Quality of NHS nurses is vital

IT should not have required Professor Don Berwick, a former health adviser to President Barack Obama, to recommend a “zero-harm culture” in the NHS as it struggles to retain the confidence of patients after a litany of care scandals.

This should already be happening as a matter of routine and the American’s reform prescription has clear parallels with the recommendations of Robert Francis QC following the needless deaths of hundreds of patients in Mid Staffordshire, and the recent intervention of NHS medical director professor Sir Bruce Keogh who placed 11 hospital trusts – including Northern Lincolnshire and Goole – in special measures.

The challenge facing the Department of Health is pulling these various reports together at a time when unprecedented financial powers have been devolved to GPs, and at a time when NHS spending nationally is failing to keep pace with an ageing population.

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There is also the issue of nurse numbers on hospital wards. Like the Francis report, Professor Berwick has called for a review of staffing levels, particularly at night-time and weekends when some of the worst care lapses have taken place.

Ominously, Health Secretary Jeremy Hunt fudged this issue yesterday with a convoluted response. He claimed that the coalition had increased spending on the NHS compared to the last Labour government – it is a rise that is marginal at best – and implied that there were more frontline staff as a consequence, even though he later said that this was a matter for individual hospitals.

However the issue is not the quantity of medical staff – the political numbers game played by Mr Hunt – but the quality of the care that they deliver and whether under-pressure A&E units have sufficient nurses and doctors to cope with the weekend influx.

If this means Mr Hunt having to issue national protocols on staffing levels, then he should do so before even more lives are compromised because of any negligence on the part of those high-earning politicians and bureaucrats who have let down the NHS.

Donors deserve value for money

SOME perspective is required over the £100,000-plus salaries now commanded by an increasing number of charity executives whose foreign aid work compliments the continuing endeavours of the Department for International Development which has seen its budget controversially ring-fenced during the continuing spending squeeze.

These are international organisations with a global reach – and it is proper that they have the right leadership to ensure grants and donations from the public are spent wisely and effectively at all times.

The problem is an increasing belief that the political lobbying of these groups is taking precedence over their invaluable work on the ground when their volunteers come to the rescue of those whose lives have been ravaged by fire, famine or floods.

Only Save the Children can say, for example, whether it is appropriate to pay £130,000 last year to its chief executive Justin Forsyth who was Downing Street’s director of strategic communications during Gordon Brown’s premiership.

What can be said for certain, however, is that these charity executives need to recognise that their salaries – some of which comfortably exceed David Cameron’s earnings – depend on the generosity of their donors who expect their hard-earned money to make a difference.

If they expect the public to respond favourably when the Disasters Emergency Committee next issues a nationwide appeal for donations, they need to prove that this money will help victims on the ground.

One final point needs to be made. Significant sums of money – and public goodwill – could be saved if these charities pooled their political activities to avoid duplication, and chose to work more closely with officials from the DfID.

Jail threat to dangerous dog owners

IT is worth recalling the objectives of Kenneth Baker, the then-Home Secretary, when he introduced the emergency Dangerous Dogs Act in 1991 after a series of attacks on young children.

He wanted to remove from the UK the pit bull and pit bull-type dogs that caused so much upset, prevent the import of three other dogs which had been bred to fight and oblige all owners not to let their dogs become dangerously out of control.

More than two decades on, there are now 210,000 attacks each year – with 6,000 people requiring hospital treatment.

Intermittently, there are harrowing cases when a young child is mauled to death. Yet, while many will welcome the Government’s calls for the owners of killer dogs to face life in prison, the reality is that such a penalty lacks bite – no such person is likely to face this sentence at a time when the jails are full.

What is needed is a policy that sees the owner of any dog held responsible for their pet’s behaviour at all times. The challenge is that this probably requires the electronic tagging of animals, a logistical nightmare which had contributed to the abolition of the dog licence in 1987 before Lord Baker became the first – but certainly not last – politician to try and grapple with the consequences of this important issue.