Child protection shake-up urged

Boy - posed by modelProf Munro wants social workers to spend more time with children
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Front-line social workers should regain the freedom to decide what is best for children, an official review of England’s child protection system says.

The review, by London School of Economics professor of social policy Eileen Munro, calls for targets to be removed and red tape to be ditched.

Developing social workers’ expertise will enable more children to stay with their families, she adds.

The government is investing £80m implementing the reforms this year.

Education Secretary Michael Gove asked Prof Munro to review the child protection system in England, focussing on whether bureaucracy and targets have been getting in the way of good practice.

In her report, Prof Munro says: “Helping children is a human process. When the bureaucratic aspects of work become too dominant, the heart of the work is lost.”

She argues that the system has become preoccupied by individuals “doing things right” rather than “doing the right thing”.

And she concludes this attitude has meant that learning from professional experience has been limited.

She recommends a chief social worker – similar to a chief medical officer – should be appointed to report directly to government and liaise with the profession.

Prof Munro’s report sets out how the system can move from one that has become too bureaucratic and focussed on compliance to one that values and develops professional expertise.

Children in care2008-9 – 60,9002009-10 – 64,400

She says centrally-prescribed time scales for formal procedures, such as social work assessments, should be scrapped.

Her report also calls on the government to revise social worker statutory guidance – said to be 55 times longer than that issued nearly 40 years ago.

The amount of regulation has led to child protection staff feeling obliged to do everything by the book rather than use their professional judgement, says the report.

Prof Munro also wants the government to ensure local areas have the freedom to innovate, with local authorities taking more responsibility for helping their staff to operate with a high level of skill and knowledge.

And she calls for the social workers’ expertise to be developed – pointing out that skilled help can enable more children and young people to stay safely with their families and bring “significant savings”.

But the report warns that more money will be needed at first to develop the additional training necessary to set the profession off on a “new path”.

And it cautions that “cherry-picking” reforms will not lead to the desired improvements overall.

One of the major challenges, the report adds, is how to enable a wide range of professionals work together well for the good of vulnerable children.

Clear lines of accountability and named contacts are “vitally important” for this, she adds.

The report also places an emphasis on early intervention, calling on the government to place a duty on local councils to ensure there are enough early-help services for children, young people and families.

In particular it singles out the effectiveness of Sure Start Children’s Centres in providing early help and intervention.

Children’s Minister Tim Loughton said the review presented some wide-ranging and radically different proposals for reform.

“It is now up to the government and the children’s sector to work together to look at the recommendations in detail and assess the implications of their implementation in practice for the long term, not as a short term fix.

“To do this the government will be working closely with a group of professionals from across the children’s sector and we will respond to Professor Munro’s recommendations later this year.”

Chief executive of children’s charity 4Children said: “This review backs many of the calls families are making for a move away from bureaucratic assessment to personalised and hands-on support for those who are struggling to cope.

“Research for 4Children’s new campaign, Give me Strength, shows that 95% of the public believe that families in crisis can turn their lives around.”

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Libya rebels ‘push back troops’

Residents run through damaged streets in Misrata, Libya (23 April 2011)Misrata has seen weeks of battles as the rebels attempt to maintain their control

Rebels in the Libyan city of Misrata say they have pushed government troops back from its outskirts.

Misrata, the only city in western Libya under rebel control, has been under siege from forces loyal to Col Muammar Gaddafi for two months.

Rebels and civilians have come under heavy fire from the pro-Gaddafi forces.

The rebels say the city is still surrounded and within rocket range, but that they have advanced about 30km (18 miles) west towards Tripoli.

Libyan state media has said Nato aircraft bombed “military and civilian targets” in Misrata and the nearby town of Zlitan on Monday.

Reporting restrictions mean the claims from both sides cannot be independently verified.

In a statement, Nato said a sortie near Misrata on Sunday hit rocket launchers, artillery and three buildings which were “hosting active shooters”.

Medical sources say at least 300 people have been killed by the weeks of fighting in Misrata.

Reda, a rebel spokesman, told Reuters news agency there was fighting in the east, west and south of the city as well as near the airport.

“The revolutionaries control the western side while the brigades are still holding the south-eastern side of the airport,” he said, adding that they had been aided by recent Nato air strikes.

An AFP correspondent in Misrata said the rebels were now in control of a stretch of coastline heading towards the capital.

Another rebel, Mohammed, told the BBC: “We’ve pushed Gaddafi away from Misrata.”

He said the situation had improved in Misrata, with fewer bombings and shootings than in the past few weeks.

“People are getting back to a safe life. Many families are going out of the houses for shopping. Many families are going back to houses they left before when this started.”

Mohammed said the morale of the rebels was high, and that “they want to keep going”.

The BBC’s Andrew Harding in Benghazi says the rebels have managed to get arms into Zlitan and are hoping its residents will rise up.

But the town is still controlled by pro-Gaddafi troops, he adds, so it will not be easy for the rebels to achieve that goal.

Meanwhile, a Red Cross ship has successfully docked in Misrata, bringing medical equipment, baby food and spare parts for electrical and water systems.

The port has become a lifeline for the city, allowing refugees to leave and supplies to be brought in, but has come under repeated attack from Gaddafi forces.

Nato Secretary General Anders Fogh Rasmussen has told CNN that Col Gaddafi has been “stopped in his track” and that his time is running out.

“The game is over for Gaddafi. He should realise sooner rather than later that there’s no future for him or his regime,” he said.

Map

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NHS ‘failing on blood clot care’

Clot preventionWearing compression stockings can prevent clots in the legs, known as DVT, and lungs
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Doctors failing to spot deadly blood clots have cost the NHS over £112m in legal claims since 2005, figures show.

The NHS Litigation Authority data reveals how much has been paid out to patients and their families as a result of medics failing to screen for or give treatments to prevent the condition.

Guidelines introduced early last year say all patients admitted to hospital should be screened for clot risk.

The charity Lifeblood says the figures should be a wake up call for hospitals.

It calculates unless more doctors follow best-practice guidelines, claims for the period 2005 to 2015 could exceed £250m.

Blood clots or venous thromboembolism (VTE) kill an estimated 25,000 people admitted to NHS wards in England every year.

But many of the deaths are avoidable with the right care.

“I expect organisations to assess every patient for their individual risk of getting a blood clot, and then to provide the appropriate prevention”

NHS medical director Sir Bruce Keogh

However, an analysis of Department of Health data by Lifeblood shows just 30 of the UK’s 159 Hospital Trusts in England are meeting the mandatory goal to risk-assess 90% of patients admitted to hospital.

This could mean as many as 4.5m patients are missing out on potentially life-saving assessments, says Lifeblood.

The charity’s medical director, Professor Beverley Hunt, warned: “The NHS has some excellent new thrombosis prevention guidelines in place but if hospitals don’t take urgent action to meet these mandatory prevention goals, then patients will increasingly turn to the courts for compensation.”

NHS medical director Sir Bruce Keogh said: “We are committed to doing something about this issue, to reduce the suffering of thousands of people and to save many lives.

“This is not complicated. I expect organisations to assess every patient for their individual risk of getting a blood clot, and then to provide the appropriate prevention.

“Not only would this more than pay for itself; it is clearly the right thing to do.”

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Labour ‘talking to other parties’

Carwyn JonesCarwyn Jones is expected to be re-instated as first minister this week

Labour has confirmed it has spoken to other parties in Wales after falling just short of an outright majority at last week’s assembly election.

It said “informal discussions” were underway after it won exactly half the seats in the assembly chamber.

Welsh Labour leader Carwyn Jones is expected to be confirmed as first minister by the end of the week.

But one Labour AM said his party should go it alone, warning a coalition with another party would be “too cosy”.

The Plaid Cymru and Conservative groups held their first meetings after the election on Monday in Cardiff Bay. Labour will hold a group meeting on Tuesday.

The first plenary session of the new assembly is expected to be held on Wednesday when the presiding officer and first minister will be chosen.

“I think really there’s an obligation on Labour to form a government. You’ve got 50% of the seats.”

Mick Antoniw Labour AM

In a statement on Monday, a Labour spokesman said: “The people of Wales have made it very clear that they want a Labour-led government and they want Carwyn Jones to be the next first minister.

“This is accepted by the other political parties in the assembly.

“Informal discussions have been taking place today and over the weekend both inside Welsh Labour and with the other political parties.

“The new Labour group will meet tomorrow to discuss options and agree the right way forward for Wales. Following that meeting, Carwyn Jones will make a statement to ensure Wales has a stable government.”

But the new Labour AM for Pontypridd, Mick Antoniw, said he opposed going into coalition “and I think we should just go it alone”.

“We are not going to go to them.”

Peter Black Liberal Democrat AM

“I think it’s feasible, it might be tough, but then I don’t think people have elected us to have a cosy time,” he said.

“I think really there’s an obligation on Labour to form a government. You’ve got 50% of the seats.

“My bigger concern is that the trouble within the assembly with coalition is that it makes it a bit too cosy and takes away the quality of scrutiny and challenge to what the government is doing.”

Labour could share power with another party, as it did with Plaid after the 2007 election, or could work out a less formal arrangement.

Labour’s campaign manager, Pontypridd MP Owen Smith, said a partnership with the Lib Dems would be “difficult”, unless they renounced the policies of their coalition with the Conservatives.

But Lib Dem AM Peter Black said his party “would want some reassurance from the Labour Party if they were going to talk to us then we wouldn’t want this strident criticism (of the UK government) all the way through”.

He said the Welsh Lib Dems were willing to criticise the UK government where they disagreed with it, for example over university tuition fees and on S4C.

“But I think we can’t just oppose everything for the sake of opposing it.”

He added: “I think the onus is on Labour.

“We are not going to go to them. If they want to come and talk to us because they can’t manage in government on 30 seats then we are happy to talk and listen to that.

“All the balls are in their court and as far as we are concerned we will let them decide how they want to go ahead.”

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Hundreds missing off Libya coast

A boat from Tunisia arriving in Lampedusa, 10 April 2011Boats from North Africa have been arriving almost daily in Lampedusa
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Nato has denied claims by a British newspaper that its naval units left dozens of migrants aboard a drifting boat in the Mediterranean to die.

It said it was unaware of the plight of the boat, which reportedly was adrift for more than two weeks.

The Guardian newspaper said 61 of the 72 people on board the boat died of hunger or thirst, despite being spotted by a military helicopter and Nato ship.

Meanwhile officials say a ship carrying 600 people sank off Libya last week.

Laura Boldrini of the UNHCR refugee agency said witnesses had seen the ship break apart on rocks on the Libyan coast, shortly after leaving, and that bodies were seen floating in the sea. She said it was not known how many of those on board were killed.

The smaller boat left Tripoli in Libya on 25 March, hoping to make it to Italy.

But it ran out of fuel and started drifting. Eventually food and water ran out, too.

The Guardian quotes a man, Abu Kurke, who it says was aboard the boat.

“Every morning we would wake up and find more bodies, which we would leave for 24 hours and then throw overboard,” he said.

The dead included mothers and babies, he added.

Those on board the boat made contact with a priest in Italy, Father Mussie Zerai, who often plays a key role assisting migrants who hit trouble. They called him on 26 March, the day after they set sail.

He confirmed to the BBC that he had alerted Italian coastguards, who said they would take action. But he lost contact with the boat when its phone battery went dead.

Abu Kurke said that shortly afterwards a helicopter appeared and dropped bottles of water and packets of biscuits onto the boat – but that after that, no further help arrived.

At one point – on 29 or 30 March, the Guardian says – the boat drifted close to an aircraft carrier. Survivors contacted by the paper said two jets took off and flew low overhead, while the migrants held two starving babies aloft. But no effort was made to assist them.

The Guardian said its inquiries suggested the ship must have been the French aircraft carrier Charles de Gaulle.

However, Nato said in a statement: “Only one aircraft carrier was under Nato command on those dates, the Italian ship Garibaldi. Throughout the period in question, the Garibaldi was operating over 100 nautical miles out to sea. Therefore, any claims that a Nato aircraft carrier spotted and then ignored the vessel in distress are wrong.”

The Nato statement referred to the fact that the boat was supposed to be in “an unspecified location between Tripoli and [the Italian island of] Lampedusa” – and not 100 miles out to sea.

Nato said its vessels were fully aware of their responsibilities to assist vessels in distress – and indeed had rescued more than 500 people in two incidents off Tripoli on 26-27 March.

But the UNHCR’s Ms Boldrini told the BBC World Service it was “scary and concerning” that a boat could drift for so long in the Mediterranean without being picked up by any of the numerous military and commercial vessels operating there.

“This thing shouldn’t ever happen,” she said.

Up to 30,000 people are thought to have made the journey from Libya and Tunisia to Italy so far this year, driven by civil unrest and enabled by a collapse in emigration controls.

Italy has called for help in dealing with the influx, which has overwhelmed its tiny island of Lampedusa.

This weekend, more than 400 migrants from Libya had to be rescued by Italian coastguards after their fishing boat hit rocks on Lampedusa.

TV images of the dramatic night-time rescue showed some migrants jumping or falling into the sea.

On Sunday Pope Benedict XVI urged people in Catholic Italy to show more tolerance towards migrants from north Africa.

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Army ‘surrounds’ Damascus suburb

Syrian anti-government protesters carry a banner Homs has been a focus of anti-government unrest

Syrian security forces have expanded their crackdown on anti-government protests, entering several key cities.

The state news agency said authorities were pursuing “armed terrorist groups” in Deraa, Homs and Baniyas.

In Homs, Syria’s third city, there were reports of gunfire and shelling as troops backed by tanks pushed into residential areas.

A 12-year-old boy is reported to have been killed there. State media say six soldiers died in the clashes.

Foreign journalists are banned from entering Syria, so reports are difficult to independently verify.

‘Faced with guns’

In Homs – a centre of the recent protests against President Bashar al-Assad – water, electricity and nearly all forms of communication were cut as reinforcements moved into the city on Sunday.

Tanks and troops charged into the Bab Sebaa, Bab Amro and Tal al-Sour districts.

One Homs resident, who wished to remain anonymous, told the BBC: “We cannot stay for a long time faced with these guns – somebody from your end, from other nations, from Turkey, should [do] something.”

BBC map

The UK-based Syrian Observatory for Human Rights said the areas were under “total siege”, and that hundreds had been arrested. The numbers of dead and injured was unknown, it added.

The Sana state news agency reported that 10 civilian workers travelling to Homs from Lebanon had been killed in an ambush by an armed gang.

Some 15 people were shot dead in Homs on Friday as they staged demonstrations after weekly prayers.

The authorities say 11 soldiers and police were also killed, blaming “terrorist groups” for the violence.

Police operations are also continuing in Baniyas and Deraa.

A witness quoted by Reuters news agency said that security forces had killed at least two unarmed demonstrators on Sunday when they fired on a night rally in the eastern city of Deir al-Zor.

State television showed what appeared to be the blood-soaked interior of a white transit van which had a bullet-ridden windshield.

In Deraa, the southern city where the unrest began in March, residents also remain cut off from the rest of the country.

Scores of people have been killed in Deraa during a 10-day security operation.

Meanwhile, the authorities have filed charges against prominent opposition politician Riad Seif.

Mr Seif, who suffers from cancer, was arrested on Friday accused of staging a protest without a permit.

Across Syria, demonstrators have been calling for greater political rights and personal freedoms. Some are calling for the downfall of the regime.

The unrest, which began in March, poses the most serious challenge to Mr Assad since he succeeded his father, Hafez, in 2000.

On Friday the US said the violence against protesters was “deplorable” and pledged a “strong international response” if Damascus did not end its crackdown.

More than 500 people are thought to have been killed since the start of the protests.

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Qamishli

A mobile phone snapshot, reportedly taken in Qamishli on 29 April, shows protesters carrying banners written in Arabic and Kurdish demanding democracy.

Damascus

Video has been posted online, apparently showing demonstrators in central Damascus, where protests began immediately after Friday prayers had finished.

This footage, which the BBC cannot verify, seems to show demonstrators in Midan, central Damascus, on Friday afternoon. A source in Damascus says he could see a lot of security and police officers in the main areas of Damascus after protests began after Friday prayers finished.

Talbisah

Amateur video has captured the moment what was a peaceful protest in the Syrian city of Talbisah was broken up forcefully by soldiers.

This unverified video seems to show a peaceful protest in Talbisah. Moments into the footage, tanks fire on unarmed civilians. Wyre Davis reports.

Deraa

A soldier walks past men in civilian clothes lying on the ground with their hands tied behind their backs in this still photo taken from an amateur video.

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Third of council seats declared

Around a third of the council posts in Northern Ireland have been declared.

The first result emerged 45 minutes after counting began on Monday morning to fill 582 seats in 26 councils.

Early trends mirror the results in the NI Assembly poll with the DUP and Sinn Fein well ahead of their rivals.

In the 2005 council elections, the DUP received 30% of the overall vote, Sinn Fein 23%, UUP 18%, SDLP 17% and Alliance 5%.

BBC NI political editor Mark Devenport said the UUP and the SDLP would hope to avoid a repeat of the assembly result.

“In the last council elections the UUP had 18%, but are now on 13%, while the SDLP had 17% but are now on 14% so they could lose out,” he said.

“That would breed discontent among people asking if their leaders are taking them in the right direction.

“That said, the single transferable vote system does save people in the later stages so it could be that the damage won’t be quite as bad as it was at the assembly.”

The final results are not expected until Tuesday.

This table is updated every 15 minutes

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GPs warn bill could ‘unravel’ NHS

 

Hospital nurseThe government says the NHS has to “modernise” through reform.
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The Royal College of GPs says the government needs to rewrite a key part of its Health Bill which encourages greater competition.

Dr Clare Gerada, the chair of the college, says otherwise the bill risks “unravelling and dismantling” the NHS.

The government says it wants competition based on quality not price to deliver better results for patients.

It is looking at the role of choice and competition as part of its listening exercise on the Health Bill.

The Royal College is one of a number of organisations lobbying Downing Street directly to make changes to the draft legislation.

There is also political pressure within the coalition following significant unease within the Liberal Democrats.

Nick Clegg has warned his party will block the Health Bill unless it is altered.

The BBC has seen the 26-page analysis sent by the Royal College of GPs to the prime minister’s office.

Some parts of the government plans are welcomed, such as the greater involvement of GPs in buying and planning care.

But it also challenges the need for a greater market in healthcare and for the first time calls for the entire section on competition in the bill to be rewritten.

“I would hope that during this pause the government will reflect on what we’re all saying and will rewrite the part of the Bill that is actually risking the NHS and risking the NHS being unravelled irreversibly for ever”

Dr Clare Gerada Royal College of Surgeons

Dr Gerada told the BBC the changes needed went far beyond any modest alterations.

She said: “I would hope that during this pause the government will reflect on what we’re all saying and will rewrite the part of the bill that is actually risking the NHS and risking the NHS being unravelled irreversibly for ever.

“And delivering in the end worse patient care – care that is more expensive for the taxpayer.”

Dr Gerada said the government had to realise that the concerns were nothing to do with the other parts of its plans, which give groups of family doctors control over budgets.

She told the BBC that as GPs had begun to understand the implications of competition element the anxiety about what it means for the health service had grown.

The government has already conceded it needs to consult more widely on its plans for the NHS in England.

More than 100 “listening” events are being held around the country, including some with staff and patients.

This is in addition to the 6,000 responses to its official consultation last year.

The Health Secretary Andrew Lansley said the priority was making sure competition works for patients.

“We have been clear that we want to see competition based on quality, not on price, to deliver better results for both patients and the taxpayer,” he said.

Some believe the government could address the concerns by redrafting parts of the Health Bill to make clear how and where it thinks competition could be of value.

That would involve setting limits to the role of Monitor, which is to become the economic regulator of healthcare.

David Cameron is taking a much closer interest in the details of the bill.

His newly appointed advisor on health policy has already begun a series of informal meetings with senior academic, former NHS managers and groups representing health service staff.

An extra special adviser is to be deployed to the Department of Health to help with communicating the complicated reforms.

Labour has called a debate in Parliament on Monday on the changes to the health service.

Shadow Health Secretary John Healey said it was now up to Mr Cameron to have the final say on the NHS plans.

“If the prime minister wants to prove to NHS patients and staff that his ‘pause’ is not just spin then he must shelve the bill as it stands and make radical changes to his NHS reorganisation plans,” he said.

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