15. The Care Show
Bournemouth BIC—20 & 21 March 2007
Details : 01425 470666 www.careshow.co.uk
16. Action on Elder Abuse National Conference
2007
The Protection into Reality Conference
26-27 March 2007, University of Warwick, Coventry
by Action on Elder Abuse
Adult protection has come a long way in the past few
years. The dignity and wellbeing of older people is
now finally on the social and healthcare agenda in a
way never previously witnessed.
The 2007 conference will have particular significance
- occurring in the same month as Comic Relief’s biannual
Red Nose Day (during which elder abuse will
be presented as a key domestic issue) and following
the release of findings on a two year project into the
prevalence of elder abuse.
Are you ready for the challenges it brings?
The two day conference will:
• Examine current legislation and how it affects
the sector including what you need to know
regarding the Safeguarding Vulnerable Groups
and Mental Capacity Acts
• Scrutinise adult protection today—assessing
the loopholes and seeking solutions
• Offer an opportunity to interact in essential
workshops covering dementia, Whistleblowing,
disciplinary procedures and mental capacity
For more information
Email: conferences@elderabuse.org.uk
Tel: 020 8765 7000
For more information click here
17. Supporting vulnerable children in custody
and beyond - a priority for children's
services after the Green Paper?
Thursday 19th April 2007 – London
This major conference is produced in partnership with
the National Children's Bureau, Nacro and the
Fostering Network and is aimed at; Directors of Children's
Services, Elected members, Prison Service
Staff, Youth Offending Team Managers, Looked After
Children Team Managers, Voluntary Organisations
and Independent Foster Care Providers.
It is estimated that almost half of all children in prison
are, or have been, in care. Although they have the
right to social care support whilst in custody, very few
systems are in place to ensure they are given the
support needed to prepare for release. These children
are very likely to re-offend and in order to reduce
the trauma and isolation they often experience, support
is crucial. Mr Justice Munby considers the local
authorities' efforts for looked after children in care
"little more than worthless."
This interactive conference, which incorporates a
panel debate and workshops, will explore the legal
responsibilities of local authorities for children in
need in custody. It will consider the role of social
workers and foster carers in supporting young prisoners,
pre & post release. Participants will hear from
Youth Offending Teams and learn about action
needed to improve care planning with best practice
examples. The Youth Justice Board is also represented
and will propose ways to reduce future reoffending.
Martin Narey, Chief Executive of Barnardos, will
chair the conference and the following prominent
speakers will be joining on the day;
• Mr Justice Munby
• Robert Tapsfield - Chief Executive, FNT
• Di Hart - Principal Officer, Youth Justice & Welfare,
NCB
• Rod Morgan - Chair, YJB
John Coughlan - President, ADSS & Director of
Children's Service, Hampshire
BOOK BEFORE 12 FEBRUARY AND SAVE £100
PER CONFERENCE
18. Effective Corporate Parenting for children
in care - taking forward the Green Paper
vision
Monday 30th April 2007—Manchester
The Minister Rt Hon Beverley Hughes, MP, is giving
the keynote speech at this major conference based
around the Green Paper Care Matters, the government's
vision to transform the outcomes for children
in care and the Next Steps, setting out how this will
be put into practice. This timely conference, produced
in partnership with the IDeA, NCB and BAAF, will
examine how effective partnerships and commissioning
can be developed in line with the Green Paper
vision. It will consider strategies which will enable
elected members to meet their corporate parenting
responsibilities and to improve outcomes for looked
after children. Delegates will also be given the opportunity
to understand the value of an independent advocacy
service and to learn from best practice how to
achieve placement stability and educational success.
Paul Ennals, CE of NCB will be chairing the day,
other confirmed renowned speakers include:
• Roger Morgan - Children's Rights Director, Ofsted
• David Holmes - CE of BAAF
• Colleen Humphrey - Manager of Advocacy Services,
Voice
• Andrew Webb, Corporate Director - Children &
Young People, Stockport & co-chair of the ADSS
Children & Families Committee
• Cllr Les Lawrence - Chair Children & Young
People Board, LGA & Cabinet Member for Children?s
Services, Birmingham
These topical conferences will be in huge demand
and I would therefore recommend that you and your
colleagues book early to avoid disappointment. We
are offering a £100 discount per delegate if you book
before 12th February. For a conference brochure
please click the following links: Supporting
Vulnerable Children in Custody and Beyond and
Effective Corporate Parenting. Bookings can be
made online at www.careandhealth.com or by contacting
the conference team on careandhealth@
wbiaevents.com or 0870 9017070.
19. NCF 4th Annual Conference
Third Sector: Leading Innovation in Care
22-23 May 2007, Venue: Chesford Grange, Kenilworth,
Warwickshire
Ivan Lewis to address the National Care Forum’s 4th
Annual Conference
Other confirmed speakers:
Julia Ross, CSIP
Andrew Cozens, IDeA
David Brindle, Society Guardian
Anne Williams
Dame Denise Platt
To register your interest in attending the NCF 4th Annual
click here.
20. ARC Annual Conference 2007
20, 21 and 22 November 2007 The Carrington
House Hotel, Knyveton Road, Bournemouth
Details of the confirmed speakers and programme will
be released as they become available.
Please contact Chris Mitchell for further information.
For full report click here
Consultations
To follow next week
CSCI, CSIW, Healthcare
Commission &
Scottish Care Commission
21. ‘Read our response to Care matters’
23 February 2007—CSCI
Read the CSCI’s response to the Government's
plans to transform the lives of children and young
people in care, outlined in the Green Paper called
Care matters.
For full report click here
22. Inspection focus areas and associated
National Care Standards for 2007/ 08
21 February 2007 – Scottish Care Commission
The Scottish Care Commission has reduced the
number of Inspection Focus Areas (IFA’s) for
2007/08.
For full report click here
23. Top healthcare bodies make pledge on
patients' safety at high-level summit
21 February 2007 – Healthcare Commission
Key healthcare organisations made a public commitment
to working together to improve the safety of
care received by patients, at a high-level summit
hosted by the National Patient Safety Agency
(NPSA) and the Healthcare Commission.
For full report go to http://www.healthcarecommission.org.uk/
newsandevents/pressreleases.cfm/cit_id/5149/FAArea1/
customWidgets.content_view_1/usecache/false
Education
Nothing to report
Ireland, Scotland & Wales
Ireland
Nothing to report
Scotland
24. The childminders who kept extra toddlers
in car seats
27 February 2007 – The Times
A Dundee childminder who took on too many toddlers
that she couldn’t remember all their names and had
to keep them restrained in car seats has been struck
off. Elizabeth D’Arcy took on up to 5 times the number
of children she was legally allowed to care for.
She had cared for children for some 13 years. Records
showed she had cared for up to 15 children at
one time although only permitted to look after 3.
Dundee Sheriff Court granted the emergency request
by the Scottish Care Commission that Mrs D’Arcy be
removed from the child minder register.
Whether she will face criminal charges is yet to be
determined.
25. Appeal over care home fire verdict
24 February 2007 – The Herald
For full report see Case Reports—item 9
26. Rosepark fire charges dismissed
21 February 2007 – BBC News
For full report see Case Reports—item 10
27. You’re on the road to a £10m bill, NHS
told
22 February 2007 – Evening Times
Health managers in Glasgow have been told that they
will have to contribute up to £10million to improve
roads in Govan if they want to build a superhospital.
Alistair Watson, chairman of Strathclyde Partnership
for Transport, which is responsible for travel in the
area, said the move should only go ahead if a massive
upgrade is approved for already congested roads
in the locality.
28. Scots doctors attack 'MOT' plans
21 February 2007 – BBC News
Leading Scottish doctors are saying that new plans to
regulate GPs will “take away from patient care” and
the British Medical Association’s Scottish Council has
said the plans are too time intensive. For further news
see NHS – item ??.
For full report click here
29. Plans for new care home revealed
20 February 2007 – BBC News
West Lothian has unveiled its plans for a new
£874,000 care centre for people with disabilities. The
new unit will provide a wide range of care and support
services for up to 12 people after approval by the
council’s health and care committee.
For full report click here
30. GPs ‘afraid to assist in euthanasia in
wake of Shipman'
19 February 2007 – The Herald
A leading consultant, Simon Kenwright, has said
doctors no longer help terminally ill patients enjoy a
peaceful death because of the Harold Shipman case.
Dr Kenwright, a semi-retired consultant gastroenterologist
from East Kent hospital said that fears of
being prosecuted are affecting patient treatment.
Ed. What a lamentable state of affairs.
31. No. 67 The Regulation of Care (Scotland)
Act 2001 (Commencement No. 7 and Transitional
Provisions) Amendment Order 2007
19 February 2007 – OPSI
For full report see Legislation Update – item 42
Wales
32. 'Shock' at school criminal checks
22 February 2007 – BBC News
It has emerged that up to 80 people working at
schools in Powys have not been cleared to work with
children. The Council said it had discovered
“weaknesses” in its checking procedures for the
Criminal Records Bureau, and that nobody who had
not been checked will work with children unsupervised
until the investigation was complete.
For full report click here
33. First Director for new Care and Social
Services Inspectorate announced
22 February 2007 – Welsh Assembly Government
Rob Pickford has been appointed as the Director for
the new Care and Social Services Inspectorate
Wales (CSSIW) which comes into being in April.
For full report click here
34. No. 396
(W.42) The Commissioner for Older People in
Wales (Appointment) Regulations 2007
21 February 2007 – OPSI
For full report see Legislation Update – item 40
35. No. 398
(W.44) The Commissioner for Older People in
Wales Regulations 2007
21 February 2007 – OPSI
For full report see Legislation Update – item 41
36. No. 307
(W.26) The Review of Children's Cases
(Wales) Regulations 2007
19 February 2007 – OPSI
For full report see Legislation Update – item 43
37. No. 310
(W.27) The Placement of Children (Wales)
Regulations 2007
19 February 2007 – OPSI
For full report see Legislation Update – item 44
38. No. 311
(W.28) The Children's Homes (Wales)
(Miscellaneous Amendments) Regulations
2007
19 February 2007 – OPSI
For full report see Legislation Update – item 45
Learning Disabilities
Nothing to report
Legislation Update
39. No. 82 The Health and Social Services
Trusts (Membership and Procedure)
(Amendment) Regulations (Northern Ireland)
2007
22 February 2007 – OPSI
For full report click here
40. No. 396
(W.42) The Commissioner for Older People in
Wales (Appointment) Regulations 2007
21 February 2007 – OPSI
For full report click here
41. No. 398
(W.44) The Commissioner for Older People in
Wales Regulations 2007
21 February 2007 – OPSI
For full report click here
42. No. 67 The Regulation of Care (Scotland)
Act 2001 (Commencement No. 7 and Transitional
Provisions) Amendment Order 2007
19 February 2007 – OPSI
For full report click here
43. No. 307
(W.26) The Review of Children's Cases
(Wales) Regulations 2007
19 February 2007 – OPSI
For full report click here
44. No. 310
(W.27) The Placement of Children (Wales)
Regulations 2007
19 February 2007 – OPSI
For full report click here
45. No. 311
(W.28) The Children's Homes (Wales)
(Miscellaneous Amendments) Regulations
2007
19 February 2007 – OPSI
For full report click here
Mental Health
46. (DCA) Mental Capacity Act: guidance for
practitioners
22 February 2007 – GNN
Guidance has been issued on the Mental Capacity
Advocacy service in England and the new criminal
offence of ill treatment or wilful neglect of an individual
being introduced by the Mental Capacity Act.
47. Independent Mental Capacity Advocacy
service from April 2007
22 February 2007 – DoH
For full report click here
48. Positive Steps: Supporting race equality
in mental healthcare
21 February 2007 – DoH
The Positive Steps guide was produced with the help
of mental health care staff and community workers
and offers advice and support for better responding
to the needs of BME patients, highlighting existing
good practice within the mental healthcare system.
For full report click here
49. 'Deficits could stop my mother's care'
20 February 2007 – BBC News
An article about the worries of Sandra Thomkins,
how her mother Joyce James will suffer due to cost
cutting of essential mental health services.
For full report click here
50. Ministers defeated on health vote
19 February 2007 – BBC News
The government has been defeated over its plans to
detain mental health patients who have not committed
an offence. Peers voted that treatment could only
be given if it is likely to help. The Mental Health Bill
would allow people with severed personality disorders
to be confined if they are judged as a threat to
themselves or others.
For full report click here
51. Mental Health Bill: Lords defeat government
over therapeutic compulsory treatment
20 February 2007 – Community Care
For full report click here
Miscellaneous
52. 1 March 2007 - The Times
The Times has reported that sick and disabled people
face having to repay more than £500 million after it
emerged they had been overpaid incapacity benefits.
The overpayments are broken down as follows
£340 million is official error, £120 million on the claimants
making mistake and £60 million on fraud.
Ed – I’m officially speechless!
53. 1 March 2007 - The Times (or Parliament)
The Government narrowly won a vote in the Commons
yesterday to privatise the Probation Service.
Their working majority of 68 was cut to 25 by
Labour rebels teaming up with the Opposition Parties.
The way is now clear for Probation services to
be run by the private or voluntary sectors.
54. Met Office wins Health and Social Care
Innovation award
27 February 2007 – GNN
The Health and Social Care Awards 2006 saw the
Net Office Health Forecasting Team win the Innovative
Services Award.
The service alerts healthcare professionals and patients
who suffer from Chronic Obstructive Pulmonary
Disease (COPD) when weather conditions and respiratory
infections may potentially increase the risk of
symptoms worsening. The Health Forecasting Service
has also contributed to a reduction in hospital
admissions for COPD by up to 75% across participating
GP practices.
The service was developed through collaboration between
the Met Office and the NHS.
55. Garlic study may leave health firms in bad
odour
27 February 2007 – The Times
Garlic has no detectable effects on the levels of cholesterol
in the blood stream a trial has suggested although
previous studies had suggested it could by up
to 12%.
Ed – interestingly 57% of those eating raw garlic
for the study reported bad breath and body odour
– now there’s a surprise
56. Scientists triumph in battle over ban on
hybrid embryos
27 February 2007 – The Times
Plans to outlaw the creation of animal-human embryos
are to be dropped as Ministers fear the effect
such a ban would have on British science. The prev-
announced intention to support a ban has been
dropped following the protests by scientists. The
intention is now to find a way to allow the HFEA to
regulate the research.
Ed - The embryos involved will be 99.9% human.
Much of the need for these hybrids stems from
the shortage of human eggs available for research.
57. Medical Backlash over health foods
28 February 2007 – The Times
Low fat foods reputedly impair ovulation and taking
vitamins increases mortality by 5%!
Also see item 58 below
58. Ice-cream “can help women get pregnant”
28 February 2007 – The Daily Telegraph
…but eating ice cream twice a week makes you
“40% less likely to fail to become pregnant because
of period-related infertility” than those who eat it once
a week or less.
Also see item 57 Above.
Ed – I shall resist making any tasteless jokes –
but I will be rationing the Vanilla at home now!
59. Food Standards Agency – launch traffic
light controls
The FSA has launched a new food labelling system
with red, amber and green “traffic lights” indicating
high, medium and low levels of sugars, fat, saturated
fat and salt. Supposedly the FSA has the backing of
consumers – but not the food industry itself. Most
food manufacturers and producers are resisting the
voluntary system, so is Tesco that sells 1/3rd of the
country’s food. Other supermarkets seem to be edging
towards its adoption.
Ed – can anyone think of a regulator that might, in
future, want you to demonstrate that each item of
food bought and provided to service users falls in
the green spectrum of the traffic lights with perhaps
if you are lucky and occasional amber?
Looks like the afternoon chocolate fix will
have to be cancelled!
60. Obese mothers blamed for high baby
death rate
28 February 2007 – The Times
This article seeks to explain why Britain’s neo-natal
death rate is on a par with Hungary and Estonia and
worse than the rest of Western Europe. The theory is
that fat women give birth to premature, underweight
babies which are more prone to die. Britain’s women
are the fattest in Europe. This coupled with the increasing
number of multiple births (again likely to give
rise to premature babies) is considered to be the principal
factors in these lamentable statistics.
61. Hospice campaigners urge parliamentary
support for palliative care Bills
23 February 2007 – Community Care
Hospice campaigners called on MPs and peers to
back two private member’s bills to improve palliative
care on 23 February as they received their second
readings in Parliament.
For full report click here
62. Ivan Lewis opposes family support bill
but offers hope in spending review
23 February 2007 – Community Care
The government has officially refused to back a private
member’s bill to provide short breaks for families
with disabled children on grounds of cost.
For full report click here
63. Debate over disabled support bill
18 February 2007 – BBC News
For full report click here
64. New measures to improve support for
carers
21 February 2007 – DirectGov
A multi-million pound package of support for carers
was unveiled today by Ivan Lewis, Minister for Care
Services.
For full report go to http://www.direct.gov.uk/en/Nl1/
Newsroom/DG_066396
For Community Care report click here
65. Fire plea over the 'vulnerable'
20 February 2007 – BBC News
Leicestershire and Rutland's chief fire officer is urging
organisations caring for vulnerable people to help
protect them from fire, after a disabled woman died
in a house fire.
A spokesperson from social services said the department
met all its statutory duties in caring for her,
however, Mr Webb asked agencies to work closer
with the fire department to prevent it from happening
again.
For full report click here
66. Legal review of Southall's cases
20 February 2007 – BBC News
Professor Southall’s cases will be reviewed by the
Attorney General after allegations of acting inappropriately.
Professor Southall is alleged to have kept
about 4,450 "special" case files on children which
were not stored on the child's proper hospital file,
with some of the cases later involving a criminal
prosecution.
For full report click here
67. Paediatrician David Southall to be investigated
for withholding children’s files
20 February 2007 – Community Care
For full report click here
68. The cost of new drugs on the NHS
19 February 2007 – BBC News
Article discussing NHS drugs and asking how bodies
such as NICE decide how to spend limited funds. It
also looks at whether patients throughout the UK get
the same treatment.
For full report click here
NHS
69. Government accepts pay review body
recommendations
1 March 2007 – GNN
Health Secretary, Patricia Hewitt has announced that
the Government is accepting the 2007 pay review
body recommendations for NHS staff and GPs in line
with the rest of the public sector.
The main recommendations are:
• 2.5 per cent for nurses and other healthcare
professionals;
• a flat rate of £1000 pa for hospital doctors and
£650 pa for hospital doctors and dentists in
training - giving an average of 2 per cent
across all groups;
• 2 per cent for general dental practitioners; and
• 0 per cent for general medical practitioners.
70. Family doctors get 0% pay award
1 March 2007—BBC News
For full report click here
71. Patient Care suffers
1 March 2007 - The Times
The Times has reported that 2/3 of responding NHS
executives reported that patient care will suffer as a
consequence of cost cutting in the NHS and almost ¾
admit that access to treatment is being restricted in
an attempt to save Patricia Hewitt’s job.
Ed – Hmm interesting choice – fire Patricia Hewitt
or treat patients in a timely fashion.
72. 1 March 2007—Daily Telegraph
The Daily Telegraph has reported that 75% of all hospital
trusts in England are now restricting admissions
and surgeries in an attempt to balance their books.
Ed – I wrote this week’s article in advance of reading
this particular piece. It looks like Patricia
Hewitt is straining every sinew to bring the NHS
back into financial balance – whatever the personal
cost to patients.
73. Children are being let down badly by
many hospitals
28 February 2007 – The Times
Nearly one in five hospitals fail to provide sufficient
emergency life support care for children at night.
Child protection and training staff to look after children
is largely overlooked. In the Healthcare Commission’s
review three quarters of the hospitals
scored either “fair” or “weak” for their overall service
to children.
Ed – The Times article lists the good and the bad
hospitals and presents sober reading.
74. NHS Pension black hole rises by £61bn
28 February 2007 – The Daily Telegraph
The NHS pensions black hole has risen by £61bn
over the last 2 years. The total pensions liability for
the NHS is now a mind boggling £165.4bn.
Ed – this is a burden for all future tax payers and
dwarfs the payout the Government would have to
make if it did compensate the pensions who suffered
maladministration.
75. Dementia care costs £17bn a year and
will at least treble
27 February 2007 – The Times
Some 700,000 people are suffering dementia in Britain
and the cost of their care is estimated at £17bn a
year. The number of sufferers is projected to increase
to 1 million in 2025 and 1.7 million in 2050
with a cure considered to be many years off. In spite
of the numbers involved Britain is in the bottom third
of the EU league table in providing drugs to sufferers.
76. £1.5bn to be spent on hospitals using PFI
27 February 2007 – The Times
Further PFI hospital schemes set to cost £1.5bn
have been approved. Andy Burnham the Health
Minister said these PFI schemes were “the right
schemes and the value for money.” Unison welcomed
the programme but regretted that it was to be
PFI funded asserting that taxpayers will be paying
over the odds for years to come. The schemes approved
include:
Bristol North& South Gloucestershire – 830 bed hospital
on Frenchay site
Tees and North East Yorkshire – 312 bed hospital at
St Luke’s
Peterborough – 612 bed hospital on Edith Cavell site
Maidstone & Tonbridge Wells – 512 bed hospital
Mid Yorkshire replacing buildings at Pinderfields and
Pontefract General
Mid Essex – new A&E department, maternity unit,
and theatres
North Middlesex – 150 beds in purpose built accommodation
77. Councils request £1billion of NHS money
23 February 2007 – Community Care
Council leaders are preparing to ask government to
divert about £1bn a year from the NHS to local government
in this year’s spending review. A paper presented
to a Local Government Association executive
meeting suggests that 1 per cent of the health service
budget has been “misallocated” to the NHS for adult
social care, and should be shifted from acute services
to prevention.
For full report click here
78. NHS faces crucial period ahead of reduced
investment from 2008: but there's no
cause for panic, says King's Fund report
23 February 2007 – King’s Fund
Discussion report issued by the King’s Fund.
For full report click here
79. NHS cash fears 'may not hit care'
23 February 2007 – BBC News
The King’s Fund think-tank has stated that the end of
the NHS’s record budget rises does not automatically
mean that health services will suffer if planned well.
NHS funds have been rising by over 7% a year since
2002, but will stop in 2008 and is most likely to drop
to about 3.5%.
For full report click here
80. Hospital bug deaths on the rise
22 February 2007 – BBC News
Deaths from the hospital bug Clostridium difficile has
outstripped those due to MRSA according to recently
published figures. The Office for National Statistics
said that Deaths involving Clostridium difficile rose by
69% to 3,800 from 2004-05, whereas in the same
period, MRSA mentions on certificates increased by
39% to 1,629.
For full report click here
81. Historic changes for the pharmacy profession
21 February 2007 – GNN
New measures forming part of the Government White
Paper will see the formation of two separate bodies to
oversee pharmacy. One organization would act as a
regulator and the second would be responsible for
leading the profession, according to the Chief Pharmaceutical
Officers from England, Scotland and
Wales.
The two new bodies will take the form of a General
Pharmaceutical Council.
82. Historic reform to the regulation of health
professionals
21 February 2007 – GNN
The Government has published landmark proposals
on how it intends to regulate health professionals and
ensure patient safety in the UK. Health professionals
will be required to prove their fitness to practice every
5 years, and also includes plans for a radical overhaul
of the processes for death certification.
83. Doctor regulation shake-up plan
21 February 2007 – BBC News
The UK government want new safeguards alongside
its response to the inquiry into the serial killer Harold
Shipman, with doctors facing MOT-style tests and
stricter checking of death certificates. The government
has taken action after Chief Medical Officer Sir
Liam Donaldson made the case for reform last year.
For full report click here
84. Doctors regulatory power ‘to go’
21 February 2007 – BBC News
For full report click here
85. Healthcare professional regulation
strengthened
21 February 2007 – DoH
For full report click here
86. GSCC welcomes report on the Regulation
of Health Professionals
21 February 2007 – GSCC
For full report go to http://www.gscc.org.uk/
N e w s + a n d + e v e n t s / M e d i a + r e l e a s e s /
GSCC+welcomes+report+on+the+Regulation+of+Health+Prof
essionals.htm
87. Reform of health professional regulation
a good deal for patients, the public and the
profession, says King's Fund
21 February 2007 – King’s Fund
Discussion paper issued by the King’s Fund.
For full report click here
88. Beds at hospice 'are a lottery'
21 February 2007 – BBC News
Wayne Smith’s parents have condemned a system
for bed allocation as a “lottery” after Mr Smith had to
wait for a bed at the Hospice in the Weald, in Pembury.
His mother, Linda Home said that “care should
be there for everybody”.
The hospice said it had to turn people away because
it could not move existing patients to recuperate in
NHS cottage hospitals due to lack of beds.
For full report click here
89. Hospitals pick hi-tech clipboard
21 February 2007 – BBC News
An electronic clipboard has been unveiled to enable
clinicians to access patient records at the bedside,
write notes and order essential tests in real-time. It is
hoped that the device will cut the time doctors and
nurses currently spend on paperwork, improve patient
safety and speed up treatment times.
For full report click here
90. Internet drug GP suspended by GMC
20 February 2007 – BBC News
A General Medical Council has suspended a doctor
who prescribed large amounts of dangerous addictive
drugs over the internet. Dr Julian Eden, medical director
of e-med.co.uk was suspended for nine
months after a string of charges against Dr Eden
were upheld. It is believed to be the longest-ever
suspension for a doctor involved with prescribing
drugs over the internet.
For full report click here
91. NHS in the East is £175m in debt
20 February 2007 – BBC News
New figures released show that the east of England
region is deeper in debt than anywhere else in the
country with total budgets of all NHS trusts in the
eastern region has deficit of £174.5m - £50m more
than in London.
For full report click here
92. NHS 'paying too much for drugs'
20 February 2007 – BBC News
The Office of Fair Trading have issued a report stating
that the NHS are paying drug companies too
much money for branded medicines. The competition
watchdog said that the Department of Health -
which buys £7bn of branded medicines a year - is not
getting the best prices for drugs and is recommending
an overhaul of the Pharmaceutical Price Regulation
Scheme (PPRS) that is used to set prices.
Pharmaceutical firm representatives insisted that the
NHS got a good deal.
For full report click here
93. Q&A: NHS deficits
20 February 2007 – BBC News
Hospitals are gradually racking up bigger debts, but
overall the health service is likely to achieve balance.
An article looking at the break down of the figures.
For full report click here
94. Leafy Cambridge struggles with debt
20 February 2007 – BBC News
For full report click here
95. Many NHS trusts face growing debt
20 February 2007 – BBC News
For full report click here
96. NHS deficits progress report due
20 February 2007 – BBC News
For full report click here
97. Dentist wait list drops to 11,000
20 February 2007 – BBC News
The number of people in Devon waiting to find an
NHS dentist has now dropped from 48,000 to 11,000
in just 18 months. The Devon Primary Care Trust
(PCT) said new contracts had enabled health trusts to
work with dentists to increase the amount of NHS
dentistry available, with new practices being opened
in Exeter, Newton Abbott, Kingsbridge and West Hill.
Services were also expanded in Teignmouth, Torrington,
Barnstaple and Chulmleigh, said Andrew Harris,
the dental lead at the Devon PCT.
For full report click here
Volume 2 Issue 9
98. Implementing Agenda for Change for
NHS Contractors Staff in England – A Best
Practice Guide
20 February 2007 – DoH
A best practice guide for the attention of those NHS
employers who have contracted out soft facilities
management services who employ staff who are not
yet in receipt of terms and conditions no less favourable
than Agenda for Change, as per the national
agreement.
For full report click here
99. Dear colleague letter: Implementing
Agenda for Change for contracted out soft
facilities management staff
20 February 2007 – DoH
A letter highlighting best practice guidance for implementing
Agenda for Change.
For full report click here
100. NHS financial performance: Quarter 3 -
2006-07
20 February 2007 – DoH
Details of a report to the Secretary of State for Health
showing details of the forecast financial position of
the NHS, as reported at the end of the third quarter
2006-07.
For full report click here
101. Explaining NHS Deficits - 2003/04 -
2005/06
20 February 2007 – DoH
A response report to the Director of Finance's commission
(in his June 2006 report on NHS Financial
Performance, 2005/06) asking for "further detailed
analysis from the Department's Chief Economic Advisor"
to consider factors that may have caused the
emergence of deficits in 04/05 and contributed to
their apparently uneven geographical distribution.
For full report click here
102. The Government’s Response to the
Health Select Committee’s Report on NHS
Deficits
20 February 2007 – DoH
A Command Paper setting out the Government's response
to the Health Select Committee’s First Report
of Session 2006-07 on NHS Deficits.
For full report click here
103. NHS must do more to tackle underlying
causes of deficits - King’s Fund response to
NHS financial performance report
20 February 2007 – King’s Fund
The King’s Fund is calling for more action to tackle
deficits.
For full report click here
104. OFT drug purchase proposals could
give NHS more influence over research priorities,
says King’s Fund
20 February 2007 – King’s Fund
For full report click here
105. King’s Fund ‘cautiously optimistic’ NHS
will achieve 18-week waiting time target but
faster progress needed on diagnostic tests
19 February 2007 – King’s Fund
The King’s Fund’s hopes for the NHS’s 18-week waiting
time target.
For full report click here
106. PM pledges 'eight-week op waits'
19 February 2007 – BBC News
Tony Blair has announced that patients are set to
wait an average of eight weeks from GP referral to
treatment in a push to bring down waiting times.
It is part of a drive to ensure no patient waits longer
than 18 weeks for their operation by the end of 2008.
For full report click here
107. Inquiry into contaminated blood
19 February 2007 – BBC News
An inquiry will be held into the supply of contaminated
NHS blood to haemophilia patients. More than 4,500
people were infected with HIV and Hepatitis C during
the 1970s and 1980s with more than 1,700 patients
having since died and many more are terminally ill.
Despite intense campaigning for 20 years, successive
governments had previously ruled out a public inquiry.
For full report click here
108. Save energy, NHS trusts told
February 2007, Vol 4, No. 1, p7—HealthInvestor
The government has given £100million to NHS trusts
over three years to help them hit energy efficiency
targets. The funding is for improving electrical efficiency,
building insulation and installing new heatand-
power equipment. Savings made will go towards
patient care.
The NHS currently uses 45 gigajoules of energy a
year which is about 1% of England’s total energy consumption.
109. How surplus beds waste money
February 2007, Vol 4, No. 1, p13—HealthInvestor
A report from the Institute of Public Policy Research
has revealed that hospitals are failing to make simple
and sensible improvements to improve efficiency.
Length of stays in different hospitals varies wildly for
reasons that have nothing to do with clinical factors.
Many hospitals can use beds more efficiently by allowing
patients to go home earlier.
110. Getting on board
February 2007, Vol 4, No. 1, p22—HealthInvestor
An article looking at the new corporate governance
code issued to foundation trusts. It examines what’s
in the code and what’s not.
111. Gerry comes up trumps
February 2007, Vol 4, No. 1, p42—HealthInvestor
Article looking at the TV series in which tycoon Gerry
Robinson tried to make a typical NHS hospital more
efficient.
Nursing
112. England’s new Nursing Officer for diversity
1 March 2007 – GNN
Professor Christine Beasley, the Department of
Health’s Chief Nursing Officer has welcomed Dawn
Atkinson into her new role as England’s Nursing Officer
for Diversity.
Dawn will be seconded to her new role for two days
a week for one year advising the Chief Nursing Officer
and other professional leadership team colleagues
about all issues that relate to diversity.
Dawn will also support the Chief Nursing Officer
Black and Minority Ethnic Advisory Group and the
Mary Seacole Awards Steering Group.
113. Nurses Poised For Pay Battle
21 February 2007 – Evening Times
A Royal College Nursing survey of 1000 nurses has
found that nearly two-thirds will take industrial action
if they don’t get a big enough pay rise this year, with
another third considering quitting the NHS, 16% leaving
for the independent sector and 13% leaving altogether.
Half of the 1000 nurses also said their morale
was poor or quite poor.
The independent review body is currently deciding
how big a pay rise to give this year and a Government
suggestion of 1.5% has caused anger.
Older People
114. Ivan Lewis urged to press chancellor for
more cash to help elderly
22 February 2007 – Community Care
MPs have called on Ivan Lewis to bring social care up
as a priority in this year’s comprehensive spending
review. In a debate on home care for elderly people,
Labour MP George Mudie said:
“British public need to be aware of how shoddily we
are treating many of our elderly citizens”
He added: “I say to the chancellor, through the minister,
that not taking urgent steps to deal with the current
problems in social care will deny so many of the
elderly their independence, dignity and well-being.
Whether this is affordable is a strange question in the
fourth richest country in the world.”
For full report click here
115. £33m carer-support plan unveiled
21 February 2007 – BBC News
A New Deal for Carers has been unveiled by the government
which is aimed at people in England helping
elderly or disabled relatives.
Some £25m of a £33m budget will go to local authorities
to fund emergency respite care for people who
need a break from the demands of their role and the
government has also set up a consultation.
For full report click here
116. Grandmother lay dying in hospital with
maggot-infested wounds
21 February 2007 – Daily Mail
The family of 86-year-old Rene Smeaton found that
she was left with ulcerated wounds infected with maggots
as she lay dying on a hospital ward. Police are
probing allegations of criminal negligence against
nursing staff at Doncaster Royal Infirmary. Mrs
Smeaton was originally taken in for a routine gallstone
operation. She died six weeks later despite the
success of the operation.
117. LGA calls for new older people strategy
to complement Every Child Matters agenda
20 February 2007 – National Care Forum
Paul Coen, the Chief Executive of the Local Government
Association, is calling for a new approach to the
way in which the care of the elderly is dealt with.
For full report click here
118. ADVICE AND ADVOCACY KEY TO DELIVERING
CARE ENTITLEMENT AND GIVING
OLDER PEOPLE ‘A SURE START TO LATER
LIFE’
20 February 2007 – National Care Forum
For full report click here
Social Care
119. Care partnership may split in two
22 February 2007 – Community Care
It has been revealed that the Care Services Improvement
Partnership might be split in two. A source
close to CSIP said that social care would then come
under the Department of Health's social care directorate,
headed by David Behan, while health programmes
would report into the regional strategic
health authorities under the plan.
For full report click here
Staff, employment and
disciplinary
120. Southampton staff lose jobs over unsocial
hours
19 February 2007 – Community Care
At least five care workers at Southampton Council
have lost their jobs after refusing to sign new contracts.
The contracts included cuts in enhancements
for unsocial hours and cover care home and domiciliary
staff. The remaining care workers will meet on
27 February to decide whether to take further industrial
action.
The council said that the cuts were necessary to
keep services competitive.
For full report click here
Blair’s legacy?
What is Mr Blair’s legacy going to be when we finally
say good bye to him as PM? Whether history and
historians judge him kindly is something which we
won’t know for some time. But at the risk of tempting
fate and the opinion of our future historians I am prepared
to pass judgement on him and his government
now.
I am firmly of the view Mr Blair and his cronies deserve
our strongest criticism and condemnation.
Why, you may ask am I so damning. Well my assessment
does not come from the obvious. I could
base my arguments on:
• the wasting of the wave of hope and optimism
that brought him and his government to power;
• the cynical manipulation of the media and public
opinion and the creation of crass monuments
to folly like “Cool Britannia” or the Millennium
Dome;
• the creation of an NHS that seems permanently
in crisis – so much for 24 hours to save the
NHS – more like 10 years for policy arrangements
to revert to where they were in 1997;
• the slashing and burning of legal aid, the consequent
threat to public justice and the resultant
creation of ambulance chasing no-win, no
fee, no risk taking lawyers as a direct result –
not that the government sees the obvious link
with the curtailing of public funding – but it is
what they created;
• the promotion of a victim agenda as a justification
for eroding the rights of suspects and defendants
and consequently the rule of law;
• the bogus portrayal of a purer than pure morality
whilst at the same time allowing government
policy to be bought such as in the Berni Ecclestone
affair or the granting of honours in exchange
for loans;
• the cynical use of “off-balance sheet” PFI arrangements
mortgaging the county’s future to
an unprecedented level but without having to
declare the huge public spending deficit it
spawns and the drain on resources in future
years;
• the creation of a dependency culture where the
vast preponderance of families with children
receive government handouts through blatant
redistribution of wealth policies reminiscent of
the Labour party of 1970s – or is it perhaps simply
a means of purchasing future Labour voters?;
• the destruction of what was in 1997 our enviable
pensions system and its reduction to the
present crippled provision – except of course if
you are a public servant or politician; or
• the way he took the country into war 5 times in
10 years and gave the world the impression
that as a nation we are no more than America’s
glove puppet.
But I won’t use those arguments –even though I think
many of these issues are sufficient to condemn our
soon to be erstwhile leader and his government.
I reserve my strongest criticism for Mr Blair and his
micro-managing mealy mouthed ministers for eroding
our cherished civil liberties, for over promising, over
legislating and under delivering with regard to our
public services and worst of all undermining the intrinsic
values of our public servants.
Those of us who work with regulators have seen just
how things have changed over the last 10 years.
Don’t get me wrong I’m not looking back to pre-1997
as some halcyon time of reason and good governance
– but things were different then.
In 1997 our regulators, with few exceptions, did not
seek publicity for the work they did. They weren’t, on
the whole media, savvy. Some may see this was
somewhat naïve and missing a trick. However I
much preferred the quieter unassuming approach of
such a regulator as opposed to those regulators that
now “go for a lap of honour” to justify their existence.
Many regulators see publicity about their work as a
key performance indicator. And woe betide any
regulator that falls behind its key performance indicators!
One such failed regulator is The Assets Recovery
Agency. It was announced with a fanfare of publicity
by the Prime Minister. It came into being in March
2003 and was supposed to be the way of recovering
the ill gotten gains of the Mr Big criminals whom the
criminal law couldn’t touch. Civil recovery powers
were to be used – but the legislation creating and
regulating the ARA was flawed.
The draconian powers granted to the ARA were too
harsh and were rightly challenged under the Human
Rights Act. The legislation also precluded the ARA
from going back more than 12 years – so many of
the well established Mr Bigs were largely immune
from the recovery process but of course that element
wasn’t publicised. The ARA was meant to be self
funding – but so far it has failed to recover more than
it has cost to run. By June 2006 the ARA had cost
£60 million but only recovered around £8 million. As
at 31 January 2007 its recovery figure has risen to
£22 million in total since it was created. Also in
January this year it was announced that the ARA
was to be abolished and its functions merged with
the Serious and Organised Crime Agency.
If you look at the ARA’s web-site you’ll see just how
important publicity is to this agency. The second
large tab on the site directs you to its press releases.
Another tab – seemingly suffused with testosterone
overload talks of “pay-back” – but then meekly directs
you to an ARA press officer and the same
press releases. Amongst those releases is one
dated 21 February 2007 commenting on the National
Audit’s Office appraisal of the agency. It contains the
following sheepish quote:
“…we fully recognise the serious criticisms of
aspects of our performance in the NAO report.
As an Agency we have always sought
the highest standards and set ourselves a
number of key performance indicators which
were deliberately challenging. As the NAO
report highlights, we have met some of those
targets but have failed to hit others including
those on the final recovery of assets on the
timescales originally envisaged.”
To my mind it was not the ARA’s fault entirely that it
failed. The legislation was poorly framed – and that
can only be the government’s fault – and pandered
too much to Labour’s dreams of confiscating assets
based on suspicion of a criminal life-style as opposed
to the traditional concept of proving wrongdoing. The
absence of basic and fundamental safeguards
against abuse by the state and its agencies in the
legislation - such as the ability of the suspected individual
to draw an income from his assets to live even
at a basic level whilst the appropriateness of the confiscation
was considered by the courts - or to have
the ability to pay for his own legal representation
struck at the heart of everything the average Briton
would consider fair and reasonable. Not surprisingly
the legislation was successfully challenged in the
courts on these bases. This also delayed the ARA’s
recovery of ill-gotten gains – and meant it could never
meet the overly optimistic recovery targets set for it.
The ARA was set on a path to fail by a publicity seeking
government acting tough – but also acting outside
the parameters of good governance and its own hu
man rights legislation. No doubt the government now
wants to be seen to be acting tough with a “failed
regulator” again in its move to abolish the ARA. The
ultimate irony is that the ARA finally and belatedly
now seems to be working!
And then we come to the Commission for Social Care
Inspection - CSCI. I have every sympathy for the
hard working inspectors who have found themselves
working for so many different employers in recent
years such as a local authority, the NCSC, now CSCI
and, of course, soon to be something else again.
Keeping things in a constant state of flux, whether it is
our schools, our hospitals or CSCI employees is not
condusive to the delivery of a quality public service.
Leaving aside the inspectors’ complex employment
history I have much greater concern about CSCI’s
performance and more particularly their focus. The
evidence I see from clients protesting about CSCI
inspections and actions almost invariably turns on
CSCI’s fixation with paper – or as they put it – written
evidence.
Those of us old enough to remember the business
world in the 1990s will recall the introduction of British
Standard BS5750 in 1991. This quality assurance
system received much publicity at a time when the
British were being accused of inconsistent quality and
poor standards. Accreditation to the BS5750 standard
was seen as a demonstration of competence.
The reality of course could be and often was very
different. Some early quality assurance schemes
written by or for companies were often no more than
manuals written by wordsmiths and did not reflect the
reality that was happening. Others, and perhaps
more commonly simply recorded poor systems and
therefore entrenched mediocrity – along the lines of
the adage “crap in, crap out!”
Whilst recording the fundamentals of a system or procedure
clearly does make sense it is wrong to think
that that process alone is sufficient to embed quality
performance. At one level such an approach can
reinforce less than excellent performance or at another
level innovation and development can be stifled
and stultified by rigid adherence to “the way we’ve
always done it.”
And let’s not forget the people receiving care may not
welcome or thrive in an overtly rules based environment
– but that’s what CSCI largely monitors.
Now most forward thinking businesses have moved
away from the old BS5750 mantra and in the guise of
the international versions of the standard ISO 9000-2
they realise that in addition to ensuring there is a
functioning quality assurance system they don’t lose
sight of the fact that it is the outcome and delivery of
the service – in other words the big picture position -
which is at least as important as ensuring adherence
to procedure.
CSCI it appears, in common with many regulators
seem to audit and review more by what is recorded in
the procedure manuals and the data generated by the
procedures rather than by the quality of care actually
delivered. They can’t, won’t, or simply don’t look at
the bigger picture issues to inform them of deviations
from what they expect. What may simply be mere
peccadilloes, or slightly less than ideal can become
blown up out of all proportion as failures to conform to
a standard.
It is perhaps CSCI and its fellow regulatory travellers
that need to appreciate that auditing by rote and failing
to see the wood for the trees is itself a great failing.
Let us not forget that the over-regulation of the
health and social care sector stems from the abuses
largely perpetrated by the hands of state employees
in the past. Micro-managing now cannot remedy
what was done previously.
There is another pervasive and corrosive aspect of
what this government has done that really makes my
blood boil. That is the intellectual corruption and politicising
of the public service. Whether one looks at
the NHS or the enforcement work of our regulators
one can see how the artificial targets set by the government
distort the delivery of the services. We can
all recall the shock Mr Blair portrayed when being
challenged in the last general election campaign
about the ability to book a GP appointment and how
many GP’s had prevented booking an appointment
more than 48 hours in advance so as to be sure that
they would be able to meet the artificial target of being
able to offer appointments within 48 hours of first
contact by a patient. There are many other examples
along exactly the same lines now. With the financial
year end around the corner hospital trusts
that need to can now manipulate the time patients’
are asked to wait for treatment so as to postpone
incurring costs into the next financial year. This is
notwithstanding there is the capacity to provide the
treatments being sought now. These manipulated
delays are occurring now, not for any good clinical
reason, rather to ensure that Patricia Hewitt can announce
good news in April that the NHS’s spending
is now largely back in balance. Rather than protesting
at the political interference in the delivery of
healthcare the hospital trust apparatchiks blithely
comply with the artifice.
For me the picture gets worse when one sees a
regulator act as if it is more concerned by its reputation,
or its achievement of a government imposed
key performance indicator as opposed to seeing justice
or fairness prevail. For me the institution of
criminal proceedings to fulfil a target as opposed to
any intrinsic need for public justice is the worst example
one can get. Ironically I believe I detect the
worst aspects of this sort of political abuse in the larger
national agencies as opposed to say, local government.
It has come as a pleasant surprise to me
as a former local government lawyer and prosecutor
that one can still talk, reason, and persuade local
authorities that prosecution for particular infractions
of the law are not always necessary. They, on the
whole, are prepared to listen and consider matters
on a case by case basis. The impression one gets
with the larger national agencies such as the FSA,
the HSE, CSCI and the like is that their decisions are
too informed by their key performance indicators and/
or their entrenched inflexible policies and procedures.
The desire to meet targets or to achieve the mythical
consistency between cases comes to the fore in advance
of individual considerations of each case. In
the halcyon days when I was a prosecutor, no doubt
viewed through hypocritical rose tinted spectacles, I
felt I was on the side of the angels. I’m not sure that
is how prosecutors today see life. I don’t believe we
under enforced or under delivered but I was sure the
decisions we took were carefully taken on their own
merits. I am prohibited by my rules of conduct from
publicising just how successful I was as a prosecutor
but if I was a footballer I think my performance would
have interested Jose, Arsene and their ilk!
So when the next election comes will the next crowd
change anything – I do hope so?
Andrew Dawson
Partner
Brunswicks LLP
Tel: 0870 766 9281
Fax: 0871 288 4089
Email: Andrew.dawson@brunswicks.eu
Mbl: 07970 635629
Podcasts - Our latest two podcasts are:
"My dad's bigger than yours" - an extract from a
seminar which Keith Lewin gave to the Lancashire
Care Association looking at CSCI's demands
for action plans; and
"Fire Safety - a cultural change" - Andrew Dawson
interviews Chris Howard from Merseyside Fire
and Rescue Service and learns how the Fire Service
is changing its approach as a regulator. Will
it be the end of the nice guy approach?
To access these podcasts either:
• go to our web-site www.brunswicks.eu and
follow the links to the Podcasts; or
• go to our host site directly
ww.brunswicks.libsyn.com; or
• use a podcast aggregator like iTunes.
If you type in any of our names, or Brunswicks
name into the search facility in the iTunes store
you'll discover we are "artists." You can subscribe
free of charge to the podcasts there!