Sasha Swire about to publish: “Diary of an MP’s Wife”

Wow – what revelations to come if this is an abysmal peek from Private Eye:

SASHA SWIRE, wife of former Tory MP Sir Hugo Swire, is about to publish her 500-page “secret diary” covering the past 20 years, billed by publisher Little, Brown as “searingly honest, wildly indiscreet and often uproarious”.

Anyone writing about Diary of an MP’s Wife for the Mail titles may need to tiptoe round some of the indiscretions, such as Swire’s account of Lady Rothermere showing her round Feme House, the Rothermeres’ Palladian-style £40m mansion in Wiltshire. “I say ‘their’ house but of course Jonathan is some sort of non-dom so it’s actually Claudia’s,” Swire writes, “which she takes great pleasure in telling us.”

Lady Rothermere’s chief obsession, when not monitoring her husband’s assets, is the Chalke Valley history festival, which she helps to run. Swire describes milady’s arrival at the festival in 2018 “looking like a character straight out of a Jilly Cooper novel in tight white riding breeches. She is her usual regal self.”

She invites Swire’s companions, including cabinet minister Michael Gove, to drinks at Feme House. They dutifully trudge off to pay court — only to be snubbed. The Rothermeres “came down from their bedroom halfway through, said their hellos and then disappeared again”.

[Sasha Swire is the Daughter of Sir John Knott (former Secretary of Defence) and his Slovenian wife Miloska]

The Tories’ planning overhaul is about to come back to bite them 

Have you made any comment yet either to your MP or to the formal consultations? There are two consultations on planning reform with closing dates 1st October and 29th October. What the consultations are about and how to respond can be found here. – Owl

Chaminda Jayanetti www.theguardian.com 

After a decade of Conservative governments actively worsening Britain’s multiple housing crises, this one finally has a plan to get England’s housebuilders building.

There’s one problem – many Tories hate it. And if they don’t now, they will soon.

The government’s proposed new planning system, unveiled last month, is designed to get more than 300,000 homes built every year. Not only will Westminster be issuing mandatory housebuilding targets to councils, but because the plans focus on new housing in areas of peak demand, the impact will be greatest in London and the south-east, according to the planning consultancy Lichfields.

Many of those areas have Tory councils and Tory MPs. A report in the Times last week reflected growing backbench disquiet among Conservatives who might find local objections to large-scale housebuilding overridden by the new government targets.

“Councillors are kicking off. MPs are going to do the same. It’s in London, it’s in the shires,” the Times quoted one Tory MP. “I think a hell of a lot of people haven’t read a lot about it but it’s going to morph into something bigger when they do.”

The government has at least made up its mind – it will back housing developers over local opposition, even when that opposition consists of Conservative members and voters. But fears of untrammelled housebuilding everywhere outside the green belt are bound to provoke staunch resistance. A major parliamentary battle looms.

The reason housing policy is so fraught is because it is a crucible of competing rights and interests that exist at different levels of democracy. National government, local government, neighbourhoods and individuals all have strong and often conflicting views on how much housing should be built, on what terms and where.

The result is a mess. National government is primarily concerned with swing voters in marginals – and, critics argue, large property developers. Local communities often want to preserve their own neighbourhoods or avoid pressure on local amenities, and this aversion to housebuilding inevitably influences what councils do – or how fast they can do it. Individuals want somewhere affordable and decent to live, but are rarely able to pressure politicians to deliver.

Housing is where pure localism fails. Different localities may simply slam the door on newcomers, depending on the attitude of local politicians and voters. Solving the housing crisis becomes someone else’s job.

The government wants to override this by using planning reforms to sledgehammer councils into building more homes. It is this that is sparking concerns on Conservative benches.

The problem is that the plans do little to promote genuinely affordable housing. The current system is dysfunctional, but the new proposals risk making things worse by giving councils the choice of whether to spend financial contributions from housing developers on affordable housing, local infrastructure or potentially even council tax cuts. Tax cuts benefit more existing residents than affordable housebuilding does – and only an optimist would rule out the former trumping the latter in local decision-making.

In this way, the plans centralise decisions over how much housing is built, but localise decisions over whether any of it will be affordable. The main beneficiaries – as with help to buy and right to buy – will be those on the edge of homeownership, mainly on middle incomes and potentially swing voters.

The losers would be those with the least wealth, stuck in unaffordable or squalid housing. Often from low-turnout demographics and sometimes located in safe Labour seats, their votes are less critical to governments of either party.

All this reveals a gaping hole in the broader devolution debate – the assumption that the preferences of local majorities are the same as those of poorer individuals.

Some argue that locally made decisions are good simply because they are local. This is fundamentalist nonsense. For those who seek greater social justice, equality and poverty reduction, the task is to identify a framework of powers to rest at national, local and individual level that can best achieve those aims.

Sometimes that will require strong central government, other times devolution and local veto powers, and in many cases it will need individual socioeconomic rights – of which there is generally little mention in political debate. Different policy areas require different responses.

England needs more houses, more social infrastructure and more genuinely affordable places to live – especially council housing. The government has identified the interests of prospective homebuyers – and property developers – as aligned with its own, and intends to bulldoze past local opponents to get England building.

But those trapped in the sink of the housing market may find that neither national politicians nor local voters have their interests at heart.

  • Chaminda Jayanetti is a journalist who covers politics and public services

 

‘Waste and corruption on a cosmic scale’

Coronavirus: ‘Waste and corruption on a cosmic scale’: Plans for 10 million COVID-19 tests attacked

Owl can’t resist posting this even though it repeats some of the BMJ article. What will the National Audit Office make of it all? It’s a desperate way to spend the public purse.

Emily Mee news.sky.com

Leaked documents reportedly show the government plans to carry out up to 10 million coronavirus tests a day by early next year, but critics say the proposals represent “waste/corruption on a cosmic scale”.

The mass testing programme would cost £100bn – almost as much as the government spends on the NHS each year (£130bn) – according to a briefing memo seen by medical journal The BMJ.

A separate document revealed there were plans to grow the UK’s testing capacity from the current 350,000 a day to up to 10 million a day by early 2021.

On Wednesday, Prime Minister Boris Johnson announced ambitious plans for millions of people to be tested for coronavirus every day, in what he characterised as the “Moonshot approach”.

These documents provide more detail on what the government hopes to achieve, including plans for private companies GSK, AstraZeneca, Serco and G4S to help carry out the proposals.

But some scientists have already expressed doubts, while a memo published by the government’s scientific advisory group (SAGE) last week warned mass testing could lead to an increased number of false positive results.

Anthony Costello, a former World Health Organisation director and UCL professor, wrote on Twitter: “The PMs Moonshot nonsense (no science, feasibility, evidence) has been earmarked for £100bn, almost the entire NHS budget, w contracts for Astra, Serco and G4S.

“This is waste/corruption on a cosmic scale.”

Others pointed out current problems with the existing test and trace programme, after people complained of having to travel hundreds of miles from home to take a test.

“This plan transmits unbounded optimism, disregarding the enormous problems with the existing testing and tracing programmes,” Martin McKee, professor of European public health at the London School of Hygiene and Tropical Medicine, told The BMJ.

“It focuses on only one part of the problem, testing, and says nothing about what will happen to those found positive, a particular concern given the low proportion of those who do adhere to advice to isolate – in part because of the lack of support they are offered.”

He added: “On the basis of what is presented here, this looks less like Apollo 11, which took Neil Armstrong to the moon successfully, and more like Apollo 13.”

Professor Jose Vazquez-Boland, chairman of infectious diseases, University of Edinburgh, was more optimistic about the plans.

“The focus of testing currently remains on confirmation of suspected cases (people with symptoms), thus missing the point that most community transmission comes from those who are asymptomatic,” he said.

“Only a mass screening programme, such as this alternative plan announced by the prime minister, which involves the regular testing of all the population for asymptomatic transmitters, can keep COVID-19 under control and eventually lead to its eradication.”

In a document published on Friday, SAGE said the cheaper and faster tests needed for mass testing were less likely to be able to correctly identify positive and negatives than the tests currently used by NHS Test and Trace.

It said that in a population with low infections, twice-weekly tests with 99% specificity would lead to 41% of the population receiving a false positive over six months.

“In such circumstances, rapid follow-up confirmatory testing will be needed to determine whether individuals should continue to self-isolate – it is important to rapidly isolate infectious individuals, but efforts will be needed to quickly release false positives,” it said.

But the committee did say using testing as a point-of-entry requirements for particular settings, such as sporting events, could help these activities resume with a reduced risk of transmission, but would “require superb organisation and logistics with rapid, highly-sensitive tests”.

Under the plans, the Whitehall briefing memo says testing will be rolled out in workplaces, football stadiums, entertainment venues and also at GP surgeries, pharmacies, schools and other local sites.

People will be given digital immunity passports that would allow those who test negative to take part in more normal activities.

Those in high-risk occupations or who are more vulnerable – such as hospital staff, ethnic minority groups and teachers – would be prioritised for regular testing.

The government is banking on technology that “currently does not exist”, the briefing memo says, including a rapid 20-minute saliva test being piloted in Salford, Greater Manchester.

Dr David Strain, clinical senior lecturer at the University of Exeter and chairman of the BMA’s medical academic staff committee, said this means the mass testing strategy is “fundamentally flawed”.

“The prime minister’s suggestion that this will be as simple as ‘getting a pregnancy test’ that will give results within 15 minutes is unlikely, if not impossible, in the timescale he was suggesting to get the country back on track,” he said.

Will Boris Johnson’s “Moonshot” become lost in space? – The BMJ

Martin McKee is professor of European Public Health at the London School of Hygiene & Tropical Medicine and a member of the Independent SAGE convened by Sir David King. He writes in a personal capacity.

blogs.bmj.com 

Improved testing and new technologies must be part of a well thought out strategy, says Martin McKee
Boris Johnson does not do detail. Somehow he failed to read, or perhaps understand, the text of the EU Withdrawal Agreement that he presented as a “fantastic moment” for the country when he signed it in January 2020. As a consequence, he now finds himself in what is an unprecedented position for a British prime minister of declaring his intention not just to breach international law, but to reject provisions of a treaty he signed only a few months earlier. Sources in Whitehall have noted his preference for papers that are brief and avoid complexity, a preference apparently enforced by his special adviser Dominic Cummings. Nor does he seem to have a sense of curiosity, demonstrated by his repeated failure to attend COBRA meetings at the start of the pandemic. It was therefore unsurprising that his announcement of what has been termed a “Moonshot” project to vastly increase testing for coronavirus lacked any detail other than that it “will require a giant, collaborative effort from government, business, public health professionals, scientists, logistics experts and many, many more.”

Fortunately, some details have become available, in the form of a leaked description of the project and a Powerpoint presentation. They are not reassuring.

The concept is based on testing on a massive scale, up to 10 million tests each day. This will be achieved by widespread use of new, and not yet evaluated tests. These would be, as Johnson predicted in March, “as simple as a pregnancy test”.  Unfortunately, it soon became clear that the tests that the government purchased, for an estimated £17 million, did not actually work. Undeterred, his government now seems, if the documents are to be believed, to be willing to spend up to £100 billion in the hope that any technical problems can be overcome. This would be the equivalent of 70% of the annual NHS budget, prompting several of us who have read it to wonder if it could be a typo, although it is impossible to check as the government does not comment on leaked documents and has failed to provide any meaningful information to Parliament.

To the extent that there are any details, we must look to the Powerpoint presentation, prepared by the Boston Consulting Group. This exemplifies the problems inherent in many management consultancy presentations. First, it draws on an analogy that seems designed to appeal to the more gullible customers, in this case invoking a mission to the moon. Yet a few moment’s reflection reveals the problems with this analogy. When Nasa was programming the guidance in its Saturn V rockets, it knew exactly where the moon would be on 16th July 1969, when Apollo 11 would land. In the centuries since Galileo, astronomers had charted its path with ever greater accuracy. In marked contrast, as has become all too apparent, our ability to predict where the pandemic will be even a few days in advance is far from perfect.

Second, it seems to convey a great deal of information until you look closely. For example, a diagram of a system for scaling up testing in Greater Manchester contains a series of circles labelled, for example, data or validation. Yet these are floating in space, rather like cosmic bodies, with no indication of data flows or lines of accountability. Worse, there is at best lip service paid to existing structures, such as local government and its public health departments. Yet, in other places there is great detail. For example, it sets out a daily schedule for oversight of the project. Every day there will be a “Public Health, Clinical, Scientific Oversight forum” from 11.30-12.00, followed immediately by a daily leadership update. The possibility that a crisis might intervene, disrupting the timetable, does not seem to have been considered. Yet, at the same time there is no information about what these meetings will actually do.

There are many other problems, commented on elsewhere, such as how to deal with false negatives and false positives that will likely be much greater using the new tests. In comments to The BMJ, Jon Deeks, leader of the Cochrane Collaboration’s covid-19 test evaluation activities, said “These are plans from the world of management consultants and show complete ignorance of many essential basic principles of testing, public health, and screening.”

Above all, these proposals show no self-awareness of the problems that have beset England’s highly problematic covid-19 response so far. They portray a government whose ambition far exceeds its ability to deliver, and which sees governing as the practice of launching grandiose initiatives detached from any clear strategy. Many aspects seem totally detached from reality. The timetable presented in the documents envisage that it would be rolled out in early 2021. Given that this is being promised in a country where successive governments have spectacularly failed in almost every major information technology project they have undertaken in recent years, with the proposed system for post-Brexit trading nowhere near ready, this timetable seems, to say the least, rather optimistic. Even if it was delivered on time, by then hopefully we will be beginning to see a vaccine coming on stream.

Once again we see a preoccupation with numbers of tests. It lists target groups, with no indication of how they will be identified and by whom and what might happen once they have been identified. Those involved in the current response know that only a small proportion of people asked to self-isolate actually do so, although once again, Johnson seems unaware, as indicated by his answer to Keir Starmer at Prime Minister’s Questions on 9th September. There is no evidence of any understanding of the importance of a joined up Find, Test, Trace, Isolate and Support system.

One of the most concerning aspects of the Moonshot project is that it continues England’s obsession with standalone initiatives, developed without any apparent involvement of those on the ground or acknowledgement of existing structures. It transmits unbounded optimism, disregarding the enormous problems with the existing testing and tracing programmes.

Another is that this will distract from fixing the problems with the existing system, especially as public health staff are struggling with the abolition of Public Health England. Colleagues report that the consultants involved in developing the proposals have already taken up much of their valuable time.

There is a need to improve testing and new technologies could play an important role. However this must be part of a well thought out strategy, drawing, for example, on thinking in Germany with its focus on in-depth investigation of emerging clusters.

On the basis of what is presented here, this looks less like Apollo 11, which took Neill Armstrong to the moon successfully, and more like Apollo 13.

Hospital boss praised by Matt Hancock told to end ‘toxic management culture’

“A hospital boss championed by Matt Hancock has been told to end “a toxic management culture” after doctors were asked to provide fingerprint samples to identify a whistleblower.”

Denis Campbell www.theguardian.com 

Royal College of Anaesthetists criticise West Suffolk hospital chief executive after staff complaints

A hospital boss championed by Matt Hancock has been told to end “a toxic management culture” after doctors were asked to provide fingerprint samples to identify a whistleblower.

The Royal College of Anaesthetists (RCoA) has urged the chief executive of West Suffolk hospital, Steve Dunn, who Hancock described as an “outstanding leader”, to take urgent action to improve the wellbeing of senior clinicians and “thereby the safety of patients”.

In a strongly worded letter sent to Dunn in July, seen by the Guardian, the RCoA president, Prof Ravi Mahajan, reminded him that “undermining and bullying behaviour is unacceptable”.

Following a three-day review of the hospital, Prof Mahajan’s letter said senior anaesthetists had complained about a “toxic management culture that risks impairing their ability to care safely for patients”.

It comes after the Guardian revealed an unprecedented “witch-hunt” for a whistleblower who had tipped off a family about a potentially botched operation. The family of Susan Warby, who died five weeks after an operation in August 2018, was sent an anonymous letter highlighting errors in her procedure. This week a coroner concluded that errors in her care contributed to her death.

After the anonymous tip-off, staff complained of harassment by hospital managers, who demanded they provide fingerprints to identify which of them had alerted the family.

The incident, and other failings in patient safety, contributed to the hospital becoming the first ever to be relegated by Care Quality Commission (CQC) inspectors from “outstanding” to “requires improvement” in January.

Prof Mahajan’s letter to Dunn said the RCoA’s concerns about the trust were “reinforced not only by press coverage and a recent CQC report, but – more significantly – by confidential information given to the college by clinicians in your hospital”.

Weeks before Warby’s operation, Patricia Mills, a consultant anaesthetist at the trust, had raised alarm internally about patient safety over a doctor who had been seen injecting himself with drugs.

As the same doctor was involved in Warby’s care, Mills was immediately suspected by managers of alerting her family to the errors. Mills has consistently denied this. But managers demanded that senior staff, including Mills, provide fingerprint and handwriting samples in an attempt to identify the writer of the letter. The trust was criticised for its tactics by regulators and promised in January that it had “no intention of pursuing fingerprint requests further”.

But Mills still faces disciplinary action by the trust for refusing to provide her fingerprints.

Prof Mahajan’s letter did not mention Mills by name, but alluded to her treatment her after she raised concerns about the drug-taking doctor. It said: “I write to seek your personal assurance that action has been taken to ensure the wellbeing of anaesthetists, and thereby the safety of their patients, is being held as a key focus point by trust management … The college asks that senior management reflects upon previous behaviour and demonstrates a commitment to improving the management approach and morale of staff.”

The RCoA removed West Suffolk hospital, which treats many of Hancock’s constituents, from its voluntary list of accredited hospitals. It also shared its inspection report with the CQC.

Dunn and Hancock both described each other as “brilliant” in a Twitter exchange in December 2018 after Dunn was awarded a CBE for services to “services to health and patient safety”.

Matt Hancock (@MattHancock)

Huge congratulations to Steve Dunn for his rightful recognition by the Queen as CBE. A brilliant leader: and how typical he calls it a team effort. It is, of course, a team effort, but Outstanding teams need Outstanding leaders. Well done SteveDunnCEO #SteveDunnCBE https://t.co/UhX76TzwnG

December 29, 2018

In January the government ordered a rapid review of West Suffolk, which Matt Hancock recused himself from because of his ties to Dunn. It had been due to conclude in April, but has been delayed until December because of the coronavirus crisis.

In March the British Medical Association urged the trust to drop its disciplinary action against Mills. In a letter to the trust, it said: “West Suffolk Hospital does not need to wait for the recommendations of a rapid review in order to bring Patricia’s process to a close.”

It added: “There is strong evidence to support a clear link between Patricia raising patient safety concerns … within the trust’s whistleblowing policy and being subsequently investigated … these actions are at odds with the principles of a ‘just culture’ that is a guiding philosophy for NHS employers.”

A spokesman for the trust said: “Ensuring our colleagues work in a supportive, safe environment is good for our staff and means better patient care, which is why we have done extensive work this year to act on feedback about our working culture, including taking action to address the concerns raised by the Royal College of Anaesthetists.”

It said it could not discuss issues about individual members of staff.

Devon covid cases up 25 per cent in a week

Of the 53 new cases, 15 are in East Devon, 10 in Exeter, four in Mid Devon, seven in North Devon, four in the South Hams, six in Teignbridge, five in Torridge, and two in West Devon, with a further 11 in Torbay, and 26 in Plymouth.

www.radioexe.co.uk 

 Devon covid cases back to levels seen in May

It’s from a low base, but still worrying

Devon’s director of public health is urging residents to do their bit to reduce coronavirus spreading after a rise in cases.

While the number remains relatively low, recent days have seen an increased infections, with 53 cases in the last seven days, compared to 42 the previous week. Dr Virginia Pearson says not all of the new cases are linked to returning international travellers, which has been the pattern previously.

Dr Pearson, who also chair the multi-agency covid-19 Hhealth protection board, said: “Just like the rest of the country, we have seen a significant rise in the number of confirmed cases in September. Not all new cases are now linked to returning international travellers, which was the pattern we had seen recently.

“We must remember that coronavirus is still a very real threat to us all, especially to our older and vulnerable residents. It’s very easy, with the relaxation of restrictions we’ve had over recent months – the call for people to return to work and to support our high streets; our children returning to schools, colleges and soon to universities – to believe that life is back to normal.

“It is not back to normal.  The virus is still here and it is very easy to get infected, especially indoors.  I am therefore urging all Devon residents, of all ages, but specifically to our younger residents who perhaps do not feel the risk felt by older and more vulnerable residents, to follow the public health advice at all times.

“We are continuing to monitor the data very closely so that we can react immediately to situations as they arise.  But we also need you, the Devon public, to carry on doing your bit to reduce the risk of coronavirus spreading in our county this autumn.”

Maria Moloney-Lucey, public health specialist, said confirmed cases remain very low compared to the national average. There are current 6.6 cases being confirmed per 100,000 population in Devon, compared to the national average of 20.2, mainly in people of working age.

While the number of cases has risen, cases would need to triple to reach the level where they would be put on the government’s watchlist, and then double again before any intervention measures would likely to put in place, with cases needing to be around ten times higher than they currently are before any ‘local lockdown’ rules may be imposed.

There are currently five notable areas in Devon (Cranbrook, Broadclyst & Stoke Canon and  Clyst, Exton, Lympstone in East Devon, Bishop’s Nympton, Witheridge & Chulmleigh in North Devon, and Churston and Galmpton in Torbay)  which have recorded three or more cases in the last week – and Mrs Moloney-Lucey said that at least one of the clusters was linked to community cases and not international travel.

She added: “We are seeing a flurry of cases, and seeing some single cases where it isn’t possible isn’t able to link to where it originated from.”

Dr Phil Norrey, the council’s chief executive, added: “With 53 cases in the last week, you would expect to see more clusters, which tells us that it is out there and it is not just about stamping down on settings. We need to be clear to general population that it could crop up and pop out anywhere, and it has been doing so.”

He said that while the number of cases was being confirmed at a higher rate in the more populated areas, Devon doesn’t have the multigenerational and high density households that there are in other parts of the country.

Of the 53 new cases, 15 are in East Devon, 10 in Exeter, four in Mid Devon, seven in North Devon, four in the South Hams, six in Teignbridge, five in Torridge, and two in West Devon, with a further 11 in Torbay, and 26 in Plymouth.

Comment from Owl

Owl’s view is that the advice and analyses reported above does put what is going on in Devon, especially in the more populated areas, into perspective. For comparison Owl posts below a table of the historical evolution of symptom reporting from the Covid-19 symptom tracking app. This has always indicated a higher prevalence than confirmed cases which have been, and still are, influenced by the availability of easily accessible testing. This study also shows fluctuations.

 

8 July 15 July 25 July 30 July 21 August 10 Sept
North Devon

79

324

1076

561

327 572
East Devon

483

181

865

300

285

431

Torbay

386

715

228

Zero

331

445

South Hams 529 306 713 706 254

403

 

Estimated active case/million people under revised calculation methods (prevalence)  Aged 20-69

The Covid symptom study is now converting prevalence and showing estimated active cases (people with symptoms and likely to be infective) for each district as follows:

North Devon 35; East Devon 45; Torbay 34; South Hams 27