Christmas Kills…Government Must Do Something

 

 

An estimated 31,100 excess winter deaths occurred in 2012-13 – a 29% increase on the previous winter.

What the BBC doesn’t say is that summer deaths also rose compared to the previous year….by 25%.

So that actual ‘excess winter death rate’ is  only 4% above what might be the expected rate in comparison to the summer rate.

Not such a headline grabbing, politically powerful message for all those with vested interests.

 

Things are never as simple as the BBC presents them.

 

Which country in Europe has the highest excess winter death rate?

Answer….Portugal…followed by Spain.

 

Here is a report from the Office of National Statistics

Death rates plunge despite coldest winter in 14 years

Date:23 November 2010

There was a dramatic drop in excess winter deaths in the severe winter of 2009/10, the coldest in 14 years, compared to the milder winter of 2008/09, according to a new report out from the Office for National Statistics. The winter brought an estimated 25,400 excess winter deaths in England and Wales in 2009/10, a 30 per cent drop compared with the figures for 2008/09. There were 10,600 excess winter deaths in males and 14,800 in females, the majority occurring amongst those aged 75 and over.

The report, Excess winter mortality in England and Wales, 2009/10 (provisional) and 2008/09(final) points out that excess winter mortality is mostly not caused by conditions directly related to the cold, such as hypothermia. The majority of additional winter deaths are caused by cerebrovascular diseases, ischaemic heart disease and respiratory diseases. Exposure to cold or to influenza infection can be fatal to people who are already vulnerable because of these pre-existing health conditions.

“Although the winter of 2009/10 was the coldest one since1995/96, excess winter mortality fell by almost a third. This is may be because levels of influenza were low for most of the winter season. The highest excess winter mortality in recent years was in1999/2000 when influenza reached epidemic levels in a relatively mild winter.”

 

 

 

Here is the latest from the BBC for last winter’s deaths:

There was a big rise in the number of winter deaths last year, official figures for England and Wales show.

An estimated 31,100 excess winter deaths occurred in 2012-13 – a 29% increase on the previous winter.

 

This is the latest from the ONS:

Excess Winter Mortality in England and Wales,

In 2012/13 19.6% more people died in the winter months compared with the non-winter months, up from 15.5% in 2011/12. There were an estimated 31,100 excess winter deaths in England and Wales in 2012/13 – a 29% increase compared with the previous winter.

 

[Hmmmm….a rise in excess deaths, compared to summer deaths, from 15.5% to 19.6% is a rise of nearly 20%……..so where does that 29% come from?….that must be taking other factors  into account….

Looking at the figures…summer deaths also went up…by 25% from 2011/12 to 2012/13

(summer deaths from 20,875 to 26,000…..winter deaths….from 24,111 to 31,100)

That means that the excess winter death increase isn’t quite so bad….if summer deaths went up 25% then excess winter deaths would also presumably at least go up that much…but have actually gone up 29%…..

…therefore, if my maths is correct….the actual, unexpected, genuinely ‘excess’, increase is around 4%

 

Now 4% of course is not just a statistic, somebody has died….but it puts things into perspective…..if I calculate correctly]

 

Here is the main factor, as the BBC admits but then ignores for the more eye catching ‘profiteering by evil energy companies kills pensioners’ narrative:

The number of winter deaths peaked in the first week of January, which coincided with a peak in rates of influenza-like illness over the Christmas weeks.

 

So…the Christmas period…any chance it is all those relatives visiting, who have spread influenza around, being the likely cause of these deaths rather than the cold?

 

Ban Christmas!

 

I showed you the excess death figures for 2009/10…here are the previous years figures, 2008/09 which was apparently a comparatively mild winter:

“In the winter period of December to March 2008/09 there were an estimated 36,700 more deaths in England and Wales, compared with the average for the non-winter period (see definition below). This was an increase of 49 per cent compared with the number in the previous winter 2007/08. This is the highest number of excess winter deaths since the winter of 1999/2000, when excess winter mortality was nearly a third higher than in 2008/09.”

 

 

 

So 2008/09, a milder winter, had 36,700 excess winter deaths.

2009/10 had the severest winter in 14 years…and a 30% drop in excess winter deaths compared to 2008/09…….25,400.

2012/13 there were 31,100 excess winter deaths.

 

If you can work out the causes let me, and the BBC, know….because they seem to be swallowing press releases uncritically and not doing some basic journalism, exactly on the day a campaign has been launched by charities and politicians on this subject…..which hasn’t been acknowledged by the BBC:

Next Tuesday [26th Nov] fuel poverty campaigners will be marching on the offices of the UK’s big energy suppliers. A range of anti-austerity groups including Fuel Poverty Action, UK Uncut, Disabled People Against Cuts and the Greater London Pensioners Association will target Npower in the City of London.

Further protests are to take place at British Gas’s new HQ in Oxford, and at Lewes and Bristol. The campaigners will march under the banner “Bring down the Big Six – Fuel Poverty Kills!”

On Tuesday morning they will deliver a coffin filled with energy bills and a “peoples’ invoice” to German-owned Npower to recover energy as a public good. In addition, a speak-out will be held where those hardest hit by fuel poverty will tell of their experiences.

 

The problem is possibly far more complicated than the BBC, and others, are letting on.  It suits many people’s agenda of course for that to be the case and for there to be yet another cause to rally around that can be used to try and force the government to spend more money on their pet projects such as ‘socioeconomic progress’….and climate change.

 

 

 

 

 

 

 

 

 

 

Poor Old Ed Miliband

 

As said before Miliband’s appearance on Desert Island Discs was pure propaganda, an opportunity that the BBC has milked for all it’s worth….even reporting it for themselves, giving the story a prominent place on its Frontpage.

The newspapers naturally couldn’t resist, which both the BBC and Labour spinners would have known…and because there was little really substance politically to the appearance, it being more about presenting Miliband as a ‘nice guy’ who loves his dad and family, there was little to attack Miliband on if a paper was that way inclined….the Sunday Times even gave Miliband practically the whole of its page 3, what a waste….and hardly laid a finger on him….telling us how emotional the interview on DID was….no surprise there.

 

But then there is this in the Daily Mirror today:

John Humphrys: Ed Miliband’s Desert Island Discs selection would have been ridiculed regardless of his choice

Poor old Ed Miliband. It’s not often I express sympathy for him or any other politician. Mostly I spend my time on Today duffing them up – or being duffed up by them.But Mr Miliband has been getting a hard time in the media for the past couple of days because he decided to appear on Desert Island Discs – and that often ends in tears.Not because it isn’t a great show – it’s brilliant – but because whatever records you choose will expose you to ridicule and you’ll spend the rest of your life wishing you’d chosen something different. 

A hard time in the media?  Not that I’ve noticed….mocking his choice of record, as Humphrys says, is standard fare for the Press.  Miliband would have known that, his focus group no doubt working over time to come up with a reasonable choice….he would have calculated that the benefits by far outweigh any negatives as long as he stays off the tricky subjects or dishes up bland, anodyne  statements that Kirsty Young doesn’t challenge.

 

Any reason why John Humphrys should be defending a Labour politician in a Labour newspaper?

Humphrys of course isn’t defending Miliband’s politics…but his article is all the more insidious and possibly effective because of that…For the Daily Mirror and Labour spinners it is all about generating a certain ‘feeling’ around and about Miliband…a genuine guy, trying his best, attacked by the nasty right wing press, smeared left, right and centre….and all he’s trying to do is play a few records and have a nice chat.

 

Humphrys should have known better than to step in to defend Miliband even in this apparently innocent way, it’s still politics…just as much as a bag of rice with ‘From The USA’ printed on the side is when handed over to victims of war or disaster.

 

Poor old Ed Miliband indeed.

 

 

FORGET ABOUT THE PRICE TAG….

I noted the BBC provided Stella Creasey with an easy run on the Today programme at 7.10am to launch Labour’s soundbite attack on the Coalition’s attempt to cap “payday” loans.  All the more remarkable is how her clear indication that Labour wants to “control” markets goes unchallenged by the BBC. What could be more natural after all? It’s amazing how the BBC is so aligned with labour each time the Coalition tries to do anything – ensuring that the UK public get to hear the smug hypocrisy from Miliband’s muppets.

The BBC’s Cover Up Of Labour’s Crises

 

 

Today the major story about the Labour Party from the BBC was this:

Desert Island Discs: Miliband brothers’ rift still open

A programme that was always about promoting Miliband and ‘smoothing over’ recent events….as indeed it did…Falkirk..nothing to see there, the Mail’s story about his father’s influence over him….nothing to see there….which is curious really as he admits…

“In modern politics, who you are, who your family is, it’s always going to be relevant and important to people, so it comes with the territory.”

‘Integrity of party’

He added: “We live in a capitalist society – my dad thought you could abolish capitalism, I don’t – but I think it throws up fundamental injustices.

“What motivates me as a politician is you see injustice and you seek to do something about it.”

 

Owen Jones, in an interview with the BBC,  said that of course he was a Marxist, it would almost be odd if he wasn’t…why?..because four generations had been so inclined and he’d grown up ion a house full of Marxist books.

At least I suppose Jones is honest enough to admit his real political leanings.

 

 

However that is digressing…..the BBC’s top story on Labour….a puff for Miliband……

 

The BBC is completely ignoring Labour’s connections to the Co-op…or rather doing its best to downplay them whilst making the most of Labour’s counter attack on the Tories.

Here they talk of ‘Parties’ but really use the article as an excuse to bash one party, the Tories…just how many times can they mention the ‘nasty party’ or other disparaging remarks in one article?

Parties continue row over Paul Flowers ‘smears’

The Conservatives have been accused of a “return to the nasty party”

The shadow home secretary said there had been a “real deterioration” in the politics pursued by the Tories.

Shadow home secretary Yvette Cooper said previous prime ministers would not have linked the revelations to Labour in the way David Cameron has.

“What we’ve seen recently is a real deterioration in the nature of the politics that the Tory party is pursuing,” she told the BBC’s Andrew Marr programme.

“It is a return to the nasty party.

“It is just smear and the politics of the gutter for the Tory party to keep pushing this”.

The “nasty party” phrase was first coined by Home Secretary Theresa May

 

 

Whilst the BBC is happy to adopt Labour’s narrative the Daily Mail reports that Labour’s tactics are a desperate bid to hide the truth:

Tories label Ed pathetic as he fumes at Co-op ‘smears’: Labour leader under fire for bid to shift blame over drug banker

‘This is a pathetic attempt to evade the serious issues. Labour have big questions to answer, and when they are asked, they simply try to avoid them by claiming they are smears,’

Here the BBC do manage to find time to report a Tory criticism of the FSA…and by association the Treasury and government…

Co-op Bank crisis: David Davis says ministers should have seen it coming

 

But is there any investigation into Labour’s connections and shady deals with the Co-op?

Such as this:

Labour Party’s property firm cashed in on cheap loans from Co-op

Opposition’s property portfolio benefited from low rates of interest offered by the bank

The revelation raises fresh questions about Labour’s close relationship with the Co-operative Bank [Not for the BBC though]

LPPL paid 2.88 per cent interest on the loan, according to the company’s 2012 accounts – a far cheaper rate than would typically be offered to property firms on the open market, one expert said.

Interesting that Labour’s response is:

It is a “smear” to call them soft loans, a spokesman said.

 

Guess Labour has no intention of being open and transparent then.

 

Wonder what they make of this if they think the last was a ‘smear’?

A commercial mortgage broker who inspected the accounts said: “This is a ratbag collection of second and third-rate properties, and any of my clients would not get money at that rate of interest out of any bank on the face of the planet.

“They are paying half the rate of interest that the rest of us would pay. This is not a genuine arm’s-length transaction – it’s far too cosy. Poor little Co-op bondholders who are taking a haircut should be asking why they are doing it.”

 

 

Just why doesn’t the BBC proactively investigate Labour rather than sitting back waiting for Labour Party press releases which the BBC then disseminates for them whilst also undermining the opposition?

Co-op bondholders, pensioners and those with plain old bank accounts at the Co-op must be wondering how the Labour Party are taking them for a ride…..whilst they counted their losses Miliband and Co plundered their assets to fund their Socialist Dream.

 

Guess Thatcher was right…..

The problem with socialism is that you eventually run out of other people’s money

 

 

Labour’s new media strategy:

“It is important to hang a lantern on any media-led campaign against Labour well before the election is called so you do not waste precious campaigning time exposing the motivation behind their attacks, as we were forced to do. Second, enlist allies and third parties to reinforce your message about media bias. Research and publicise the concrete examples early and often. Put together a team to ‘war-game’ possible attacks by hostile media outlets and how to pre-empt them or respond effectively. Utilise social media as a strong alternative means of disseminating your message.

“It is also a very effective medium to lampoon and expose media bias. And enlist their competition to expose bias. Remember, your enemy’s enemy is your friend”.

And remember Ed…the BBC is your best friend!

 

 

 

 

 

 

The Few

 

 

 

The BBC has been looking at the NHS, the number of nurses in particular.

 

This, which might have some relevance, they haven’t looked at:

 ‘Stealth’ pay rises for NHS staff costing £1bn a year

 The NHS is spending almost £1 billion a year on a “stealth” system of automatic pay rises, which have seen some workers’ earnings rise by up to a third in five years, an investigation discloses today.

The system means the cost of employing 1.3 million NHS workers is constantly increasing above inflation.

The system, known as increments, have led to pay increases as high as 45 per cent over the last seven years for some staff without any promotion or improvement in performance.

 More than half of NHS staff received an incremental rise last year, giving an average total rise of 4.5 per cent last year, well above the rate of inflation.
 
The nationally announced pay settlement was a one per cent rise last year.

Last night Dr Dan Poulter, the health minister, said he system was not fair because it meant senior managers gained far more in cash terms than low-paid workers, and was not affordable.

Abolishing the system would allow the NHS to recruit at least 10,000 more front line staff, he suggested.

 

 

The BBC asks if there are enough nurses in the NHS and informs us that below a certain number patients will die:

Are there enough nurses in the NHS?

A recent study by the National Nursing Institute seems to confirm this.
It found that half of hospitals are regularly running wards with fewer than one nurse to every eight patients.
The one-to-eight ratio is considered the minimum level – below this research shows that an average-sized hospital could expect to see as many as 20 extra deaths a year.
According to official data from the Health and Social Care Information Centre, there are just under 307,000 midwives and nurses working in England (in terms of full-time equivalent posts).
Once you strip out the midwives, health visitors and school nurses, which are not employed by the NHS, there are about 275,000 nurses working across the health service in both hospitals and community services.
That represents a drop of 6,000 – or 2% – since the election.

 

This raises two questions…firstly are the BBC’s figures for the number of nurses accurate, secondly are the claims made regarding the effectiveness of certain nurse to patient ratios correct?

Answering the first, it should be noted that getting an accurate number of staff in the NHS seems to be fairly difficult.
The BBC limits it here to the number of nurses in England, full time ones at that…and limits it further specifically to fully qualified nurses…disregarding Health Care Assistants as well as Midwives, despite right at the very end of the article stating that the mix of staff should also be considered.

This is the total NHS figure in 2012 (not just England):
Professionally qualified clinical staff? There were 687,810 professionally qualified clinical staff in the NHS Workforce, an increase of 1,063(0.2%) since 2011.

For the NHS as a whole these figures are relevant and put things in perspective:

2011-2012  the NHS lost 3238 staff members in total.

A total of 8602 non-medical staff were made redundant.  That would indicate that at least 5364 more frontline medical staff were employed.

The number of nurses lost was 2409.…but there were 2239 doctors employed, and 1,063 professionally qualified clinical staff added to the payroll….and 6000 Health Care Assistants have been recruited as well as hundreds of Midwives.

The total figure for nurses lost since 2010 seems to vary….but the usual figure is between 5,000 and 6,000.…but, the BBC does mention…by the end of this financial year the NHS will be employing an extra 3,700 nurses.

Even the government can’t get its figures to add up though, this from Aug 2012:

“There are 2,400 more clinical staff working in the NHS than there were two years ago in May 2010, including over 3,700 more doctors, and over 900 extra midwives. In contrast, the number of admin staff has fallen by over 17,500, creating savings that will be reinvested into frontline patient care.
“Funding will increase by £12.5bn over the next three years, protecting the NHS for the future.”

This from March 2013:
Health minister Dr Dan Poulter said: “These figures are exaggerated. There are now more clinical staff in the NHS than in 2010, including around 5,500 more doctors, 1,300 more midwives and more than 900 more health visitors. In contrast, the number of admin staff has fallen by over 18,000, and the money saved put back into frontline patient care.

But no doubt qualified nursing jobs have gone.

It should be noted though that highly qualified nurses are not needed for all the tasks that patients need to have done for them….these can be done by the HCA’s, allowing the qualified nurses to concentrate on the patients with the most need…thereby possibly improving care.

So you have to look at the whole picture…which the BBC doesn’t.

Also whilst nurses leave the NHS they are not lost to nursing…and in fact are often still employed, via private companies, by the NHS, often providing care in the community.
Midwives should not have been dismissed by the BBC here either….for if they provide services in the community that means mothers to be don’t have to go to hospital…and therefore fewer nurses are required in hospital:

NHS figures reveal 5,000 fewer nurses since 2010
Trade unions and Labour blame drop on coalition’s cuts, but figures may also reflect nursing moving to private firms or charities.
The drop in nursing numbers is significant because it represents in part a shift from state employment to working for private companies and charities. Nursing is moving out of hospitals and into the community, where staff work for private firms or the voluntary sector but are paid for by the NHS.

 

The BBC article paints the loss of nurses as a bad thing…telling us that below a certain nurse staffing level and…an average-sized hospital could expect to see as many as 20 extra deaths a year.

So the next thing is to ascertain whether claims about the nurse/patient ratio are correct.

The figures on which the BBC is basing its report comes essentially from a single piece of research in the USA, in California, where they made it  law to maintain a certain ratio of nurses to patients.

These are some qualifications in that research itself which might be relevant but again the BBC doesn’t mention them:

Our study is cross sectional and we cannot establish causality in the associations we observe.

Although our data are cross sectional and lack baseline measures, our positive findings are bolstered by other research showing improved nurse staffing in California hospitals between 2004 and 2006 (Bolton et al. 2007) and increases in satisfaction of California nurses between 2004 and 2006 (Spetz2008

There is little evidence in the research literature that having more unlicensed personnel in hospitals adversely affects patient outcomes.

 

So no causality, no baseline and little evidence elsewhere.  

 

Here is the Royal College of Nursing’s take on the report:

The potential consequences of such ‘compromised’ care were made explicit in recent research (Aiken et al., 2010) which found that lower patient per nurse ratios (as a result of mandated minimum staffing levels in California) were associated with significantly lower mortality rates.

Put bluntly, the research concludes that fewer patients die in hospitals with better nurse staffing levels.

 

But here is a report on that research from Bristol University in the UK in 2012, ignored by one and all, and the BBC:

New study reveals increasing nurse-to-patient ratios do not extend patient safety
Press release issued 27 February 2012

We evaluate the impact of California Assembly Bill 394, which mandated maximum levels of patients per nurse in the hospital setting……We find persuasive evidence that AB394 had the intended effect of decreasing patient/nurse ratios in hospitals that previously did not meet mandated standards.
However, these improvements in staffing ratios do not appear to be associated with relative improvements in measured patient safety in affected hospitals.

A study into the effects of a law requiring increased nurse-to-patient ratios on patient mortality finds that mandating such changes do not reduce adverse patient outcomes.
Dr Andrew Cook, lead author of the study, said:  “Our findings suggest that mandating nurse-to-patient ratios, on its own, does not lead to improved patient safety.”
Martin Gaynor added: “While we do not find evidence that the regulation improved patient safety, that does not necessarily mean that nurse staffing levels are unimportant.  Improved nurse staffing might be crucial in improving patient safety, but only in combination with other elements. It is important that analysts, policy-makers, and healthcare providers sort out these important issues.”

 

And there are many more doubters:

Many registered nurses believe that nurse staffing in acute care hospitals is inadequate. In 1999 California became the first state to mandate minimum nurse-to-patient ratios in hospitals. State officials announced draft ratios in January 2002 and expect to implement the legislation by July 2003. We estimate that the direct costs of compliance will be small. However, mandatory ratios could generate opportunity costs that are not easily measured and that may outweigh their benefits. Policymakers elsewhere should consider other strategies to address nurses’ concerns, because other approaches may be less costly and produce greater benefits to nurses and patients.

A key finding from this synthesis is that the implementation of minimum nurse-to-patient ratios reduced the number of patients per licensed nurse and increased the number of worked nursing hours per patient day in hospitals. Another finding is that there were no significant impacts of these improved staffing measures on measures of nursing quality and patient safety indicators across hospitals. A critical observation may be that adverse outcomes did not increase despite the increasing patient severity reflected in case mix index.

We find persuasive evidence that AB394 had the intended effect of decreasing patient/nurse ratios in hospitals that previously did not meet mandated standards. However, these improvements in staffing ratios do not appear to be associated with relative improvements in measured patient safety in affected hospitals.

 

What is certain is that more nurses means a happier staff as noted by all reports…naturally I suppose…a lighter workload is going to make life easier and more manageable with some benefits all round….less stress and less burnout.

 

Here is the RCN’s look at staffing levels from 2009:

A key theme in the 2006 RCN ward staffing level guidance was the recommendation that skill-mix on acute wards should not be more dilute than the benchmark average of 65 per cent registered nurses
A large-scale RCN survey of 9,000 nurses in 2009 (Ball and Pike, 2009) found that on average NHS hospital wards have a ratio of eight patients per registered nurse during the daytime, and 11 at night (see Table 5.1). Across all specialties, on average 5.4 nursing staff are on duty during the daytime – roughly three RNs and two HCAs/auxiliaries per ward

 

So the average Registered Nurse ratio was around 9 patients per nurse in 2009.…the ratio the BBC tells us is ‘acceptable’ on average is 8 to 1.

The BBC discounts the number of other staff, such as HCA’s, helping…and with those on hand the ratio drops to around 5 patients per staff member….well below the 8-1 ratio.

The HCA’s do much of the lower skilled work thereby allowing the more qualified nurses to deal with patients who have the most serious problems rather than having such highly qualified nurses running around emptying bed pans etc.

So for the BBC to just make a blanket claim that a ratio of 1 nurse to 8 patients saves lives doesn’t give a full and sophisticated explanation of the mix of skills that could be used on a ward.

 

Here is a brief summary of the research from California:

Aitken and colleagues compared outcomes from common surgeries in the three states. Nurses in California care for an average of one fewer patient per shift, and these lower ratios have sizable associations with surgical mortality.After adjusting for extensive patient and hospital characteristics, the investigators found that better nurse staffing was associated with a decreased risk of 30-day mortality and failure-to-rescue. The effect of adding an additional patient to hospital nurse workloads increased the odds of a patient dying by 13% in California, 10% in New Jersey, and 6% in Pennsylvania. The effects of increased workloads on failure-to-rescue were similar. The investigators then estimated how many fewer deaths would have occurred in New Jersey and Pennsylvania from 2005-2006 if those hospitals had the same nurse staffing ratios as California.

The findings suggest 222 fewer surgical deaths, (a 13.9% reduction) in New Jersey, and 264 fewer surgical deaths, (a 10.6% reduction) in Pennsylvania. Thus, in the two states alone, 486 lives might have been saved among general surgery patients in a two-year period if the hospitals adopted California nurse staffing levels.

Although this study cannot draw cause-and-effect conclusions, it strongly suggests that better nurse staffing is associated with better nurse and patient outcomes.

 

 

Here is the actual study and its own conclusions:

Implications of the California nurse staffing mandate for other states.

We have tried to minimize this source of potential bias by obtaining reports from nurses in states without legislation and by using in-dependent patient data to validate the better outcomes for California hospitals. Our study is cross sectional and we cannot establish causality in the associations we observe.

Although our data are cross sectional and lack baseline measures, our positive findings are bolstered by other research showing improved nurse staffing in California hospitals between 2004 and 2006 (Bolton et al. 2007) and increases in satisfaction of California nurses between 2004 and 2006 (Spetz2008

There is little evidence in the research literature that having more unlicensed personnel in hospitals adversely affects patient outcomes.

When we use the predicted probabilities of dying from our adjusted models to estimate how many fewer deaths would have occurred in New Jersey and Pennsylvania hospitals if the average patient-to-nurse ratios in those hospitals had been equivalent to the average ratio across the California hospitals, we get 13.9 percent (222/1,598) fewer surgical deaths in New Jersey and 10.6 percent (264/2,479) fewer surgical deaths in Pennsylvania

 

This is the important bit where they lay out what they conclude are the odds on a patient dying if one more patient is added to the nurses’ workload:
The effect of adding an additional patient to hospital nurse workloads increases the odds on patients dying by a factor of 1.13 in California, 1.10 in New Jersey, and by a factor of 1.06in Pennsylvania. The effects of increased workloads on FTR were substantially similar, with odds ratios of 1.15 in California, 1.10 in New Jersey, and 1.06 in Pennsylvania.

 

What that says is that in California the odds of you dying are actually greater than in States where they don’t have mandatory ratios when you add one more patient to the nurses’ workload.

This proves that mandatory ratios save lives?……

That might seem odd…..but I can only assume that because the death rate in States with higher ratios is already higher than in California one more patient will make little difference to the odds of you dying…if the odds are already, for example, 100%, then you can’t really get much worse can you?

But then you look at the figures and the Californian odds are a factor of 1.13 as opposed to 1.10 or 1.06…..very marginal differences.

As suggested above the cost effectiveness of employing highly trained nurses may be less than adopting other measures that will also save lives…possibly more lives……mandatory ratios could generate opportunity costs that are not easily measured and that may outweigh their benefits. Policymakers elsewhere should consider other strategies to address nurses’ concerns, because other approaches may be less costly and produce greater benefits to nurses and patients.

 

What isn’t in doubt is that more nurses/HCA’s reduces the workload on them and must reduce stress and ‘burnout’……whether that is a factor to consider is one any employer has to think about….but the BBC is presenting this as a life and death matter….that maybe each hospital could see 20 extra deaths per year if they don’t adopt these lower ratios….but only mentions qualified nurses…without considering the mix of skills that could actually be utilised cost effectively for the same health outcomes….telling us that:

…half of hospitals are regularly running wards with fewer than one nurse to every eight patients.

But as seen from the chart above that isn’t the true picture when other staff are considered who also help with patients….and right at the end the BBC admits….

But it is not just about numbers. Skill mix is important too.

The support they receive from healthcare assistants varies too.

Some do no nursing roles, while others have been trained to change dressings and monitor a patient’s vital signs.

As in any work environment a mix of experienced and junior staff is needed.

 

But that is after a long article which is essentially a promotion of the higher ratio of qualified nurses to patient concept.

In other words the article is highly misleading and, well, wrong about its central claim….at least based on much contrary evidence and the less than certain evidence of the research all this is based on….a study which admits there was no causality, no baseline and little evidence elsewhere to say that staff, like HCA’s, were detrimental to patient outcomes.

 

 

 

 

 

 

 

 

 

 

OBAMA SAVES THE WORLD…

Well then, after months of private talks, Obama and the seven dwarfs cut a deal with the Mullahs. It’s been fascinating listening to the BBC cover this with Israel (and even Saudi) being instantly positioned as the bad guys because they think this has been a terrible deal. The BBC have idolised Obama for years – he’s their new JFK – and so they are very cute to use all types of language that implies it is somehow unreasonable to take issue with the outcome of the Kerry-led negotiation, even when the Iranian Foreign Minister instantly goes on TV to declare that Iran can almost instantly reverse the deal if it chooses to do so. I heard Jeremy Bowen on the Today programme talk about this “potentially momentous” deal with little regard to the central fact that the Mullahs have played Obama just like Russia played Obama, just liked Assad played Obama, just like the Muslim Brotherhood played Obama. The hamfisted approach taken by the Obama regime to foreign policy matters is given a pass by the comrades at the BBC and I suppose if in doing so they can beat up a little further on Israel then that is a double win?

#norskrasisme

 

The BBC has been caught out several times using photographs that were not actually photographs of what they were claimed to be of.

Very often they have come by way of ‘Social Media’.

The BBC assures us here how careful they are to verify such images or information that comes from user generated content:

Altered Images Questioning whether cameras never lie

BBC News receives photos every day from people across the world, many purporting to show unfolding events. Trushar Barot, of the BBC’s user generated content team, says there are two aspects to verifying whether images are genuine – technical checks and editorial judgement.

“There are several tools we use to help us assess image data, including whether an image is an original or whether it has been manipulated digitally. We’ll also look for visual clues that we can cross reference, for example the weather, the location, number plates, signs, language and so on. We do reverse image searches to see if the images appear elsewhere on the web to help us track their origin.

“Editorially, we’ll start from a point of scepticism, posing the question ‘Is this image too good to be true?’ We’ll analyse the context of the image and the motives behind why it might have been uploaded on the web at that time. We will also seek to cross-reference what the image purports to show against official or verified sources, such as news agencies or with our own teams on the ground.”

 

 

The BBC has no such qualms though when it comes to reporting that a whole nation might be ‘racist’ on the evidence of a few Tweets from a Muslim in Norway:

 

The tweet that sparked a debate over racism in Norway

 

Well…not sure if it was a debate…more a witch hunt by the sounds of things.

 

Things of course are different here, we like to debate sensitive subjects openly…..

When Dominic Grieve suggested that Pakistani’s were prone to corruption, more prone than perhaps other communities, he has had to back down and apologise:

Dominic Grieve ‘sorry’ for minority corruption remark

 

….as out came the usual ‘victims’ who are all highly ‘offended’ …..

 

 

 

So no ‘sparking of a debate’ there then about corruption imported from abroad…or anything else by way of foreign culture imported from abroad that is detrimental to good order in this country.

 

You can see why debate might be unwelcome in some quarters……

‘Is the BBC biased?’  does it’s usual good job in looking at ‘Sunday Morning Live’ which examines immigration…..

Is immigration good for Britain?

Recent reports have suggested that immigrants to the UK since 2000 have made a “substantial” contribution to public finances and immigrants were less likely to claim benefits and live in social housing than people born in Britain. 

So are immigrants actually good for Britain? You can have your say by voting online now and then by text when the programme is on air.

 

Note the  reference is to a report that is highly positive about immigration….one that spins the figures in Sir Andrew Green’s words.

 

And the outcome?

Can you guess what the result of this morning’s Sunday Morning Live poll result was, when the question put was:

Is immigration good for Britain?

Of course you can.

It was inevitable:

11% said ‘yes, immigration is good for Britain’

89% said ‘no, immigration is not good for Britain’

 

Yes…I guess the BBC is right not to trust that user generated content…they just don’t vote the way you want them to!

 

 

Owen Jones’ Totally Shameless Exploitation Of The Poor

 

 

 

The BBC never seem to tire of Owen Jones….they must think he has something worthwhile to say….well, not so far.

 

 

 

 

Karl Marx in London: Owen Jones on Marxism

 

 

 

 

 

He pops up again on the Beeb, this time his derivative Marxist pap on the prestigious RTS Huw Weldon Memorial Lecture:

 

Totally Shameless: How TV Portrays the Working Class

From Little Britain’s Vicky Pollard to the Jeremy Kyle Show to toxic documentaries on ‘feckless scroungers’ – writer and broadcaster Owen Jones argues that this growing strain of malevolent British TV programming denigrates the working class.

 

 

 

Of course that is how the working class are always portrayed by TV:

 

   

 

 

It’s a shame that a person who propagates an ideology that is so old and so discredited, one that has caused so much death and misery in the world, not least for the ‘working classes’ he pretends to speak for, should be given such a platform, the respect for which can only lend ‘authority’ to Jones in future and give his Marxist ramblings credibility.

Jones cleverly limits his outrage, crocodile tears some might say, to the TV’s depiction of the  ‘working class’, to ‘Chavs’ in particular….because of course TV only mocks Chavs…upper class twits or ‘exploiters’ of the poor, or middle class pretentions are never ridiculed by TV…

 

 

Safe ground he calculates, lucrative ground, Jones is the ‘Wonga’ of the ‘Wonks’, a poverty parasite…making a splendid living whilst ‘helping’ the poorest in society out…knowing he will get immediate approval for his pious grandstanding ….and so it proves with a very rewarding career, built like the Cathedrals of old, on the sweated labour of the very Chavs he says he is speaking up for….to the Glory of Owen.

Vicky Pollard… her story is actually a bit of an inspirational one….she used to be a bit of a tearaway however she has turned her life around:

 

 

 

And the posh birds don’t get the same treatment do they?

 

 

 

The trouble is, and the reason why the BBC should think twice before giving him so much prime air time,  Jones is a Labour Party stooge…he works for the Unite union, which of course is the principle backer and influential policy ‘adviser’, to Miliband.

owen

 

 

As Guido tells us: he is a paid lobbyist for UNITE the union and as such he should be registered. When Guido called his CLASS think-tank recently the phone was answered by someone who said “CLASS or UNITE business?” It is just a lobbying front for Red Len…

 

When Miliband has staked his political future on being seen as the man who can put an end to his so called ‘living standard’s crisis’,  to have Owen Jones continually invited onto the BBC to promote that idea, whilst not admitting his close ties to Labour, is verging on the dishonest.

Class seeks to shape ideas that can inspire the trade union movement, cement a broad alliance of social forces and influence policy development to ensure the political agenda is on the side of working people.

National Advisory Panel Owen Jones advises Class on policy direction.

 

Jones doesn’t like how the ‘Working Class’ are portrayed…but he’s not above shutting down debate and labelling those who disagree with him…’demonising’ trolls….despite all those appearances on BBC’s ‘Freespeech’ programme…..

Embedded image permalink

 

It’s flattering to think they regard the right to follow me on Twitter as a basic civil right

This is normally how it goes: they’ll spray something across my timeline like “Go live in North Korea you communist prick”, then I block them, meaning I won’t be able to enjoy their Wildean wit anymore. They then wail to the world that I have attacked their freedom of speech, presumably in the same way that hanging up on a crank call or walking away from a pub bore is attacking free speech.

 

The odd thing is those ‘Trolls’ are probably the very ‘Chavs’ he defends elsewhere…..people who see through his pretensions and express their contempt in the way that comes naturally in the society they move in….by sticking two fingers up to him…verbally.

 

Owen Jones, ‘the slave of some defunct economist‘ is little different than Islamist extremist Anjem Choudary,…a cheap huckster, a ‘poverty hustler’, generating false grievances, inciting anger,  encouraging class conflict, both ‘distilling their frenzy’ from the ancient scribblings of a charlatan they have latched onto and used to lend credence and authority to their own ramblings……the carpetbagger of cheap and incoherent ideas, exploiting the poorest in society, troughing away whilst talking about inequality and the gap between the rich and the poor as he gets paid a couple of grand for a column in the Guardian or Independent.

 

You could respect him if he lived his ideals…but he doesn’t….when he earns what must be at least 5 times the weekly wage of many working class people for writing a single column in a newspaper, regurgitating stuff that’s been said a thousand times before, not even original stuff, how can he justify his pretence of being the ‘People’s Champion’?

You can’t really take him seriously until he joins up with the likes of Polly Toynbee and starts handing out a good proportion of their own income to the needy.

Touring the TV studios grandly pontificating and theorising about poverty whilst doing nothing concrete is showbiz and self promotion.

Shame the BBC doesn’t call him out on it….instead of which they lay out the red carpet and treat him as if he is the second coming of Marxism….the opium of the Bien Pensant.

 

 

 

A Woman’s World

 

 

 

 

 

The World Economic Forum has produced a ranking for women’s position and influence in societies around the world. (page 16)

The UK ranks  18th, one below South Africa, whilst Japan ranks 105 and Kazakstan 32….and France 45, Israel 53.

 

 

The BBC is quick to make sure you know that:

The G20 group of leading industrial nations has no representative in the top 10, nor do the Middle East or Africa.

 

That was undoubtedly just in case you were thinking that Islamic countries were oppressive regimes for women….Western Democracies are too…..what the BBC doesn’t point out is the massive gap between those G20 countries and ‘The Middle East’ as it coyly names the offending regimes.

What it could also point out is a remarkable trend…..it is Christian countries that  dominate the upper ranks.  Australia, geographically many miles from Europe, yet it ranks highly….what could be the common denominator?  Maybe it’s all those immigrants from Europe bringing diversity and cultural and social uplift…something perhaps Saudi Arabia could do with?

 

Even India, which I claim for the ‘Golden Age’ of the Raj’s influence, is not in the bottom ranks….at 101 ahead of Japan.

 

 

 

But why are they the best or the worst?

 

 

Just by coincidence there’s this map of the world’s religions in the Daily Mail:

 

 

Remarkable similarity.