Health secretary says NHS issues aren"t just about money but also standards

Jeremy Hunt sought to play down a row about the amount of new funding available for the NHS, saying the health service’s challenges are not “just about money”.

The health secretary was challenged by the BBC’s Andrew Marr over the gulf between the government’s claim that the NHS has been awarded an additional £10bn of funding, and estimates by independent organisations that have put the “true” figure at about £4.5bn.

Last month, MPs on the health select committee threw their weight behind the lower figure, with Tory parliamentarian Dr Sarah Wollaston warning the government’s £10bn figure “is not only incorrect but risks giving a false impression that the NHS is awash with cash”.

Last week, Nigel Edwards, the Nuffield Trust’s chief executive, warned: “The NHS is going into its toughest winter yet with the odds stacked against it. Demand for healthcare is on the rise, funding for both health and social care is being squeezed and A&E departments are missing their targets.”

Hunt dismissed a suggestion from Marr that the NHS’s performance was suffering because of a lack of funding: “We do tend to get in the run-up to the autumn statement a coalition of people who will say that the answer to all the NHS’s problems is more money from government.”

He said: “The big question is, does the NHS have enough money, and the answer to that is that we do need more resources – we are looking after a million more people aged over 75 than five years ago, that’s why we are putting in £4bn more.”

But he added: “It isn’t just about money – it’s also about standards.”

Ensuring that lessons were learned from medical accidents could help save the NHS on legal bills, Hunt said. “There’s lots of things we can do in terms of helping to ensure we are better at learning from mistakes, so that we don’t have this huge legislation bill of £1.5bn because of some of the mistakes we have made – that all helps on the money front.”

He added: “There are, of course, financial pressures, but I think it’s a mistake to say this is only about money. It’s also about getting the culture right.”

Winter is “extremely tough” for the health service, Hunt said: “I can say I think we are better prepared this year than we’ve ever been.”

But he added: “There’s always the unpredictable, the cold spells, the flu outbreaks and so on … I think it would be wrong for any health secretary in the run-up to winter to say everything’s tickety-boo.”

Health secretary says NHS issues aren"t just about money but also standards

Scottish food standards agency criticised over E coli poisoning case

Scotland’s food standards agency has come under attack after it confirmed it had no samples or test evidence linking a cheese-maker with a food poisoning outbreak that killed a three-year-old girl.

Prof Sir Hugh Pennington, a world authority on the bug blamed for the outbreak, E coli O157, said the information issued by Food Standards Scotland on its investigation had been “a mess”, and had failed to answer basis questions about the case.

“The whole thing is a mess in terms of the public information coming out; from my point of view, I just don’t understand what’s going on,” said Pennington, emeritus professor for bacteriology at Aberdeen university and a former adviser to the UK Food Standards Agency.

He said he was puzzled by the agency’s delay in releasing its report in the outbreak, which ended several weeks ago. “The sooner we see all the data which has been collated which allows the FSS to point the finger, the better it will be for everybody,” he said.

The agency issued an alert in July after it linked an E coli outbreak that had affected 20 people with two batches of Dunsyre Blue, one of the best known brands from an artisan cheese firm in Lanarkshire, Errington Cheese, which has pioneered the use of unpasteurised milk.

The firm withdrew the cheeses from sale in July, but the scare escalated last week after the FSS revealed that a three-year-old girl in Dunbartonshire had died and 11 people were hospitalised after contracting the E coli O157 bug. Prosecutors at the Crown Office are studying a file on the case.

Errington Cheese insisted its repeated testing had found no traces of E coli in any of the cheeses involved, but Food Standards Scotland said last week two batches of Dunsyre cheese “were implicated based on epidemiological evidence”.

Two days later, the company said that withdrawing the cheeses from sale was in “the best interests of consumers to protect them from potential risks to public health”.

However, the agency told the Sunday Herald at the weekend it had no direct proof the cheeses it had named and had banned from sale were to blame. “Tests carried out to date from samples taken by South Lanarkshire council as part of this investigation have not detected the same strain linked to the outbreak,” it said.

It is understood the FSS did not test any samples of the cheese eaten, had no swabs from any restaurant or home or supplier, and was relying instead on a questionnaire of those affected by the outbreak. The FSS would not comment on those elements of its investigation.

The agency said on Saturday its testing of Errington’s cheeses led to a positive finding of E coli O157 on a different product, the firm’s Lanark White brand; although it had not yet established that that cheese had the shiga toxin that makes the bug so dangerous.

The company withdrew its Lanark White from sale, too, on the agency’s instructions but again tried to defend its food hygiene and production standards. In a statement on its website, Errington Cheese said its advisers were unhappy about the testing used by the FSS: those batches of Lanark White had been on sale for three weeks with no reports of ill-health.

The company said in August there had been no E coli detected at all at its factory or in its cheeses since 21 March, either by its own laboratory, the local council or by its customers.

Its six samples of the Dunsyre Blue that was targeted by the FSS had all been clear. From the limited information given to it by the FSS, all the cases occurred in the first two weeks of July, even though the cheese had been on sale for up to nine weeks.

The FSS said on Monday: “Public health is and will continue to be FSS’s priority and any actions will continue to be determined by what is necessary to protect public health and the interests of consumers. As there is an ongoing food safety investigation, we will publish more information when this is necessary to protect public health and provide information to consumers.”

Pennington said it was often directly to directly link a suspect batch of cheese to a poisoning outbreak because an E coli bug may only affect part of each block, and consumers could literally eat the only evidence available.

In some cases, people could pick up the bug from an infected knife without eating the cheese involved. However, without very detailed analysis, such as DNA testing, of each bug detected in every patient to prove a direct link, there could more than one source of the outbreak.

Pennington has not been contacted by the Errington family in this case but gave expert evidence in the company’s defence in 1994 when it was unsuccessfully prosecuted after traces of listeria were found it its Lanark Blue cheese. He said in this case, the Erringtons had a right to see the FSS’s report as soon as possible, so it could understand why its brands had been identified as the source of this outbreak.

But he said the FSS attitude in this case underlined long-standing hostility in Scotland’s public health and food safety sectors towards cheeses made by unpasteurised milk, including the Errington brands. English regulators were more relaxed about unpasteurised milk; Scottish agencies became far more hardline after two major salmonella outbreaks in the 1970s caused a number of fatalities.

Scottish food standards agency criticised over E coli poisoning case

Employing Passion, Standards And Value To Produce A Niche Item With Heart

Necessity is the mother of invention, and Shann Jones is a perfect example. She used goats’ milk and kefir to develop her healing probiotic drinks, soaps and lotions when her family suffered from medical problems – and has developed them into a successful small business, the aptly named Chuckling Goat, which achieved 383% growth in 2013. Jones moved to Wales from California, where she was a radio talkshow host with over a million listeners. “I was the city girl who couldn’t boil an egg,” she recalls with a laugh. “My husband Rich is a harp-maker; he brews his own beer, butchers his own lamb – think Crocodile Dundee with a Welsh accent. Our 25-acre farm looks out over the ocean and it’s very beautiful. It’s not quite the Laura Ashley fantasy with the floppy hat and the copper milk pail that I had when I started out: it was tough, I’d never worked so hard. But Wales entrances me.”

Chuckling Goat’s products are entirely made from natural, sustainable ingredients; no dyes, no perfumes, no parabens, no petrochemicals, no pthalates. The brand’s Pro-Biotic Skin Care For Troubled Skin scooped a Bronze Award in the FreeFrom Skincare Awards earlier this month.

Shann Jones, founder of Chuckling Goat

So: what makes Chuckling Goat’s combination of innovative thinking and unusual ingredients a winner?

I discovered my niche by accident

“My small son was getting terrible bronchial infections and was on antibiotics all the time; one time he got bronchiolitis and the doctor quite literally said: ‘Run, there’s an ambulance waiting at the door!’ Rich suggested getting a goat. In Welsh farming traditions, they know goats’ milk is good for bronchial conditions. It sounded crazy to me but I was desperate. I picked a little black kid who was still on her mother, and she had a twin so we had to have them both. And I learned to milk. It’s not easy to milk a goat! I cried every night – but I managed to learn. I gave the milk to my son and it cleared his asthma. The inhalers went away into the back of the closet and we stopped going to the doctor. I went online and did some research, and found that there is indeed a body of scientific evidence showing that goats’ milk is effective – the Gabriela Study, for example, found that unboiled farm milk is preventative for childhood hay fever and asthma.

“We had too much milk to drink, so back to my computer I went. I discovered goats’ milk soap and thought ‘hmm! That’s different.’ I went to a place called the Soap School in Yorkshire and learned how to make soap and skin cream. The woman who runs the school helped me to work out the chemistry, I started using the products on my son – and they cleared my eczema too. I thought ‘Now we’re really onto something.’ Goats’ milk carries wonderful anti-inflammatories, minerals, and enzymes. We started selling on a small scale – the other mums on the school run began showing an interest. That was the point where I said ‘Rich, you need to quit your job and I need to quit mine.’ It was very scary, but I could see if we didn’t both throw in our full-time energy, Chuckling Goat wasn’t going to go anywhere.”

The power of probiotics

“Then Rich got colitis and had a major operation. The second time he came out of hospital, he had an abdominal incision infected with MRSA, the ‘superbug’ that resists antibiotics. I went back to my computer and read about essential oils and medical honey; I was desperate and I had nothing to lose. I infused his surgical dressings with medical honey and wiped him down with essential oils in warm water.

“We were making something called kefir: a fermented product that’s a bit like yogurt, only much stronger, from Eastern Europe. It’s big in Russia and California, but not in the UK. Our kefir is pure and strong, with no sweeteners, no flavourings: we are the only people in the UK making kefir from raw goats’ milk and raw kefir grains. I already knew how kefir works in the gut: kefir contains non-transient bacteria and it permanently repopulates your gut with ‘good’ bacteria. Using antibiotics is like pouring bleach into a river: it kills everything alongside the infection you’re trying to treat, and in Germany and Poland, doctors routinely offer probiotics after surgery. The problem with MRSA is that it colonises all over the skin, so I tried using the same theory: I wanted to knock the bad bugs back enough to let the good bugs get a foothold. We had been trying to make a coconut water kefir – I had tried with coconut milk and skimmed off the oil. The drink was awful, but the oil was beautiful. So I used this probiotic coconut oil on Rich’s skin. Two weeks later, it swabbed clear of MRSA. I had our CG Oil tested by a professional laboratory and it kills MRSA, E. coli, campylobacter and salmonella. We are now working with the Welsh Assembly Government’s innovation sector, which has set us up with Swansea University to do further testing – we need to do clinical trials and sensitivity tests.

“Once I had figured out that the kefir was good on skin, I thought: ‘I’m already putting the milk into the soap and skin cream, what would happen if I put the kefir into the soap and the skin cream?’ It turned out it works great. Kefir contains lactic acid, a gentle exfoliant that’s good for conditions like acne. There are a lot of goats’ milk products out there but none with probiotics and kefir – that makes us unique.”

My learning curve was seriously steep

“Rich is very practical, very common sense, very bottom-line. I’m very creative, very blue sky, very big ideas: jump off the cliff and figure it out on the way down. I’m the kite, he’s holding the string. Both are really necessary: if you’re too grounded, you’ll never get off the ground, but if you’re too much ‘jump off the cliff!’, it can be impractical. We balance each other out. The steepness of the learning curve was to weep over: if there’s a mistake to make, I’ve made it! The goats were easy and wonderful: I love them. Maths is hard. Innovating the product is fun. Business plans are cruel. Learning the hygiene regulations jargon was incredibly difficult. Downloading Business Plans for Dummies to my Kindle was where I was at, so I hired coaches. The social media thing: I’m OK on the computer but Twitter, Facebook – what? I found a wonderful woman who trains big companies and said “I’ll pay you double what you normally charge per hour to sit with me for two hours on the phone.” I hired a PR coach. I have a great accountant who’s also legally trained.

“We’re now in an arena where the rate of change is so rapid that what will determine who will stand and fall is resilience and being able to adapt. Life has bashed me about, so you could put me on the moon and I’d adapt. What you need to know is how to learn. That’s it, in a nutshell. There’s always someone you can hire, a book you can read, something you can download, a class you can take.”

Building our product range

“I work with Janey Lee Grace for our PR – she’s an expert on natural products and we’ve won her Platinum Award twice, in 2012 and 2013. She has helped us so much, mentored me, tutored me. She has helped us work our products into the Tesco Tesco NutriCentre, which is where a lot of practitioners of complementary and alternative medicines shop. Our soap was rated nine out of 10 in a national newspaper review and we started to get media attention. So I sent a copy of the article and some sample boxes to Selfridges, Harrods and Fortnum & Mason. It was just a cheeky shot in the dark, but I got a call from the buyer at Fortnum & Mason. When I went up to London, I said: ‘I now have something even better: probiotic soap’ and they said ‘Great: let’s do it.’ I made an exclusive line for them, with black walnut wood tops which Rich makes here. But a lot of mums who need these products for their kids can’t afford expensive prices so I created another line, our Natural Magic range, which is very reasonably priced. Our brand is very specific – it’s aimed at mothers who want products for children with conditions that medical science finds hard to tackle: eczema, asthma, colitis, IBS. I’m looking to solutions that are natural but backed by science; I’m not into airy-fairy or hippy-dippy.”

Employing Passion, Standards And Value To Produce A Niche Item With Heart

NHS chiefs" spend rises condemned as "double standards" by nurses

The Royal University of Nursing, which carried out the analysis, stated the figures highlighted the increasing disparities on pay for NHS personnel. Photograph: Christopher Furlong/Getty Photos

Hospital bosses’ pay has been growing far faster than that of frontline NHS workers for the duration of the service’s unprecedented monetary squeeze, prompting angry claims by nurses’ leaders of double requirements.

Senior NHS managers’ salaries have risen by an average of six.one% in excess of the last two years – virtually four occasions the regular charge of 1.6% for nurses, midwives and wellness site visitors, in accordance to new figures.

Some hospital trust chief executives and other senior figures have obtained bonuses of at least £40,000 – much more than a ward sister’s yearly salary – pay rises of up to £30,000 and benefits in type, this kind of as a leased vehicle, worth £10,000, freedom of details requests show.

The disclosures have led the Royal University of Nursing (RCN), which conducted the research, to condemn what it says are unfair and increasing disparities on shell out in England at a time when most NHS workers who seem after sufferers have had pay freezes or small pay out rises.

They come as anger is expanding amongst unions representing the NHS’s one.35 million-sturdy workforce at the selection by the health secretary, Jeremy Hunt, to reject the NHS pay out-overview body’s recommendation that all NHS staff need to get a 1% pay out rise this year. Several of the unions are contemplating undertaking a coordinated programme of industrial action in the autumn, ranging from an overtime ban to likely strike action, in protest.

The RCN mentioned: “People currently on the highest salaries in the overall health service are seeing their rewards accelerating ahead of the earnings of the staff they lead.” Its general secretary, Dr Peter Carter, described the findings as “yet another kick in the teeth for hardworking and loyal nursing staff”.

NHS hospital trusts are in a position to determine with out ministerial interference how much their senior employees must be paid but are anticipated to do so “with obligation and sensitivity to the place of personnel who are subject to national contracts and restraint over their pay out”.

Dan Poulter, the wellness minister, not too long ago insisted that most were carrying out that. But he said that the specifics supplied by hospitals, contained in a new RCN report, “fly in the face of this assertion”.

For instance, the chief executive of Oxford University Hospital NHS Believe in, which runs the city’s John Radcliffe hospital, acquired a bonus of among £40,000 and £45,000, even though one executive received one of £5,000-£10,000 and six other individuals of amongst £10,000 and £15,000.

Similarly, the chief executive of West Hertfordshire Hospitals NHS Trust, which runs Watford standard hospital and other hospitals, also got a £40,000-£45,000 bonus, while 3 executives acquired bonuses of £15,000-£20,000 and a single of £20,000-£25,000.

The chief executive at 10 other hospital trusts and deputy chief executive at a single other each enjoyed pay out hikes of among £15,000 and at least £30,000 throughout 2011-twelve and 2012-13. For instance, the salary of the chief executive of York Teaching Hospitals NHS Foundation Believe in rose from £160,000-£165,000 to £190,000-£195,000.

“It is incredibly worrying that the government believes that trusts are acting responsibly when it truly is clear several are failing to display the leadership they ought to on senior management pay out,” said Carter.

“The government has maintained an iron grip on the pay out and advantages of frontline staff whilst the senior managers’ shell out bill has gone seemingly unchecked. This is the worst kind of double regular and can make a mockery of their insistence that fairness has been at the heart of their selection-making on public-sector pay out.”

Jamie Reed, the shadow health minister, stated: “Difficult-operating nurses and midwives will locate this galling. David Cameron need to have honoured his promise to give frontline workers a spend rise.”

Bosses have been awarded enhanced packages at a time when the support has been acquiring the smallest spending budget increases in its historical past and struggling to provide £20bn in efficiency financial savings in between 2011 and 2015 – the so-referred to as Nicholson Challenge.

The NHS Confederation, which represents senior managers, declined to comment.

The Division of Wellness (DH) said the RCN’s findings were not dependable simply because they had integrated exit packages awarded to some of the 7,250 NHS managers who had misplaced their jobs because 2010 but not carried out the identical with nurses. There are now 16,300 much more clinical employees and 7,250 fewer managers in the NHS than when the coalition took energy in Might 2010, a DH spokesman explained. He claimed that the government’s radical overhaul of the NHS was conserving £5bn, which was far a lot more than the fees of the 7,250 redundancies.

In a separate matter, Carter stated that the NHS would be forced to rely on rising numbers of company and foreign nurses to bridge the gap brought on by cuts to the quantity of pupil-nurse instruction locations.

Speaking from the RCN yearly congress in Liverpool, Carter said: “The NHS, possessing cut the number of places for pupil nurses, is now not receiving the by way of-put, they’re now having to go off to all points of the compass.

“As an illustration, three many years ago, the NHS in London minimize instruction locations by 24%. Now the result of that is beginning to come through.”

NHS chiefs" spend rises condemned as "double standards" by nurses

Half of foreign medical doctors are beneath British standards

“The truth that you currently have overseas doctors becoming more than-represented at GMC hearings is indicative of the problem. Several are merely not qualified to the very same requirements.”

More than 88,000 foreign-skilled doctors are registered to perform in Britain, like 22,758 from Europe. They make up almost a third of all NHS medical doctors but account for approximately two thirds of these struck off every single 12 months. The Skilled and Linguistics Assessments Board, the examination they have to pass to practise in Britain, is made to guarantee the identical ability degree as a British graduate a year right after finishing medical college.

But UCL identified there was “no formal mechanism” to guarantee the examination was as tough as assessments taken by British medical doctors. When researchers compared benefits they located that foreign doctors had been consistently carrying out much less effectively.

Close to half of physicians educated abroad would not pass the most comparable British check, the report authors mentioned.

“It may be that some overseas medical doctors have had poor coaching and when they come to Britain they will catch up speedily and thrive in a better environment,” mentioned Prof McManus.

“But alternatively some might really feel fully overwhelmed, particularly with new technologies that they have not however come across. And that is of concern.”

Figures from 2012 showed that of 669 doctors who were struck off or suspended in the previous five years, 420 had educated abroad.

The nation with the largest variety of medical professionals eliminated or suspended from the health-related register is India, followed by Nigeria and Egypt.

In 2011 the GMC set up a operating celebration to overview whether or not the competency examination required to be up to date and asked UCL to compile analysis. The doing work get together is due to report later this year but UCL’s findings have been produced public following they have been utilized to defend an allegation that the GMC was racist in marking the exams of foreign medical professionals.

The British Association of Doctors of Indian Origin launched a judicial assessment claiming the GMC failed as well numerous medical doctors from overseas in GP tests. But a High Court judge ruled against them this month right after seeing UCL’s report.

Prof McManus said: “We’ve been via the figures with a fine-toothed comb and there is simply practically nothing to demonstrate that examiners are becoming racist.”

The Indian physicians’ association (BAPIO) stated it was dismayed by the findings. It has named for a frequent test for all medical doctors. Dr Ramesh Mehta, its president, mentioned: “We have to drive requirements up, but we want goal proof and fair processes. We are foremost NHS physicians and want the NHS to be the ideal this blame game is not helpful.”

The GMC mentioned the research raised important questions and agreed that modifications were “vital” for patient safety.

“We are determined to do what we can to sustain high specifications of medical practice in the United kingdom, irrespective of in which medical doctors obtain their coaching,” mentioned Niall Dickson, the chief executive of the GMC.

“That is why we are reviewing the way in which we assess the expertise and skills of these looking for to practise here … This evaluation, along with our selection to enhance the score we require in our assessment of English language skills, will support us make sure that high standards of practice are maintained.”

The study, which is published in the British Healthcare Journal, also showed that medical doctors from inside of the EU fall brief.

In 2008, David Gray, a pensioner, died right after a medical doctor trained in Germany, Daniel Ubani, gave him 10 times the suggested dose of pain relief whilst doing work his very first shift as a locum GP.

Tougher language checks for European medical doctors come into force this summertime.

Dr Maureen Baker, chairman of the Royal University of Basic Practitioners said: “In the interests of patient security and fairness to global health care graduates, we advise that the existing Specialist and Linguistic Assessment Board normal setting process is reviewed as a matter of urgency.”

Half of foreign medical doctors are beneath British standards

Alder Hey children"s hospital fails 4 in five standards checks

The Care Quality Commission identified ‘very worring problems’ at Alder Hey, like managers allegedly not listening to theatre workers complaints. Photograph: Christopher Thomond for the Guardian

A single of England’s 4 kids-only hospitals has “extremely worrying troubles” in its working theatres, in accordance to security watchdogs.

Alder Hey in Liverpool failed to meet 4 of five nationwide standards checked by inspectors from the Care High quality Commission (CQC) in December. There was a faulty emergency phone alarm method, possible safety incidents, and “close to misses” went unreported, while operations had been cancelled due to the fact of employees shortages.

There were also issues in the theatres about lack of ample gear to keep track of patients and poor maintenance checks.

Staffing problems meant that individuals in the theatre recovery spot following surgery had been at improved risk, too.

There have been also complaints from theatre workers that managers did not pay attention to their “repeated issues”. Some wards at the hospital did not have ample certified, skilled and experienced staff, in accordance to the CQC.

The CQC’s regional director, Malcolm Bower-Brown, said: “The troubles we recognized at the Alder Hey hospital are very worrying. We have advised the believe in the place more action have to be taken to make sure national specifications are met and that patients acquire the good quality of care they are entitled to assume.”

The unannounced pay a visit to by the CQC in December came right after it was alerted by theatre workers more than their issues about standards. Its report fails the hospital on care and welfare of individuals making use of its services, staffing, support of employees and high quality monitoring. Cleanliness and infection management met nationwide specifications.

A report by the hospital’s director of nursing, Gill Core, had presently warned of shortcuts in security processes, “restricted reporting of incidents”, and a belief among staff that senior managers condoned the working circumstances.

Two years ago, the Royal University of Surgeons warned that relations within the surgical department had broken down, even though total surgical efficiency was protected.

Louise Shepherd, chief executive of the basis hospital trust, explained there was “no evidence that individuals have been harmed as a consequence of these concerns and we continue to be assured that we are providing a safe service for our youngsters and youthful people”. An action plan had already been created and “many” components of it implemented.

But Shepherd stated it was regrettable that a small number of the theatre staff felt they had had to speak to the CQC about how they had been supported at operate. “Theatres by nature are extremely stressful, demanding operating environments and we are also facing an increased demand on our solutions,” she added.

Alder Hey children"s hospital fails 4 in five standards checks

Autism care standards need to have to be enhanced, says Wonderful

A child plays at a college that aids autistic youngsters. Photograph: Felix Clay for the Guardian

The high quality of care for men and women with autism is poor and varied across England, wellness leaders have warned.

There is a real variation in the kind and good quality of care that men and women acquire and several sufferers typically have other circumstances that go undiagnosed, in accordance to the Nationwide Institute for Overall health and Care Excellence (Nice) in a report on autism, the developmental problem which affects the way the brain processes details. It can lead to lifestyle-lengthy problems and difficulties with social interaction, impaired language and communication skills.

Wonderful has known as for clearer requirements to guarantee consistent remedy across the country. As element of a new set of proposed suggestions, Good states that people who are referred to autism experts should acquire a diagnostic evaluation within three months.

Jonathan Green, professor of youngster and adolescent psychiatry at the University of Manchester, who helped to create the new set of requirements, claimed that poor, inconsistent care for autism individuals could have “lasting results on each the person and their families or carers”. There have been a lot of “essential regions needing improvement”, he mentioned.

Prof Gillian Leng, director of overall health and social care at Nice, explained new recommendations would permit doctors to deliver “the extremely greatest care and help” for patients.

“Folks with autism can discover every day life tough and confusing, and frequently have symptoms or factors of other problems that go undiagnosed,” she mentioned. “This quality regular outlines how to deliver the quite best care and help for grownups and kids with the problem.”

Mark Lever, the chief executive of the National Autistic Society, claimed that speeding up the diagnosis process would let sufferers to receive the correct support. He said: “People with autism have campaigned lengthy and tough for their needs to be addressed when pros are creating help and solutions measuring progress towards this standard will aid to make certain that this occurs.”

About 1 in one hundred men and women in England endure from an autistic spectrum disorder, in accordance to the NHS Alternatives internet site.

Due to the fact autism is a spectrum problem, it can have an effect on sufferers in many various ways. Although some are ready to reside independently, other folks may possibly endure from significant learning disabilities and require expert support throughout their lives.

Though there is evidence to propose that genetic variables as effectively as bodily elements are accountable for some types of autism, scientists have been unable to set up the brings about of the issue.

Autism care standards need to have to be enhanced, says Wonderful

Bangladesh shipbuilder sets benchmark in overall health and safety standards | Ruth Evans

Bangladesh’s Western Marine Shipyards has witnessed a 99% reduction in accidents. Photograph: WMS

In a cavernous hangar, an imam recites a short prayer as employees gather round. When he has completed, managers sporting white overalls and hardhats mount the platform, pick up wooden mallets and strike an aluminium keel.

The noise ricochets close to Western Marine Shipyards, 1 of Bangladesh’s leading shipyards, as absolutely everyone applauds. The keel is the basis and spine of any ship, and this short keel-laying ceremony marks the begin of work on the shipyard’s most recent buy. Work also recommences on the 13 other ships, fishing trawlers and ferries in different stages of construction at the yard.

Shipbuilding is a development industry for the nation, bringing in considerably-essential foreign currency. Export earnings from ship development reached $ 46m in 2010-eleven and the government hopes the sector will contribute 4%-5 % of GDP by 2015 – and possibly develop 1m jobs.

3 years in the past, problems at this Chittagong shipyard had been extremely distinct, with one,000 injuries a month in a workforce of 3,500. Now, through reasonably basic measures, there has been a 99% reduction in accidents.

This has been attained by way of a public-private partnership among Western Marine and Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) to promote better well being and security in the workplace. A 3-yr partnership, portion of bilateral German advancement co-operation in collaboration with the ministry of wellness and loved ones welfare, was the first of its kind in Bangladesh utilizing personal sector infrastructure for the provision of public wellness providers.

A worker inspects a factory in Dhaka soon after a fire killed eight individuals final Might. Photograph: Andrew Biraj/Reuters

The aim was to make sure a match and healthy workforce, by way of better accessibility to wellness providers, and the business agreed to build a health clinic. The wellness ministry pays for a nurse, and the shipyard pays for a element-time physician – who also attends to the nearby community – and two paramedics, who are also obtainable to the regional community, in which numerous of the workers live.

Following a welder was electrocuted and died whilst functioning without having protective equipment, Western Marine set about analysing the hazards and hazards employees faced – such as eye injuries and harm to hearing from noise. A health and security policy was drawn up to tackle the higher accident charges, training was provided for managers and workers, and protective clothes and products have been distributed.

Rigid reporting procedures had been established, so that every single incident or accident was recorded and investigated, and preventive measures implemented. The shipyard also recruited a wellness and security adviser to monitor, record and deal with any important troubles. The influence of these measures was quick and dramatic.

Well being and safety is now embedded in the company’s practices. “The initial issue is that when you do any task you guarantee the security is assured for all the employees – that is the leading priority,” says Arifur Rahman Khan, the firm’s technical director, “Which is how we begin our day.” In the past 3 years there have been no fatal accidents.

As a result, the clinic can focus on typical health checks for employees, to determine perform-related problems. The underlying philosophy is that prevention is greater than cure . “If we look right after our people, we’ll get better perform from them,” says Abu Mohammed Fazle Rashid, the deputy managing director.

Kemal Hasan, a welder, says circumstances have improved enormously. Now, he constantly wears gloves, protective overalls and a face mask, which prevent a lot of the injuries that previously occurred. There are fewer stoppages due to accidents, he says, and morale has improved. Workers want to keep with the organization simply because conditions are greater than elsewhere.

Considering that the Rana Plaza garment factory collapsed in April, with the loss of a lot more than 1,100 lives and 2,500 employees injured, and fatalities in fires in other factories, international consumers are increasingly demanding better overall health and safety checks. There is also a developing recognition that health and security are not just a matter of worker’s rights, but also an essential improvement situation. One particular worker often supports a massive extended family members, so fatalities or injuries can be catastrophic for communities. A healthy and productive workforce is important for economic improvement, and employers have a vital role to play.

Bangladesh has come underneath intense worldwide strain to overhaul labour laws and working problems. Nevertheless, Dr Paul Rueckert, GIZ’s principal adviser for overall health in Bangladesh, believes as well much consideration has been targeted on reactive processes to deal with fire and development hazards alternatively of introducing a lot more extensive occupational health and safety programs. Impetus for change must come from the owners and managers of the sector, he says, not just be imposed by government inspectors, who are number of and can’t be all over the place at when.

Rueckert believes there has in no way been a stronger crucial for powerful occupational wellness and safety measures, and hopes the Marine Shipyards undertaking will turn into a model for other industries. The challenge will be to convince other employers in Bangladesh to stick to suit, and accept that workers’ health and safety should be a priority for each financial improvement and far better enterprise.

Bangladesh shipbuilder sets benchmark in overall health and safety standards | Ruth Evans