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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.

#CIA #torture report brands post-9/11 program as brutal and ineffective

Report released by Senate after four-year, $40m investigation concludes CIA repeatedly lied about brutal techniques in years after 9/11.

CIA headquarters in McLean, Virginia.CIA headquarters in McLean, Virginia. The majority of the 6,000-page classified torture report remains classified. Photograph: Larry Downing/Reuters

Spencer Ackerman in New York, The Guardian.

The CIA’s post-9/11 embrace of torture was brutal and ineffective – and the agency repeatedly lied about its usefulness, a milestone report by the Senate intelligence committee released on Tuesday concludes.

After examining 20 case studies, the report found that torture “regularly resulted in fabricated information,” said committee chairwoman Dianne Feinstein, in a statement summarizing the findings. She called the torture program “a stain on our values and on our history”.

“During the brutal interrogations the CIA was often unaware the information was fabricated.”

The torture that the CIA carried out was even more extreme than what it portrayed to congressional overseers and the George W Bush administration, the committee found. It went beyond techniques already made public through a decade of leaks and lawsuits, which had revealed that agency interrogators subjected detainees to quasi-drowning, staged mock executions, and revved power drills near their heads.

At least 39 detainees, the committee found, experienced techniques like “cold water dousing” – different from the quasi-drowning known as waterboarding – which the Justice Department never approved. The committee found that at least five detainees were subjected to “rectal rehydration”, in some cases leading to anal fissures and rectal prolapse. It also found that death threats were made to some detainees. CIA interrogators, the committee charged, told detainees they would hurt detainees’ children and “sexually assault” or “cut a detainee’s mother’s throat”.

At least 17 were tortured without the approval from CIA headquarters that ex-director George Tenet assured the Justice Department would occur. And at least 26 of the CIA’s estimated 119 detainees, the committee found, were “wrongfully held”.

Contractor psychologists James Mitchell and Bruce Jessen played a critical role in establishing the torture program in 2002. A company they formed to contract their services to the CIA was worth more than $180m, and by the time of the contract’s 2009 cancellation, they had received $81m in payouts.

The committee’s findings, which the CIA largely rejects, are the result of a four-year, $40m investigation that plunged relations between the spy agency and the Senate committee charged with overseeing it to a historic low.

The investigation that led to the report, and the question of how much of the document would be released and when, has pitted chairwoman Feinstein and her committee allies against the CIA and its White House backers. For 10 months, with the blessing of President Barack Obama, the agency has fought to conceal vast amounts of the report from the public, with an entreaty to Feinstein from secretary of state John Kerry occurring as recently as Friday.

Global Network For CIA torture

CIA director John Brennan, an Obama confidante, conceded in a Tuesday statement that the program “had shortcomings and that the agency made mistakes” owing from what he described as unpreparedness for a massive interrogation and detentions program.

But Brennan took issue with several of the committee’s findings.

“Our review indicates that interrogations of detainees on whom EITs were used did produce intelligence that helped thwart attack plans, capture terrorists, and save lives. The intelligence gained from the program was critical to our understanding of al-Qaida and continues to inform our counterterrorism efforts to this day,” Brennan said.

“EITs”, or “enhanced interrogation techniques”, is the agency’s preferred euphemism for torture.

Obama banned CIA torture upon taking office, but the continuing lack of legal consequences for agency torturers has led human rights campaigners to view the Senate report as their last hope for official recognition and accountability for torture.

Though the committee released hundreds of pages of declassified excerpts from the report on Tuesday, the majority of the 6,000-plus page classified version remains secret, disappointing human rights groups that have long pushed for broader transparency. Senator Mark Udall, a Colorado Democrat who lost his seat in November, has flirted with reading the whole report into the Senate record, one of the only tactics to compel additional disclosures remaining.

Senate majority leader Harry Reid weighed in to back the report. “Today, for the first time, the American people are going to learn the full truth about torture that took place under the CIA during the Bush administration,” Reid said on the Senate floor. “The only way our country can put this episode in the past is to confront what happened.”

“Not only is torture wrong but it doesn’t work,” said Reid. He said torture “got us nothing except a bad name”.

But Republican members of the intelligence committee questioned the report in their own 100-page document. They wrote “procedural irregularities” had negatively impacted the study’s “problematic claims and conclusions” and accused Democrats of bias and faulty analysis.

The Republicans specifically disputed the report’s claim that torture had failed to provide actionable intelligence and claimed “aggressive” interrogation of Zubaydah led to the capture of al-Qaida associates and the disruption of a plot plot aimed at hotels in Karachi, Pakistan, frequented by American and German guests.

In a statement, James Clapper, director of national intelligence, said he could not recall a report “as fraught with controversy and passion as this one”.

He said the officers who participated in the program “believed with certainty that they were engaged in a program devised by our government on behalf of the president that was necessary to protect the nation, that had appropriate legal authorization, and that was sanctioned by at least some in the Congress.” But he said “things were done that should not have been done”.

“I don’t believe that any other nation would go to the lengths the United States does to bare its soul, admit mistakes when they are made and learn from those mistakes. Certainly, no one can imagine such an effort by any of the adversaries we face today,” said Clapper.

The Guardian.

#UK jails first #Briton for attempting to join #ISIS in #Syria

Mashudur Choudhury, 31, received a four-year-sentence after he was found guilty of preparing acts of terrorism. (Photo courtesy: Thames Valley Police)Mashudur Choudhury, 31, received a four-year-sentence after he was found guilty of preparing acts of terrorism. (Photo courtesy: Thames Valley Police).

Staff writer | Al Arabiya News.

A UK court handed the first indictment against a Briton for travelling to Syria to join the Islamic State of Iraq and Syria (ISIS) militant group, the Daily Mail reported.

Mashudur Choudhury, 31, received a four-year sentence after he was found guilty of preparing acts of terrorism against the UK.

“Whatever the motivation, anybody who prepares to fight for a political or ideological cause in another country must be in no doubt that they commit a serious offence,” Judge Paul Dodgson, who sentenced Choudhury said.

The convicted father of two reportedly returned to the UK after 18 days with the militant group at the end of which he failed to pass the selection process, the Mail reported.

Choudhury is one of six men from the city of Portsmouth who travelled to join ISIS in Syria.

“I have no doubt that when you embarked on this trip you and your companions hoped that your actions would encourage others to take the same journey,” Dodgson was quoted as saying by the Mail.

“That has indeed occurred with the disastrous consequences we, and so many young men’s families, now live with”’

Choudhury has made several false claims about his origins and his jobs, the judge said adding that he put on an image of a “teacher or scholar” that could provide “advice” and guidance to younger members of the group.

‘Twinkle twinkle little star’

He was arrested in October last year and first claimed he has been involved in aid work in Syria.

After confessing to his involvement with the militants, Choudhury said he was sidelined and was forced to cook, wash and sing Twinkle Twinkle Litte Star to children, the Mail reported.

His own lawyer conceded that he had been living a lie, having claimed to his wife that he had cancer, who in turn gave her husband more than £35,000 for treatment.

He reportedly spend the money on prostitutes and foreign holidays.

Al Arabiya News.

#Britain to establish first permanent Middle Eastern #military base for 43 years in #Bahrain

Human rights activists slammed the UK for its 'silence' over abuses.Human rights activists slammed the UK for its ‘silence’ over abuses.

Lizzie Dearden, Jamie Merrill, The Independent.

Britain is establishing its first permanent military base in the Middle East for 43 years in Bahrain to bolster security against Isis.

Four Royal Navy ships are already permanently based at the Mina Salman Port but the deal will allow more destroyers and aircraft carriers to be moored in the area.

Britain closed all is major bases east of the Suez canal following major defence spending cuts in 1971 and while the return to the region has been welcomed by defence sources, it has been widely condemned by Bahraini activists who have a labelled it as “reward” for the British government’s for a “silence” over human right’s violations in the country.

Although military officials have reportedly been working towards the move for around two years, the threat from Isis in Iraq and Syria has heightened the focus on Britain’s presence in the region.

Philip Hammond signed the £15 million deal with Bahrain’s foreign minister, Sheikh Khalid bin Ahmed bin Mohammed Al-Khalifa.

The Foreign Secretary said: “This will guarantee the presence of the Royal Navy in Bahrain well into the future.

“The expansion of Britain’s footprint builds upon our 30-year track record of Gulf patrols and is just one example of our growing partnership with Gulf partners to tackle shared strategic and regional threats.”

A string of human rights groups, including Human Rights Watch, have criticised Bahrain’s human rights record and anti-arms campaigners protested outside a This is Bahrain conference staged in Westminster earlier this year, demanding the Government and royal family sever all ties with the regime.

Activists gather outside the Queen Elizabeth II Conference Centre in central London.Activists gather outside the Queen Elizabeth II Conference Centre in central London.

Observers have recorded “arbitrary” arrests of anti-government protesters, torture and deaths in custody, the persecution of political critics, crackdowns on the freedom of assembly and expression, forced labour and poor treatment of women in Islamic courts.

Nabeel Rajab, an opposition politician and president of the Bahrain Centre for Human Rights, told The Independent: “This base is a reward to the British government for the silence they provided on human rights abuses in Bahrain, and for their continued support of this tyrannical and corrupt regime – the money to be paid by Bahrain to build these base, in fact, is for buying the silence of the British government and support for the regime and against our struggle for justice, democracy and human rights.”

The announcement follows a damming report last month by the influential House of Commons Foreign Affairs Committee, which found there was “little or no evidence that Bahrain has made enough progress in implementing political reform and safeguarding human rights.”

The report added that Foreign Office should have “bitten the bullet and designated Bahrain as country of concern”.

Thousands of Bahraini protesters march near Manama.Thousands of Bahraini protesters march near Manama.

However last night the report’s chair seemed to distance himself from this conclusion and welcomed the base announcement.

Conservative MP Sir Richard Ottaway said the base was “an excellent decision”.

He added: “Its strategic value to Britain is tremendous. And hopefully the presence of our sailors and soldiers there at a permanent base will persuade Bahrain implement the outstanding Bahrain Independent Commission of Inquiry human rights reforms.”

Sheikh Khalid said Britain and Bahrain shared a “joint determination” to maintain regional security and stability and would enhance co-operation.

Under the deal, the existing facilities at the port will be expanded and a forward operating base established, with Bahrain paying most of the infrastructure costs.

Michael Fallon, the Defence Secretary, said the base was a “permanent expansion” for the Royal Navy that would allow the use of more, larger shifts to “reinforce stability”.

“We will now be based again in the Gulf for the long term,” he added.

A Bahraini anti-government protester throw a stone toward riot police during clashes in Daih.A Bahraini anti-government protester throw a stone toward riot police during clashes in Daih.

Sir Nicholas Houghton, the Chief of the Defence Staff, told BBC Radio 4’s Today programme the move was strategically important.

“Rather than just being seen as a temporary deployment to an area for a specific operational purpose, this is more symbolic of the fact that Britain does enjoy interests in the stability of this region,” he added.

“And the fact that the Bahraini authorities and government agreed to fund infrastructure within the country to base our maritime capability forward, both is recognition from their perspective of the quality of the relationship with the United Kingdom, but also of our interest over time in maintaining the stability of this very important area.”

Additional reporting by PA.

The Independent.


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