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#NHS: crisis feared as record numbers of patients wait more than four hours in A&E

Growing pressures on emergency departments contribute to their second-worst performance ever.

In the seven days to 7 December, 286,429 patients sought treatment from NHS A&E departments across England.In the seven days to 7 December, 286,429 patients sought treatment from NHS A&E departments across England. Photograph: Robert Stainforth/Alamy

Denis Campbell, health correspondent, The Guardian.

Record numbers of patients had to wait more than four hours for A&E treatment last week, fuelling increasing fears the NHS is facing a winter crisis even before very cold weather has arrived.

Growing pressures on hospitals also meant that emergency departments recorded their second-worst performance ever against the politically important target that 95% of patients should be treated within four hours.

In the seven days to Sunday 7 December, the NHS across England managed to treat and then admit or discharge just 87.7% of the 286,429 patients who arrived at hospital A&E units. That was significantly down on the 90.4% performance seen the week before.

The highest-ever number of patients were also forced to spend between four and 12 hours on a trolley waiting to be admitted last week, in a further sign the service is struggling to meet the rising demand for care, despite ministers giving it an extra £700m to help it cope.

NHS England, which runs the service and allocates its £96bn budget, admitted that hospitals are being put under “extra pressure” and identified the rising number of attendances at A&E as a key reason.

It is “pulling out all the stops” to avoid not being able to cope, it insisted.

In total 35,373 patients waited more than four hours in what the NHS calls Type 1 A&E units – those situated at hospitals – before they were treated, the highest figure since records began in late 2010. The previous highest figure was 34,595 in April 2013, just after the problem-strewn launch of the NHS’s new 111 telephone advice service led to a surge in demand.

Last week’s 35,373 is also more than 50% up on the 21,276 patients who waited more than four hours in the same week last year.

In addition, 7,760 patients who had been treated then endured between four and 12 hours on a trolley as they waited to be admitted to the hospital from its A&E. That is more than 2,000 more than the week before, and is further evidence that hospitals are facing mounting difficulty in dealing with the growing number of patients and increased complexity of illness and injury they are facing.

It is also more than double the 3,666 patients who experienced a trolley wait in the same week in 2013.

Dame Barbara Hakin, NHS England’s national director of commissioning operations, said: “This week over 110,100 emergency admissions to hospital and 436,229 attendances – up nearly 30,000 on the average for the same week over the past years. Unsurprisingly this level of demand continues to put extra pressure on our hospitals.

“But the NHS remains resilient and is pulling out all the stops, with local hospitals, ambulances, GPs, home health services and local councils all working hard to open extra beds and seven day services using the extra winter funding that has been made available”, she added.

The Guardian.

#UK ministers met #Senate committee during #torture inquiry, papers reveal

Representatives including Theresa May held 24 meetings with US officials writing CIA report in which UK references were redacted.

Theresa May met members of the Senate committee working on the CIA torture report, according to documents obtained by Reprieve.Theresa May met members of the Senate committee working on the CIA torture report, according to documents obtained by Reprieve. Photograph: Euan Cherry/Photoshot

Rowena Mason, political correspondent, The Guardian.

The government is under pressure to explain whether UK ministers and officials repeatedly lobbied the US to delete references to British spies from a damning report about CIA torture of detainees in the wake of 9/11.

New documents show that, from 2009, UK government representatives had 24 meetings with members of the US committee that found CIA methods were brutal and ineffective.

Among those who met the committee were the home secretary, Theresa May, the former Labour minister Lord West and the UK’s ambassadors to Washington, according to information obtained by the human rights group Reprieve.

Downing Street has admitted that British spies were granted redactions on “national security grounds” but denies that there was a cover-up.

However, the number of meetings has led to suspicions about a concerted UK lobbying campaign to secure redactions.

The Reprieve spokesman Donald Campbell said: “We already know that the UK was complicit in the CIA’s shameful rendition and torture programme. What we don’t know is why there is no mention of that in the public version of the Senate’s torture report.

“There are important questions which members of the current and the previous governments must answer: did they lobby to ensure embarrassing information about the UK was ‘redacted’ or removed from the report?

He said May and West both met the Senate committee while it was working on its report. “They need to provide clear answers on whether they sought to lobby the committee to keep embarrassing information about the UK out of the public eye.”

In a letter to Reprieve in July, the then foreign secretary, William Hague, said: “The UK government has not sought to influence the content of the Senate report. We have made representations to seek assurance that ordinary procedures for clearance of UK material will be followed in the event that UK material provided to the Senate committee were to be disclosed.”

Sir Malcolm Rifkind, the former foreign secretary leading the current scrutiny of UK involvement in torture, acknowledged the redactions could create suspicions but insisted there was no cover-up.

He told the BBC: “I actually had a conversation two days ago with the head of the relevant intelligence agency, and he stated quite categorically what we have now heard publicly: that there were no requests to redact or to conceal anything in the report that referred to any allegations of United Kingdom complicity in the treatment of detainees; that the only redactions that were being requested were with regard to operational matters, which were genuine national security issues. Now, that’s what he has said to us. Of course, as part of our inquiry we will look into that further to be absolutely satisfied.”

On Thursday, a spokesman for David Cameron acknowledged the UK had been granted deletions in advance of the publication, contrasting with earlier assertions by No 10. The spokesman said any redactions were only requested on “national security grounds” and contained nothing to suggest UK agencies had participated in torture or rendition.

However, the admission will fuel suspicions that the report – while heavily critical of the CIA – was effectively sanitised to conceal the way in which close allies of the US became involved in the global kidnap and torture programme that was mounted after the al-Qaida attacks.

On Wednesday, the day the report was published, Cameron’s official spokesman told reporters, when asked whether redactions had been sought, that there had been “none whatsoever, to my knowledge”.

However, on Thursday, the prime minister’s deputy official spokesman said: “My understanding is that no redactions were sought to remove any suggestion that there was UK involvement in any alleged torture or rendition. But I think there was a conversation with the agencies and their US counterparts on the executive summary. Any redactions sought there would have been on national security grounds in the way we might have done with any other report.”

The two main cases relevant to the involvement of Britain’s intelligence agencies related to Binyam Mohamed, a British citizen tortured and secretly flown to Guantánamo Bay, and the abduction of Abdel Hakim Belhaj and Sami-al-Saadi, two prominent Libyan dissidents, and their families, who were flown to Tripoli in 2004 where they were tortured by Muammar Gaddafi’s secret police.

There is no reference at all in the Senate’s 500-page report to UK intelligence agencies or the British territory of Diego Garcia, which is used by the US as a military base. But the executive summary contained heavy redactions throughout, prompting speculation that references to US allies had been erased.

In the wake of the Senate report, the UK government is coming under increasing pressure to order a more transparent inquiry into the actions of MI5 and MI6 amid claims of British complicity in the US torture programme.

Asked about the need for a full public inquiry, the deputy prime minister, Nick Clegg, conceded on Thursday that he was open to the idea if the current investigation by the parliamentary intelligence and security committee leaves remaining questions unanswered. No 10 also suggested Cameron had not ruled this out if the ISC does not settle the torture issue.

The government had initially commissioned an inquiry by retired judge Sir Peter Gibson to look at the UK’s treatment of detainees after 9/11. However, he only managed a preliminary report raising 27 serious questions about the behaviour of the UK security services, before it was replaced by an investigation handled by the ISC in December last year.

The ISC’s report will not, however, be completed before next year’s election, so it is unclear how many members of the nine-strong panel of MPs and peers will still be in parliament to complete the work.

The Guardian.

UK: David #Cameron accuses Ed Balls of #Masosadism – but what is it?

David Cameron at prime minister’s questions. Photograph: PADavid Cameron at prime minister’s questions. Photograph: PA

It all started off as an ordinary prime minister’s questions – the normal quips between the leaders, the questions, and the bad gags.

Yet it became a case of raised eyebrows and suggestive double-entendres as the prime minister, David Cameron, made a dig at the shadow chancellor, Ed Balls.

Cameron said:

The shadow chancellor said he would be tough on the deficit and tough on the causes of the deficit. He is one of the causes of the deficit.

I think we’ve all found one of the first ever examples of political masosadism.

Some MPs were left open-mouthed, while others shouted: “You mean sadomasochism!”

The Speaker of the house, John Bercow, cried: “Order, order! We all know what the prime minister meant. I understand the house gets excited.”

One MP said audibly: “You screwed it up.”

Cameron corrected himself, saying: “I meant to say masochism,” and added:

Normally the shadow chancellor likes to dish it out but can’t take it, but after this quote he likes to take it as well, so there we are.

Ed BallsEd Balls (right)

But pray tell, what is masosadism, Mr Cameron?

The Guardian.

Maria Eagle MP: #Communities at risk of #flooding won’t buy this spin from David Cameron

£2.3bn for flood defences in England is not new money, and spending has gone backwards under this Tory-led government despite its claims to the contrary.

Pumping out flood water‘The government … is having to rely on councils to meet three-quarters of the costs as the private sector sit on their hands. It is difficult to see how cash-strapped local authorities will be able to raise anything like £600m for flood defences in the next six years.’ Photograph: Adrian Sherratt/Alamy

Maria Eagle MP, shadow environment secretary for the Labour party.

Climate change is a serious threat to national security and last year’s winter storms highlighted the cost, damages and disruption that extreme weather can cause. Yet within the first six months of the coalition, David Cameron cut the flood protection budget by over £100m, leaving many communities, including the South West, overly exposed.

Ever since then the government has been playing catch up and that’s what today’s promise of £2.3billion for flood defence schemes is all about.

Communities at risk of flooding won’t buy this spin from David Cameron. The £2.3bn is not new money, instead it is another re-announcement of capital funding confirmed a year ago. As a result the Committee on Climate Change claims that the government’s plans will leave 80,000 additional properties at significant risk of flooding in the next five years alone. There were even reports over the weekend that these plans contain a £500m black hole.

There are some heroic assumptions underlying these plans. The government has assumed it can raise £600m of the £2.3bn from its ‘partnership funding programme’, four times more than at present. The programme includes contributions from both the public and private sectors. Yet this has been a disaster.

Not only has the government failed to raise even the original target of £140m in this Parliament, it is having to rely on councils to meet three-quarters of the costs as the private sector sit on their hands. It is difficult to see how cash-strapped local authorities will be able to raise anything like £600m for flood defences in the next six years.

The reality is that flood risk management has gone backwards under this Tory-led government. Despite repeatedly telling us that they’re spending ‘more than ever’ and promising that “money is no object” they have been found out time and time again. Just last month the National Audit Office confirmed that David Cameron has cut flood defence spending by 10% in real terms since 2010.

This same short-term approach has been applied to the ongoing maintenance of flood defences which were cut by 20% in 2010. As a result the Committee on Climate Change has said that three-quarters of existing flood defences are not being maintained to their identified need. This will end up costing the taxpayer more in the long-term because maintaining existing flood defence systems can be among the most cost-effective use of resources.

This replaces The Guardian’s video which was not available to share.

Communities at risk of flooding deserve a proper long-term plan for infrastructure investment, including flooding. That is why Labour has called for an Independent National Infrastructure Commission to set out its flood defence spending in the context of a 25-30 year infrastructure plan.

Taking climate change seriously is not something only to be done a few months before an election. Voters won’t be fooled by the prime minister who pledged to lead the “greenest government ever” and then instructed his aides to “cut the green crap”.

Maria Eagle MP is Labour’s shadow environment secretary.

The Guardian.

#Fracking risk compared to #thalidomide and #asbestos in Walport report

Historic innovations that have been adopted too hastily with grave unforeseen impacts provide cautionary examples for potential side effects of fracking, says report by government’s chief scientist Mark Walport.

The world could tackle climate change with energy efficiency and renewable energy alone but vested interests in the fossil fuel industry stand in the way, says report. Photograph: Julie Dermansky/CorbisThe world could tackle climate change with energy efficiency and renewable energy alone but vested interests in the fossil fuel industry stand in the way, says report. Photograph: Julie Dermansky/Corbis

Adam Vaughan, The Guardian.

Fracking carries potential risks on a par with those from thalidomide, tobacco and asbestos, warns a report produced by the government’s chief scientific adviser.

The flagship annual report by the UK’s chief scientist, Mark Walport, argues that history holds many examples of innovations that were adopted hastily and later had serious negative environmental and health impacts.

The controversial technique, which involves pumping chemicals, sand and water at high pressure underground to fracture shale rock and release the gas within, has been strongly backed by the government with David Cameron saying the UK is “going all out for shale”.

But environmentalists fear that fracking could contaminate water supplies, bring heavy lorry traffic to rural areas, displace investment in renewable energy and accelerate global warming.

The chief scientific adviser’s report appears to echo those fears. “History presents plenty of examples of innovation trajectories that later proved to be problematic — for instance involving asbestos, benzene, thalidomide, dioxins, lead in petrol, tobacco, many pesticides, mercury, chlorine and endocrine-disrupting compounds…” it says.

“In all these and many other cases, delayed recognition of adverse effects incurred not only serious environmental or health impacts, but massive expense and reductions in competitiveness for firms and economies persisting in the wrong path.”

Thalidomide was one of the worst drug scandals in modern history, killing 80,000 babies and maiming 20,000 babies after it was taken by expectant mothers.

Fracking provides a potentially similar example today, the report warns: “… innovations reinforcing fossil fuel energy strategies — such as hydraulic fracturing — arguably offer a contemporary prospective example.”

The chapter, written by Prof Andrew Stirling of the University of Sussex, also argues that the UK and the world could tackle climate change with energy efficiency and renewable energy alone but vested interests in the fossil fuel industry stand in the way.

There is a “clear feasibility of strategies built entirely around energy efficiency and renewable energy”, the report, published earlier this month, says. “Yet one of the main obstacles to this lies in high-profile self-fulfilling assertions to the contrary, including by authoritative policy figures.”

“In energy… the obstacles to less-favoured strategies [such as energy efficiency and renewables] are typically more commercial, institutional and cultural than they are technical. Among the most potent of these political obstructions are claims from partisan interests — such as incumbent nuclear or fossil fuel industries — that there is no alternative to their favoured innovations and policies.”

A spokesman for the Royal Academy of Engineering, which produced an influential 2012 report on shale gas with the Royal Society that concluded it could be safe if it was properly regulated, said the risks from fracking were very low.

“Our conclusion was that if carried out to highest standards of best practice, the risks are very low for any environmental contamination. The most serious risks come in the drilling and casing and surface operations rather than the fracturing itself.”

“You can’t eliminate the risk of something going wrong, but you can monitor very closely and be very open and transparent about what’s going on.”

On the chief scientific adviser’s report, he said: “I think he’s making a very broad and general point.”

Greenpeace UK’s energy campaigner, Louise Hutchins, said: “This is a naked-emperor moment for the government’s dash to frack. Ministers are being warned by their own chief scientist that we don’t know anywhere near enough about the potential side effects of shale drilling to trust this industry. The report is right to raise concerns about not just the potential environmental and health impact but also the economic costs of betting huge resources on an unproven industry. Ministers should listen to this appeal to reason and subject their shale push to a sobering reality check.”

The Guardian.


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