Editorial
On Monday, 12.05.08, the Prime Minister, Gordon
Brown, launched the long awaited consultation on
paying for long term care.
It is critical that there are no ‘sacred cows’, no issues
that are off the table, no topic that cannot be
discussed. For too long the care sector has listened to
central Government say that it provides plenty of cash
to pay for social care, to provide for training blah, blah,
blah.
On the other hand we have listened for too long to local
councils assert that they simply don’t have enough cash
to pay much for care.
The Government is correct. Plenty of cash has been
delivered by Government to councils to pay for care;
however, councils chose how to spend it. They
generally decide to ‘redirect’ that cash to other
uses. Some councils have decided that it is not
appropriate to provide any increase in the payment it
makes for care, notwithstanding all the costs forced on
care providers by Government, such as extra holidays
for staff, increases in the national minimum wage etc.
etc. etc. Not to mention other increased costs such as
heat and light! Providers will, however, also need to
improve care etc. as part of the bargain.
It is high time that a careful
consideration is given to ringfencing
of payments for social
care. Without it, some councils
will continue to cheat.
This week’s article
There have been statements from Government spokesmen that there will be moves to amend the Health and Social Care Bill to the effect that the Human Rights Act will be extended to all those persons whose care in care homes is paid for by the State – again reported in this issue of BHCR see item 6. This week’s article is by the renowned human rights barrister Cherie Booth QC; Ms Booth represented the National Care Association when it intervened, at the invitation of the Attorney General, in YL v Birmingham City Council (see BHCR Vol 2, issues 11 and 40). The article is taken from her key-note address to NCAs national conference in October 2007 and whilst it gives an historical perspective to human rights and their general application, nevertheless, as is clear from the article, rights are protected in other ways. I am very grateful to Ms Booth Q.C. for consenting to BHCR publishing her speech.
To read article click here.
Parliament
19.05.08 – HoL – Baroness Greengross to ask about
the progress in development of Polyclinics
Earl of Glasgow to ask about the introduction of
measures to use electric mobility devices on roads
No information from House of Commons was
available to us on business for next week at the time
of going to press.
Next
Abuse
1. UK SIGNS UP TO NEW GLOBAL APPROACH
IN PROTECTING CHILDREN FROM
SEXUAL ABUSE
9 May 2008 - UKPolicing.info
Home Office Minister Vernon Coaker stepped up the
Government's commitment to the global protection of
young people, having signed the Council of Europe's
Convention on the Protection of Children from Sexual
Exploitation and Abuse.
2. 5,000 complaints a month over care abuse
fears
5 May 2008 - Daily Mail
Councils ‘guesstimate’ of calls from worried relatives
concerned that their loved-one may be at risk of
abuse is some 60,000 annually.
Business News
3. Claimar Care Group PLC
9 May 2008
Claimar Care a provider of domiciliary, high dependency
and acquired illness care services to local auth
o r i t i e s , Primary Care Trust s and
the NHS announced it will publish its interim results,
in respect of the 6 months ended 31 March 2008, on
Monday 30 June 2008.
Trading update is upbeat reporting on new contracts,
it also reported that it had not been possible to recover
increased costs arising out of the Working
Time Directive.
The Board anticipates interim results will represent a
substantial improvement over those of the prior year.
It also anticipates, in light primarily of the factors described
above, that the performance for the year ending
30 September 2008 will be broadly in line with
current market expectations.
In a separate note Claimar announced its finance
director, David Jackson, resigned by mutual agreement
and left on 08.05.08. A successor is not in
place.
4. Tracscare may change hands
6 May 2008 - The Telegraph
Sovereign Capital which owns Tracscare has appointed
advisors to conduct a strategic review of the
business – this might lead to a sale expected to be in
the region of £200m.
5. ‘Unacceptable’ sales practices to
cost Smith & Nephew £50m in lost revenue
2 May 2008 - The Times
Having recently bought Plus Orthopaedics for £450m
Smith & Nephew called in lawyers and forensic accountants
to investigate the sales operation in
Greece which accounted for about a 33% of the sales
of Plus.
Ed. It looks like there will be some serious litigation,
in the form of warranty claims, against the
vendors of Plus. It is intriguing to ponder what is
suspected of having happened as the police have
not been called in.
Care Homes
6. New law to protect elderly in care
11 May 2008 - The Sunday Times
Item repeating Ivan Lewis’ statement that there will be
an amendment to the Health and Social Care Bill extending
the reach of the Human Rights Act to all service
users funded by local authorities.
Ed. See what Cherie Booth QC has to say on this
topic. Interestingly, she promotes the view held
by a number of care sector lawyers, me included,
that direct application of the Human Rights Act is
not needed to address the mischief feared – these
matters are already dealt with in other legislation
which protects all service users, not just those
who happen to be state funded.
7. A civil war in Northants
May 2008 - Caring Business
A look at the statistics of care provision in Northamptonshire
as compared to UK averages and the pressure
on income as 47% of funding is provided by the
council which last year did not increase the fees paid
at all and this year increased the fees by 3% after
originally announcing an increase for this year of 0%.
8. Few care homes earn new three-star rating
7 May 2008 - The Times
Of the English care homes inspected 731 failed to get
any stars from CSCI – suggesting, perhaps, that they
should not be operating.
13% of the 24,370 homes were awarded the maximum
of three stars.
9. CSCI star ratings:
6 May 2008 - LCA Newsletter
Lancashire has twice the national average of 3 star
rated care homes. It also has a third higher 3 star
care businesses than the national average. CSCI
have just launched the new star ratings information
on its website. From a quick early look at the Lancashire
data (and taking the data on face value) it presents
a very positive picture of Lancashire. Nationally,
16.8% of care homes (2278 of 13,565 reported)
are 3 star while Lancashire (LCC area) figures are
30.9% (110 of 356 reported). Blackpool is 16.4% (11
of 67 reported) and Blackburn w Darwen, 26.3%, 10
of 38 reported). Dom care businesses given 3 star
ratings are 18.5% nationally (670 of 3620 reported)
but 24.7% in Lancashire (29 of 117). The headline
nationally is that the number of 0 rated (“poor”)
homes is just 1.4% (1.1% in LCC area, 0% in Blackpool
and 0% in Blackburn). Nationally, 4.5% of dom
care providers are rated as “poor” but in Lancashire
the figures are 0.8%, 0% and 0% across the three
authorities, respectively. This is a major good news
story for Lancashire.
10. Star Ratings
7 May 2008 - ECCA
The English Community Care Association (ECCA)
welcomed the news that the vast majority of care
homes have been given ‘good’ to ‘excellent’ in the
new CSCI star ratings system.
Martin Green, Chief Executive of ECCA, said:
“We welcome the advent of star ratings which will
give more information to the general public when
they are selecting a home. We will also be monitoring
whether or not commissioners make their decisions
based on quality or price and it is our hope that
the CSCI will use this information to challenge poor
commissioning decisions.
ECCA will be watching the implementation of the new
system and will be looking for consistency across the
country and where providers feel they have been unfairly
judged we hope that CSCI will investigate these
issues swiftly and, if necessary, amend the star ratings.”
11. CSCI launches new quality ratings for
care services
7 May 2008 - CSCI
CSCI launched its new quality ratings; as a care provider,
you will know that CSCI wrote to you to give
the opportunity to have your interim rating published
on the website. CSCI says 82% of all respondents
agreed.
Read more about quality ratings
Case Reports
Law Reports
12. C v East Sussex County Council
Court of Appeal reminded social workers that the
court is the ultimate arbiter of what is in the best interests
of a child, notwithstanding that Parliament had
given social workers wide powers – which they must
not abuse. The council in the case had, in the view of
Lord Justice Wall demonstrated disgraceful conduct.
See item 13 below.
13. RP v (1) Nottingham City Council & (2)
Official Solicitor
The court gave guidance on the steps to be taken
before and during care proceedings where there was
an issue as to a parent's capacity.
Disciplinary cases
Nothing to report this week
Cases in the news
14. Aricept costs award
10 May 2008 - The Times
National Institute for Health and Clinical Excellence
has to pay the majority of the legal costs incurred by
Eisai which won its judicial review case over the drug
Aricept.
For case report, see BHCR Vol 3, Issue 15, item
76.
15. Paediatricians' GMC case delayed
8 May 2008 – BBC News
In the case of David Southall, the General Medical
Council has won a delay in a new investigation into
the paediatrician’s work so it can assess further evidence.
Southall already faces being struck off the medical
register pending appeal, but can continue practicing
until then.
For full report click here
Ed. Perhaps Prof. Southall will be retired before
this saga is concluded.
16. Nurse sentenced for patient abuse
7 May 2008 – BBC News
Senior sister Agnes Lawrence has been ordered to
carry out 150 hours of community after assaulting a
dementia patient at Rowantree Nursing Home in
Rutherglen in January 2007. The patient became aggressive
after being asked to sit down for dinner and
Lawrence grabbed his hair, pulled him to the floor and
banged his head off a door.
For full report click here
17. Judges condemn ‘foul play’ on adoptions
2 May 2008 - The Times
Lord Justice Thorpe was extremely critical of the underhanded
behaviour of East Sussex County Council
in ensuring that a child was adopted “by means more
foul than fair...which fuels public distrust in the good
faith of public authority”.
Ed. The claim brought by the father whose efforts
to be heard in the adoption process failed. I
hope he reports all the council social care staff
who were involved in this shameful sequence of
events to the General Social Care Council for investigation
– their Lordships judgement should
be quite sufficient to cause a number of individuals
to justify why they should not be ‘struck
off’. For an item on the GSCC, see 58.
Children
18. Inside the home for angry infants
11 May 2008 - The Sunday Times, Colour Supplement
Five page moving article about the devastated lives
of young children cared for at the Mulberry Bush
school the subject of a TV documentary ‘Hold Me
Tight, Let Me Go’ to be broadcast on BBC4 22.05.08
at 21:00hrs.
19. Fears for children at risk as care order
applications fall by a third
6 May 2008 - The Times
A new procedure designed to cut costs and speed up
care proceedings has placed children in greater danger
as applications fell spectacularly – 30% down in
London, some Boroughs by as much as 75%.
Martha Cover, a barrister specialising in child care,
regards the fall as “alarming”.
Conferences & Courses
To follow next week
Consultations
20. Consultation on the Medical Profession
(Miscellaneous Amendments) Order 2008
Closing Date: 5 June 2008
A consultation paper asking for comments on a draft
order. The changes proposed in the draft order seeks
to implement two of the reforms set out in the White
Paper: Trust Assurance and Safety. The draft order
also provides an additional route to the Specialist
Register for NHS consultants. All amendments relate
to the functions of the General Medical Council.
For full consultation click here
21. Private and voluntary healthcare: Care
Standards Act 2000. Regulations and national
minimum standards consultation
document
Closing Date: 10 June 2008
DoH plans to make sweeping changes to the way
that health and adult social care is regulated and performance
managed, from April 2009 (a date which
may ‘slip’). The consultation document contains the
proposed changes to the regulations and proposed
changes to the associated National Minimum Standards
(NMS).
For full consultation click here
22. The Future Regulation of Health and
Adult Social Care in England: A consultation
on the framework for the registration of
health and adult social care providers
Closing Date: 17 June 2008
A consultation seeking views on the future regulation
of health and adult social care. It seeks to consider
which health and adult social care services should
require registration with the Care Quality Commission
and what the requirements for registration should be.
It also considers when providers of regulated services
should be required to have a registered manager and
how primary care services should be included in the
new registration system.
For full consultation click here
23. Children and Adoption Act 2006: Court
rules – Consultation
Closing Date: 20 June 2008
A consultation seeking views on draft court rules and
forms to support the implementation of the remaining
provisions of the Children and Adoption Act 2006.
These provisions would then enable courts to use
contact activities to help resolve child contact disputes
and give them more flexible powers to enforce
contact orders.
For full consultation go to http://www.justice.gov.uk/
publications/cp0708.htm
24. Consultation: Human rights inquiry
Closing Date: 21 June 2008
Consultation seeking views on how public authorities,
such as hospitals, schools or local and national government
offices, make sure they treat people well and
in line with legal requirements under the Human
Rights Act.
For consultation go to http://www.equalityhumanrights.com/
e n / p r o j e c t s / h u m a n r i g h t s i n q u i r y / P a g e s /
Gatheringevidence.aspx
25. Consultation: Statutory guidance for children's
trusts on the duty to cooperate
Closing Date: 26 June 2008
This consultation seeks views on draft statutory guidance
for children's trusts on inter-agency cooperation
to improve the well-being of children, young people
and their families.
For full report go to http://www.dcsf.gov.uk/consultations/
conDetails.cfm?consultationId=1544
26. NICE Consultation: The 2008 update to
the guidelines manual
Closing Date: 1 July 2008
Consultation seeking views on a draft update of a
manual that describes the detailed process and
methodology used to produce NICE clinical guidelines.
For full report go to http://www.nice.org.uk/aboutnice/
howwework/developingniceclinicalguidelines/
clinicalguidelinedevelopmentmethods/
guidelinesmanualconsultation2008update.jsp
27. Proposals to change NHS structure in
Wales
Closing Date: 2 July 2008
The Welsh Assembly has announced proposals to
change the NHS's structure in Wales.
The proposals are part of a three-month consultation,
include plans to abolish the internal market by providing
funding from the Welsh Assembly or an NHS
Board for Wales directly to trusts and local health
boards.
For full report go to new.wales.gov.uk
28. Call for Evidence: The Child and Adolescent
Mental Health Services review - Next
steps to improving the emotional well-being
and mental health of children and young people
Closing date: 7 July 2008
This consultation calls for evidence on how universal,
targeted and specialist services can be improved to
meet the needs of children and young people who
are experiencing, or are at risk of, mental health problems.
For consultation click here
29. NICE: Current consultations
To browse through consultations go to http://
www.nice.org.uk/page.aspx?o=consultations.current
CSCI, CSSIW, Healthcare
Commission &
Scottish Care Commission
30. Care watchdog staff praised for exam
success
9 May 2008 - SCC
Scottish Public Health Minister, Shona Robison has
congratulated nearly 50 staff from the Care Commission
who have completed a new academic qualification.
The qualification puts them at the forefront of all
modern regulations for adult, children’s and healthcare
services.
For full report click here
31. ’Star ratings don’t add up’ - R&RA
8 May 2008 – NCF
The Relatives & Residents Association is expressing
their concerns at CSCI’s new star ratings for care
homes.
The Association said “Star ratings seem to be more
about reducing the numbers of inspections rather
than safeguarding residents. Most people calling us
to want to see more inspections – and not fewer.”
Gillian Dalley, Chief Executive of the R&RA said “we
worry about the people who live in homes that may
only be inspected once every two or three years. We
are concerned that this new system will obscure the
failure of some care homes to meet fundamental
standards.”
For full report click here
32. CSCI launches new quality ratings
7 May 2008 – CSCI
CSCI launches its new star ratings for care homes so
that for the first time ever, the public can see at a
glance whether care services in their area are excellent,
good, adequate or poor
For full report click here
33. Care home ratings 'may mislead'
7 May 2008 – BBC News
The charity, Age Concern, has criticised the Commission
for Social Care Inspection’s new star ratings for
care homes in England. The ratings range from three
stars (excellent), two stars (good) or one star
(adequate). The charity said that many have been
given a one star rating which was undeserved and
gives a misleading impression.
Research by the charity found cases in which inspections
had failed to establish residents were treated
respectfully.
For full report click here
Education
Nothing to report this week
Ireland, Scotland & Wales
Ireland
Nothing to report this week
Scotland
34. Heart Attack A&E Care To Be Centralised
At Two Hospitals
8 May 2008 – The Herald
West of Scotland residents suffering from severe
heart attacks will now only be taken to just key hospitals,
bypassing all other A&E departments.
The Golden Jubilee National Hospital in Clydebank is
to become the centre for serious heart attacks for
Greater Glasgow and Clyde while Hairmyres in East
Kilbride will serve Lanarkshire and much of Ayrshire.
This means longer journey times to hospital for
many, but will give every patient access to what is
currently considered to be the best treatment - an
emergency angioplasty to open their blocked artery.
35. Deal to allow more to die at home
8 May 2008 – BBC News
NHS Lanarkshire and the charity, Marie Curie Cancer
care and NHS Lanarkshire have signed a £1m
deal to allow more terminally ill patients to die in their
own homes.
The charity said it this would provide 15,000 extra
hours of nursing care to offer end of life care to patient
with cancer and other life-limiting illnesses.
For full report click here
36. Care funding gap 'will be filled'
7 May 2008 – BBC News
Health Secretary, Nicola Sturgeon has announced
that the £40m funding gap in Scotland’s free personal
care will be filled. She will also be demanding a £30m
allowance be reinstated, which was previously withdrawn
from Scottish care home residents.
She also said there will also be new laws on food
preparation charges will also be brought forward, after
Ms Sturgeon said previous guidance was wrong
and lacked clarity.
For full report click here
37. GBP2m Facelift For Flagship Hospital
Site
5 May 2008 – Evening Times
The Golden Jubilee National Hospital in Clydebank,
Scotland’s flagship hospital is to have two new front
entrances to cater for the growing number of patients
being treated at the former HCI hospital.
Since it was bought for £37.5m by the NHS almost
six years ago, the hospital has become a leader in
cutting waiting times and also cutting down on potentially
deadly infections. It has had no cases of the
superbug MRSA in two years.
Wales
38. Health plan 'missing key targets'
9 May 2008 – BBC News
The BBC has learned that key targets in the Welsh
Assembly Government’s flagship health plan are being
missed in as many as 10 areas such as bed
blocking, bowel cancer screening and reducing waits
for heart surgery.
For full report click here
Learning Disabilities
39. Research will look at numbers of adults
with autism and transitions challenges for
young people
8 May 2008 - COI
Care services Minister Ivan Lewis announced
£500,000 for Government research into the numbers
of adults with autism and their specific transitions
needs. This prevalence study will inform the first ever
Government strategy on adults with autism and Aspergers
syndrome, due to be published next year.
The number of children with autism is as high as 1 in
100 (according to Prof. Baird’s 2006 study) and this
prevalence study will give us a more accurate picture
of how many adults have the condition. Part of the
new research will focus on the period of transition to
adult life and will inform service planning for adults
with Autistic Spectrum Disorders (ASDs). This will be
led by Prof. Baird and it will examine the lessons and
challenges in the transition process and focus on areas
such as mental health, social care, housing and
further education needs.
Ivan Lewis said:
“Adults with autism and Asperger’s syndrome are too
often abandoned by services with their families left to
struggle alone. Equally, people are frequently misappropriately
referred to either mental health or learning
disability services
“This study will inform the development of a national
strategy designed to ensure that adults with autism
and Asperger’s syndrome are supported to have full
lives.”
“We still don’t know enough about autism, but we do
know that left unsupported, it can have a devastating
impact on those who have the condition and their
families. One of the key gaps in our knowledge is
simple - we don't know how many people have the
condition in any given area. That is why I am ordering
a study to address this.”
40. Government Response to the Joint Committee
on Human Rights: A life like any
other? Human rights of adults with learning
disabilities
7 May 2008 – DoH
A memorandum setting out the Government's response
to the conclusions and recommendations in a
report on the human rights of adults with learning
disabilities published by the Joint Committee on Human
Rights.
For full report click here
Legislation Update
41. No. 1184 The Mental Health (Hospital,
Guardianship and Treatment) (England)
Regulations 2008
7 May 2008 – OPSI
For full legislation click here
42. No. 1189 The Disabled Facilities Grants
(Maximum Amounts and Additional Purposes)
(England) Order 2008
7 May 2008 – OPSI
For full legislation click here
43. No. 1204 The Mental Health (Mutual Recognition)
Regulations 2008
7 May 2008 – OPSI
For full legislation click here
44. No. 1205 The Mental Health (Conflicts of
Interest) (England) Regulations 2008
7 May 2008 – OPSI
For full legislation click here
45. No. 1206 The Mental Health (Approved
Mental Health Professionals) (Approval)
(England) Regulations 2008
7 May 2008 – OPSI
For full legislation click here
46. No. 1207 The Mental Health (Nurses)
(England) Order 2008
7 May 2008 – OPSI
For full legislation click here
47. No. 1210 (C.52) The Mental Health Act
2007 (Commencement No. 6 and After-care
under Supervision: Savings, Modifications
and Transitional Provisions) Order 2008
7 May 2008 – OPSI
For full legislation click here
Mental Health
48. Mental Health Act 2007: Report on the
consultation exercises on the draft revised
code of practice and secondary legislation
9 May 2008 – DoH
The report covers the results of a consultation on the
Mental Health Act 2007 and secondary legislation.
For full report click here
49. Attitudes to mental health remain broadly
sympathetic
8 May 2008 - COI
The public is generally understanding of people with
mental health problems, with 85% thinking they deserve
our sympathy and more than 8 out of 10 saying
society needs to be more tolerant towards them.
A number of attitudes that worsened during the nineties
have since started to improve. There are also
some signs that fears about coming into contact with
psychiatric patients, which worsened during the nineties,
have started to lessen again.
50. Attitudes to mental illness 2008
8 May 2008 – DoH
The latest national statistics on Attitudes to Mental
Illness produced by the Department of Health were
approved by the UK Statistics Authority and released
on 8 May 2008.
For full report click here
51. Mental Health Act: revised code of practice,
new secondary legislation and response
to consultation
7 May 2008 – DoH
Now available is a range of new secondary legislation
issued in the light of changes to the Mental
Health Act 1983 made by the Mental Health Act
2007. Subject to Parliament, they will come into
force, together with the main changes to the 1983
Act, on Monday 3 November 2008.
For full report click here
52. Confusion on the frontline about mental
capacity says report
5 May 2008 – NCF
A report by the Mental Health Foundation has revealed
confusion by many health and social care
staff on mental capacity issues. 98% of staff who
were interviewed for the report ‘Whose Decision?’
said they felt that they needed more training on the
subject.
For full report click here
Miscellaneous
53. Rusty surgeons put patients at risk
10 May 2008 - The Times
Christopher Eden, Consultant specialising in keyhole
surgery on prostates, says prostate cancer patients
are being put at risk by surgeons who undertake
too few procedures to remain competent. Mr
Eden suggests that such complex surgical procedures
should be confined to high-volume surgeons.
Ed. Mr. Eden was a winner of one of the Laing &
Bussion Healthcare Awards in September 2007.
54. Foreign doctors fiasco lambasted by MPs
8 May 2008 - The Times
Handling of junior medics 'inept'
8 May 2008 – BBC News
The House of Commons Select Committee on Health
has ripped into the Government’s Modernising Medical
Carers providing the training of doctors which
“handed NHS jobs to foreign doctors at the expense
of British candidates”. Sir Liam Donaldson has seen
his reputation battered.
For BBC report click here
55. People’s peerages dominated by great
and the good, earl protests
8 May 2008 - The Times
Donor to LibDems is client of party treasurer’s
lobbying firm
6 May 2008 - The Times
Lord Onslow critical of ‘people’s peer’ process and in
particular item focuses on Lord Hameed, former chief
executive of Cromwell Hospital and Alpha Healthcare
which donated huge sums of money to the Lib-
Dems. Lord Tim Clement-Jones of law firm DLA also
comes in for comment after there was a failure on the
part of all concerned to declare that Alpha was a donor
to LibDems.
56. Doctors feel there is a need for clearer
understanding of their role
8 May 2008 – King’s Fund
A new report by the King’s Fund and the Royal College
of Physicians shows that many doctors feel that
there needs to be a clearer understanding of their
distinct role in the increasingly multidisciplinary environment
of the modern NHS where other health professionals
are taking on expanded responsibilities for
patients’ care.
For full report click here
57. Warning over hospital infection
7 May 2008 – BBC News
Scientists are warning that hospitals could face a
growing threat from another deadly bacterial infection.
An analysis by the Wellcome Trust Sanger Institute
has found that Stenotrophomonas maltophilia has the
capacity to develop drug resistance rapidly.
There have been currently less than 1,000 reports of
Steno blood poisoning in the UK a year - a third of
which are fatal, but the Genome Biology study warns
it may eventually prove harder to treat than superbugs
such as MRSA.
For full report click here
58. Champion of the caring cause
6 May 2008 - The Times, Public Agenda
Focus on Mike Wardle, chief exec of General Social
Care Council. He makes the comment that children’s
social workers are demonised – hummmm! There
are reasons why the public thinks the way it does –
see items 17 and 12.
Ed. I understand that in every organisation, profession
etc. There will always be bad apples. It is
for Mr Wardle’s organisation to lead the way in
clearing out the stables. They have the power to
strike off the register those who are so poor at
what they do that they can no longer be permitted
to continue!
59. Ivan Lewis announces social enterprise
fund open for business
6 May 2008 - COI
Care Services Minister, Ivan Lewis announced the
opening of the second round of the Department of
Health Social Enterprise Investment Fund. He also
announced that this year, it would include a new element,
the 'Innovation for Life Challenge Fund', developed
in collaboration with the Social Enterprise Coalition.
The Innovation for Life Challenge Fund will
encourage Strategic Health Authorities (SHAs) and
their partners to find collaborative solutions to health
and social care needs through social enterprise.
The Minister announced that SHAs would be invited
to bid for up to £100k revenue each (from the existing
Social Enterprise Fund) to support the commissioning
of innovative cross-sector social enterprise
solutions. Funding from the new 'Innovation for life
Challenge Fund' for 2008 -/9 could be used to support
local boroughs to develop social enterprise solutions
to health and well-being issues and to provide
cross-sector solutions to local problems, for instance
the health and housing sectors working together.
More information about the Department of Health's
social enterprise programme can be found at: http://
www.dh.gov.uk/en/Managingyourorganisation/
Commissioning/Socialenterprise/index.htm
60. Johnson plans 12 new GP practices
5 May 2008 – BBC News
Health Secretary, Alan Johnson has proposed plans
to set up 12 new GP practices in poorly-served areas
and a £105m investment in clinical and GP services.
The new practices proposed are in , Birmingham,
Middlesbrough, east London, Bury, Somerset, Telford,
Bristol, Gateshead, Coventry and Lancashire,
with the first being expected to open to patients
within the next 12 months.
For full report click here
61. New GP surgeries to open at weekends
5 May 2008 - The Times
There are to be 12 new GP surgeries around England
which it is said by Government will provide enhanced
opening hours for consultations.
NHS
62. How the NHS is letting my father die – by
a top hospital consultant
11 May 2008 - The Mail on Sunday
Ophthalmologist, Sarah Anderson, is convinced of
the existence of the ‘post code lottery’ as her father is
denied Sutent, a new cancer drug, which is his only
real change of prolonging his life.
Ed. Clearly, she is exasperated by the process of
resource allegation.
63. Up to 5,000 beds facing axe in cancer
shake-up
11 May 2008 - The Sunday Times
Profs. Nick Bosanquet and Karol Sikora have analysed
figures published by Govt as part of the Cancer
Reform Strategy (which will deliver treatments
through out-patient clinics) and conclude that up to
5,000 beds will need to be scrapped to balance the
financial savings claimed in a separate document on
an ‘obscure’ part of the DoH website.
64. Supersize NHS
10 Mat 2008 - The Times
Article about the ‘heavy-duty’ equipment needed by
the NHS to cater for the growing obesity in society.
65. Lord Darzi sets out tough rules for
changes in the NHS
9 May 2008 - COI
Health Minister, Lord Darzi, issued five pledges to the
public and staff on how the NHS will handle changes
to services. He set out a rigorous process requiring
any change to be transparent, clinically evidenced,
locally led and for the benefit of patients.
1. Change will always be to the benefit of patients.
This means that change will improve the quality of
care that patients receive - whether in terms of clinical
outcomes, experiences, or safety.
2. Change will be clinically driven. We will ensure that
change is to the benefit of patients by making sure
that it is always led by clinicians and based on the
best available clinical evidence.
3. All change will be locally-led. Meeting the challenge
of being a universal service means the NHS
must meet the different needs of everyone. Universal
is not the same as uniform. Different places have different
and changing needs - and local needs are best
met by local solutions.
4. You will be involved. The local NHS will involve
patients, carers, the public and other key partners.
Those affected by proposed changes will have the
chance to have their say and offer their contribution.
NHS organisations will work openly and collaboratively.
5. You will see the difference first. Existing services
will not be withdrawn until new and better services
are available to patients so they can see the difference.
Leading Local Change can be found at http://
www.ournhs.nhs.uk
66. New rules cut hospital MRSA cases
9 May 2008 - The Times
The use of cannulae must be ‘signed off’ by a specialist
and a doctor so that they are used only when
absolutely needed; when in place the tube is flushed
with saline and inspected each day. This has reduced
to nil new cases of MRSA in Royal Hampshire
County Hospital in Winchester.
67. Our NHS Our Future: NHS next stage review
- Leading local change
9 May 2008 – DoH
The report forming part of Lord Darzi's NHS Next
Stage Review, presenting local visions for the NHS
and the principles to guide their implementation.
For full report click here
68. Darzi report reveals service change plans
9 May 2008 – HSJ
Promises made over NHS overhaul
8 May 2008 – BBC News
Darzi review: PCTs told reforms must save
lives
8 May 2008 – HSJ
Ministers are currently trying to allay fears over the
forthcoming overhaul of the English NHS, as doctors
accuse the Government of undermining GP practices.
For full report click here
69. NHS Confederation responds to Darzi
report
9 May 2008 – HSJ
NHS Confederation policy director Nigel Edwards
has commented on a report outlining the principles
behind junior health minister Lord Darzi's vision
for the health service. Mr Edwards said: "This new
guidance is very welcome in sharing good practice
and helping reassure the public about what they can
expect."
70. King’s Fund statement on Department of
Health reconfiguration pledges
9 May 2008 – King’s Fund
Commenting on the Department of Health’s publication
of 'Leading Local Change', which contains five
pledges to the public and staff on how the NHS will
handle changes to services, King’s Fund chief executive
Niall Dickson has commented upon the Department
of Health’s publication of ‘Leading Local
Change’ containing five pledges to the public and
staff on how the NHS will handle changes to services:
“This is good first step. We welcome Lord Darzi’s
commitment to avoid a national blueprint and to ensure
that any future changes to services are clinician
led, with the needs of patients paramount and the
interests of local people taken into account.
‘We have a health system that must change, and
some of that change will be challenging. Where the
evidence is strong those responsible at a local level
should move forward with confidence, where it is
weaker, there must be a commitment to pilot and
evaluate new ways of delivering care.”
“The difficult part is always going to be moving from
broad principles to real services – that involves balancing
arguments about quality, access and cost,
reconciling different interests and taking account of
local people’s views. Real political courage and commitment
will be needed to achieve this and to make
our health system more effective and more responsive.”
For full report click here
71. MRSA 'cut by stopping injections'
8 May 2008 – BBC News
Winchester and Eastleigh Healthcare NHS Trust has
claimed that it has eliminated MRSA bloodstream
infections by putting a stop to the routine practice of
administering intravenous injections. The Trust has
now begun prescribing the insertion of cannulae
which is a small tube used for giving intravenous fluids.
The Trust said since the introduction last November
there have been no new cases of MRSA infections,
which covers all forms of MRSA, including bloodstream
infections (also known as bacteraemia) and
wound infections.
For full report click here
72. Launch of biggest ever inspection programme
in acute NHS trusts to check infection
control
8 May 2008 - Healthcare Commission Newsletter
The Healthcare Commission has launched the biggest
inspection programme ever carried out in NHS
acute trusts to check whether they are meeting standards
on infection control.
It will inspect all acute trusts annually as part of a
drive to: reduce death and illness from healthcareassociated
infections (HCAIs); improve the experience
of patients in hospital; and increase public confidence
in the NHS. The programme was established
at the request of the Secretary of State for Health.
73. New national clinical advisor for nursing
8 May 2008 - Healthcare Commission Newsletter
Senior nurse Ann Close last month joined the Healthcare
Commission as a national clinical advisor, responsible
for providing senior strategic advice on issues
related to nursing and patient care.
Professor Close is currently Nursing Director and Director
of Infection Prevention and Control at The Dudley
Group of Hospitals NHS Trust in the West Midlands.
She will continue in her role at Dudley while
acting as advisor to the Healthcare Commission.
74. Charities call for reform of prescription
charges to end ‘risk to patients’
6 May 2008 – The Times
Health charities are calling on the Government to
reform the “unacceptable” NHS prescription charges
in England and claim that the system is “inherently
unfair”.
75. Countdown to NHS 60th anniversary
6 May 2008 – BBC News
Scottish Health Secretary, Nicola Sturgeon has announced
a programme of events counting down to
the 60th anniversary of the NHS. There will be national
and local celebrations up to and including 5
July 2008.
Thousands of people across Scotland, including
NHS staff, patients and the public, are being encouraged
to join the festivities, with the celebrations being
launched at a vintage ambulance display in Glasgow.
For full report click here
76. Hospitals become foundation trust
6 May 2008 – BBC News
Essex Rivers Healthcare NHS Trust, which runs Colchester
and Essex County hospitals, has now become
Colchester Hospital University NHS Foundation
Trust.
The new status is said to give local people and employees
a greater say in the future of the organisation,
as foundation hospitals are still part of the NHS
but can set their own financial and operational priorities
and are run by an elected board of governors.
For full report click here
77. NHS staff dub e-records 'clunky'
5 May 2008 – BBC News
A study by a team from University College London
has evaluated the electronic patient records and comments
on the technology ranged from “clunky” to
“immature”.
The same study warned the system has major bugs
and access problems but that it had “real benefits” for
treating patients in emergency or unplanned situations.
For full report click here
Nursing
Nothing to report this week
Older People
78. Dementia sufferer denied her pension
10 May 2008 - The Times
A cock-up by the Department for Work and Pensions
and no refund of unpaid benefits to a woman suffering
dementia was overturned, but, only after the intervention
of a financial journalist. The refund, over
£15,000!
79. Health care for elderly at home
7 May 2008 – BBC News
A service that currently helps the elderly in Cumbria
stay in their own homes and out of hospital has been
extended and will expand into Eden and Barrow. The
scheme means that trained workers can carry out
basic health care tasks which allows them to help
with washing, bathing, changing dressings and providing
basic health care assistance.
The service already operates in Carlisle and West
Cumbria, where it has helped reduce avoidable hospital
admissions.
For full report click here
80. MPs: homes too reliant on drugs
May 2008 - Caring Business
Item about the All Party Parliamentary Group on Dementia
‘Always A Last Resort’.
Jeremy Wright MP, chairman of the Group said “We
must not accept swift resort to inappropriate chemical
restraint when better care is needed”.
Frank Ursell, CEO of Registered Nursing Home Association,
said “It must be remembered that clinical decisions
about medicines are made by patients’ doctors
not by care home staff”.
81. New impetus to raise dementia care standards
May 2008 - Caring Business
One of a collection of articles focussed on dementia
care; How breaks can mend – respite and holidays
for carers; Memorable designs – memory prompts
and navigation aids; A grounded high-flier – interview
Prof. June Andrews, Scotland’s Dementia Services
Development Centre; How to colour their judgement –
a look at design of the built environment
82. A battle we can win
May 2008 - Caring Business
Neil Hunt, chief exec, Alzheimer’s Society, discusses
his views on the National Dementia Strategy announced
in August 2007 – most important, perhaps,
not to under estimate the scale of the dementia challenge.
Dementia care costs about £17bn a year –
more than the combined cost of cancer, heart disease
and strokes.
The draft strategy is due to be published in the next
few weeks.
Social Care
83. Warning over social care funding
11 May 2008 – BBC News
Ministers are about to begin a major consultation on
how social care is currently funded, and are warning
that England’s social care system is heading towards
a £6bn funding gap unless radical reforms are put in
place.
Health experts predict the ageing population means
state funding for the care of the elderly and disabled
will face a huge shortfall within 20 years.
For full report click here
84. Face down forces of conservatism, minister
tells annual conference
7 May 2008 – Community Care
Care Services Minister, Ivan Lewis, is warning social
care staff to expect a backlash against personal
budgets and possible headlines about alleged misuse
of public money in the face of radically changing
the social care system.
For full report click here
85. Skills for Care put people who use services
at heart of policymaking
7 May 2008 – NCF
The board of Skills for Care has now agreed to implement
participation strategies to put the voices of
people who use services and carers at the heart of
its policymaking and implementation planning at national
and regional levels.
The social care workforce development charity has
created the strategies after two years of widespread
consultation with a large number of organisations
who represent people using services and carers nationally
and regionally.
For full report click here
86. Social Enterprise Investment Fund
6 May 2008 – DoH
This page shows information on the Social Enterprise
Investment Fund, which supports the delivery by social
enterprises of health and/or social care services
and products in England.
For full report click here
Staff, employment and
disciplinary
87. Judicial review still on the cards
May 2008 - Caring Business
Consultation over changes to work permit rules has
been extended by a further 90 days – Govt. has said
that only workers paid £7.02 or more can have their
permits renewed. However, the judicial review proceedings
have not been withdrawn.
88. Apprentice, you’re hired
May 2008 - Caring Business
Rob Finch looks at the availability and usefulness of
apprenticeships in care settings notwithstanding the
cost as they are supernumerary.
89. Left alone to get on with my job – but
what is the job?
May 2008 - Caring Business
Julie Andrew provides ideas on the provision of training
on a low budget and dealing with excessive workloads.
The National Care Association
– Annual Conference
Key-note address by Cherie Booth QC
“Photograph reproduced courtesy of john@johnymillar.com”
I have been asked to speak to you today about importance
of human rights - to be if you like counsel
for the defence at a time in which sadly human rights
get a very bad press.
I want to argue that despite, what you might have
read and heard, human rights belong to us all, can
and are improving all our lives and that the Human
Rights Act is playing a valuable role in bringing these
rights home to us.
There is no doubt that human rights is an issue rarely
out of the news nowadays. Only last week, for example,
the Prime Minister launched a consultation
process on a Bill of Rights which could help spell out
more clearly both our rights and our responsibilities
to each other.
It is a process I wholeheartedly welcome because it
is an opportunity for all sections of society to engage
in a dialogue about what human rights are, their value
and importance.
I fear this is needed more than ever at the moment.
And that’s partly because we rarely get the full
story.
Let me give just give you a couple of recent examples.
There was the case of a man trying to evade
arrest in Gloucestershire who staged a roof-top protest.
When he was sent up some Kentucky Fried
Chicken by the police, it was immediately claimed
they had to do this – with a supportive quote from the
familiar unnamed source – to ensure his human
rights were not breached.
Now I am pretty well acquainted with the European
Convention. And I can assure you that nowhere does
it say how many buckets of KFC a fugitive should be
given.
The decision to send him food and drink was, in fact,
nothing to do with human rights and everything to do
with operational judgement of the police that there
was a better chance of getting him down quickly if
they stayed on good terms – and they were right.
Or take another case which did involve a court case
involving someone claiming their human rights were
breached.
Dennis Nilsen is a serial killer who has, rightly, been
gaoled for life. In an application for judicial review, he
sought access to homosexual pornography, claiming
that the Prisoner Governor’s refusal to allow him such
access constituted ‘inhuman or degrading treatment’
contrary to Article 3 of the European Convention, or in
the alternative was discrimination against gay men
under Article 14.
Understandably, it got huge publicity in the media.
What hardly got a mention in the media was the
fact that Nilsen’s application was refused by a single
judge at the permission stage. This means that he
wasn’t even able to seek judicial review, because he
hadn’t established that he had an arguable case. In
colloquial terms, his case was laughed out of court.
What characterises both these examples is that despite
the accusations made in connection with them
about human rights and human rights legislation, the
actual resolution of them was a matter of common
sense.
The risk of reporting cases in such distorted terms
whilst largely ignoring those where rights helped ordinary
and often vulnerable individuals, is that many
people will come to see rights as irrelevant to them.
Even worse, the danger is that such controversies
may make people feel that human rights are actually
harmful.
Even those who support human rights often see them
as solely concerned with repressive regimes or, if
they see them as relevant to this country at all, about
offering safeguards against some grave injustice.
But rights are not just about political prisoners in
other countries or torture and imprisonment.
They are about each and everyone one of us as we
go about our lives. They are violated by gangs on the
streets who intimidate their local community.
They give us protection against bullying at work or
against discrimination in health treatment if we are
elderly.
They guarantee our children a proper education.
They are about, and this is particularly relevant
to this conference, the standard of care we should
expect in residential institutions for the elderly, the
young and mentally ill.
So I want to examine what human rights are, and
crucially what they are not, where they come from
and why they are important for each and every one
of us and in particular how they relate to the rights
and responsibilities of both those in care and those
helping to provide that care.
The origin of the concept of human rights is not, you
may be glad to hear, one for this speech – otherwise
we might all have to cancel dinner.
However, it is necessary to briefly see their origins to
appreciate their application today.
There are some who argue that the application of
human rights is somehow alien to the fabric, nature
and character of the UK. This shows a sad lack of
knowledge of our history. From Magna Carta – which
began to set down the right to freedom - to the Human
Rights Act stretches a golden thread of rights in
Britain. We have just celebrated, for example, the
200th anniversary of our country’s role in the abolition
of slave trade – a proud role not just here at home but
across the world.
Slowly these rights became established – accepted
by the courts, by Government and by people. By the
last century, the right to freedom, family life, association
and privacy, among others, were all part of the
fabric of our country.
Sadly, this was not the case everywhere. And it was
in a reaction of the utter horrors of the Second World
War - with Britain again in the lead - that the world
came together to set down minimum standards of
treatment which everyone – no matter where they
lived – deserved from their Government and the responsibility
of states to ensure these rights were protected.
This came to be known the Universal Declaration on
Human Rights, agreed by every member of the then
fledgling United Nations.
Identifying these fundamental individual rights was
seen as protection against abuse of power. And it
was also underlined that this all stems from our intrinsic
human dignity – that irrespective of our differences,
of who we are, where we come from, what we
have done - there is a basic level of respect and treatment
that we are entitled to simply because we are
human.
These rights include:
• freedom to have a family;
• freedom to enjoy our property;
• freedom to meet and discuss ideas;
• freedom to hold peaceful protests;
• freedom to think and believe what we as individuals
decide is right;
• freedom to practice religion or not;
• equal treatment;
• freedom from the worst abuses, such as torture or
slavery and guarantees against being deprived of
our liberty without a fair process established in law.
And it was also underlined that these rights stem from
our intrinsic human dignity – that irrespective of our
differences, where we come from, what we have
done or [what we] are, there is a basic level of respect
and treatment that we are entitled to simply because
we are human.
No one would dispute the importance and validity of
these rights. They give expression to the values of
our society. They are common sense and they are
common to us all.
In Europe, such was the determination to ensure we
never slipped back to the dark days of the Second
World War, we went further and came together to
establish a human rights document with teeth, the
European Convention on Human Rights and Fundamental
Freedoms, co-written by British lawyers as
well as jurists from across Europe – and the World’s
first specialised international human rights court, the
European Court of Human Rights. This is an institution
which for the first time in history allowed individuals
to hold the State directly accountable before an
international tribunal for how it had treated its own
citizens.
It was Winston Churchill and not any more recent
Prime Minister as you might believe from recent media
whose wholehearted advocacy of the idea ensured
that Britain was one of the leading countries in
the drafting and signing of the Convention.
For over 50 years, British citizens have been protected
by the rights guaranteed under the European
Convention, rights defined to protect against the excesses
of the State. With the Human Rights Act
1998, these rights were “brought home” by enabling
individuals to bring their claims in UK courts rather
than going to the European Court in Strasbourg. By
adopting the Human Rights Act the British government
gave British citizens the opportunity to benefit
from the rights protected by the Convention in British
courts - a right that had long been enjoyed in almost
all other European countries.
Whatever complaints there are about these rights and
how the courts are enforcing them, no one can say
they are new or alien. They are not. It also seems
strange that some of those critics complaining most
loudly about bringing power back from Europe to this
country would in every other circumstance be applauding
it.
Nor is it true to suggest that human rights are limitless.
No matter how fundamental you and I and everyone
else may see them, they are very rarely absolute.
In the first place, they can’t be absolute simply because
these rights frequently conflict with those of
other individuals and of society as a whole.
Your right to freedom of expression might conflict, for
example, with your right to privacy.
And secondly, from the very beginning, it was accepted
that these rights can be curtailed by Government
not just in times of national emergency but
every day.
Those that drew up these rights half a century ago
knew they were making judgements on competing
interests and had to strike a balance between the individual
and the collective interests.
Flexibility not precision is the key.
They also understood that human rights are not a
one-way street but that they carry obligations as well.
Consequently all human rights documents – national
and international – in addition to recognising individual
rights also recognise individual responsibility and
the need for the State representing the collective interest
to take sensible action.
There is of course some truth in the allegation that
human rights protect the worst people in society. As I
have already mentioned we have rights because we
are human no matter what we have done. It is only
when the least favoured groups in our society are
able to claim their rights that we can be confident that
we too can claim ours. Human rights are an expression
of our best impulses so as to guard us against
our worst; principles to be applied without fear or favour
no matter how difficult or testing times may be.
Some of you may think that as a lawyer specialising
in human rights law, I would say this. You may be
thinking what difference does this make to all of us?
Well, it makes a real difference. One of the main
ideas behind the Human Rights Act was to create a
“human rights culture” so that these rights were automatically
taken into consideration when shaping social
policy. It is about making a better country for
people to live in: reconnecting people and politics,
improving public services, getting more respect into
society, more respect for one for another’s basic human
dignity and promoting basic values we can all
share.
It’s about making rights an intrinsic part of decisionmaking
and planning and enabling us to balance the
rights of the individual against those of other individuals
and society as a whole. This is important in all
sectors of society but it is particularly so in the care
sector.
Some of the most vulnerable in society be they children,
the elderly or those with physical or mental impairments
are looked after by the care sector and the
manner in which decisions are made can have a profound
impact upon the individuals involved.
This usually does not involve the courts. Indeed the
whole point of the thinking behind the Human Rights
Act is to try and keep the courts out of it by ensuring
rights and responsibilities are taken into account in
decision-making in a way which is beneficial to all
involved.
I know how hard you strive to look after those in your
care. But there are inevitably times when standards
are not as high as you might want across the industry.
Older people are unfortunately sometimes neglected.
Relatives are sometimes told they cannot
visit because they ask awkward questions. Married
couples are told that, against their wishes, they cannot
stay in the same care home. These are usually
seen as examples of poor practice but they are human
rights issues. The most effective way to achieve
respect and protect the rights and interests of all, that
everybody wants to see, is not through the courts but
through proper training and raising human rights
awareness and integrating it into our decision making
processes.
Where the Courts have become involved they have
time and again sought to strike a careful balance between
the interests of all involved. As I noted earlier,
despite what is often reported, the Courts do not simply
seek to protect the interests of some with a total
disregard to the rights of others. The Courts carefully
look at the rights and obligations of all and make their
decisions accordingly.
For example in a case from 2003 a decision to close
a care home managed by East Sussex County Council
was challenged on human rights grounds. It was
in part argued by some of the residents that this violated
their rights: specifically, the right to life pursuant
to Article 2 of the European Convention; the right not
to be subjected to degrading treatment pursuant to
Article 3; and the right to respect for their home pursuant
to Article 8 of the Convention.
With regard to Article 2 the Court accepted the extended
the meaning of that provision but did not feel
that a real and substantial risk to the applicants was
established and this part of the claim was quickly dismissed.
The Court also did not feel that the decision
to close the home was degrading to the applicants as
claimed. In the context of the claim both Articles 2
and 3 are absolute rights but the Court did not feel
that a case had been made.
With regard to Article 8 and respect for an individual’s
home the Court had to balance the interests of the
residents and those of the Council. In doing so the
Court gave due weight to the financial interests of the
Council and how it was seeking to find the most effective
way of fulfilling its various statutory responsibilities
within existing financial constraints. On that basis
it found that the interests and rights of the individuals
did not outweigh those of the Council.
In another case, however, where a decision was
taken by a Council to close a residential home without
consulting the residents, the High Court found that
this did amount to a violation of their right to a home
under Article 8 of the European Convention. It was
not the decision itself that violated their rights and the
Court recognised that such a decision could be justified
but the failure to consider the residents’ interests
that was crucial. A proper process of consultation
and consideration of the residents’ interests in the
decision making process was essential.
These cases, however, involved care homes run and
owned by councils. As you are all aware, nine out of
ten care homes in the UK are now privately run and it
is such homes that many of you are involved