High hospital death rates exposed
By Anonymous on Jul 16, 2013 02:54 am 15 July 2013 Last updated at 20:24 ET By Nick Triggle Health correspondent, BBC News 
Fourteen hospital trusts have been investigated in light of their high mortality rates
Standards of care at 14 hospital trusts with the worst death rates in England are to be laid bare in a report later.
An investigation was launched earlier this year after the public inquiry into the Stafford Hospital scandal.
The trusts all had higher-than-expected death rates from 2010-11 to 2011-12.
The probe, led by NHS medical director Professor Sir Bruce Keogh, has focused on whether the figures are indicative of sustained failings in the quality of care and treatment at the trusts.
It has been looking at whether existing action by the trusts to improve quality is adequate or whether they are in need of any "additional external support".
The report was ordered by the government after the publication of the Francis Inquiry into Stafford Hospital, amid concern that failing hospitals were not being held to account.
That inquiry accused the NHS of betraying the public by putting corporate self-interest ahead of patients.
The 14 trusts investigated by Sir Bruce have the worst records in terms of mortality rates, which look at the number of deaths beyond what would be expected.
'Smoke alarm' High death rates are in effect a "smoke alarm" - a sign that something may be wrong.
So Sir Bruce's team has carried out inspections and spoken to patients and staff to see if there were signs of serious failures that were not detected by regulators.
The trusts which have been investigated are:
• Basildon and Thurrock University Hospitals NHS Foundation Trust
• Blackpool Teaching Hospitals NHS Foundation Trust
• Buckinghamshire Healthcare NHS Trust
• Burton Hospitals NHS Foundation Trust
• Colchester Hospital University NHS Foundation Trust
• The Dudley Group NHS Foundation Trust
• East Lancashire Hospitals NHS Trust
• George Eliot Hospital NHS Trust
• Medway NHS Foundation Trust
• North Cumbria University Hospitals NHS Trust
• Northern Lincolnshire and Goole Hospitals NHS Foundation Trust
• Sherwood Forest Hospitals NHS Foundation Trust
• Tameside Hospital NHS Foundation Trust
• United Lincolnshire Hospitals NHS Trust
At the moment, regulatory action is being taken against seven of the trusts, but none is facing the ultimate sanctions of fines, closure of individual units or administration of the entire organisation.
Key questions Action Against Medical Accidents chief executive Peter Walsh said: "These investigations are welcome but well overdue. The problems at these trusts were known to the authorities well before any decision to look into them.
"What patients most want to know are answers to some key questions. Are these hospitals safe now? Is the regulatory system now robust enough to detect problems when they arise and intervene quickly to protect patients? Will those responsible for allowing these avoidable deaths to go on be held to account?"
Roger Taylor, of Dr Foster, a research company that has pioneered the use of mortality data, said: "In the past, there has been a culture in the NHS, which at best aims to reassure the public and at worst seeks to conceal failings.
"That culture has had its day. The reluctance to speak plainly about the risks to patients has meant that, too often, poor care has been allowed to continue. The desire to support organisations struggling to provide a high standard of care in difficult circumstances has cost patients their lives."
The Stafford Hospital inquiry was launched after data showed there had been between 400 and 1,200 more deaths than would have been expected.
It is impossible to say all of these patients would have survived if they had received better treatment, but evidence made it clear many were let down by a culture that put cost-cutting and target-chasing ahead of the quality of care.
Examples included patients being so thirsty that they had to drink water from vases and receptionists left to decide which patients to treat in A&E.
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Cutting Trident 'naive or reckless'
By Anonymous on Jul 16, 2013 03:19 am 15 July 2013 Last updated at 22:27 ET 
The UK has had a continuous at-sea nuclear deterrent for more than 40 years
The findings of a review set up to help the coalition resolve its differences over replacing the UK's Trident nuclear deterrent are due to be published.
The Liberal Democrats favour cutting the number of Vanguard missile-carrying submarines, but the Conservatives say this would be "reckless".
The review has examined alternative options to like-for-like replacement.
Its findings come as a group of former defence secretaries and military chiefs said Trident should not be downgraded.
In a letter to the Daily Telegraph, former Conservative defence secretaries Liam Fox and Sir Malcolm Rifkind, Labour's Bob Ainsworth, Lord Reid of Cardowan and Lord Robertson, together with ex-chiefs of defence staff Lord Boyce and Lord Stirrup, set out their support for like-for-like replacement by saying the government should not "take risks with our security" by downgrading Trident in an "uncertain world".
Defence Secretary Philip Hammond will present the findings of Lib Dem cabinet minister Danny Alexander's Trident Alternatives Review at 11:00 BST.
MPs will debate them on Wednesday.
'No conclusions' The UK has had a continuous at-sea nuclear deterrent, with at least one submarine on patrol at any given time, for more than 40 years and has used the Trident system since the early 1980s.
Continue reading the main story Analysis
Jonathan Beale Defence correspondent, BBC News
The Trident Alternatives Review was never going to settle the debate about the future of Britain's nuclear deterrent.
The review asked three key questions. The first two were: Are there credible alternatives to a submarine-based deterrent? Are there credible submarine-based alternatives to the current proposal - such as modifying the Astute submarines?
In both cases the answer appears to be no. Basing nuclear missile silos on land was never really a starter. Too controversial and too easy to target. And the review appears to conclude that modifying the Astute submarines to carry nuclear cruise missiles would be both more expensive and less effective.
The one hope for the Liberal Democrats is in the last question: Are there alternative nuclear postures, such as a non-continuous at-sea deterrent?
For the Conservatives the answer is still no. Philip Hammond says it would be like having a part time deterrent. He wants a like-for-like replacement.
But the Liberal Democrats will argue you could save billions of pounds by having two submarines instead of four. There will be clear blue water between the two parties before the next election.
The current four-submarine fleet will reach the end of its lifespan in the 2020s.
A final decision on whether to renew it has been delayed until 2016 amid differences between the coalition partners.
The review results from a compromise reached by the Conservatives and Liberal Democrats in the 2010 coalition agreement.
The Conservatives, who support like-for-like renewal, and the Lib Dems, who have long been sceptical, agreed to the value-for-money review to look into other options, including alternative delivery systems and a slimmed-down version of the current system.
But BBC defence correspondent Jonathan Beale says the review does not draw conclusions nor make specific recommendations and will sharpen the divide between the parties.
Critics have questioned whether the UK can continue to pay for Trident in its current form. The government estimates renewal costs will be between £15bn and £20bn but anti-nuclear campaigners say the figure will be much higher.
The Ministry of Defence says the current cost of operating the Trident fleet is about 5% of the annual £34bn defence budget.
Mr Hammond, a Conservative, has said all possible alternatives to Trident would be "less capable, less credible and more expensive" and would not provide the same "level of protection" from external aggression.
'Nuclear ladder'
But Lib Dem former defence minister Nick Harvey told the BBC it was time to "take some steps down the nuclear ladder" following the end of the Cold War.
Continue reading the main story TRIDENT TIMELINE
- 2007: MPs approve plans for renewal in Commons vote. "Concept phase" launched to assess future submarine designs and consider value for money of project
- 2010: Defence review decides to delay final decision on renewal to 2016
- 2011: "Initial Gate" procurement phase to begin. Some building materials and components of nuclear propulsion system to be purchased over five years
- 2016: "Main Gate" decision due to be taken. Submarine design and missile component contracts to be finalised
- 2028: First replacement submarine to be delivered
The review will not have any direct impact on the policy of the coalition government, which affirmed its commitment to Trident in its programme for government in 2010.
But it will inform debate on future spending priorities and on Lib Dem policy in the run-up to the next election.
The Campaign for Nuclear Disarmament said cancelling Trident would bring "strategic and economic benefits" and for the government not to consider this seriously would be an "abdication of responsibility".
Publishing an alternative review, which it says has the backing of a number of Lib Dem and Labour MPs, its general secretary Kate Hudson said not proceeding could save £100bn and give the UK "moral leadership" in global disarmament talks.
The letter from the former defence secretaries and defence chiefs warns the UK cannot "foresee what threats will develop over the next 30 years. Reducing our submarine-based Trident capability would weaken our national security for the sake of a very small fraction of the defence budget".
They say: "It is our view that if Britain is to remain a leading global power with strong defences, nothing less than a continuous-at-sea deterrent will do."
Read in browser » Cartel leader captured in Mexico
By Anonymous on Jul 16, 2013 02:34 am 15 July 2013 Last updated at 21:25 ET 
Trevino Morales took over the Zetas in October 2012
Miguel Angel Trevino Morales, head of the brutal Zetas drug cartel, has been captured in northern Mexico, according to a US official.
Trevino Morales, known as "Z-40", was captured in Nuevo Laredo, near the US border, the unnamed official said.
He took control of the Zetas following the death of group founder Heriberto Lazcano in October 2012.
Correspondents say his capture would be a success for authorities battling the powerful drug-trafficking cartels.
The Zetas were formed by defectors from a Mexican elite police unit and quickly became infamous for their brutality, which included the beheadings of kidnapped migrants and rival gang members.
Trevino Morales has been described as a sadistic figure, who enjoyed torturing and killing his victims.
Read in browser » 'Slow' horsemeat inquiry condemned
By Anonymous on Jul 15, 2013 08:40 pm 15 July 2013 Last updated at 20:40 ET 
No one has yet been prosecuted over unlabelled horsemeat found in UK food products
MPs say they are dismayed at the slow pace of investigations into the horsemeat scandal, six months after the first mislabelling cases emerged.
The Environment, Food and Rural Affairs Committee said it heard mislabelling of horsemeat as beef in products in the UK and Ireland was "highly organised".
Its report said there must be prosecutions if fraud was detected.
The Department for Food, Environment and Rural Affairs (Defra) said police were still investigating.
Horse DNA was first found in processed beef products by Irish food inspectors in January, and the MPs' committee criticised both British and Irish authorities for failing to "acknowledge the extent of this".
In its report into food contamination, the committee said: "We are dismayed at the slow pace of investigations and would like assurance that prosecutions will be mounted where there is evidence of fraud or other illegal activity."
It added: "The evidence we received from retailers and food processors in the UK and Ireland suggests a complex, highly organised network of companies trading in and mislabelling frozen and processed meat or meat products in a way that fails to meet specifications, and that is fraudulent and illegal."
Authorities carried out several raids across the UK amid the horsemeat scandal and three men were arrested under the Fraud Act, but no prosecutions have so far been brought.
The MPs acknowledged that "contamination was limited to a relatively small number" of products with 99% of processed and frozen beef products tested in the UK found not to contain any horsemeat.
'Lack of clarity' Across the EU as a whole, 4.66% of products tested were found to contain at least 1% horsemeat.
But the report expressed "surprise" that 14 out of 836 samples of food containing horsemeat from the UK tested positive for the painkiller bute - the highest number of positive tests in the EU.
The committee complained that there had been a "lack of clarity" within Whitehall over where responsibility lay for dealing with such issues.
It also said there were clearly "many loopholes" in the current system of horse passports, and called for assurances that horse movements within the UK and between the UK and Ireland were being properly monitored.
The report said the Food Standards Agency "hesitated" after horse DNA had been found, causing confusion for the public and retailers.
The MPs blamed changes made in 2010, which took some responsibility for food monitoring and labelling from the authority.
Those duties went to the Defra but the committee's report said that split caused problems when the horsemeat scandal emerged and should be reversed.
It said the FSA's testing regime was not "sufficiently innovative or forward-looking" and recommended that it "must become a more efficient and effective regulator of industry".
In June the FSA announced the results of its own review of the crisis.
It called for a strengthening of its major incident plan.
Addressing the issue of criminal prosecutions, a Defra spokeswoman said: "The police are investigating how products containing horsemeat came to be on sale in the UK and they will take action where any unlawful activity has taken place."
She added: "It is absolutely wrong for any businesses to con the public by allowing horsemeat to be labelled 'beef'.
"That's why we have set up an independent review to identify any weaknesses in the food supply chain or the regulatory system to prevent this happening again."
Read in browser » Six blast bombs thrown at police
By Anonymous on Jul 16, 2013 03:26 am 15 July 2013 Last updated at 14:59 ET 
The Crumlin Road in north Belfast is closed between Tennent Street and Twaddell Avenue
At least four blast bombs and several petrol bombs have been thrown at police during rioting in east Belfast.
A plastic baton round has been fired by police during the trouble on the Newtownards Road. Water cannon has also been deployed.
Elsewhere, the Crumlin Road in north Belfast is closed after a pipe bomb was thrown at police.
Police said the device was thrown at officers from Brompton Park in the Ardoyne area at about 17:00 BST.
The road is closed between Tennent Street and Twaddell Avenue.
The device exploded close to police but there were no reported injuries. Motorists have been advised to avoid the area.
Police Service of Northern Ireland Superintendent Emma Bond said: "We consider ourselves extremely fortunate that we are not dealing with a much more serious incident and that all of the officers were able to walk away from that situation unharmed.
"We have appealed for calm in the area and I continue to do so.
"I would appeal to anyone with influence in the community to exert it to ensure that the next few days pass off without incident."
Northern Ireland Secretary of State, Theresa Villiers, condemned the attack in north Belfast, which she said was "deplorable".
DUP assembly member William Humphrey said loyalist protesters were demonstrating peacefully in the Twaddell Avenue area when the incident happened.
He described the attack as an "attempt to injure and kill".
Sinn Fein assembly member Gerry Kelly said the attack was "completely unacceptable" and "not supported by the vast majority of the community in Ardoyne".
Forty-four police officers have been injured over three nights of rioting in Belfast.
Officers were attacked in the Woodvale area of north Belfast on Sunday night.
It followed more serious rioting on Friday and Saturday nights after a Parades Commission determination that a parade by three Orange Order lodges would not be allowed to march along a stretch of the Crumlin Road that separates loyalist and nationalist communities on its return journey from the main Belfast 12 July demonstration.
Read in browser » Energy firm warns of bill increases
By Anonymous on Jul 15, 2013 07:01 pm 15 July 2013 Last updated at 19:01 ET By Roger Harrabin Environment analyst, BBC News 
RWE Npower says it supports government plans to invest in renewable energy
Household energy bills are likely to rise £100 a year more than the government projects, says the energy firm RWE Npower.
It says official predictions of future energy savings are over-optimistic and warns the average bill will rise £240 a year by 2020.
The firm says it supports government plans to renew power networks and build more renewables such as wind and solar.
But it says there must be more honesty about the costs of this investment.
It comes as a new poll by Cardiff University suggests that the public is willing to pay extra for clean and reliable energy.
'Heroic assumptions' Both reports acknowledge, though, that the public does not trust energy firms or government - and both say trust must be restored if energy policy is to succeed.
In Npower's case, the trust exercise starts with a publication setting out exactly how bills are likely to rise, in order to renew the creaking energy supply system and install clean energy supplies.
The firm says it believes the government has underestimated the effect of this investment on bills, because its calculations rely on "heroic" assumptions about the energy individuals will save through efficiency and behaviour change.
This criticism has frequently been levelled at the government's projections.
The firm believes the average combined fuel bill in 2020 will be about £1,487 – that's £200 a year more than now and £100 more than the government projects.
The company says it is essential for energy firms - often accused of profiteering and misleading customers - to be honest about future bills.
'Blame game' The new chief executive of Npower, Paul Massara, said: "Energy costs are rising. This is an indisputable fact, and it's time that all of us involved in energy in the UK are upfront about it."
He went on: "We are very clear that we do not want to be critical of government - rather, we want to ensure customers have the facts, so that they understand that for this cost, they will get a low-carbon economy, security of supply and warm, insulated homes."
He said his firm was calling for an end to the energy "blame game".
Continue reading the main story Public views on renewable energy
- 82% worried about fossil fuel import dependency
- 79% keen to reduce fossil fuel usage
- 85% supportive of power from the sun
- 75% supportive of wind power
- 74% concerned about climate change
Source: Cardiff University
The report is issued coincidentally as the academic body, the UK Energy Research Centre, warns that plans for a clean energy future risk being undermined by lack of trust.
A poll of about 2,500 people commissioned through Cardiff University suggests that the public is worried about dependency on fossil fuel imports (82%); keen to reduce use of fossil fuels (79%); supportive of power from the sun (85%) and wind (75%); and concerned about climate change (74%).
The report's authors say people are willing to pay extra to obtain a stable energy supply. The lead author, Prof Nick Pidgeon, said people would also pay more overall to avoid sudden peaks in prices. He said the researchers had not tested specific figures in the poll because projections about future energy costs were "notoriously slippery".
Keeping the lights on 
The government says its policies will prevent blackouts
"What's interesting is that despite what you might see in parts of the media, it's clear that very broadly the public want a long-term commitment to clean energy," he told BBC News.
"But the trust issue is critical. We have seen protests round energy system developments like wind farms over recent years. There won't be all the investment that's needed on energy systems if the energy firms and the government can't persuade people to trust them."
He said young people dependent on electronic gadgets were very worried about the prospect of black-outs and willing to pay to avoid them.
But he envisages a Catch-22 in which the government and energy firms fail to deliver the energy future that people want, because the public don't trust them.
The government said its policies would keep the lights on and help to smooth bills by reducing dependency on the gas imports that have caused recent jumps in energy prices.
Greg Barker, Minister for Energy and Climate Change, said: "It is right that we have a grown-up discussion about the impact of energy investment. However, global gas prices, not green policies, have been primarily pushing up energy bills.
"In 2020, bills will be £166 lower than they would be if we left ourselves exposed to global price shocks, left our homes leaking energy, and left future generations to deal with climate change."
Follow Roger on Twitter @rharrabin
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