The Government's own neighbourhood crime adviser has accused Gordon Brown of letting people down on antisocial behaviour.

Louise Casey said that not enough was being done to stop yobs making other people's lives a misery. She said that, unless police and councils got a grip on the problem, it would pass from generation to generation.

She said that she was shocked by the cases of Fiona Pilkington — who killed herself and her daughter after suffering years of abuse from bullies — and the brothers who attacked two boys in Edlington, South Yorkshire. “Honestly, I think we have let people down,” she said. “I am not suggesting that anybody personally is responsible for the extraordinarily tragic case of Mrs Pilkington and her daughter, but can you go to bed at night knowing everything is being done to prevent these things from happening? That is the test.”

Last week the Home Office published an action plan to end what Alan Johnson, the Home Secretary, described as years of “coasting” on the issue. It follows Gordon Brown's promise to the Labour Party conference last month to tackle antisocial behaviour.

Labour's private polling shows that crime and antisocial behaviour are key issues, but Ms Casey's blunt assessment will be seen as very unhelpful as it gives the Opposition ammunition.

When Mr Brown became Prime Minister two years ago he split policy on antisocial behaviour between the Home Office and the Department for Children, Schools and Families, with greater emphasis placed on prevention than enforcement.

Mr Brown's allies admit that he ordered the move because he wanted to signal a break with Tony Blair's agenda, which he believed played to irrational fears of crime among voters.

Friends of Ms Casey believe that the split allowed the policy to drift. She said: “I felt personally frustrated at that point. You have to be tough on crime and tough on criminals and then get the support and rehabilitation right. In that order.”

Ms Casey spearheaded Mr Blair's antisocial behaviour initiatives. She said: “You need to nip it in the bud as early as humanly possible. There is no point giving someone a warning letter if, when they rip it up, you don't go and visit them. There is no point doing a home visit which they ignore. There is no point in just doing interventions if there is no end product.”

Police dismissed the plight of a single mother who went on to kill herself and her disabled daughter by setting her car on fire.

Officers believed Fiona Pilkington was "over-reacting" to abuse she suffered over more than 10 years at the hands of a gang of youths who targeted her children.

Many of the calls she made were not linked together and individual incidents were considered to be just anti-social behaviour.

In her despair she doused her Austin Montego in petrol and set it alight while she sat with her daughter Francecca Hardwick in a lay-by. The bodies of Ms Pilkington, 38, and her 18-year-old daughter, who had severe learning difficulties, were found in the car at the side of the A47 near Earl Shilton, Leicestershire, in October 2007.

Ms Pilkington, her daughter and her 19-year-old son Anthony Hardwick, who has severe dyslexia, had suffered relentless abuse from the gang, who lived in their street in nearby Barwell.

The youths, up to 16-strong, would often pelt their home with eggs, flour and stones, while shouting insults at the children about their disabilities.

Ms Pilkington contacted police more than 30 times in the seven years before her death about her family's ordeal but officers failed to respond on many occasions because there were not enough resources.

Despite her son being locked in a shed at knifepoint, beaten with a metal bar and her daughter made to endure calls for her to lift up her nightdress as she went to bed, no-one was ever prosecuted.

On the second day of an inquest at Loughborough Town Hall into the deaths of Ms Pilkington and Francecca, who was known as Frankie, the court heard officers considered her to be “over-reacting”.

The jury heard that when she complained in April 2007 about youths smoking in her front garden, an officer visited her but closed the incident log soon after.

The coroner, Olivia Davison, said: “They were walking up and down smoking. This woman we know is shy and timid and on occasions has been too scared to come out her house. So when the officer visits this woman, he listens to her and accepts her statements and she is considered as over-reacting. “I wouldn't care if someone was in my front garden, whether they were smoking or not. Don't you think this is a massive invasion of her privacy and her rights as a human being to tranquillity?”

The inquest heard that many of the incidents recorded were filed as grade 2, which did not require an immediate response from police.

But the family still did not receive a visit from an officer on many occasions because there were not enough available.

Chris Tew, former Assistant Chief Constable of Leicestershire Police, admitted that many of the calls to police were not linked and were regarded as anti-social behaviour. On other occasions the reports were not passed on to the street's beat officer.

Ms Davison, Assistant Deputy Coroner for Rutland and Leicestershire, said: “The reporting system is that residents rang up and if there was something ongoing it's given a grade 2.

“It's infrequent that there any resources to respond and if it's graded 3 then there's not even a search for resources because the incident has stopped.

“It's quite difficult if you are a resident in that street to get it right.”

Mr Tew said anti-social behaviour was difficult to deal with in the street.

He said: “Anti-social behaviour often occurs in residential areas when no actual crime is being committed. There's no damage or assault and it doesn't pass the threshold for a crime.”

But Ms Davison disputed this, saying many of the attacks against the family could have been prosecuted in the courts.

She said: “It seems to me that, given the history and the context of the abuse, it would not have been anti-social behaviour but a crime because we had people being hounded in their own house.

“It's coming back to me now, it's Section 5 under the Public Disorder Act.”

It is known in medical circles as the Oscar Pistorius question: if an athlete with no legs can compete at Olympic level, why should an employee with a history of mental illness not be allowed the chance of holding down a decently paid job?

Richard Saville-Smith is posing precisely this question at an industrial hearing in Edinburgh, where he claims that he was dismissed from his high-powered public relations job with Scotland's tourist agency, despite a track record of achievement at executive level, because of an onset of bipolar disease, or manic depression.

The case is continuing, and the facts have not yet been established. But it is an important test not just of discrimination law, but of civilised values. There is no justification for bias these days against those who carry the burden and the stigma of mental illness.

Indeed the law forbids it. The Disability Discrimination Act specifically protects job applicants or employees from discrimination on the ground of serious mental impairment up to and including schizophrenia. The European Convention on Human Rights included it as recently as this year: no personnel office is unaware of the implications.

And yet the very phrase mental illness makes employers shrink. For all that we have learnt about the causes of mental illness, its likely course, and the ways it can be controlled, it remains one of the great taboos of society. It is seen as hard to predict, unstable, unreliable: qualities that do not encourage confidence in a future employer.

Unlike Pistorius, whose disability is hard to ignore, that streak of depression that hits you from time to time, or the bipolar episode that haunts you from the past, cannot be seen, defined or predicted. The Act deliberately refrains from offering a definition of mental impairment, and leaves it to the judgment of the individual, GP or employer to gauge its seriousness.

And so, if you are applying for a job, every instinct tells you to suppress all reference to the counselling you may have briefly had as a student, or the time when you were prescribed antidepressants to take you through a rough patch in your life. You know, and who is to gainsay it, that if you are just one of a dozen applicants for the post, that minor revelation, however buried in the past, is likely to be the element that flips your application on to the reject pile. No one will be able to prove that was why you were turned down, so any appeal is doomed.

So you decide to omit it. Yet, even as you do so, you know that if your little deception is found out, that really will finish your prospects. Attempting to demonstrate your sanity by airbrushing out any reference to a previous illness may well rebound against you. If the omission is detected, it will be seen, not just as a minor suppression, but as a failed attempt to conceal something really serious — your own insanity. Mental illness may be a drawback, but lying is terminal.

No one pretends that the decision is easy. The police, for instance, have to be aware of their responsibilities to the public — no one is going to be particularly impressed if an armed response team includes an officer prone to bouts of manic depression. But approaches vary from force to force. At Scotland Yard, all applicants have to fill in a medical questionnaire that asks specifically if they have any history of mental illness. They may then be called in for a medical assessment, and are judged case by case. At Lothian and Borders Police in Edinburgh, no past history is taken into account, but anyone suffering from a current mental illness is unlikely to be considered for an officer's job.

“Employers are nervous about mental illness, of course they are,” said one expert I spoke to. “But it is not as threatening as they think. We need to educate them more.”

This is not just a moral dilemma for a small minority. A World Bank international study of mental illness in 2000 found that it was second to heart disease as the greatest disability among employees. By 2020 it is expected to have reached No 1. Dealing with it is no longer a marginal concern.

Yet, understanding mental illness does not require a journey into an unknown world. As anyone with first-hand knowledge of it is acutely aware, what may seem a permanent condition to some is often nothing of the sort. It may, like a bout of flu, be treatable in days. It may linger for years and yet be well controlled by a chemical regime that is enough to suppress its more extreme symptoms. It may, from time to time, require a period of absence, but be matched by long bouts of well-balanced behaviour.

And the compensations make any minor inconvenience more than worthwhile — for it is frequently the most creative, imaginative and inspiring of colleagues who suffer from bouts of depression or even a bipolar condition that may, from time to time, take a more serious form.

By turning our backs on those who do not easily conform to our notions of the conventional, we are excluding those who may well surprise us by their innovation. And that is not just a bias against mental illness, it is a bias against achievement.

Nice idea, Dave. Cut ministers' salaries, dump a third of their chauffeur-driven chariots and bump up the price of subsidised Westminster tuck to a level that might ring a bell with the humble voter. Isn't that just what we want to hear when we're still reeling from the pong of all the nasty stuff that steamed into our nostrils during the MPs expenses scandal?

David Cameron thinks so. But as the newly demoted Alan Duncan has pointed out — unwisely but pertinently — there are limits. He didn't quite say, pay peanuts and you get monkeys, but he is not the first to understand that if you cut the funding of our political leaders to the bone, it will be difficult to attract able — and potentially high-earning — people into politics unless they are independently wealthy.

Peter Davies is not wealthy. He is a retired religious studies teacher, but as the Mayor of Doncaster, an English Democrat elected in June at the height of the MPs expenses debacle, he is already putting Cameron's ideas to the test. Davies slashed his own salary from £73,000 to £30,000, disposed of the mayor's chauffeur-driven Toyota Prius and plans to cut the number of the town's councillors from 63 to 21.

“People are suspicious of anyone in local government,” he says. “I thought, let's go back to the days when public service was important and people gave of themselves to the town, show the people of Doncaster that I'm here to serve them and not in it for any self-gain. Here's a different agenda, one that appears to coincide with what the man on the Clapham omnibus is thinking.”

Davies prides himself on saying what he thinks. He supports “harsh punishment for young thugs” and promises to run a no-frills value-for-money bureaucracy that will maintain essential services and eradicate what he regards as politically correct dead wood. Yet his tactics are raising questions, not least one that is applicable to Westminster at a time when it suddenly feels bound to cut the cost of its workforce. Has Davies, who has never previously held a publicly elected office, got the experience and nous to take on a big political job?

Prior to his administration Doncaster had been led by a socialist council for 35 years. Did the voters realise how right wing he is? “I don't think I am right wing. Labour voters will tell you they're in favour of capital punishment, they're fed up of Eastern European immigration. People can just wander into the country willy-nilly. Right, left and even centre have gone.” So where do you stand? “I don't know. I stand where the ordinary citizen stands who feels neglected by the three main political parties.” Do you support capital punishment? “Yeah, I do.” To what extent? Hanging? “I'm not bothered what the means is.”

It's the “don't know” words that are strange in a political context, and Davies uses them a lot. He wants to tackle antisocial behaviour but doesn't know how this will work, he wants to remove PC jobs but doesn't know where they are in his council, he doesn't know how much money he has saved because he hasn't yet added it up, and replies by working through the individual items. This may be honest, guileless and entirely lacking in spin — but do we want to be led by people who can't anticipate, who admit they don't have answers? Doesn't good leadership depend on a sense of confidence and certainty that provides security for those operating below?

We are in the mayor's office, a plain room in an ugly 1960s tower block once used by the National Coal Board. The grey walls are scuffed and there is no computer on Davies' desk — he doesn't use them, and neither does he accept calls on his mobile phone. It is hard to guage how his populist messages are going down in Doncaster — and whether Cameron might learn a lesson from him. Speak to people in the streets and it seems that they have yet to form an clear opinion, though he says his office has received 2,000 e-mails of support. There is a campaign against him on the internet, and there are others who dissect the moments when he has been unguarded and unprepared but the mayor doesn't read their rumblings.

If the majority have yet to make up their minds about him it is perhaps because while he is well-intentioned and has a remarkable lack of ego for a politician, he doesn't come across as a man who listens. Did he expect to be elected? “No.” Was he ready for it? “Yes.”

That is hard to believe. What did he mean when he wrote in his manifesto that he would scrap politically correct non-jobs “and encourage the former employees to seek meaningful employment”.

“It was a throwaway remark, wasn't it?” Can there be such a thing in politics? “My manifestos are truthful but there's an element of humour in there. I get quizzed on every nuance but my manifesto is going to be kept far more than any political party's has been kept in the past.”

Davies is 66, the son of a socialist butcher from a mining background, and a Conservative mother from a farming family. His childhood on a farm outside Doncaster was idyllic, and for the first ten years of his adult life he voted Labour.

In 1973 he attended a Mayday socialist rally, realised he didn't fit in, and joined the Conservative party three weeks later. Twenty years after that, when John Major signed the Maastrict treaty, Davies joined UKIP, but left when it split in 2000. He joined the English Democrats five years later, and supports its call for a separate English parliament.

“It's a very popular message, I tell you. Dead easy. You would reduce the number in Westminster, throw that lot out altogether, probably only need 50 of them to do things like defence and law and order.

“National politics should listen to what people want. What we've got is a patronising and condescending approach from the three main parties, they know best, there's no debate, completely out of touch with the public. We're full of professional politicians, people who have no experience in life of anything outside that cocoon of the House of Commons.”

True, Davies has lived outside that cocoon. He has spent 30 years entertaining children in classrooms, he maintains — “A teacher has got to be a ham actor” — and now he lives in a small detached house with his second wife and two cats, drives himself to work in a Nissan Almeira Twister, and uses his leisure time reading Thomas Hardy, watching cricket and betting to support his part-ownership of three horses. There are those who think he is admirable, others who would describe him as an amateur who is on a steep learning curve.

“If you tell people things as they are, and you're honest, then you're halfway there,” he maintains. “There's a difference between mistakes in policies or things that I don't do, and words and nuances.” Which will come as news to Westminster.

Britain now has one of the worst teenage drop-out rate of any developed country.

Only Turkey, Israel and Brazil have more 15 to 19-year-olds not in education, employment or training according to the report by the Organisation for Economic Co-operation and Development (OECD).

The UK also has among the highest numbers who fail to complete their higher education — with vocational courses having particularly low graduation rates.

The figures, from a wide-ranging study of the international education landscape before the recession hit, indicate that the situation for teenagers in the UK is now even more severe. Andreas Schleicher, of the OECD education directorate, said that young people are less well equipped to weather the storms of the economic crisis. “Those with better qualifications have better life prospects," he said. “At the other end [among those with fewer qualifications] there is rapid deterioration.

“It will get more difficult. Young people who become unemployed, stay unemployed. If you get out of the labour market it's going to be hard to return if you don't have qualifications.”

The UK has more than double the average number of teenagers not in some kind of work, training or education in the OECD.

It jumped from sixth to fourth worst between 2006 and 2007 with 14.5 per cent of 15 to 19-year-olds not in school, work, or training compared with 10.9 per cent in 2006 and 9.3 per cent the year before.

“Younger cohorts are typically more sensitive to changes in supply and demand for skills as they try to get a foothold in the labour market,” the report's authors said.

Jim Knight, the Employment Minister, admitted that there was still more to do to help young people.

"This report highlights the improvements made to the quality of the education young people receive. But in the current recession we are doing everything we can to ensure young people can still make the most of their talents and skills.

"We are investing £1 billion in the Future Jobs Fund which will create 100,000 jobs specifically for young people, giving them the vital first steps on the ladder."

The report also found that graduation rates in the UK have stalled. Britain has had a graduation rate of 39 per cent since 2004 — but the OECD average has now caught up, suggesting that Britain has reached its limit in terms of participation rates in higher education.

Mr Schleicher suggested that more private investment in tertiary education was needed if the UK is to increase its participation rate. This finding reinforces calls for an increase in tuition fees, expected in the Government's review of university funding to begin before the end of the year.

But the report's authors warn that increasing the number attending university will be detrimental for those without skills.

“If too many individuals with higher levels of education are entering the labour market young individuals with lower levels of education will find it increasingly difficult to find skilled jobs, increasing the advantage of older cohorts,” the report said.

The UK has increased its spending on education and is now at the OECD average of 6.1 per cent of GDP on schools and universities.

But Mr Schleicher warned against spending cuts during the recession, which he said was the time to invest in the education sector in order to drive economic recovery.

As our healing alternative, Healing Nations makes this very simple point:

Do not ask: 'what sort of teenage drop-outs does our country have?'

Ask instead: 'what sort of country are to have such drop-outs?'

So long as e continue to ignore the real need to recreate communities and neighbourhoods, we will not solve or heal our social and political problems.

Healing Nations. The practice, philosophy and language of healing and alternative medicine for ourselves, for our neighbourhoods and for our nations. The philosophy and language of healing and alternative medicine transferred into the social / political arena: transforming politics and communities and how our nations function. Healing Nations. The key to creating a society, to creating neighbourhoods, communities and nations, that will work for us all. HEALING, THE KEY TO THE 21ST CENTURY HEALING OURSELVES, HEALING NEIGHBOURHOODS, HEALING COMMUNITIES, HEALING POLITICS, HEALING NATIONS.

John Kampfner writes in the Times:

Why is it that so many people are willing to give up their freedoms in return for an easy life? The question goes to the heart of the political and economic crisis that is afflicting countries around the world, whether they are considered authoritarian or democratic.

This is what I call the pact . In each country it varies; citizens hand over different liberties in accordance with their own customs and priorities. In some it is press freedom; in some it is the right to vote out their government; in some it is an impartial judiciary; in others it is the ability to get on with their lives without being spied upon. The model for this new world order is Singapore, the state in which I was born, and which has long intrigued me. I am constantly struck by the number of well-educated people there who defend a system that requires an almost complete abrogation of freedom of expression in return for a good material life.

The pact belongs not just to states in transition such as Russia and China. It belongs also closer to home. Citizens in all systems have colluded, but in the West we colluded most. We had the choice to demand more of our governments, to rebalance the relationship between State and individual, but for as long as the consumerist going was good we chose not to exercise it. What mattered, particularly for the middle class, were “private freedoms” — the right to own property, to run businesses according to contract law, the right to travel unimpeded and the right to determine one's own personal life.

The unspoken trade-off was this: the State would resist the urge to intervene in the private realm as long as the citizen did not “cause trouble” in the public realm. Public freedoms became disposable.

During the past two decades of globalised glut, the pre-eminent freedom was financial — the right to earn money and to consume it unimpeded. Political leaders such as Gordon Brown even extol shopping as a patriotic duty. This, combined with the internet and other technological advances, created a cultural homogeneity not seen before. The super-rich, the quite rich and the aspiring rich, whether in Shanghai, São Paulo or South Kensington, inhabited a uniform world of the same designers, the same communications tools and the same holiday destinations. A cultural conformism was born, a herd mentality that provided an easy environment for those in power to operate in.

My travels took me to a beach party for the wealthy in Moscow (where they imported the sand from the Maldives), to a round-table discussion at a golf club in Shenzhen, to behemoths of excess in Dubai and Abu Dhabi, to maudlin conversations with sacked newspaper editors in Italy, which by any standards of political and constitutional theory is close to being a failed state. They took me to anti-corruption local politicians in Mumbai and to American liberals.

Nowhere, however, has left me as depressed as Britain. From ID cards and CCTV, to a national DNA database, to long periods of detention without charge, to restrictions on protest, to the most stifling libel laws of any equivalent nation, the UK Government has rewritten the relationship between State and the individual. In doing so, it has met little popular resistance.

For a decade, Britons enjoyed increasing prosperity, indulging in their favourite hobby of borrowing and spending money. The people that really mattered, the top 1 per cent, were pampered as never before. Tony Blair and Gordon Brown resisted all attempts to tax or regulate them. When I once wrote about Singapore that the State was “providing a modicum of a good life, and a quiet life, the ultimate anaesthetic for the brain”, I could have easily been referring to my own country. The tragedy is that Britain had an extraordinary opportunity to combine an emphasis on social justice with civil liberties. By the end of the new Labour era, not only are these liberties in jeopardy, but representative democracy has rarely been weaker.

Yet much of the rage directed at politicians is synthetic. It is hard to make the case that the people were duped. Blair and Brown had been fairly frank about their priorities. The role of government was to create the environment for wealth creation, and to use all the forces at the disposal of the State to stop those who threatened that good.

What does all this say about us and about our choice of freedoms? In the end, how important is public freedom? In Britain pockets of civil society remain strong. But how much change has it really brought about? How many fall into the category of troublemakers? What percentage of the population consists of NGOs, defence lawyers, dissenters or investigative journalists? How many people take part in marches? Participatory democracy has all but disappeared. And even where it has occasionally broken through into the mass consciousness, such as the huge anti-war march in London in 2003 on the eve of the Iraq conflict, it made no difference.

Will a new generation of world leaders produce something different and more inspiring, a post-crash version of freedom that inspires and addresses the many iniquities around the world? I fear the answer is a resounding “no”, although I hope I am proven wrong. People's priorities reflect the socio-economic conditions of their time. So although it may have been the bankers and hedge fund managers who caused the immediate mess, the bigger culprits were we, the people, particularly in the West, for allowing democracy to mutate into something it should never have become — a vehicle to deliver consumption.

In Britain, as elsewhere around the world, a critical mass of people vested in their leaders almost unlimited powers to determine questions of liberty. In return they were bought off by a temporary blanket of security and what turned out to be an illusory prosperity.

Freedom for Sale by John Kampfner is published today by Simon & Schuster

Simon Heffer writes: Since McKinsey and Co, the consultancy company, is not a registered charity, I presume it cost the taxpayer a substantial amount for the firm to conduct an efficiency review into the National Health Service. Having commissioned the report, the Department of Health took one look at its main finding – that 10 per cent of NHS staff should go in order to achieve efficiency savings – and rejected it. If you seek an example of how superbly the Government spends money, this is a magnificent one.

Any fool knows that the NHS is overmanned: perhaps not with doctors and nurses, but certainly with bureaucrats and support staff. Even the fools who run the Department of Health must have realised that if they asked McKinsey to do this job, it would find there were too many people on the payroll. To order this review and then to reject it immediately is completely obtuse.

Having read some of the findings of the report, even I would not agree with all of them. I doubt it is sensible, with our ageing population, to pursue a goal of fewer doctors and nurses. But it has long been apparent that the NHS is an organisation that exists as much for the benefit of many of those who work in it, as for those it purports to treat. It is also apparent that, despite numerous reforms since it began in 1948, it is shaped by an immediate post-war ideology that has about as much relevance today as Bile Beans and Craven "A"s. No private-sector health concern would begin to think of running itself as the NHS does: it would be bankrupt within weeks. But then no private-sector health concern has as its mission in life the provision of jobs for Mr Brown's client state.

Labour rejected McKinsey's plans because it deemed them politically unworkable. It is not prepared to have a mature conversation with the British people about how their right to a health service free at point of use would not be affected by a desire to secure better value, in an economy that is cruising towards bankruptcy. Sadly, the Tory party doesn't want to have this conversation, either. Feeling morally blackmailed by a climate in which public spending, irrespective of the value obtained from it, is a good thing, it too has dismissed McKinsey, though with the caveat of saying (quite rightly) that there are bureaucratic jobs that can be lost.

Given the expense of the NHS – more than £100 billion a year, or about a seventh of total public spending – cowardice about how to reform it is not an option. It is derelict of anyone who seriously wishes to govern this country to say that we can go on in the same bloated, welfarist way that we have pursued since 1948. For a failure to get costs under control will, sooner rather than later, ensure that those same vulnerable people the NHS is supposed to help are at risk of having very little decent care at all.

The bold move for a government to take would be to contract out the management of the NHS. Hospitals, then possibly even whole health authorities, should be franchised out to the private sector, to break the culture of jobbery and self-serving trade unionism that has handicapped the development of the NHS. The service would still be free at point of use: but it would be delivered more efficiently. As McKinsey found, some hospitals are abominably wasteful. The rescue of the whole NHS should start with them.

Of course, all our politicians can carry on claiming that value doesn't matter, and believing that there is a bottomless pit of money to run our health-care service. In the suffering this will inflict on patients in the long term, it reveals an utter unfitness to govern.

Daily Telegraph

NHS nurses aree criticised today for their cruel treatment of more than a dozen elderly patients. A report published by the Patients Association, a health watchdog, records 16 incidents of people left lying in their own faeces and urine, having call bells taken away from them and being left without food or drink. One former nurse told of the substandard care she received as a patient, describing her experience as “scary”. The Patients Association said one hospital had threatened it with legal action if it chose to publish the material, but added that there was a “striking similarity between many of the cases — nearly all of them centre on concerns over basic nursing and domiciliary care.” It urged the Government and the Care Quality Commission, the health regulator, to conduct an “urgent review of the standards of basic care” in hospital, and called for tougher inspections and regulations. Jayne Knowles Smith, 49, a nurse with 30 years' experience, said she witnessed “nursing from another angle as a patient” of the Gloucester Hospitals NHS Foundation Trust. “I'm not sure if it's the training that's lacking, the basic skills or just understaffing,” she said. She criticised the way fluids were taken from her and then monitored in the treatment of her heart disease. Other examples of poor care included that of the late Professor Leslie Vaughan, 81, a leading vetinary surgeon who was fitted with a leaking urinary catheter while being treated for stomach cancer. The hospital involved, run by West Hertfordshire Hospitals NHS Trust, said it had responded to a complaint and had expressed its “sincere condolences”. Adrian Goddard, following the death of his 82-year-old mother, Pamela, claimed she was “often found in her own faeces and urine” at the Royal Surrey County Hospital, before she suffered an “agonising death from a bedsore”. Surrey and Sussex Health NHS Trust said it was carrying out an investigation after receiving a complaint about Mrs Goddard's treatment. In a foreword to the report, compiled from a database of complaints received by the association, Claire Rayner, the organisation's president, said she was “sickened” by the incidents, and called for the nurses responsible to be struck off. “For far too long now, the Patients Association has been receiving calls on our helpline from people wanting to talk about the dreadful, neglectful, demeaning, painful and sometimes downright cruel treatment their elderly relatives had experienced at the hands of NHS nurses,” she said. The former nurse and television agony aunt, added: “I am sickened by what has happened to some parts of my profession of which I was so proud. “These bad, cruel nurses may be — probably are — a tiny proportion of the nursing work force, but even if they are only 1 or 2 per cent of the whole they should be identified and struck off the register.” Katherine Murphy, the charity's director, added that the stories were often about the most vulnerable elderly and terminally ill patients. “These accounts reveal patients being denied basic dignity in their care — often left in soiled bed clothes, being given inadequate food and drink, having repeated falls, suffering from late diagnosis, cancelled operations, bungled referrals and misplaced notes. “There are also worrying instances of cruel and callous attitudes from staff towards vulnerable and sometimes terminally ill patients.” The Government's chief nursing officer, Christine Beasley, said that all patients deserve the highest quality of care from the NHS but added that the report did not reflect the majority of people's experiences. “The poor care received in these cases is simply unacceptable. “Where care falls below expected standards, this can be distressing for the patients concerned and their families and we expect trusts to take immediate action to investigate and ensure this does not happen again.” “The NHS treats millions of people every day and the vast majority of patients experience good quality, safeand effective care - the Care Quality Commission's recent patient experience survey shows that 93 per cent of patients rate their overall care as good or excellent.” Peter Carter, chief executive of the Royal College of Nursing (RCN), added: “We will not condone nurses who behave in ways that are contrary to the principles and ethics of the profession. “However, we believe that the vast majority of nurses are decent, highly skilled individuals.”

As our healing alternative, Healing Nations says that so many of the problems that occur in the British National Health Service have nothing to do with resources but having everything to do with the size of the organisation. The National Health Service is the third largest employer in the world. Local accountability is vital. Neighbourhoods need to have real input into how their hospitals are run. National guidelines can operate, but local communities need to ensure that those guidelines are followed. We should also be looking to involving patients' families far more. If doctors and nurses are freed to concentrate on medical and cleanliness issues, and families and volunteers are employed to concentrate on care issues, we could transform not only the service we are able to give our patients but also the atmosphere and moral of our hospitals. Healing Nations. The practice, philosophy and language of healing and alternative medicine for ourselves, for our neighbourhoods and for our nations. The philosophy and language of healing and alternative medicine transferred into the social / political arena: transforming politics and communities and how our nations function. Healing Nations. The key to creating a society, to creating neighbourhoods, communities and nations, that will work for us all. HEALING, THE KEY TO THE 21ST CENTURY HEALING OURSELVES, HEALING NEIGHBOURHOODS, HEALING COMMUNITIES, HEALING POLITICS, HEALING NATIONS.

There was a time when characters in children's books enjoyed wonderful adventures after which they all lived happily ever after. By contrast, a former children's laureate warns, reality weighs heavily on today's young readers. Anne Fine says that cosy tales in which children's characters looked forward to future adventures has been replaced by gritty stories that offer no hope for their protagonists. Contemporary literature is dauntingly bleak, with depressing endings that do little to inspire. “In the Fifties, when a strong child was dealing with difficult circumstances, there was always a rescue at the end of the book and it was always a middle-class rescue,” she says. “The child would win a scholarship to Roedean or something, and go on to do very well. That was felt to be unrealistic and so there was a move away from that. Books for children became much more concerned with realism, or what we see as realism. “But where is the hope? How do we offer them hope within that? It may be that realism has gone too far in literature for children. I am not sure that we are opening doors for children who read these books, or helping them to develop their aspirations.” The bestselling writer makes her comments at Compelling Novels, Vulnerable Children, an event organised by the umbrella group Children in Scotland for the Edinburgh Book Festival. She says she does not want to see a return to the standards of Enid Blyton, but she is worried about the effect that gloomy books can have on children. “I can't see how we roll back from this without returning to the sort of fiction that is no longer credible — books with a Blyton-ish view of things.” Her concerns are not shared by Anthony Browne, the current Children's Laureate, who believes that a lot of children's literature remains upbeat. “There are both types of endings, happier and unhappier. I prefer open endings. I don't think we are living in an age of depressing, dark endings. If you look at Jacqueline Wilson, she does deal in gritty realism, but her books don't lack aspiration.” He recently changed the ending to his forthcoming book — Me and You, a retelling of Goldilocks and the Three Bears in which Goldilocks comes from an impoverished background — so that the ending was less miserable. “My original version had Goldilocks being chased out of the bears' house and her ending up on bleak, dark streets. I decided to give it a more ambiguous ending, so now she is running toward something that may or may not be her mother.” Fine was accompanied on the panel at the book festival talk by Melvin Burgess, whose children's books have dealt with child abuse in a care home and teenage heroin abuse. Burgess argued that young people had a right to know about the seamier side of life. “I think well-informed young people are better able to deal with things they may come across,” he said. “I have had letters talking about the humanity of my books, even when the situations the characters are in are very dark and difficult. Just the fact that they are still making jokes and falling in love. Perhaps the light of hope comes from the reader and not the story.”

Great ape guide to a Great Reform Act We need to rediscover personal familiarity in our political life, says the creator of Yes, Minister. But how? The answer lies in the history of human evolution In 1962 I became editor of Tonight , a nightly topical programme on BBC television. My first crisis was Don Haworth's decision to apply for a producer post in Manchester. It was a crisis because Don was our best film director. He did not want to leave, but he needed the extra money. I tried to get his salary increased, but he was already at the upper limit of his grade, so I failed. On the same day, I had a visit from Administration. They had a crisis, too: they had underspent on their office furnishing budget. Would I like new carpets, curtains and chairs? The amount available was more than it would have taken to keep Don in London, and, since our furnishings were fine, I asked if Don could have the money instead. As anyone who has worked in a government bureaucracy could have foretold, it was completely out of the question. Administration would never transfer a penny to Personnel, and even if they would, Personnel was handcuffed by the BBC's grade structure and remuneration policy. I mention this incident because it was the point at which I realised the folly, waste and destructive nature of bureaucracy. The higher up decisions are made, the worse they are likely to be. The higher up money is spent, the more likely it is to be wasted. Bureaucratic empire-building is not a distortion of the natural order, but a response to a basic human need. People in large organisations will always strive to enlarge their staff, increase their budgets and widen their areas of authority and jurisdiction. It is a cancerous growth. Over the past 200 years, central government has sucked authority, decision-making and independence out of local communities. It has drained money out of the pockets of citizens, and has created a vast proliferation of tribunals, inspectorates, regulatory authorities, quangos and councils. In addition, central government has taken on an army of consultants, advisory committees, czars, action groups and task forces, and printed millions of questionnaires, guidance notes, instructions, licences, tick boxes and leaflets that, between them, have created the bureaucratic nightmare of 21st-century Britain. What is remarkable about this change is that no one set out to make it happen. No plan, no plot, no conspiracy. But the effect is, as more and more observers have been pointing out, that the people of Britain are not represented in Parliament, but governed by a self-serving, almost unaccountable political class. It may be that the parliamentary expenses scandal will provide the impetus for change. But what change? If we are to reform our inefficient and unrepresentative political system, we must rediscover and reinstate the personal knowledge, the common interest, the trust and the day-to-day, face-to-face familiarity that holds groups together and enables them to function as political units. And over the past 50 years or so, it has become apparent that we carry the answer within us. The study of evolution, in particular of the social evolution of the great apes, has revealed that we have a natural group size — or to be more exact, a number of natural group sizes — which have taken us down from the trees and up to the Moon. Any system that is to work must follow our evolutionary nature. For millions of years, we evolved as primates in groups of 50 or so, which is still the size of a normal group of our nearest relatives, the gorillas and chimpanzees. Although we split from them about six million years ago, this group size persisted. It is found everywhere: small businesses, departments of larger ones, common rooms, military squadrons. It is a size people are happy with. You know everyone, you know what they do and how well they do it; you notice when they are not there. Any system of representative government must re-create these evolutionary groups. It is not a big deal. All that is required is a street representative for each group of 20 to 30 households, available to hear queries, complaints or suggestions, and calling occasionally to give information or warnings. Through their street representative they are locked into the community. This platform of existence, many millions of years old, continues today with the gorillas and chimpanzees. But some time after our ancestors, the hominims, split from them, a profound change took place. That change was the emergence of the tribe. It did not mean losing the primate group; that is still within us all. It meant the coming together of a number of groups, so that instead of rival groups of 50 to 60 individuals roaming the area, the landscape was dominated by co-operative groups of 500 to 600, who formed a single social unit.This number of around 600 is firmly in our nature. It is as large a group as we can belong to, where we can all know each other. When the hunting tribes turned to agriculture 10,000 years ago, it became the farming village. As industry developed, it became the mill or pit village. Right into the 19th and 20th centuries, tribe membership was lifelong: cities grew up, but around and within them, the tribe where you were born and raised, where you lived, worked and died, formed the limits of the human world that supported your existence and defined your identity. Look around the developed world and you find tribes everywhere. Not birth-to-death tribes, but working communities of a few hundred people (often within large organisations) who spend most of the week in contact with each other. Armies come in all shapes and sizes, but the building blocks are battalions and regiments of 500 to 600. That most decimal of people, the Romans, had a tent of 10, and 100 men under a centurion, but each unit was the cohort of 600. Practical businessmen will tell you that 400 to 750 is the largest number that a single boss can run. Private schools that are free to choose their own numbers usually stop at 600, even if it is profitable to accept more. Actors will tell you that a full house of 600 is the most satisfying to play to; something is lost when the audience gets bigger than 1,000 (indeed, a few hundred is the largest number that can reasonably be addressed by the unaided human voice in the open air). So a tribe of 600 members is the largest possible natural unit of the human community. And yet, outside rural areas, this ancient grouping has no administrative recognition. There is no problem about putting this right, since outside large towns and cities, the basic structure is retained in parish councils. So the first necessary reform is to create city villages, areas of some two or three hundred households, electing their own village councils (the street representatives). Any reform that leaves money and power in the same hands will be ineffectual tinkering. The city village councils must have a budget, and they must have the authority to make some decisions — on their playschools or parking restrictions — that affect the community. Some experts believe there is one other unit which has its genetic base in human evolutionary history. They put this last unit, the supertribe, at 6,000. This would comprise ten tribes, ten being the largest practicable number for the ancient- human hunting band or the modern committee. The leaders of the tribes form the supertribe's leadership. The supertribe, the market town of a few thousand, is a number we have been happy with over the centuries. It can be self-sufficient in a way that a village of a few hundred cannot. Our cities are full of these potential market towns; 6,000 is the sort of number that can support a shopping parade, a school and all the services for everyday living. It is not that long — a few hundred years — since towns that size ran themselves with minimum help or interference from above. They still could. Six thousand may sound a small number, but a government budget of £600 billion means that such a group contributes and consumes £100 million a year. At the moment, each citizen deals separately with an absurd range of government institutions, whereas almost all of these transactions could be carried out at the offices of his city township. Creating suburban townships would not simply involve removing work from the bloated centralised agencies. It would mean turning the whole system on end and running Britain from the bottom up. Of course, there will be services the city townships will need higher authorities to provideand there will have to be equalisation payments from rich areas to poor areas. And the State will need armed services, a foreign service, a Treasury. But once the huge mass of work dealing with individuals has been handed back to the townships, the size, cost and complexity of the higher levels of government would be drastically reduced. Central taxation would be slashed and replaced by local taxation, raised and spent by the townships. Local people have a strong incentive to economise — it reduces their tax payments. All this may sound like abstract theorising. In fact, it is the rediscovery of something we have known and possessed for a long time, but have unintentionally lost. The restoration of city villages and townships means getting government back in line with our evolutionary nature — humanising it. It's time to rediscover lost truths. The time for a new Great Reform Act has come. — A New Great Reform Act by Antony Jay will be published by the Centre for Policy Studies on 17 July.

Hundreds of secondary schools across Britain are wondering if they are still on a government hit list. Last year they failed to reach the government's minimum target of 30 per cent of pupils gaining five or more GCSEs, including English and maths. However, as an example one head teacher has still not heard from the government as to whether they have now been take off the hit list. The head teacher says: “We have moved from a failing school to being above the national average. But we have not heard from anybody what this means. Nobody has confirmed whether or not we will remain in the National Challenge... If the National Challenge brings me a string of advisers, I don't want anything to do with it. If they give me cash to hire more English and maths teachers so I can reduce class sizes, then I'll have it. Ben Slade, principal of Manor Community College in Cambridge, is also unsure of his school's current status. “There has been no communication with schools apart from a folder with cartoons on the front and a letter from Ed Balls saying we have got to come together to make schools better. Nowhere in any of this information is there anything to say that if you do well you will be taken off (the hit list). We have been offered no extra money, nothing has come to us and they don't even know how much money is available, everyone is poking around in the dark waiting for the next announcement from the Government.”

1. As our healing alternative, Healing Nations says there must be services to which we can relate, to which we can feel we have ownership. Part of our problem is that we just feel like numbers. In terms of our health, these proposals could have us feeling like mere pieces of meat, mere presenters of symptoms. Healing Nations. The practice, philosophy and language of healing and alternative medicine for ourselves, for our neighbourhoods and for our nations. The philosophy and language of healing and alternative medicine transferred into the social / political arena: transforming politics and communities and how our nations function. Healing Nations. The key to creating a society, to creating neighbourhoods, communities and nations, that will work for us all. HEALING, THE KEY TO THE 21ST CENTURY HEALING OURSELVES, HEALING NEIGHBOURHOODS, HEALING COMMUNITIES, HEALING POLITICS, HEALING NATIONS.

2. As our healing alternative, Healing Nations says to give us a sense of ownership it should not be central government that is forever deciding how our services should be structured. This should be decided at a local level. British politics needs to change. Politicians need to change. The entire political system needs to change. Healing Nations. The practice, philosophy and language of healing and alternative medicine for ourselves, for our neighbourhoods and for our nations. The philosophy and language of healing and alternative medicine transferred into the social / political arena: transforming politics and communities and how our nations function. Healing Nations. The key to creating a society, to creating neighbourhoods, communities and nations, that will work for us all. HEALING, THE KEY TO THE 21ST CENTURY HEALING OURSELVES, HEALING NEIGHBOURHOODS, HEALING COMMUNITIES, HEALING POLITICS, HEALING NATIONS.