Friday, May 8, 2009

Nurses lack decontamination areas

Some nurses are having to decontaminate vital equipment in hospital bathrooms because they have no access to a dedicated cleaning room, a survey says.

A Royal College of Nursing (RCN) survey of 2,000 nurses found 37% had no access to a room for cleaning equipment.

Of those, a third have had to use a bathroom as an alternative.

The RCN described the results as "shocking", but the Department of Health said it was for individual trusts to make proper arrangements.

Dr Peter Carter, RCN chief executive and general secretary, said: "Having the time and space to clean and then store essential everyday hospital equipment such as IV stands, commodes and patient cushions is crucial in keeping patients safe from dangerous infections.

"It's shocking that some nurses have no choice but to store equipment in hospital bathrooms.

"People need to recognise that fighting infection is about much more than just hand washing."

The RCN survey also found that more than one third (34%) of nurses who have responsibility for decontaminating patient equipment have never received any formal training in how to do it.

Four out of 10 nurses said their organisation did not provide cleaning services 24 hours a day.

Training budgets

Dr Carter added: "Every trust should protect training budgets for nurses and make sure that every nurse in the country is given the opportunity to update their infection prevention training.

"Every nurse should have access to round-the-clock cleaning services.

"Overall, infection rates have been going down over the past couple of years, but that's from a very high point indeed."

Shadow health minister Anne Milton said: "This is yet more evidence that nurses aren't getting the support they need.

"Given that three times as many people now die from hospital infections each year than die on Britain's roads it is simply unacceptable to find basic standards of hygiene are not being met because the resources aren't available.

"Nurses are being put in an impossible position. It's unfair on them and unfair on patients."

A Department of Health spokesperson said: "We have made substantial investment - an additional £270m a year by 2010/2011 - for the NHS to tackle healthcare associated infections.

"Trusts must make adequate arrangements for decontamination, out-of-hours cleaning and staff training in infection prevention and control."

Minister in £25k security claim

Tourism minister Barbara Follett claimed more than £25,000 for security patrols at her London home, the Daily Telegraph claims.

It is the latest in a string of expense claims leaks which MPs said were made with Commons approval.

The wife of author Ken Follett and one of Parliament's richest MPs, Mrs Follett said her claims for security had been made within the rules.

Police have been asked to probe how the details were leaked to the paper.

'Disgusting reporting'

In a further disclosure, the Telegraph says immigration minister Phil Woolas claimed for nappies and women's clothing on his expenses, an allegation he vehemently denies.

He says they were listed on a receipt for food which he submitted, but he did not receive any money for them.



Mr Woolas called the Telegraph's reporting "absolutely disgusting" and said they were handling stolen property and making false allegations against ministers.

He said he believed the newspaper's claims might be "actionable" and he was seeking legal advice.

The paper reported that care services minister Phil Hope had spent more than £37,000 over about four years on refurbishing and furnishing a two-bedroom south London flat.

Mr Hope said: "I claimed the cost of running and furnishing a flat in London, in full accordance with the rules that apply to members of Parliament.

"The purchases I made were no more than was necessary to live in a habitable residence and replacements only occurred when furniture and fittings were worn out. These items were then disposed of.

"I have not personally benefited from this process, nor did I make purchases that were inappropriate for the property concerned."

Claims cleared

Mrs Follett's total bill for security patrols between 2004 and 2008 was £25,411.64, the paper said.

She told the BBC: "I claimed it, it's within the rules and I have no comment to make".

She also claimed £528.75 for a Chinese needlepoint rug to be repaired and cleaned, but was only paid back £300 after it was deemed excessive, the Telegraph said.

She told the newspaper: "As all of [my claims], bar one, have been accepted and cleared by the House of Commons Fees Office under the rules laid out in the Green Book, I have no further comment to make on them.










"The item not accepted by the Fees Office was claimed in error and is, to the best of my knowledge, one of the only two occasions in the last 12 years when my expenses claims have been queried by them."

Full details of all MPs' expenses dating back four years, running to 2.4 million receipts, were due to be published in the middle of July after the Commons authorities lost a Freedom of Information battle.

But instead, the Telegraph is revealing the information early and over several days.

BBC political correspondent Ben Wright said: "Clearly at the moment it is very much the government that is suffering because of this, because it is cabinet ministers who are having the spotlight shone on their expenses and junior ministers, as we discovered today.

"But MPs from other parties are going to be drawn into this, backbenchers too. There is a feeling that that is where, perhaps, some of the real, shocking horror stories of claims may then come to light, on the back benches."

Resignations predicted

The former independent MP, Martin Bell, said he believed a few MPs would now have to resign, and others would have to accept major changes to their expenses.

"I think the more we know about this, the worse it gets. I think Barbara Follet is in an almost impossible situation now.

"It's not a matter of her wealth, it's a matter of how can you possibly claim this amount of money for protection when we have a police service."

Other expense claims revealed earlier include a £6,500 claim by Gordon Brown to pay his brother for a cleaner. Downing Street has said there was "nothing wrong" with the claim.

And Lord Mandelson, who claimed £2,850 for his home, before quitting as an MP and selling it for a large profit, said the claims were for essential repairs.

Thousands flee Pakistan fighting

A Pakistani offensive against militants in the Swat Valley has displaced some 200,000 people and 300,000 are on the move or about to flee, the UN says.

As jets and helicopters pounded targets in the valley, the UN said it was threatening to become one of the world's biggest displacement crises.

The army says its "full-scale" assault had killed more than 170 militants in 24 hours, with the loss of 10 troops.

It accused the Taleban of trying to stop civilians leaving the area.



"We tried negotiation, we tried reconciliation, we offered the olive branch but we can't allow the writ of the government to be challenged," he said, speaking to Radio 4's PM programme.

Despite now abandoned attempts to secure a peace deal in and around Swat, the area - close to the border with Afghanistan - has long been riven by tensions.

Some 550,000 people had already been displaced before the current crisis, said UNHCR spokesman Ron Redmond.

Militants 'entrenched'

Those displaced over recent days have been forced to flee with very little preparation, aid workers say, with families often separated, and doctors in displaced camps report widespread psychological trauma.





Many are fleeing Mingora, the main town in Swat Valley, which was home to several hundred thousand people before the latest fighting began.

Locals say that most of the current fighting is centred on the Kabal and Charbagh areas of Swat, as well as Mingora itself, and fighting is reported in Buner and Lower Dir.

Militant strongholds were hit from the air on Friday as troops conducted operations on the ground.

Pakistani military spokesman Gen Athar Abbas announced the new casualty figures, which could not be verified independently.

Troops had killed 143 rebels in Swat, 25 in Lower Dir and six in Buner, he said, losing seven soldiers in Swat and three in Lower Dir.

"The army is now engaged in a full-scale operation to eliminate miscreants," he told reporters.

"They are on the run and trying to block the exodus of civilians from the area."

Earlier, he told the BBC the military's objective was to eliminate some 4-5,000 militants from the Swat Valley and neighbouring districts of Dir and Buner.

He warned it would be a "drawn-out affair" because militants in Swat had "entrenched themselves".

They were, he added, "making best use of the terrain, which is ideal country for any guerrilla warfare".

The government is confident it has public support for its military campaign but this could easily be eroded if civilian casualties mount, the BBC's Mark Dummett reports from Islamabad.

Threat of hunger

The Pakistani military says it is trying to help displaced civilians by establishing camps where they can seek shelter.




But reports suggest many thousands of civilians under threat from the fighting are unwilling or unable to move.

Roads have been blocked or reportedly mined by the rebels.

The Pakistani military has also imposed an indefinite curfew over swathes of the region.

A local journalist in Mingora told the BBC that electricity and water had been shut down and markets had been closed since Thursday. There was, the journalist said, a real threat of food shortages in the coming days.

While the army accuses the Taleban of holding the people left in the Swat Valley hostage, people who have escaped blame both sides for the conflict and the dire position of the civilians caught between them, our correspondent notes.

The government signed a peace agreement with the Swat Taleban in February, allowing Sharia law to be locally imposed.

But in the face of territorial advances by emboldened Taleban forces, the strategy came under increasing fire from Washington, a key ally.

The US insists the militants pose a direct threat to its security, and has demanded they be confronted

Thursday, May 7, 2009

Skull and cross bones warnings on cigarette packs from May 31

The government on Wednesday assured the Supreme Court that it would ensure pictorial warnings like the skull and cross bones or a cancer-disfigured face were carried on the packets of cigarettes and other tobacco products from May 31.

Additional Solicitor General Gopal Subramaniam told the bench of Justice B N Agrawal and Justice G S Singhvi that the government will not defer beyond May 31 the implementation of the law mandating pictorial warnings on cigarette packets.

"The Union of India undertakes to implement the Cigarette and Other Tobacco Products (Packing and Labeling) Rules, 2008, from May 31, 2009," the government’s law officer said.

"Its implementation will not be further delayed in any case," he added.

Approving of the government’s commitment, the bench ruled, “No court in the country can pass an order that might hinder the implementation of the law.”

The rider came on a plea by senior counsel Indira Jaisingh, who said that the powerful tobacco lobbies that had been behind repeated deferments of the law's implementation for the last three years might still delay this.

The government's undertaking came during the hearing of a lawsuit by NGO Health for Millions seeking implementation of the law on pictorial warnings on the packets of all tobacco products. The pictorial warning would occupy 40 percent of the space on the front of all packets.

The undertaking came a day after the court queried the government on Jaisingh's charge that despite a Group of Ministers (GoM) at its meeting Feb 3 deciding that the pictorial warning should be carried on both sides of the packet, the government notification only provided for this on the front.

Jaisingh contended that this was due to the pressure of the tobacco lobby and was much against the wishes of former health minister A. Ramados, a staunch supporter of the "No Smoking" cause.

Thereafter, the bench Tuesday sought the minutes of the Feb 3 GoM meeting.

Producing these in the court Wednesday, Subramaniam explained that though the agenda mentioned that the displays would be on both sides of packets, the minutes of the meeting did not specify this.

The GoM chairman had wanted to convene another meeting to rectify the lacunae but this did not happen due to the paucity of the time in the run-up to the general elections, Subramaniam said, adding that had another meeting been convened, the May 31 deadline would have been missed.

Lauding the court order, Bhavana Mukhopadyay, director (Health Promotion) at the Voluntary Health Association of India, said: "Since the 2006 act (mandating pictorial warnings) was passed, the issue was being diluted or delayed for one reason or another. Even now, had the Supreme Court not stepped in, there would have been further delay."

"There is no question of any hiccups now. Whichever government comes to power (after the general elections) will have to follow the court's order and the warnings will be there from June 1. And then, there is the injunction that no court can pass an order inconsistent with today's order," Mukhopadyay told IANS.

P.C. Gupta, director of the Healis Sekhsaria Institute for Public Health, said: "It is most unfortunate that the GoM, since its constitution in early 2007, had delayed the implementation of the law for two whole years, not to mention having diluted the stronger warning for a milder one."

According to a health ministry official, the pictorial warnings are a crucial step to protect the public from the hazards of tobacco and second-hand smoke, and to reduce the use of tobacco by the youth
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The woman who saved Delhi from Pappus

On Thursday, when 53 per cent voters turned out to choose their leader, Delhi not only outdid other metros like Mumbai and Bangalore, it also created a record of achieving the highest poll percentage in the last 20 years.

So, how did Delhi achieve this feat? If you believe Satbir Silas Bedi, Delhi’s Chief Electoral Officer (CEO) and the brain behind the catchy Pappu Can’t Vote campaign, it is not merely the ad that resulted in the high polling percentage.

“Much of the credit also goes to my colleagues and staff. Like the Block Level Officers who went to each and every residential colony to ensure citizens get themselves registered for voting,” she said.

The groundwork to ensure better polling had started much before, Bedi said.

“Election management in metro cities is a different ballgame. A team of 80 officials has been constantly on the job since October 2007 — revising and updating electoral rolls. Finally the dedication of my staff paid off,” she said.

Bedi said the Pappu Can’t Vote campaign also hit the right chord with voters, especially young voters. “The campaign had a high recall value. It touched a chord with Delhiites psyche. It was not a preachy campaign but very subtly motivated voters. Through radio, television and newspapers we were constantly hammering it in people’s mind,” she said.

“The awareness created by the campaign was so much that the call centre of the CEO office received more than 2,000 calls per day with voters wanted to clear their voting-related queries”, she added.

“I am very happy today. Common citizens have been calling up our office since evening saying they saw our ad and were motivated to vote,” added Bedi.

After the gruelling session that lasted over a month, she is now looking forward to relaxing with her family. “Though we live in the same house I hardly spoke to my son. Now I am looking forward to some quality time with him before counting day on May 16,” she said.

Round four of polling ends, hunt for allies intensifies

The two major contenders for the Delhi throne — the Congress and the BJP — appear to have intensified their hunt for allies as the likelihood of a hung Parliament increased after the fourth round of polling on Thursday.

An estimated 57 per cent voters braved the heat to cast their votes for 85 Lok Sabha seats spread across eight states in the largely peaceful polling, barring West Bengal, where four voters were killed in poll violence.

One person died in Rajasthan when security forces opened fire to foil an attempt to capture a booth.

With voting now over for 457 of the 543 Lok Sabha seats and only 86 seats left for voting on the last round on May 13, the focus has now shifted to post-poll alliances.While West Bengal recorded the highest voting percentage (75 per cent), Jammu and Kashmir capital Srinagar recorded the lowest turnout (24 per cent), mainly due to a boycott call by separatists.

Capital Delhi saw a 50 per cent turnout on a typical summer day. In terms of voting, the city scored over Mumbai, which had seen a mere 41 per cent voting a week back, considered to be lowest since 1977.

President Pratibha Patil, Vice-President Hamid Ansari, Congress president Sonia Gandhi, her children Rahul and Sonia, and Chief Minister Sheila Dikshit were among those who cast their votes in the capital.

The ruling Congress is defending six of the seven seats in Delhi which it had won in 2004. “We are going to do well this time also. The assembly elections held five months back had shown which way the wind is blowing,” Dikshit said.

With voting now over for 457 of the 543 Lok Sabha seats and only 86 seats left for voting on the last round on May 13, the focus has now shifted to post-poll alliances.

The BJP’s managers are counting on Bahujan Samaj Party chief Mayawati to spring a surprise and gravitate towards them. The Uttar Pradesh chief minister is at present inclined towards the so-called Third Front, a loosely knit formation of regional parties propped up by the Left.

Her rival and Samajwadi Party chief, Mulayam Singh Yadav, put forward a pre-condition for those looking for his support. “We will support whoever dismisses the Mayawati government in Uttar Pradesh,” he said after casting his vote in Mainpuri. The Congress was quick to reject such a demand but kept the door open for the SP. Amar Singh, SP general secretary, also hinted at supporting the Congress.

But, the Left parties appeared to adopt a wait and watch policy. The focus now shifts to the final round next week. The most crucial state in this phase will be Tamil Nadu where all 39 seats will go for polls. Polling for 14 seats in Uttar Pradesh, 11 in West Bengal, 4 in Himachal Pradesh and 5 in Uttarakhand will also be held the same day.

In-N-Out: Can perfection survive?

My life as a fast-food consumer pretty much ended the moment my kids became old enough to drive themselves to the nearest hamburger stand.

But even back then I knew that all such chains could be divided into two categories: There was In-N-Out, and there was everybody else.




The In-N-Out cult -- is there any other word for it? -- is rooted in its patrons' appreciation for its simple menu and its sedulous devotion to fresh, high-quality ingredients.

To be sure, there are other fascinations. These include the mystique created by its management's traditional refusal to ever speak to the press (including for this column).

Then there are the biblicalcitations imprinted on the edges and seams of its burger wrappers and disposable cups, a practice started by the late Richard Snyder, the born-again younger son and onetime heir apparent to In-N-Out's founders, Harry and Esther Snyder.

Finally, there are the intertwined issues of In-N-Out's colorful past and its unsettled future, which are touched on in a new book titled simply "In-N-Out Burger," by BusinessWeek writer Stacy Perman.

Perman observes that In-N-Out has prospered by hewing close to the stolid principles of controlled growth, limited menu, fresh food and regional focus -- with the exception of one store in Utah, its 232 locations are all in California, Nevada or Arizona -- set in stone by its founders, like commandments. (Harry died in 1976, his widow in 2006.) As a private company, In-N-Out doesn't release financial figures, though the trade press estimated sales in 2005 at $370 million -- a healthy sum for a small chain.

Southern Californians have grown up appreciating the company's virtues, while the rest of the country slavers from afar: In-N-Out generally pays better than other burger chains, in return for which employees are held to rigorous standards of appearance and behavior. It's a fair bet you'll never see a video on YouTube of workers adulterating In-N-Out food even in jest, as recently befell another chain.

In-N-Out management, from corporate headquarters in Baldwin Park and Irvine down to store level, is first class.

"The executive corps is the key to their success at weathering problems," says Perman, who didn't get the company's help with her book.

The menu never changes -- burgers that can be piled high like flapjacks, fries and shakes or soda. The provisions are all fresh thanks to the chain's fabled quality control and a tight geographic footprint that keeps all stores within a few hundred miles of regional distribution centers. There's no denying that next to an In-N-Out burger, the fare at McDonald's, despite the latter's relentless menu experimentation and customer research, tastes like premasticated garbage.

That's not to say that In-N-Out serves health food. I don't have room here for a detailed analysis of its nutritional value, other than to say that a normal adult should be able to cross the Sahara fueled by the caloric, fat and sodium content of a standard dose double-double with fries and a shake. I believe the In-N-Out meal I ingested a week ago Tuesday (submitted as a reporting expense) is still burbling about in my system somewhere, not that I didn't enjoy it to the utmost.

Yet In-N-Out's history is anything but dull. The Snyders established a line of succession skipping over their older son, Guy, in favor of the more stable Richard. That well-laid plan dissolved with Richard's death in a 1993 plane crash. The inheritance passed to Guy, who had a history of drug abuse and died from an overdose of a prescription painkiller in 1999. With Esther's death seven years later, majority control became vested in two family trusts. It will pass after 2011 to Guy's only natural child, his daughter Lynsi Martinez, 27.

What little has been said about Martinez for public consumption comes from the 2006 court battle between the company and Richard Boyd, a former executive who said he had grown close to Esther, only to be shouldered aside by Lynsi and In-N-Out Chief Executive Mark Taylor, the husband of one of her half-sisters.

The fight aired a pile of In-N-Out's dirty laundry, which goes to prove that no matter how hard you work to keep your public image sewn up tight, it can blow at any seam.

Boyd alleged that Taylor and Martinez kept the nearly bedridden Esther Snyder a virtual prisoner in her home, screening and intercepting phone calls and visitors. He depicted Martinez as an immature religious fanatic with a taste for "partying hard" who cast him from the company after concluding he was no "man of God."

The company dismissed these assertions as "conspiracy theories" and said Boyd had been dismissed for fraud and embezzlement. Boyd called the allegations against him "demonstrably false."

The dueling lawsuits were eventually settled on confidential terms, though the courthouse allegations animate Perman's book. Boyd, for his part, remains upbeat about the company where he worked for more than 20 years.

"It's a great company," he told me this week. "When Rich Snyder died, he had so many good people in place that it never missed a heartbeat."

But that still leaves the question of how forcibly Martinez might impose her will on the company and -- even more intriguing -- what is her will? Once she takes formal ownership, if she declares In-N-Out will henceforth sell only Buffalo Burgers or Broccoli Burgers, or will dispense prayers rather than food, her word will be law. Indeed, given the inviolability of the trusts, her word probably already is law.

What should keep the chain's fans up at night is whether In-N-Out can continue to tread the fine line between modern business imperatives and its own traditions. Taylor has been quoted as saying he intends to stick to a pattern of opening 10 to 12 new stores a year, though Boyd claimed in his lawsuit that he had heard him express national ambitions.

An expansion across the Mississippi would probably strain In-N-Out's self-generated financial resources to the limit -- the chain doesn't even accept franchisees. But a public offering, much less a buyout by a public company, would almost certainly render it unrecognizable. The homogenizing cost-cutting of corporate number-crunchers ("let's drop the beef by a grade; the customers won't notice") could mean the end of In-N-Out as we know it.

That suggests the company's best option might be to remain the happy prisoner of its own success. Boyd may be right when he says: "If they leave it exactly as it is and don't make any changes, they'll last forever