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Researchers now want to carry out trials on healthy volunteers who are carrying MRSA but are not infected by it. It is estimated that between 20% and 40% of people in the UK carry MRSA, mostly in their noses or on their skin, without any ill effects.

But nurse and aromatherapist Jacqui Stringer, clinical head of complementary therapies at the Christie hospital in Manchester, said the European clinical trials directive was slowing their progress. The directive was applied in the UK a year ago by the Medicines and Healthcare Regulatory Agency (MHRA).

"We are trying to do this in the right way so it is evidence-based and there is all this red tape preventing us," Ms Stringer told Hospital Doctor magazine.

"It seems crazy. The MHRA has put all this legislation in place and it is an absolute nightmare trying to start the trial. We are trying to hack through all the directives."

The full article is here.

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The very high numbers of teenage pregnancies and lone parent families in Britain have everything to do with the framework created by this government and its predecessors. Britain has not always been a world capital of teenage pregnancy and lone parenting. The rate of lone parenting in Britain was tiny after the second world war and it was only after welfare benefits were increased persistently - particularly for lone parents - that the rate increased. This, in turn, made it more acceptable for teenage girls to let themselves get pregnant without worrying too much if they were married first.

The contrasts between Europe countries are dramatic and revealing. Four countries offer little or no welfare benefits to lone mothers. Those same four countries - Italy, France, Greece and Portugal - are the same ones which have only a tiny percentage of lone mothers. It is true that three of these countries are Catholic. But that is not the deciding factor. Ireland is Catholic yet still has one of the highest rates of lone parenting in Europe. The difference is that Ireland offers relatively substantial welfare benefits to lone parents. Britain and Ireland were found to be the two with the highest benefits for lone parents in a survey of 14 European countries. They were also the countries with the highest proportions of lone mothers.

On this evidence, it seems that welfare benefits have a major impact on the rate of lone parenting. So governments cannot just wash their hands of it. They can and should act.

It is simply not true that there is nothing they can do about it. In 1996, Bill Clinton, in combination with the Republican majority in Congress, made major welfare benefit reforms designed to make benefits-assisted parenting a 'waystation' instead of a 'way of life'. The American government decided not to pay benefits to people for more than five years of their lives. All those on benefits, including women with young children, were required - yes, 'required', not 'encouraged' as in Britain - to seek work.

As a result, fewer young women with children in America are now defined as being 'in poverty'. More of them are working and the upward trend in lone parenting has, for the first time in decades, been arrested and is now beginning to turn down. Teenage parenting has been reduced. Meanwhile in Britain where the rate of births outside marriage was higher in the first place, it is still rising. In reality, the British government knows about this. It knows that governments can make a difference. But what it lack is the guts and the moral determination to do something similar to the USA.

The American government has since gone further and supported the teaching of sexual abstinence in schools. This has helped cause a drop in the pregnancy rate among 10 to 14 year-olds to the lowest rate for 60 years. Here in Britain, in contrast, 'sex education' tends to mean teaching children how to have sex and, implicitly, that it is a perfectly sensible thing for unmarried children to do.

Does all this matter? It is true that it is possible for lone parents and even a teenage lone parents to bring up children well. But it is far more difficult. All the evidence is that lone parenting results, on average, in children who are disadvantaged emotionally and educationally. They are more likely to be poor, more likely to be unemployed and more likely to become delinquents. If Mr Blair really wants a culture of respect, he will have to do something to discourage lone parenting - and thus the rate of teenage pregnancy. He will have to do something very different from the usual. Talking tough and blaming other people won't cut it.

(This research, by Assistant Professor Libertad Gonzalez in Barcelona, is the basis for the assertions made here about benefit levels for lone parent families and the incidence of such families. Please note that when she refers to single parent families she is referring to what, in Britain, we would call 'lone' parent families. The distinction, which I hope I am right in drawing, is that a single parent in British usage is someone who has never been married. A lone parent, which is what Ms Gonzalez is referring to, is a parent who may or may not have been married before but who is now living without a man present. There are all sorts of statistics flying about on the subject of teenage pregnancy, lone parenting, single parenting and so on. The definitions used can make a big difference. I also understand, having spoken to Ms Gonzalez, that her figures for benefits received do not include the value of subsidised housing such as council housing. In Britain, of course, that is one of the biggest parts of the benefits received by many lone parents.)

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Much of the leadership since her has spent its time apologising and agreeing, like Theresa May, that the Conservatives are seen as 'the nasty party'. But there is nothing 'nasty' about trying to make Britain a better place. If supporters believe that, they should stand up for those beliefs. To accept media and Labour Party attempts to smear the Conservatives is to surrender and, worse still, concede that there is substance to the attacks of your enemies. This acceptance that the Conservatives have been unappealing and done a lot wrong is inaccurate and highly damaging to the reputation of the party.
In retrospect it seems that the defeat in 1997 was a trauma which wholly deflata ed the self-confidence of the party. Michael Portillo was the prime example of someone who had been a Thatcherite but whom defeat changed into a neo-Blairite. Even David Willetts, as nice and intelligent a politician as you could find, has spent a large part of his time in the post-Thatcher years compromising the passion and belief of the past in desperate attempts to appease the enemies of what he used to believe in.

What came through last night was a suggestion, at least, that there is new generation of younger Conservatives out there who have had enough of appeasement, who are not marked and wounded by that 1997 defeat but, instead, increasingly are outraged by the failure of Tony Blair and Gordon Brown's socialism-lite. They believe that free markets work better. They believe it matters and is absurd that the poor are heavily taxed. They want to cut waste and hand back responsibility to people for their own lives.

And if people say, 'you want to dismantle the NHS' they are prepared to say, 'Yes. We do. It is a lousy system. Why wouldn't anyone sensible want to replace something that has failed - that causes thousands of unnecessary deaths a year with something much better?'

Some of them were also arguing that the party needs to be saying such things for years and that, as the failure of the NHS model - for example - becomes still more apparent, then the party's idea will be seen to be vindicated and the Conservatives will be perceived as the right organisation to do something about it.

It is interesting and encouraging to see some of the Cosnervatives, at least, getting their guts back. It makes quite a background to the leadership contest. The fight can be seen, in part at least, as one between the appeasers and the believers.

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The comments in (1) still apply ; the application of tickboxes is variable to say the least. They write what they want.

(3) The standards have to be measured. This forces towards things which are quantifiable. Quality of Care, Happiness of Patients etc is not quantifiable. Forms and Records are. So they require more and more forms and records, which makes less time available for the job of actually caring. Inspection is usually about 70-80% looking at records and forms, and has been done without viewing any practice at all. This is like OFSTED inspecting a school without ever seeing a classroom or child.

(4) They can say and do what they like. The complaints route is all to them and their above levels, and they will ignore the ombudsman, basically. There is a tribunal, but the burden of proof is on the complainant, not on CSCI. A variation on OFSTED is you always get the same inspector, so if you make a complaint the same person will come back effectively wanting revenge. So no-one complains, though I know no-one who thinks any of them are competent.

(5) Like any quango, the main aim is to increase its reach, budget, areas of control. Much effort goes into this. There is a laughable punch up going on where I live between SSD & CSCI, which involves them refusing to invite each other to meetings etc. (for the benefit of the children, doubtless). This is because both want the power and money that comes with "child protection"

(6) Because they don't have to pay for anything, the requirements extend endlessly as a back covering exercise. It is always in their interest to demand more staff, more targets, more forms, more systems. This increases costs, which most users cannot afford and SSDs will not pay. So care home owners sell up and quit, or they focus purely on meeting the targets. You get the impression that as long as the forms are okay they don't care about what is actually happening.

The worst cost increase is staffing. They are demanding minimum levels of staff training, which is fine, except someone has to pay for it at some time. Care Homes are run to some extent on cheap employees to do mundane jobs. Having everyone at NVQ3 (another rule ignored for public care homes and schools) racks up employment costs spectacularly, let alone training costs. At the same time, they want more staff (except for Local Authority provision).

(7) As a carry-on from (1), LAs are dodging the targets by redefining care homes as "rented accommodation with 24-hour support". This way most of the regulations don't apply. So they dodge them (something Private orgs aren't allowed to do), even though the practice is identical. To be fair, there's nothing actually wrong with the homes, they just don't tick the boxes.

(8) It repeatedly reorganises at great expense. Originally it was done by SSD. Then they all went to work for NCSC (late 2002). Two weeks after NCSC started, they were told they would be converted to CSCI and CHAI (early 2004). Now they are going to be OFSTED and CHAI. Imagine the money wasted !

The glossary:

IME : In my experience

LEA : Local Education Authority ; run public sector schools, pretty
badly. It's worse than you can possibly imagine.

SSD : Local Authority Social Services Departments ; roughly
divided into "Children & Families" and "Adult" divisions, though they
are trying to combine this back and add control over education. Yet
another bureaucratic turf war. Also responsible for Child Protection,
but are squabbling with CSCI over this at the moment. Both sides want
the clout.

DfES : Department for Education and Science. *Also* squabbling for power with NCSC/CSCI/CHAI, over who has control of Residential Mainstream and Special Schooling.

NCSC : National Care Standards Commission, monitoring Residential
Accommodation, Hospitals, Fostering, OAP Care, Residential Schools,
Sheltered Housing and all sorts of other similar stuff. Typical Blairism Monitoring and Targets organisation. Basically a "OFSTED for Care Provision".

Later (announced 2 weeks after opening !) split into :-
CHAI : Commission for Healthcare Improvement
CSCI : Commission for Social Care Improvement

Which does the same thing. Not quite sure where the split is. I think
CHAI does Hospitals, CSCI does the rest but wouldn't swear to it. I
*think* that CSCI are going to be subsumed into OFSTED, this is one of
Gordo's red tape reductions. I'd bet my life savings the same people
will be doing the same jobs .... it's a joke.

Incidentally, as far as I can tell despite all these switches the same
people (literally) do the same jobs in the same way, they just change
the name and bring out masses of new initiatives and reprint all the
stationery.

OFSTED : Office for Standards in Education. Quango for schools
monitoring. Infamous.

NVQ : National Vocational Qualification.

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First, a large proportion of the schools using the International Baccaleureate are state schools and sixth form colleges. I believe some of the grammar schools in Kent are among them. There is also, of course, a lot of interest now from the independent sector.

Second, the IB is promoting a belief in 'internationalism' as a required article of faith and this is working through the curriculum. George Walker, the current Director General of the IB, apparently takes the title of his book To Educate the Nations from this quote (by Harry Ree): "We must continue to aim at world government and educate the nations that this is their only hope."

There are other reasons why some heads are uneasy about the IB. With this added, I am further confirmed in the belief that a wholly new exam board should be established which gives schools - and parents - a real choice and a chance to pursue studies where knowledge and the ability to argue a case are valued above the political prejudices of those setting the exams.

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The essays are short and easy (2 x 3000 word essays per year) and you get 6 weeks to do them in (and more time off to do them in). It's not particularly high level stuff at all; you can't write anything in depth in 3000 words really, and the essays are multiple-topic, so you are really only writing a few hundred words on each part. The hard part is fitting it into 3300 words (you can go 10% either way). I spent an hour pruning her first essay just to get it down to size.

I *think* they are used to having things on a plate and can't cope with being expected to work for it, be marked on their essays and so on, general lack of gumption, and I suspect they think it's going to be like "Casualty".

Like any other caring job, there's a fair amount of messy stuff and that puts people off.

And I suspect it's the old "instant gratification" requirement. I
suspect you've read "All Must Have Prizes", it's like that but worse. It's also the move towards degrees in Nursing, i.e. an academic qualification. Nursing is not an academic skill really IMO.

The work appear to bear little resemblance to actual "nursing" ; it is all the codswallop about "facilitation" groups, they have discussions and presentations a lot of the time, there are reams of documentation which seem to be box ticking jobbies of the type that the DfES produces daily, producing evidence that course targets are met presumably to be fed back purely to tick more boxes. A background in teaching was handy for me to translate this into coherent English ;-) [smile] I think the end of year "exam" is a
short multiple choice test.

There was no training (literally) in actual useful skills - taking
pulses and so on - until the week before the first placement, when they had a few days of crash training. Not a good way to learn a skill really.

The bit that is hard is the practice ; this has involved 8 or 9 consecutive 10 hour days with awkward shift patterns apparently constructed at random - and lots of weekends ; my wife has said that there seems to be more students about at weekends, and certainly she's worked for more Saturdays and Sundays than anything else -
but she can't really complain. Certainly her shift pattern would be
unworkable over a long period ; you would just simply collapse. She says friends of hers have done 7 days in a row 12 hour shifts. But I don't think this has made a massive difference, people were dropping out on the above timetable.

I don't think it is at all unusual. A friend of ours is in the last year of a Mental Health Nursing course at the same hospital reckons about a third of the students are left from the start 2 1/2 years ago.

No-one appears bothered about the dropout rate. It appears to be
accepted as the norm.

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I looked at several other homes during her initial 12 weeks. I was appalled: many were dirty, smelt awful and the patients were left to sit and stare into space. We have more compassion for animals in this country than our elderly. If I could have had her living with me, then that is what I would have done rather than subject her to this.

My dad is also in a nursing home; at just 56 he had diagnosed a degenerative brain disease. Thankfully his experience has been better and the home is wonderful. The catch is that he is 35 miles away in Milton Keynes, as that was the nearest place that could care for him.

Debbie Stokes,
Watford

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Yobbery among the young has increased and - despite its claims to the contrary - the government has a policy of discouraging the expulsion of disruptive children. So at schools, middle class children, too, are more likely to be bullied and have their study disrupted.

Those who make the sacrifices to pay for full-time private education have long had to pay for education twice: once through their taxes and again through their fees. Now the government, in the Queen's Speech, has revived a plan to make them pay a third time, by forcing private schools to do more charitable work or else be taxed more heavily.

We grow up and get a job. Before we know it, we are paying a third of our income in tax and national insurance. If, in our efforts to get on, we succeed in earning more than £36,000, we are quickly into the top rate of tax. More people pay the top rate now than ever before.

The next step could be to buy a car. That's fine except that the tax on petrol is so high that a litre is not far short of a £1. Oh, and the Labour Government virtually stopped improving roads when it came to power in 1997, so they are more jams than before. The car - as Tony Blair once recognised - is the modern symbol of middle class life and it has come up against an anti-car culture, wholly in contrast with that in France or America.

Many of us then get married and have children. It is a quaint old tradition that survives among the middle class. Unfortunately the tax system is now loaded against you if you would like to split your roles with, say, the wife looking after childen and home and the husband going out to work. There is no married couples allowance or children's tax allowance any more. After the second world war a married man on average earnings with a wife looking after their two childen paid no income tax at all. Now they pay plenty.

At least we all have far more holidays than we used to. Unfortunately, the Euro has been strong in the last few years so holidays in Europe are pretty expensive. And it is not exactly cheap if we stay at home, either. A recent survey suggested that London is the second most expensive city in the world in which to live.

Still, we plough on. At least the middle class does not get the worst of rising crime, although we endure an increasing amount of rudeness and theft. There comes a point where we begin to think more about saving for a pension. Unfortunately we find that Gordon Brown has been thinking about pensions, too, and has been taxing them. Mr Brown has introduced an anti-savings tendency in government - a direct hit at the middle class. And if that was not bad enough, the stockmarket, into which most pension money is invested, has performed miserably since 1997.

Some of the middle class are doctors, teachers and policemen. They increasingly find that their role in life is being told what to do. Their independence and judgement have been replaced with instructions. And then, when the government-dominated system fails, who gets the blame? The government points the finger at precisely these middle class professionals whom it has disempowered.

Other members of the middle class run their own businesses. If they do well, they want to employ more people. That's a pity because there is a big tax on employment called employer's national insurance. Then they have to comply with a massive raft of laws. They must master the terrible complexities of the working tax credit, comply with the new religion of health 'n' safety and be ready to defend themselves in court if they have the temerity to sack anyone.

Even when we die - and probably would like to pass on our hard-won assets to our children - we are obliged to hand over 40 per cent of anything over £275,000 to that non-relative of ours, Mr Brown.

We keep going, but it seems like an uphill struggle. It feels as though the government does not want us to succeed and, instead, is piling extra weights on our backs.

All of which may explain the rising emigration from Britain. A record 191,000 Britons packed up and left last year. That was more than fifty per cent more than in 1994. The number going to Australia has doubled in the past two years.

Has the increasing burden on the middle class at least done some good to the rest of society? Have the poor benefited? Sadly, even that does not seem to be the case. The poor are almost as highly taxed as the middle class - mostly through indirect taxes. On top of that, they get the worst of state education and medical care.

So it is all for nothing. Being a member of the British middle class is still better than most fates. But it is no longer the great privilege it once used to be.

(This is an unedited version of an article that appears in today's Daily Express. The surprise in the research I did for it was the major rise in the rate of emigration. 125,000 Britons left the country in 1994. 191,000 left in 2003.)

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A nine-year-old boy has died after an operation to treat his severe epilepsy was cancelled because Britain's top children's hospital had run out of money.

Peter Buckle, from Evenwood, in County Durham, had a massive seizure and died last Monday. He had been waiting to undergo surgery at Great Ormond Street Hospital for Children in London.

The brain operation which might have saved his life had been cancelled twice. The first time, on March 15, Great Ormond Street cut back its operation lists after finding that it had treated more children than its budget allowed for. The operation was rescheduled for April 22, but cancelled three days beforehand when a ward was closed after staff contracted a viral infection. It had since been rescheduled for June 10.

See full Sunday Telegraph story here.

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Some people go to the NHS and get a service which may involve delays and not seeing a specialist but is free. A second lot of people pay fees, in addition to their taxes, to go private and get seen by a specialist fairly soon. Now it seem we may have a third tier of the health system. If you are Tony Blair, you get priority treatment, you are seen by a specialist and it is free.

Perhaps this is what Tony Blair when he boasted he would introduce a new Third Way in British politics.

Don't bother asking if you, too, can have 'priority treatment' which does not affect other patients. Only Tony Blair, and perhaps other members of the Politburo, receive this.

It is surprising that the news media have not investigated this 'priority treatment' further.

I suppose the origin of Mr Blair's 'priority treatment' is this: as a busy man, he could not be kept waiting for NHS treatment like an ordinary citizen. As a Labour Party leader, however, it would look bad if he went private. So he has now experienced a kind of fake NHS treatment in which he was rushed to the front of the queue. It is, bluntly, a corruption of power and an insult to the intelligence of the populace. If he believes the NHS is a good system and that the billions of extra taxpayers' money he has taken has been well spent, he should be prepared to experience the reality of the NHS, not a fake version of it.

UPDATE: I have just talked to one of the authors of the Daily Telegraph story who tells me that Downing Street gave few details of what had happened but he understood that Mr Blair got a 'swift appointment'. In other words, he got treatment at a speed and with a convenience not available to everyone else.

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In a lot of cases the disability, physical or mental, is secondary to the problem of a poor basic education in the first place. Without basic literacy, numeracy and organisational/reliability employment prospects are massively limited. We are certainly seeing a large proportion of youngsters for whom you wonder what they actually did at school.

It's pretty clear that for a long time gov't thinking was on inclusion in mainstream education and organisations, charity based and specialised like ourselves, were not flavour of month. There is now a realisation that this approach does not work for everyone and has left many people marginalised as mainstream providers have not got the resources or skills to give the level of support necessary. This seems to be changing but the problem that a lot of charitable organisations have when applying for funding is the enourmous levels of beaucacy that accompanies any application e.g. setting targets,
review procedures, equal opps, inspection and auditing etc. In other words, introducing the same levels of inefficieny and inflexibility that the state insists on for itself!

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First, they are unnecessarily generous to attract people to work in the public sector. Most people when they start on a career in their 20s, have little or no concept that public sector pensions are vastly higher - in relation to the salaries - than those provided by the private sector. So the employees could be hired to serve us at lower cost.

Second, these luxury pensions are then abused and effectively inflated still further. Police and firemen and other public servants take early retirement on excellent terms far more frequently than people in the private sector.

Why does this happen? It is a simple case of the 'producer interest' at work. Those who are in charge of such things are, at the same time, part of the workforce that benefits from 'generosity' (as some may call it) or 'selfish waste of taxpayers' money' (as it should more rigorously be viewed).

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Labour would blame the Thatcher government. But the real cause goes back to Edward Heath's government a decade earlier. Then, for the first time, the level of benefit for the incapacitated was raised above that for the unemployed. The Heath government gave them 5 per cent extra. Harold Wilson, in charge of the following Labour government, bumped the premium up to 22.4 per cent. It was after this big premium was created that the boom in numbers began.

It helped to make incapacity benefit the 'benefit of choice' for the unemployed. The benefit is worth much more, can last until retirement and you don't have to seek work.

So yes, MrBlunkett is absolutely right to take this on. But what is he going to do? He is going to produce a Green Paper. That was going to be produced before he arrived. He is likely to propose brand new benefits, at least for new people who claim. That was going to happen before he arrived, too. It will take a long time before having any significant effect. He will extend the 'Pathways to Work' pilot programme which gives extra encouragement to people to get back to work. If this went nationwide, it is claimed it would get 100,000 people back to work. Fine, but that would only be a fraction of the million which Mr Blunkett is talking about.

Mr Blunkett may want to do something more radical. But even he - who normally prides himself of being bold - is talking about 'consulting' with others. The 'others' are Labour backbenchers because Mr Blunkett cannot do what he likes, now that Labour has a reduced majority. He can only do what serried ranks of Old Labour MPs will agree to.

For eight long years, Mr Blair had the power to reform incapacity benefit. He failed to do it and now he has left it too late.

As for Mr Blunkett, this won't be the first time he has talked big but achieved much less. He boasted by how much he would improve literacy, saying he would resign if he missed his target. The target was missed yet he did not resign. He had already moved on to another job. As Home Secretary, he was going to deport 30,000 asylum seekers a year. It didn't happen.

Expect the same this time. There is a real problem, but it will only be tackled at the edges. We have been waiting eight years for Labour to make radical reforms that even begin to approach those made in parts of America like New York. Under Mayor Rudi Giuliani, those with incapacities were strictly assessed for what they could do. If they could do any job at all, they were given help by one of several competing private companies to find a real job. If a regular job couldn't be obtained, they had to try for a subsidised one. If that could not be found, the City gave them a job like cleaning the parks for part of the week while obliging them to keep looking for a regular job the rest of the time. The numbers claiming welfare benefits fell by more than half. Those who took jobs, developed more self-esteem and ceased to be a burden on everyone else.

That sort of reform - the sort that would really make a difference - hasn't happened yet. It looks as though it never will.

(This is an unedited version of the article which appeared in today's Daily Express.)

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You, as heads of private schools are forces for good. If you come to believe this - which I profoundly do - then you should tell the world.

2) Argue in public fora that private schooling is good. That it is better than state schooling.

You should not do this to boast. You should do it because it is in the national interest. State schooling has failed and private education is better. To argue for private education is not just self-indulgence or self advertisement, but public duty. This is a political battle and if you don't fight, you will get squashed. You are already under attack, though the charities bill, in particular.

You have the ability and the money. But to win you need to make the moral case as well. Which leads to third thing you should do with your independence.

3) Team up with the growing number of religious private schools.

They are the ones where the dramatic stories of children being rescued from bad lives demonstrably take place.

4,) a group of you who subscribe to what I am saying could create your own association and put forward these ideas.

This group would have a press spokesman and parliamentary lobbyist who, in the most reasonable but firm terms, would argue that private schools are a force for good and that they should be treated well by government instead of increasingly told what to do.

5) As a group - since I know it is tough to do individually - publicly declare that you will no longer subscribe to the national curriculum.

The curriculum has no clothes and you can do better.

The original idea of the “national curriculum”, introduced in 1992, was to force state schools to teach children the three Rs. But now the national curriculum has been turned into a tool to shape all education, including private education. I asked one headmistress of an "independent" school why she did not give up computer lessons or merely provide a short course, instead of taking time away from genuine, academic subjects. She claimed it was “the law”, which it isn’t. But “Information and Communication Technology” (ICT) is indeed in the national curriculum and so there is pressure to teach it.

This pressure is transmitted partly through inspections. Not long ago, independent schools were not inspected at all. Then many schools began to fear the Government would start inspecting them so they got together and offered to create their own inspectorate, thinking they would keep control of its agenda. That was a pipe dream. The Government now lays down an increasing number of things which it requires the “independent” inspectorate to check on. As for those independent schools which do not accept the independent inspectorate, they must receive OFSTED, the Government’s inspectorate, instead.

So any school which does not do the approved things in the approved way is on the defensive. If it does not do “design technology”, it risks being criticised. By being different – in other words, truly independent – a head is likely to get a critical inspection report, which could make the governors and potential parents nervous.

The Government likes to throw its weight about. A passing-through bunch of politicians and a few civil-servants-cum-“educationalists” are vain enough to think they have all the answers. In an extreme case, Summerhill, a school which allows children to decide whether or not to attend lessons, was severely criticised in an OFSTED report and the Government threatened to close it down. Summerhill won in the courts in 2000. But there is no occasion to celebrate since the Government has subsequently given itself further powers to tell schools what to do in the 2002 Education Act.

Personally I find it galling to spend a fortune in fees for an independent school only to find it is increasingly dominated by the state – the very organisation whose incompetence in education I am trying to get away from.

6) Set up a new exam board which explicitly is your own design and not in hock to government ideas.

Last year I visited a lot of British private schools.

I went round schools to choose the next one for our children. Before we started visiting, I assumed we would come across a wide variety of attitudes to education. Instead, I was struck by how similar they were. It was the educational equivalent of The Stepford Wives. Each school was worryingly like the last one and, even more worryingly, subscribed to Government propaganda about nearly everything.

Control of the exams is one of the ways in which the Government has increasingly come to dominate private education. Exams frame what our children learn in class, day by day. The exams determined, for example, that for a while, children taking A-level French were not required to translate from English into the foreign language.

Exams used to be set by a dozen or more different, independent educational boards. They had contrasting reputations and some offered several different syllabuses in subjects like history and English literature. Schools had a terrific choice. But since then, the boards have been intimidated by Government to merge so now only three are left. All depend on the approval of the Qualifications and Curriculum Authority, a quango appointed by the Government. Indirectly, therefore, the Government now strongly influences exams.

So set up your own board, or boards.

7) Take teachers who have been privately trained or not trained at all or trained by you.

The willingness of most “independent” schools to submit to government is strange. They have been regularly shown to outpeform state schools in their results. Yet they meekly accept instruction from the same state that they beat hollow. Why?

One reason is that the state gets hold of teachers early. Most primary school teachers have taken a B.Ed. course to “qualify”. That means they have been subject to at least two years induction into Government-approved educational theories. Secondary school teachers have received less Government propaganda, but still some.

So accept teachers from the course in Buckingham University and anywhere else that has a teacher-training course that you approve of, regardless of whether it is anything to do with the government.

8.} Look abroad

Look to what is happening around the world, to Sweden - where 75 per cent or 85 per cent of what would be spent on a child's state education can be transferred and spent in a private school. Look to the Netherlands and Denmark where semi-independent schools are a major part of the education system. We don't have to stick with the existing system. You can influence the political debate.

9) Argue for private education for all.

State education only got going 135 years ago. It was understandable and, in many cases, idealistic in its intentions. It was meant to save the poor. Instead, it has condemned them. A mere 1.7 per cent of the lowest social class gets to university.

It was understandable to think that state education might be a good thing. But it would be cowardly and dishonest not to recognise that, instead, it has failed and has caused real damage into the bargain. It is our duty to argue that the whole population should have the benefit of private education.

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Yet in Brown’s eyes, this doesn’t matter: more subsidy is going to the poorest, ergo "inequality" is statistically reduced, ergo things must be okay. Labour is blinded to the second part of Clinton’s equation: poverty is a social phenomenon. Family matters.

This is not moralistic. Research shows a child raised by a lone parent is seven times as likely to fall into poverty, four times as likely to be expelled from school, three times as likely to become dependant on welfare and twice as likely to go to prison.

These dynamics do not hold for upper income groups, where a single parent usually has the resources (and family support) to give a child a loving, stable background. It is among the poorest families that marriage makes the most difference.

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As with fox-hunting, the attack has necessitated various illogicalities and a large dose of hypocrisy to enable any kind of justification for the changes proposed. There is every reason to believe that, if the attack is at all successful, it would cause harm rather than good.

Chris Woodhead, in an excellent speech towards the end of the conference, clearly did not think the attack was too serious. He said that giving up charitable status would add four per cent to fees and that this would not be significant given the large fee increases of recent years.

Four per cent would, of course, do some damage - to those who are struggling to afford private education and for whom this would be the last straw. But there is a worse threat which he did not mention. It is possible that schools may not be allowed to give up charitable status. A school that does not do as it is told and do the charitable activity required, may not be permitted to 'go commercial'. Its assets were created by charitable donations and the law could easily say that they must remain for charitable use. The assets could be removed and assigned, perhaps, to some other charity. (Whether it would necessarily be another private school or, say, a charity supporting state schooling the lawyer did not say.)

So the real threat is that private schools will be closed down if they do not obey. The chances are, in the circumstances, that they will obey.

What is wrong with that? Isn't charitable activity a good thing? Yes, I certainly agree with that. But this is not charity. This is an extra tax under the guise of charity. Charitable activity is voluntary. This is not voluntary. It will be done under threat of closure. It is more like extortion.

Two essential points are missed - deliberately - by the government:

1. Parents at private schools are already paying for their children's education twice. They are paying through their taxes. Since they do not use the state education they are buying with their taxes, they are effectively already paying state scholarships for two or more of the children of other people. Then they pay the private fees. So they pay twice. Making private schools do a lot of charitable work - perhaps free places for children of parents without much means - would mean they would pay three times. This is unjust and penal. It is a discouragement to private educaiton. Deliberately so.

2. One of the fastest growing kinds of schooling is that provided by relatively low-cost faith-based schools. The customers are not rich - one of them whom I met was a single mother living on a council estate who gave up 40 per cent of her income to save her children from a crime-producing state school and put them in an evangelist school instead. If such schools are taxed, this would be obscene. But if such schools are not taxed, on the basis that it would be taxing those who are of below average means, this would mean that schools suffered taxation depending on whether the customers were rich or poor. Private education of the poor would be untaxed, education of the rich would be taxed. The brutal fact that this proposed change in law is an attack on the wealthy - that class hatred, is the motor - would be exposed.

Another underlying truth about those who favour this change: they hate private schooling and its growth because it suggests that state schooling is not good enough. The truth of this is something which they loathe to admit. The easy way to dispose of the uncomfortable suggestion is to make life as hard as possible for private schools and, if possible, destroy them.

Of course it is said that private schools 'get a tax break'. That is absurd. In the first place, the parents pay twice, as already mentioned. In the second, education should not be taxed anyway. It does not have to be regarded as a charity to be regarded as a 'good thing', like medical care. Private medical does not suffer VAT. Nor should private education.

It is also said that private education is divisive. No. It is state education that is divisive. It is state education that creates seriously badly educated children. It is state education that has produced an adult population a fifth of whom are functionally illiterate. State education has created a divide in society that private education would never have done.

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Forget all the talk about a 48-hour working week: most mothers in Britain put in at least 100 hours and form the "hardest-working profession in Europe", according to a report today.

Business leaders may scoff at the idea that doing the laundry, the school run and vacuuming constitutes "work", but most mothers would disagree, pointing out that such labour is often physical, relentless, goes unnoticed and is certainly unpaid. Many also combine it with part-time paid work.

Research among 1,035 mothers found that for nearly 40 per cent of them, the day did not end until 9pm on a regular basis, and a third slept fewer than six hours a night.

For those in London, seven hours a week was devoted to the school run alone.

The research comes as a book on the stresses of motherhood, Perfect Madness: Motherhood in the Age of Anxiety, says women are living lives of silent desperation, trying to be supermums by looking after the children, keeping the home spotless and securing places for their children at the right school.

Here is one possible contributor to the phenomenon of the phenomenally hard-working mother: the tax system now favours two people in a couple working rather than one.

It used to be the other way round. It used to be that a married woman with children working part-time (which is very widespread now) would be taxed at the top rate of income tax incurred by her husband. In those days when the top rate of income tax was 83 per cent, that meant it was pretty much a waste of effort for the wife of a wealthy man to take a job. It was also not very remunerative for those with husbands on any above-average income.

Then Nigel Lawson introduced separate taxation. This was supposed to provide equality of treatment for women. But did it in fact contribute to the way that women now work incredibly hard?

He gave each member of a married couple a separate personal tax allowance and in each case, the rate of tax would rise first to the standard rate and only later to the top rate. So if, say, a husband and wife both earned £30,000, their combined income of £60,000 would mostly be taxed at the standard rate and over £9,000 of it would not be taxed at all. Whereas, currently, if all of it were earned by the husband, half of it would be taxed at the top rate and the tax free personal allowance would only be about £4,500 (or whatever the personal alowance has now reached).

Whereas before, for given combined family income, the tax advantage lay with only one of the two going out to work. Now the tax advantage lies with both of them having a job.

It might be better, perhaps, to go for something which - from memory - David Willetts suggested some years ago: a transferable personal allowance. A woman (or man) would be able to say to the inland revenue, 'I prefer to stay at home to look after the children and the home. I hereby transfer my personal allowance to my husband (or wife)'.

That would not entirely remove the tax disadvantage suffered by one-earner couples, but it would reduce it. In the process, it would allow many women the opportunity - but certainly not any compulsion - to stay at home looking after children and home if that is what they would prefer.

(The research that revealed the 100-hour working week of most mothers was commissioned by Comfort, manufacturers of fabric conditioner, but unfortunately the Daily Telegraph article on this does not say which organisation carried out the research.)

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Ms Hewitt said £3bn will be spent on private sector treatment over five years to pay for 1.7m operations.

And NHS figures released ahead of her speech have shown waiting lists and times have fallen again.

Hospital choice

The money will pay for the second wave of independent treatment centres, which carry out non-urgent surgery, and more private operations to help create a patient-led NHS, Ms Hewitt told a conference in Birmingham.

It will mean the number of operations carried out by the private sector, but paid for by the NHS, will rise from 5% at the moment to between 10% and 15%.

This coverage is from BBC Online.

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Thess enable people to save for future medical treatment yet keep control of how the money is spent. Because the money comes out of their own savings, people have an incentive not to waste money (something that happens quite often in the French system and indeed in many insurance-based systems).

Incidentally, when in Miami recently I asked about how many MRI scanners there are. I was told that there could be as many as five in a single street. There were competing MRI scanning centers. How long do you have to wait for a scan?

You could have one today. (In the NHS, you can be asked to wait six months or more.)

I don't think that the American healthcare system is good. It isn't. It is a mess in many ways. It is just that the NHS is a much bigger mess and thousands of people die premature deaths each year because of its marked inferiority to the systems in practically all other advanced countries.

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They are now having to carry a huge weight of private outperformance on this pin of 'richer families'. It is, frankly, incredible to anyone who is open to the evidence, that it is all due to that.

There are plenty of state schools which have plenty of ambitious middle class and upper class parents. Tony Blair is the obvious example. The London Oratory has plenty of them. So does Our Lady of Victories in London. Then there is Henrietta Barnett in the North London, which has seven applicants for every place and children being tutored to get into it. The list goes on and one. Yet even when these 'top' state schools are full of the cleverest children of the well-educated and ambitious, they still underperform the private schools.

Those who defend state schools are in denial about their failure. For the sake of the next generation of children, it is important that they face reality.

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Secondly, they believed " they had become so prosperous there was no further need for it."
Charles Darwin gave them a severe paternal lecture. "I can assure you that all the rumours about uniting the clubs to form a common fund are lies, spread for some evil purpose." He went on to explain that their Club had not accummulated excessive assets, that actuarial estimates of funeral expenses and the funds needed to provide for ill health came to about a thousand pounds, leaving only one hundred and fifty pounds available for distribution, if they so wished. "Therefore I hope that you will allow me to warn you all, in the most earnest manner, to deliberate for a long time before you dissolve the club, not only for the sake of your wives and children, but for your own sakes..."
The members took his advice.

Charles Darwin died five years later, on April 19, 1882, leaving an estate worth in excess of 280,000 pounds. The government never did form a common fund, but several decades later it succeeded in pushing the Friendly Societies to the edge of extinction.

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The document says members of Nice's citizen's council believe "where age is an indicator of benefit or risk, age discrimination is appropriate".

When the document was released for consideration last month, Nice stressed that it was not seeking to formulate guidance for the NHS but for its own committees when they were making recommendations on drugs or treatments.

The document also asks whether patients' lifestyle or habits, such as smoking or over-eating, should be a consideration. Age Concern said about 80 per cent of GPs already believe there is discrimination against older people within the health care system.

Jonathan Ellis, the policy manager for health and social care at the charity, said: "To suggest that anyone should receive less care and attention simply because they happen to be older is blatant discrimination.

The full article in the Telegraph is here.

NICE has already shown discrimination against the old by suggesting lately that dementia drugs like Aricept should no longer be prescribed. This would be an outrage if it ever happened.

Why?

The Daily Mail today carries a short account of how Aricept has changed the life of one man, Keith Turner:

Since his diagnosis a year ago, his condition had slowly declined. 'I could not remember three words in a row,' said Mr Turner, 66, from Hastings. 'I feel asleep in front of the TV because I couldn't remember what I'd seen and I gave up reading. I couldn't go out on my own because I would get lost.'

But since starting on Aricept four months ago he has started to believe in 'life beyond dementia'.

I feel almost back to normal,' he said. 'I can read a book, watch TV, have a conversation, go out on my own and drive the car.'

His wife, Lilian, 66, said: 'Without the drug, people with Alzheimer's will again be second-class citizens.'

It should be said that it is not claimed that Aricept acutally reverses dementia at all. The biggest claim for it I have heard made by a doctor is that it can arrest decline. However there is occasional evidence, like that of Keith Turner, that in a minority of cases (probably a small minority) it can actually improve matters. But even if that is exceptional, an arrest of decline is extremely valuable and important to the individuals concerned and it may also reduce healthcare costs because people can remain independent for longer.

But there I find myself lapsing into the mind-set of the NHS: taking for granted that money is very tight and there must be severe rationing and so simply treating people is not good enough as an ambition by itself and must be supported by the idea that money would be saved. This is the mindset that leads to the idea that is so prevalent in the NHS - that the old have only a few years left and so are 'not worth treating'.

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Rather than blaming it all on the spill-over from the war effort, Bartholomew claims that the rot set in as early as 1536. The first act of nationalisation was Henry VIII’s seizure of the monasteries, which had previously spent some ten per cent of their income on charitable work (alms, medical care etc.). Ten per cent may not sound much, but medieval income was land-based, the monasteries owned some one-third of the land in England, so monastic welfare must have accounted for around three per cent of GDP.

Realizing that her father had demolished the medieval welfare system at a stroke, Elizabeth I attempted to plug the gap with her ‘Poor Law’ of 1563, which obliged local parishes to look after their own paupers and for everyone else to pick up the tab. Fast-forward then to 1832 when Viscount Althorp, Chancellor of the Exchequer and Leader of the House, announced in Parliament that he was setting up a royal commission to ‘ascertain how the different systems worked in different parishes’ (i.e. to address the serious problem of Poor Law welfare-dependency).

For the Elizabethan system was widely abused. In the words of Edwin Chadwick, the commission head, the pauper ‘need not bestir himself to seek work; he need not study to please his master; he need not put any restraint upon his temper.’ The parallels between early-Victorian pauperism and our own culture of welfare-dependency are uncanny: Gordon Brown appears to have lifted his working family tax-credits system directly from the 1795 Speenhamland system, whereby meagre wages were made up with a supplement from parish funds. But, as the commissioners reported, this led to farmers paying lower wages and hiring part-timers, subsidised by the parish. Plus ça change…

Bartholomew is careful to allow for the (frequently) good intentions of the advocates of state intervention in welfare and education. W.E. Forster, the architect of the 1870 Elementary Education Act, merely proposed ‘to complete the present voluntary system, to fill in the gaps’. Forster only wanted to create free state schools under ‘special circumstances’ in places of ‘exceeding poverty’ and would have been horrified to see his modest proposals lead to the replacement of the existing diversity of provision by a state monolith. Nevertheless the high levels of pre-1870 literacy (over 95 per cent) have now been replaced by the scandal of one in five adults being functionally illiterate after eleven years of full-time state education (DES, 1999). As Karl Popper was to observe a century later, every social action has unanticipated consequences which usually drown out the intentions of the original agents.

In the social security arena Lloyd George, Churchill and Beveridge wanted self-sufficiency and mutual support through friendly societies to continue. As a result the benefits introduced by the 1911 National Insurance Act were very selectively targeted and even after being made universal following the 1942 Beveridge Report, were still to be at the ‘subsistence’ level. The benefits should only be basic, otherwise they would discourage voluntary insurance and savings. What Beveridge failed to foresee was that subsequent generations of politicians (Eden, Macmillan and Wilson being the prime culprits) would raise benefits to the level that work itself became only marginally worthwhile. As Bartholomew demonstrates, increases in unemployment have shadowed increases in benefit rates almost exactly. And under New Labour, household savings levels have halved.

The author is not always so charitable in reporting the motives of political actors. According to Michael Foot, Nye Bevan’s biographer, the foundation of the NHS was attributed to Bevan’s ‘detestation of a class-ridden society’, his ‘belief in a collectivist cure’ and ‘his dream … that democratic processes and democratic vigour, intrepidly unleashed, could accomplish revolutionary ends.’ No mention of the quality of healthcare. Although Bartholomew doesn’t doubt the benign intentions of Beveridge’s proposals, the grandiloquent language in which they were expressed was a reflection of the author’s disappointment that his prodigious talents were being wasted on a ‘mere tidying-up exercise’. (Ernest Bevin, his political boss, asked him to write the report as a way of ‘getting rid of someone whom he had come to see as a pain in the neck.’). H.A.L. Fisher’s 1918 Bill to establish free schooling was prompted largely by military concerns, implicitly concurring with Bismarck’s view that the Prussian schoolmaster was the real architect of German unification. And Lloyd George’s national insurance proposals were a desperate attempt to secure the future of the Liberal Party by taking the wind out of the socialist sails (not to mention Churchill’s wish to make a name for himself).

Like his idol Margaret Thatcher, Bartholomew’s explanatory framework is thoroughly Marxian, albeit repackaged as ‘rational choice’ theory. Human behaviour is largely shaped by the economic infrastructure; ideology is an epiphenomenal and plays no causal role. Thus Thatcher didn’t waste time with communitarian waffle about the loss social capital, she just encouraged people to buy their own homes from the council. In a similar vein, Bartholomew claims that the cultural decadence that the Daily Mail (along with many readers of this magazine) sees as the cause of our modern malaise is in fact the consequence of the welfare state. As the Victorians discovered, get rid of welfarism and the result is moral regeneration.

Some historians claim that the Victorian revival was caused by the earlier evangelical revival, but Bartholomew would have no truck with that. The connection between traditional (non-state) welfare and religious charity is no coincidence and the relationship is mutually beneficial. Conversely, there is a direct correlation between the growth of the welfare state and the decline of the church. The decline of religion has nothing to do with modern scepticism; educated Victorians were a pretty cynical lot, yet they were still frantically building churches long after Darwin published his book, as the church played an essential role in welfare and education in Victorian Britain. Pace Callum Brown the decline of Christian Britain has nothing to do with cultural developments during the 1960s (although the Forsyte Saga certainly helped kill off Sunday evensong), otherwise the US would show an even greater decline in religious participation. Christian Socialism is an oxymoron in the sense that although it is possible for a Christian to be a socialist, state socialism sounds the death knell of Christianity. The one Western country where religion is still flourishing, the USA, is the only one to remain largely untouched by socialism.

The Welfare State We’re In is a bloody good book and deserves to sell by the truck-load. Everyone should read it – including Will Hutton (who kindly donated the title) and the Pollyanna Toynbees of this world. Bartholomew’s own banking apprenticeship shows in his clear presentation of financial data and statistics; his lucid prose-style – every sentence is carefully crafted for ease of understanding – owes a lot to his time as a leader writer at the Telegraph and Mail. Give the man a medal (and his courageous commissioning editor, Iain Dale).

Writers of critical reviews are obliged to find some fault with the work under consideration. In the case of a book as good as this, it’s a bit of a challenge! I’m reduced to the cheap jibe that the jacket illustration (fresh-faced youths in ‘hoodies’) might well have been lifted from a Next catalogue – the boys look remarkably like my son’s friends from his posh private school. And I might also complain that Gordon Graham’s comments on university education should be properly cited from his book Universities: The Recovery of an Idea (which I happened to publish).

In fact the author’s compelling presentation of the case against the welfare state is reminiscent of another of Professor Graham’s books, The Case Against the Democratic State. Both authors are left with the problem – OK doc, thank you for the diagnosis, but what about the cure? Gordon Graham concludes that even if an individual‘s vote cannot affect the outcome of an election, voting still provides an invaluable exercise in civic education. That may be good enough for a professor of moral philosophy but it’s not much help for those of us interested in constitutionalism and political science. Does Bartholomew have anything better to suggest as to how we might undo the appalling mess he uncovers in his book? He takes heart from the close parallel between our present condition and the report of the 1834 royal commission on the Poor Laws. Edwin Chadwick’s team reported that:

Moral character is annihilated, and the poor man of years ago, who tried to earn his money, and was thankful for it, is now converted into an insolent, discontented, surly, thoughtless pauper, who talks of ‘rights and income’.

As a result, the commissioners proposed that virtually all welfare benefits paid to people outside the poorhouses should be abolished and the regime of the poorhouses should be made far tougher. Parliament accepted the report and implemented its recommendations in the same year (1834). As a result the Victorian era was a period of dramatic economic growth, low unemployment, plummeting crime levels and the re-invigoration of both middle-class charitable giving and self-provision among working people. In 1885 the combined incomes of London charities came to more than the revenue of several European governments and the average middle-class household spent more on charity than on housing or clothing. Most of the workers covered by the 1911 National Insurance Act were already insured through their friendly society or trade union.

Most readers of this journal would agree that the 1834 quotation is also an accurate description of our current malaise. But is it conceivable that a modern parliament would act with same radical decisiveness? The Great Reform Act of 1832 extended the franchise, but in no conceivable sense were the beneficiaries of welfare ‘represented’ in Parliament. By contrast thirty-eight per cent of voters are now in receipt of means-tested benefit and nine out of ten families are able to claim the (means-tested) children’s tax credit. Governments of all persuasions compete with each other to provide ever more generous benefits, by bribing electors with their other people’s money.

In the light of gerrymandering on this scale it’s inconceivable that any parliament would be able to act as decisively as the Parliament of 1834. Some of us were gullible enough to believe New Labour slogans about ‘thinking the unthinkable’ in welfare reform but remember what happened to Frank Field. The sad truth is that a revolution in the welfare state will only happen after equally dramatic constitutional changes. To the barriers!

Keith Sutherland is author, The Party’s Over: Blueprint for a Very English Revolution.

[he above is the unedited draft of the review. I am grateful to Keith Sutherland for emailing it to me.]

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First, most people are on below-average incomes (the average being raised by those who are on exceptionally high incomes). They think that they will not be very much affected by increases in taxation.

Second, these people think that they, their loved ones and those poorer than themselves depend on the services provided by the state and they think that to vote for parties which believe in state services will help them the most.

This is what the Professor E.G.West might have called 'the economics of politics'. Most of the voters think that they will gain by sustaining state provision. It means that this democracy - and perhaps most democracies - will, for most of the time, vote for an ever-growing role for government provision.

What can hold or reverse this trend?

Five things: culture, referenda, local democracy, subterfuge and disaster.

The culture of the USA - its belief in enterprise, self-reliance and freedom - has held back the trend to some extent. But only up to a point. The USA has government schooling for most people and the government accounts for 40 per cent of medical care spending.

Referenda can hold things back by focusing the minds of people on a single issue at a time and enabling them to argue through the pros and cons. Referenda can help people realise that more spending mean more taxes, for example, and that those on below-average incomes actually pay almost as high a proportion of their income in tax as the rich.

Local democracy has the advantage that, again, people are more likely to look at the downside of any given policy and think that this downside might affect themselves, rather than be swallowed up in a great mass of people elsewhere. (When poorer people in the North vote for more taxes in Britain, they are to some extent expecting richer people in the South to pay them. if they realised the tax would fall on themselves, they would not be so keen.)

Subterfuge has enabled this Labour government to reduce the value of unemployment and incapacity benefits in comparison to average incomes. This was never declared as a policy. It has been done under the radar of most political commentators.

Disaster - in the form of sky-high inflation and rubbish uncollected from the streets - is what led to enough people voting Conservative for the party to form a government in 1979.

In the future, one option is indeed to await the development of the next disaster. It is quite possible that in four years' time, when the next election is likely, it will be clear that despite all the extra money put into the NHS, it is still decidedly inferior to other medical systems around the advanced world. It would not be a disaster as such, but it would be an evident failure.

However, there are more positive things than waiting for disaster that those of us who believe that government should have a smaller role can do.

First, we should argue that the government is not an efficient protector of the people, that self-provision, mutual provision and charity put more people in better circumstances. Putting this argument is a way of trying to change the culture - the assumptions that people bring to their votes. The Conservative Party has been frightened to put this argument ever since John Major lost office in 1997. They lost morale after that defeat and started apologising for themselves - joining in the idea that the Conservative Party had become 'the nasty party'. This was an error because it amounted to giving up the fundamental argument: that the statism is socialism and means guaranteed waste and incompetence. Free enterprise and personal responsibility are far better in their economic and moral consequences, for the poor as well as the rich.

Second, those of us who want to see small government should, perhaps, argue for referenda. There are referenda in some states in the USA and in Switzerland. These are both countries which have had more success than we have in resisting the dominance of the state. Referenda calling for, say, personal tax-free allowances of £10,000 a year or for the option for parents to take the money it costs to educate a child in the state sector to be taken and used in the private sector instead would get minds thinking. Referenda take some of the party tribalism out of politics and encourage them to think seriously about what makes sense.

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What they are spending it on precisely is not revealed by this survey. At a guess the money is partly for tuition fees, partly for living expenses for the increasing numbers going on to higher education and partly because more people are resorting to private tutoring. According to a previous survey, one in four children at state schools has tutoring at one point or another. There is also the apparently rapid growth of fee-paying faith schools which may not be captured by the usual statistics on private schooling.

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A hospital consultant put his career on the line yesterday by warning publicly that a desparate shortge of nurses is putting patients' lives at risk....

Mr [Milton] Pena, an orthopaedic specialist, is a surgeon of more than 30 years' experience.

He revealed the crisis at Tameside General Hospital, Ashton-under-Lyne, Greater Manchester, after warning for two years that nursing levels on three wards which deal with his patients as well as some with acute chest pain or head injuries were dangerously low.

Yesterday he said he feared that someone would die. His concerns were echoed by the Royal College of Surgeons who warned of a severe shortage of nurses in the NHS nationally....

...he could now face disciplinary action for making his fears public...

Tameside General Hospital had the 11th worst nurse-to-patient ratio in England in 2003 at 102.8 staff per 100 beds, compared to the national average of 131.7.

Mr Pena alerted bosses in 2003 after 14 separate occasions when there was just one qualified member of staff on duty to cover 28 patients.
Yesterday he said he had decided to release the confidential nursing logs from the wards because the situation had not improved two years on.

"...I felt I had no choice but to speak out on behalf of my patients and I'm prepared to take the consequences - if they suspend me then so be it."

"When I retire, I don't want to feel that I knew about the problems here but did nothing about them."

Some of the comments from the hospital in reply to the story which appear in the Daily Mail (not online as far as I can find, unfortunately) are most revealing:

"Last year we employed external consultants who recommended that we increased staffing levels on the orthopaedic wards. This was done and we do not currently have any nursing vacancies."

"Unfortuantely we have recently been affected by sickness and that has made it difficult to meet those levels".

The comments reveal that the hospital:
a) needs external consultants to realise it needs extra nurses, even when one of its own consultants has been telling it this for two years.
b) spends some of its budget on consultants that might better be spent on the extra nurses needed.
c) is unprepared for the eventuality that sometimes nurses become ill.

The hospital, according to the Daily Mail, has not ruled out disciplinary action for Mr Milton Pena.

The public does not understand the true level of the inadequacy of the National Health Service partly because doctors and nurses are contractually bound not to speak out about it. Like Mr Pena, they fear they might be disciplined.

Here are a few of the 2005 nursing records publishing by Mr Pena:

January 27 2005: Two trainees, three qualified staff on duty: '28 very dependent patients. Unable to carry out basic needs for patients; pressure care, nutritional needs, continence care, observation, unable to carry out four-hourly observations. Complaints from relatives. Will put in letter of concern.'

February 12: Trainee absent. Three qualified nurses, two trainees on duty: 'Patient care, drinks, toileting, medications late. Wound care and care plans not done.'

March 17: One qualified nurse sick. Two qualified and three trainee nurses: 'Unable to take patients to toilet. Nutrition needs not properly met.'

Not being a nurse or doctor, I cannot properly describe the health implications of what is described. But it sounds as though people who are very seriously unwell have not been fed properly. They have even gone without fluids to drink. They have, perhaps, lived with unemptied bags of urine. They have not been given the drugs they need which, presumably, have been prescribed to reduce their pain, to prevent them getting dangerous infections or to help cure them.

It is appalling for those who may depend on this hospital to think that they or perhaps their elderly loved ones might be treated in this way.

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The Conservative Party has proposals which are radically different from those of Labour.

If it actually got into power and gave people the right to use tax money to buy private education (at a school charging no more than the cost of state education) it would transform schooling in Britain. The supply of cheap private education would increase from its small base and over a period of, say, ten years, the landscape of schools would be very different.

The Conservatives also proposed to give people money towards operations in private hospitals (half the cost of the NHS operation). That would dramatically change the balance between government-supplied and private hospital care - especially because private care is already quite substantial.

These policies would have their drawbacks and problems but they offer the prospect of more choice for more people than anything equivalent in, say, the United States. They would enable healthcare and education in Britain to regain something of their former world standing.

It is true that the Conservatives themselves have not put these, their most radical policies to the fore. One gets the impression that the leadership believes in the policies but fears they do not have big electoral appeal. But the media should be zooming in on them, because they do represent a radically different vision. The Labour Party thinks that another few quangos and another few billion pounds will fix the lamentable performance of government-supplied medical care and schools. The Conservatives don't. They are offering a chance of private-provided healthcare and education for those who cannot easily afford to buy their way out already.

They are offering a life-line to people whose lives are educationally impoverished and physically endangered by the current government-dominated system.

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Yes, if you live in East Sussex and can go to the Conquest Hospital at St Leonard's-on-Sea. And maybe soon you will also have access to one in Colchester. There was big fuss about the one coming to East Sussex in January and it was said it would be the first one in Britain. By implication, there is no machine of this sort in London.

In other words, a voluntary hospital in a suburb of Miami now has a scanner of a sort that people in the very capital of the United Kingdom do not have access to.

This is one example of how the NHS is behind the curve in the giving its patients the benefit of the latest technology and treatments.

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Yahaira said that students at public school 'get drugged'. She said it was 'more challenging here' academically. There are small classes in the Academy - often 14 or 15 - whereas in the public school there were classes of 30.

Elisabeth said about public school, "you see guns, you see knives".

Geniver said in the public school there were "a lot of drugs. I told my mom. She sent me here". She said she was getting higher grades here and learning a lot more.

Elisabeth added that when she was at the public school, she expected to go to a "medium" college (university) but here she could expect to go somewhere like Columbia.

I asked how they expected their lives might be different now compared to what they would have been if they had stayed at their public schools.

Yahaira said that many at the pbulic school dropped out, got into drugs or got pregnant. She added that in the private school, "We're like in a little bubble. We're not into that stuff."

Denise said, "If I had stayed at public school, I would be a completely different person. There were so many temptations.

They made reference every now and again to God. I asked them what their favourite subjects were. Denise said the Bible. Elisabeth and Geniver said health (which is a subject including venereal disease, sex, drugs and nutrition) and Yahaira said gym.

When they were explaining why their parents had sent them to the Greater Miami Academy, it was noticeable that they kept on using the words 'safe' and 'safety'.

There is enormous opposition to the policy of school choice which has been promoted by the Governor, Jeb Bush. But when you meet girls whose lives do appear to have been significantly improved, such opposition seems strange, if not cruel.

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