Dr Bala Kovvali: Doctor who travelled from India to work in Britain failed to send seriously ill diabetic man to hospital hours before he died

• Dr Bala Kovvali failed to recognise diabetic ketoacidosis
  
• Andre Fellow had no history of diabetes but his body ran out of insulin
• Kovvali, 64, admitted causing the death by gross negligence

By Anna Edwards

PUBLISHED: 12:32 EST, 12 February 2013 | UPDATED: 13:29 EST, 12 February 2013

An out-of-hours doctor has been jailed for two-and-a-half years for manslaughter after he failed to send a seriously ill diabetic man to hospital - diagnosing him as 'depressed with a headache'.

Dr Bala Kovvali ignored the classic signs of diabetes-related poisonous acids building up in 42-year-old Andrew Fellows' body, a court heard.

Instead of dialling 999 for an ambulance, the on-call locum told Mr Fellows' mother that her son was depressed and had a headache and should see his own doctor the next day.

Less than nine hours later Mr Fellows died at home from diabetic ketoacidosis.

Sheffield Crown Court heard how Mr Fellows became thirsty in the week before he died

A test which takes less than a minute would have alerted the GP to raised blood-sugar levels and it is 'virtually certain' Mr Fellows would have survived with an insulin injection and rehydration.

Jailing the doctor Judge Roger Keen told him: 'It was criminal negligence and a wholly preventable death followed.'

Experts who examined the case said any competent doctor would have recognised the classic symptoms of ketoacidosis and Dr Kovvali's breach of duty to his patient was 'appalling and gross.'

It was revealed at Sheffield Crown Court that the GP was based in India but flew to Britain to work every summer for two or three months for the nationwide doctors' deputising service Primecare.

He was arrested in the United States and extradited after a Sheffield coroner adjourned an inquest into Mr Fellows' death for police investigations.

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Father-of-two Kovvali, 64, admitted causing the death of Mr Fellows by gross negligence in failing to carry out an adequate clinical assessment, failing to send Mr Fellows to hospital as an emergency and failing to diagnose diabetic ketoacidosis from which he died.

Michael Burrows QC, prosecuting, said Mr Fellows, who lived with his family in Handsworth, Sheffield had no medical history of diabetes but suffered from anxiety and depression.

In the week before his death, the painter and decorator was working outside and became restless and began drinking huge quantities of water. Both he and his mother Brenda believed he had caught sunstroke.

When her son's condition worsened Mrs Fellows called Primecare at 17.50 on June 4, 2009.

She told a triage nurse her son was 'very muddled and mumbling', his breathing was erratic and his eyes were sunken with his breath smelling odd 'like pear drops.'

She was asked about his depression and replied: 'He had had episodes before but if this is depression I've never seen one as bad as this.'

Dr Kovvali was asked to attend Mr Fellows and arrived at 21.13. Mrs Fellows expected her son to be taken to hospital and had even packed a bag for him.

He had now decided to quit as a doctor and 'will not be working in the UK ever again'?

Mrs Fellows asked if her son was in a coma or had an infection and specifically if he might be diabetic. 'She says Dr Kovvali shook his head to all these questions,' said Mr Burrows.

'According to Mrs Fellows, Dr Kovvali did not have any equipment with him and did not examine her son. He said he was depressed and advised that he should see his own GP the following day for his medication to be reviewed.'

After the doctor left, Mrs Fellows gave her son something to drink but he could not swallow.

He appeared so dehydrated she gave him an ice cube at 1am. She returned at 6am to find him dead in bed.

The court heard Mr Fellows had basically run out of insulin in his body. It switched to burning fatty acids and produced acidic ketones.

When ketones are produced in excess the blood becomes more acidic and blood-sugar levels rise leading to a coma which can be fatal.

Professor of Forensic Medicine Ian Wall, who reviewed the case, said he considered the patient's confusion, thirst, smell, sunken eyes and inability to answer were 'classic symptoms of ketoacidosis.'

Dr Kovvali should have checked sugar levels in the patient's blood or urine and he should have been immediately admitted to hospital 'where he could have been treated or saved.'

Professor Robert Tattersall, a retired professor of clinical diabetes, said the GP's records were 'grossly deficient' and he could and should have measured blood sugar.

'It would have taken less than a minute and shown high blood sugar levels. Dr Kovvali should then have called for for an ambulance as an emergency... the failure to diagnose his condition was the main cause of death.'

Dr Kovvali, who worked as a GP in Sheffield from 1981 to 1988 before returning to India, was arrested in the United States on August 27, 2012 and brought back to the UK.

When questioned he admitted he had a blood-sugar testing kit in his car which he failed to use.

It was clearly criminally negligent and a wholly preventable death followed?

Just a fortnight after Mr Fellows died, Dr Kovvali attended another patient Christopher Timms who had been diagnosed with type 1 diabetes and prescribed insulin.

He felt unwell but the GP told him not to take his insulin as well as failing to examine him or test for ketones.

A consultant said the advice to stop taking insulin was 'wholly inappropriate' and lack of insulin would have put the patient 'in a life-threatening situation in a matter of hours.'

In a victim impact statement Mrs Fellows said that to test her son's blood 'would have been such a small thing to do but that one small thing would have saved her son's life.'

Stephen Climie QC, defending, said the doctor had 'misdirected' himself.

He had a particular interest in mental health matters and coupled with Mr Fellows not taking his medication it led him to rule out diabetes as a risk factor.

He qualified as a doctor in India in 1973 and came to the UK a year later. He completed his training before becoming a GP and had been subject to appraisals in the years leading up to these events. 'He is not allowed to practise without supervision,' said Mr Climie.

He had now decided to quit as a doctor and 'will not be working in the UK ever again.' His wife back in India was ill and lived alone and had been badly affected by his arrest.

Judge Keen told Kovvali: 'You have devoted your working life to caring for others. I have seen glowing references as to your competence, empathy and thoughtfulness.

'It is a tragedy for you that this brought about an end to your career, destroyed your good character and your ability to work in this country.'

He went on: 'However the nature of your offending is too serious for anything other than a custodial sentence.

'You failed to recognise Mr Fellows' condition despite the fact that all the classic signs of a diabetic condition were present.'

He had opted for a diagnosis that was contrary to all the evidence. 'That was a gross breach of your duty of care,' said the judge. 'An expert has called your decision appalling. I agree. It was clearly criminally negligent and a wholly preventable death followed.'

After the hearing Mrs Fellows said: 'We want everyone to know how much we loved Andrew. He was a loving son, brother, grandson, uncle, nephew and cousin and his death has caused a huge hole in the lives of everyone who knew him.

'He was honest and upright, funny and sensitive. He loved science and nature and was very proud of the fact that he got a BSc degree later in life.

'He was known to his friends as "Fell" and was described by them as the man with the hundred watt smile.'

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Source: http://www.dailymail.co.uk/news/article-2277607/Dr-Bala-Kovvali-Doctor-travelled-India-work-Britain-failed-send-seriously-ill-diabetic-man-hospital-hours-died.html?ITO=1490&ns_mchannel=rss&ns_campaign=1490

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Home altitude tied to obesity risk

NEW YORK (Reuters Health) - Americans who live where the air is thinnest are less likely to be obese than those in low-lying areas, according to a new study.

The results don't mean people should move to higher altitudes to lose weight, said study lead author Dr. Jameson Voss. But the work suggests that elevation may be part of obesity puzzle.

Based on data for more than 400,000 people in the U.S., researchers found Americans living closest to sea level were four to five times more likely to be obese, compared to people who live well above sea level in Colorado.

"I was surprised by the magnitude of the effect? I wasn't expecting such a consistent pattern as what was emerging," said Voss, from Uniformed Services University of the Health Sciences in Bethesda, Maryland.

About 36 percent of American adults are obese, according to the U.S. Centers for Disease Control and Prevention (CDC). Rates vary across the country, however, with a higher percentage of obese adults in southern states. Western states, such as Nevada and Colorado, report the fewest obese adults.

The reasons behind the difference in obesity prevalence between states are unclear, according to Voss and his colleagues, who published their findings in the International Journal of Obesity.

One possible explanation, they write, is differences in elevation, which can affect appetite hormones, growth and how many calories the body burns.

Cynthia Beall, who researches how the body adapts to high altitudes but was not involved with the new study, said it's common for travelers to high elevations to burn more calories in their first few weeks.

"That person would probably lose some weight during the course of a three week vacation? It would in fact be an interesting question whether that would sustain," said Beall, a professor of anthropology at Case Western Reserve University in Cleveland.

To examine obesity rates at different altitudes, the researchers combined information from several databases, including a telephone health survey of 422,603 Americans from 2011.

The researchers had information on 236 people who lived at the highest altitude of at least 3,000 meters (about 9,800 feet) above sea level. Those people all lived in Colorado and tended to smoke less, eat healthier and exercise more.

The researchers also had information on 322,681 people who lived in the lowest altitude range - less than 500 m (about 1,600 ft) above sea level.

After taking into account other factors that could influence the results, the researchers found adults living in the lowest altitude range had a Body Mass Index (BMI) - a measurement of weight in relation to height - of 26.6.

That compared to people who lived in the highest altitude range, who had a BMI of 24.2.

A healthy BMI falls between 18.5 and 24.9, and obesity is a score of 30 or more, according to the CDC.

Voss and his colleagues also found a drop in the risk of a person being obese was tied to every 200 m (about 660 ft) increase in elevation.

"It provides some evidence that these associations persist over the long term," Voss said.

RETIREMENT PLAYS A ROLE?

But Beall cautioned that the new findings don't prove the higher altitude prevented people from being obese.

For example, she said that other researchers have found that people living in Colorado's higher altitudes move to lower altitudes when they get sick with chronic diseases.

Voss said that he and his colleagues tried to adjust for retirement and population loss, but they write that they were not able to see how long each person actually lived at a certain elevation.

Beall told Reuters Health that it would be interesting to take a closer look at the people living in Colorado, and to see whether their obesity prevalence would change if they move to a lower altitude.

"I know from my own self that when I come back to my own activities and diet, I come back to my own weight too," she said.

SOURCE: http://bit.ly/WEWACs International Journal of Obesity, online January 29, 2013.

Source: http://news.yahoo.com/home-altitude-tied-obesity-risk-160612089.html

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Regeneron says Sanofi plans to buy more stock

NEW YORK (AP) -- Regeneron Pharmaceuticals Inc. said Monday that the French drugmaker Sanofi, its partner on a recently approved cancer drug, intends to buy more shares of Regeneron stock.

The Tarrytown, N.Y., company said it received a notice about the planned transaction from the Federal Trade Commission. The notice said Sanofi intends to own more than $500 million in voting shares. Sanofi is Regeneron's largest shareholder. It owns about 15.8 million shares of Regeneron, which is worth about $2.6 billion and is a one-sixth stake in the company.

Under the terms of the agreements between the two companies, Sanofi is not allowed to own more than 30 percent of Regeneron's Class A stock and common stock. However Sanofi said it does have the right to buy more shares and may do so. It described the filing as a technical move, and added that it is "very happy" with its relationship with Regeneron and has no plans to take a controlling stake in the company.

Shares of Regeneron rose $6.50, or 3.9 percent, to $172.38 after being halted early in the day. Earlier the shares gained as much as 10.1 percent. Regeneron stock is up more than 60 percent over the last year and reached an all-time high of $188.95 in November.

Sanofi and Regeneron collaborate on the cancer drug Zaltrap. The Food and Drug Administration approved Zaltrap as a treatment for colorectal cancer, and the companies are marketing it together in the U.S. European regulators approved the drug Tuesday. The two companies are also studying treatments for rheumatoid arthritis, "bad" cholesterol and asthma. They are also working on other cancer drugs.

Regeneron also makes the eye drug Eylea, a treatment for "wet" age-related macular degeneration and for macular edema with central retinal vein occlusion. It expects to report $790 million to $815 million in sales of the drug in 2012, including about $230 million to $250 million in the fourth quarter.

Regeneron will report its quarterly results Thursday.

Source: http://news.yahoo.com/regeneron-says-sanofi-plans-buy-160448509.html

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Folic Acid Before Pregnancy Linked to Lower Autism Risk, Study Finds

Feb 12, 2013 7:01pm

Credit: Getty Images

Folic acid has been?recommended?to pregnant women for years, usually as a way to prevent birth defects?such as spina bifida.

But a new study published today in?the Journal of the American Medical Association?found it may also prevent autism.

The study comes at a time when pregnant women are increasingly worried about how their actions will affect their growing fetuses ? from eating certain foods to getting vaccines to dying their hair.

?Many women have significant concerns, anxiety and stress during pregnancy about the things that they eat, consume or come into contact with in an environmental sense,? said Dr. Jennifer Ashton, a senior medical contributor to ABC News.

The JAMA study, which used data from the Norwegian Mother and Child Cohort Study, found that mothers who took folic acid four weeks before and eight weeks after pregnancy had a 40 percent reduced risk of giving birth to a child with autism. While the researchers found an association between folic acid deficiency and autism, that does not mean that folic acid taken during pregnancy?would?result in fewer autism cases.

?We know that folic acid deficiency leads to defects in the development of the nervous system,? said Dr. Ari Brown, a pediatrician in Texas, who was not involved in the JAMA study, referring to spina bifida. ?So it would not be surprising that a deficiency might also affect brain development in other ways.?

The Norwegian Mother and Child Cohort Study? followed more than 85,000 babies born between 2002 and 2008, and their parents. About 270 babies whose parents participated in the study were born with a developmental disorder on the autism spectrum.

Mothers reported whether they were taking folic acid before and during early pregnancy before they found out whether their children had autism, which eliminated some potential bias, said molecular epidemiologist Rebecca Schmidt, a professor at the University of California, Davis School of Medicine. In 2011, Schmidt was one of the first scientists to?publish a study that found that autism arises because of both genetic and?external factors, including women?s prenatal vitamin intake before conception.

?Given the replication of findings showing reduced risk of autism associated with folic acid supplements taken near conception, more research is needed to investigate whether this association is causal,? she said. ?Interestingly, both studies reported ? a nearly 40 percent reduction in risk for autism.?

The number of children with autism spectrum disorders in the United States rose to?one in 88 in 2012, up from?one in 110 in 2006, according to the Centers for Disease Control and Prevention.

It is not clear whether mothers who did not take folic acid had other risk factors for bearing children with autism, said Dr. Schlomo Shinnar, a professor of neurology at the Albert Einstein College of Medicine in New York. ?He?said that the Norwegian study population was also more?homogeneous?than the population in the 2011 University of California, Davis study, and that Norway might have different diagnostic tests for autism spectrum disorders than we do in the United States.

?The findings are of great interest,? Shinnar said.

Alfred Romeo, a counselor at the Organization of Teratology Specialists affiliate in Utah, said he works on a hotline set up for pregnant women who are worried about how their medications, vaccines and food choices will affect their unborn children. Romeo?s center gets about 9,000 calls a year from 10 states.??Autism is a hot topic,? he said. ?We?re watching all the research studies to see if anything increases or decreases the rate of autism.? The organization has not yet reviewed the JAMA?study.

Ashton said she tries to help the patients in her OB/GYN practice to weigh the benefits and risks of things that might affect their pregnancies, such as medications, chemical exposure or foods. She said she knows from her own pregnancy how confusing and frightening it can be, and she aims to alleviate some of that by reassuring mothers that fetuses are resilient.

?Society can sometimes do a really good job of laying blame and guilt, and when there is no medical proof that it is the mother?s fault,? she said.? ?I usually tell women pregnancy is no different than parenting. ?There are never 100 percent guarantees of anything.?

Source: http://abcnews.go.com/blogs/health/2013/02/12/folic-acid-before-pregnancy-linked-to-lower-autism-risk-study-finds/

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Body slam for wrestling: Sport cut from Olympics

LAUSANNE, Switzerland (AP) ? For wrestling, this may have been the ultimate body slam: getting tossed out of the Olympic rings.

The vote Tuesday by the IOC's executive board stunned the world's wrestlers, who see their sport as popular in many countries and steeped in history as old as the Olympics themselves.

While wrestling will be included at the 2016 Olympics in Rio de Janeiro, it was cut from the games in 2020, which have yet to be awarded to a host city.

2004 Olympic Greco-Roman champion Khasan Baroev of Russia called the decision "mind-boggling."

"I just can't believe it. And what sport will then be added to the Olympic program? What sport is worthy of replacing ours?" Baroev told the ITAR-Tass news agency. "Wrestling is popular in many countries ? just see how the medals were distributed at the last Olympics."

American Rulan Gardner, who upset three-time Russian Olympic champion Alexander Karelin at the Sydney Games in an epic gold-medal bout known as the "Miracle on the Mat," was saddened by the decision to drop what he called "a beloved sport."

"It's the IOC trying to change the Olympics to make it more mainstream and more viewer-friendly instead of sticking to what they founded the Olympics on," Gardner told The Associated Press in a telephone interview from Logan, Utah.

The executive board of the International Olympic Committee reviewed the 26 sports on its summer program in order to remove one of them so it could add one later this year. It decided to cut wrestling and keep modern pentathlon ? a sport that combines fencing, horse riding, swimming, running and shooting ? and was considered to be the most likely to be dropped.

The board voted after reviewing a report by the IOC program commission report that analyzed 39 criteria, including TV ratings, ticket sales, anti-doping policy and global participation and popularity. With no official rankings or recommendations contained in the report, the final decision by the 15-member board was also subject to political, emotional and sentimental factors.

"This is a process of renewing and renovating the program for the Olympics," IOC spokesman Mark Adams said. "In the view of the executive board, this was the best program for the Olympic Games in 2020. It's not a case of what's wrong with wrestling; it is what's right with the 25 core sports."

According to IOC documents obtained by the AP, wrestling ranked "low" in several of the technical criteria, including popularity with the public at the London Games ? just below 5 on a scale of 10. Wrestling sold 113,851 tickets in London out of 116,854 available.

Wrestling also ranked "low" in global TV audience with a maximum of 58.5 million viewers and an average of 23 million, the documents show. Internet hits and press coverage were also ranked as low.

The IOC also noted that FILA ? the international wrestling federation ? has no athletes on its decision-making bodies, no women's commission, no ethics rules for technical officials and no medical official on its executive board.

Modern pentathlon also ranked low in general popularity in London, with 5.2 out of 10. The sport also ranked low in all TV categories, with maximum viewership of 33.5 million and an average of 12.5 million.

FILA has 177 member nations, compared to 108 for modern pentathlon.

Modern pentathlon, which has been on the Olympic program since the 1912 Stockholm Games, was created by French baron Pierre de Coubertin, the founder of the modern Olympic movement.

It also benefited from the work of Juan Antonio Samaranch Jr., the son of the former IOC president who is a UIPM vice president and member of the IOC board.

"We were considered weak in some of the scores in the program commission report but strong in others," Samaranch told the AP. "We played our cards to the best of our ability and stressed the positives."

Klaus Schormann, president of governing body UIPM, lobbied hard to protect his sport's Olympic status and it paid off in the end.

"We have promised things and we have delivered," he said after Tuesday's decision. "That gives me a great feeling. It also gives me new energy to develop our sport further and never give up."

The IOC executive board will meet in May in St. Petersburg, Russia, to decide which sport or sports to propose for 2020 inclusion. The final vote will be made at the IOC session, or general assembly, in September in Buenos Aires, Argentina.

Wrestling will now join seven other sports in applying for 2020, but it is extremely unlikely that it would be voted back in so soon after being removed by the executive board.

The other sports vying for a single opening in 2020 are a combined bid from baseball and softball, karate, squash, roller sports, sport climbing, wakeboarding and wushu, a martial art.

"Today's decision is not final," Adams said. "The session is sovereign and the session will make the final decision."

Wrestling featured 344 athletes competing in 11 medal events in freestyle and seven in Greco-Roman at last year's London Olympics, with Russia dominating the podium but Iran and Azerbaijan making strong showings. Women's wrestling was added to the Olympics at the 2004 Athens Games.

Tuesday's decision came via secret ballot over four rounds, with 14 members voting each time on which sport should not be included in the core group. IOC President Jacques Rogge did not vote.

Three sports were left in the final round: wrestling, field hockey and modern pentathlon. Eight members voted against wrestling and three each against the other two sports. Taekwondo and canoe kayaking survived the previous rounds.

"I was shocked," said IOC board member Rene Fasel of Switzerland.

"It was an extremely difficult decision to take," added IOC Vice President Thomas Bach of Germany. "The motivation of every member is never based on a single reason. There are always several reasons. It was a secret vote. There will always be criticism, but I think the great majority will understand that we took a decision based on facts and for the modernization of the Olympic Games."

Wrestling was featured in the first modern Olympics in Athens in 1896. Along with Russia's Karelin, it has produced such American stars as Gardner, Bruce Baumgartner, Jeff Blatnick and Jordan Burroughs.

U.S. Olympic Committee CEO Scott Blackmun also expressed surprise at the IOC decision, citing "the history and tradition of wrestling, and its popularity and universality."

"It is important to remember that today's action is a recommendation, and we hope that there will be a meaningful opportunity to discuss the important role that wrestling plays in the sports landscape both in the United States and around the world," Blackmun said in a statement. "In the meantime, we will fully support USA Wrestling and its athletes."

FILA said in a statement that it was "greatly astonished" by the decision, adding that the federation "will take all necessary measures to convince the IOC executive board and IOC members of the aberration of such decision against one of the founding sports of the ancient and modern Olympic Games."

It said it has always complied with IOC regulations and is represented in 180 countries, with wrestling the national sport in some of them.

The federation, which is headed by Raphael Martinetti and based in Corsier-sur-Vevey, Switzerland, said it would meet next week in Thailand to discuss the matter.

Gardner cited wrestling's worldwide popularity and urged a campaign to keep it in the Olympics.

"It just seems like wrestling ? if we don't fight, we're going to die," he said. "At this point, it's time for everybody to man up and support the program."

The decision hit hard in Russia, which has long been a power in the sport.

Mikhail Mamiashvili, president of the Russian Wrestling Federation, suggested FILA had not done enough to keep the sport in the games.

"We want to hear what was done to prevent this issue from even being discussed at the board," he said on the Rossiya TV channel.

In comments carried by ITAR-Tass, Mamiashvili added: "I can say for sure that the roots of this problem is at the FILA. I believe that Martinetti's task was to work hard, socialize and defend wrestling's place before the IOC."

Alexander Leipold, a 2000 Olympic champion from Germany and former freestyle German team coach, said he was shocked.

"We are a technical, tactical martial sport where the aim is not to harm the opponent," he said. "Competing at the Olympics is the greatest for an athlete."

Wrestling's long history in the Olympics has featured some legendary names and moments:

? Karelin won the super-heavyweight gold in Greco-Roman over three straight Olympics ? 1988, 1992 and 1996 ? until his streak was ended by Gardner, who beat him for the gold in 2000.

? Baumgartner won four Olympic medals, including golds in 1984 and 1992.

? Blatnick overcame cancer to win gold in Greco-Roman at the 1984 Los Angeles Games, bursting into tears after the match. Blatnick died last year at age 55.

? Burroughs emerged as the star of the sport in London, where he won the 74-kilogram gold.

The last sports removed from the Olympics were baseball and softball, voted out by the IOC in 2005 and off the program since the 2008 Beijing Games. Golf and rugby will be joining the program at the 2016 Games in Rio.

Among those in Lausanne were the leaders of the recently created World Baseball Softball Confederation. The two sports agreed last year to merge in a joint bid to return to the games.

Don Porter, the American who heads international softball, and Riccardo Fraccari, the Italian who leads baseball, are working out the final details of their unified body ahead of their presentation to the IOC in May.

A major hurdle remains the lack of a commitment from Major League Baseball to release top players for the Olympics.

Porter and Fraccari said they hope to have another meeting with MLB officials in April in Tokyo.

"The next thing is to sit down with them and see how they can help us," Porter said. "It all depends on the timing, the timing of the season. It's not an easy decision to allow players a week off."

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Associated Press writers Lynn Berry in Moscow and Luke Meredith in Des Moines, Iowa, contributed to this story.

Source: http://news.yahoo.com/body-slam-wrestling-sport-cut-olympics-223518799--oly.html

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Sometimes It's Peaceful: Mission creep warning! CME guidance ...

CME (Children Missing Education) is central government's statutory guidance to local authorities on how to interpret section 436A of the Education Act. A new version has recently been drafted and this is open for public consultation requesting an email response before this Friday 15 February 2013 at 5pm.

This section of the law was allegedly not intended to 'catch' or check up on home educating families and the first version made this explicit:

[Clip = 66 seconds long]

["The two sets of guidance were originally conceived to do two different things. I was involved with discussions when the first draft of that was made, of the Children Missing Education guidance, and the civil servants who we were dealing with assured us that this was not something which was being designed to entrap home educators. They assured us that the whole point of that exercise - giving the statutory guidance on section 436A - was to find children who had completely slipped through the net who were not receiving any education at all. It was not designed to target home educators in any way. And the first version of it actually said explicitly that this guidance does not apply to children who are educated at home." - Jane Lowe, giving oral evidence to The Commons Education Select Committee's inquiry into EHE support on Wednesday 5 September 2012]

Later versions were to lose this statement in an ongoing process of mission creep, although I think they did keep the link to the all-important 2007 EHEGLA, thereby rendering their non-statutory status defacto statutory. This new draft appears to have lost that link, which I think is worrying and in need of our urgent response.

In my view it's important for home educators to regularly check the CME guidance and respond to consultations when it changes because the guidance is often misused by local authority officers in their approach to home educators, so we need its wording to be very clear and unambiguous, especially considering Ofsted's role in inspecting local authorities' compliance with it. (See Fiona's response for more on this.)

The new draft guidance seems blissfully short and simple compared to recent versions, but I think it contains many problems, as follows:

1. From the Introduction - overview: "The purpose of the section 436A duty is to ensure that local authorities can identify and return to full-time education those children who are missing education (or those at risk of becoming CME)." I can find no reference in section 436A which speaks of "at risk of becoming" and think this should be removed to prevent further mission creep.
2. "The duty relates to children of compulsory school age who are not on a school admission register and not receiving a suitable education otherwise than at school, for example, at home." There is no such thing as 'compulsory school age', only 'compulsory full-time education age' and the guidance should use the legally accurate term throughout, instead of the false one.
3. "Issuing School Attendance Orders (SAOs) to parents who the local authority believes are not securing a suitable education for their child" is the end of a process at every step of which the best interest of the child should be prioritised. If the authority believes a parent is not securing a suitable education for their child, government guidelines advise informal enquiry first.
4. This guidance should reference and link to the Elective Home Education Guidance for Local Authorities for instructions in their approach towards home educating families.
5. "Safeguarding duties, for example, visiting a family if they have concerns about a child?s welfare and poor school attendance and, if appropriate, making an application to the family court." This sentence implies a proactive stance which I believe is an incorrect interpretation of the cited section 47 of the Children Act 1989. My concern is that any proactive conflation of Education with Welfare may lead to home educating families being automatically treated with suspicion when there are no indications that their children are at risk of being harmed or neglected and their privacy and wellbeing suffering unnecessary damage from any such suspicion.
6. "Children at particular risk of missing education" This whole section needs to be removed in my opinion as it contains items of prejudice and refers to the issue of risk itself, which is not mentioned in the section 436A of the Education Act. I think it should be the purpose of this guidance to interpret the law as it stands, not to facilitate mission creep.
7. "Families moving between local authority areas can sometimes lead to a child becoming ?lost? in the system and consequently missing education. Where a child has moved, local authorities should check with other authorities ? either regionally or nationally ? to ascertain where a child has moved to and ensure that they are attending education or being home educated." I can see nothing in section 436A of the Education Act which calls for families' movements to be tracked around the country in this unnecessary way. Section 7 of the Education Act already sets out parental responsibility for the full-time education of children and local authorities should only address evident current failings in this. Tracking movement of families would go beyond this legal requirement and infringe on civil liberties.
8. "Local authorities should regularly raise awareness of their procedures with local schools, partners and agencies working with children and families, for example, GPs and other health professionals, police, emergency services, children?s homes, Youth Offending Teams." I would like to take this opportunity to express a warning about the unintended consequences which may arise from too much connection between issues of health, education and welfare. This is the increased, so-called 'service-resistance' of families seeking to preserve the peace and freedom required for their wellbeing.
9. I think this guidance should somewhere restate the original intention that section 436A and associated guidance should not be used to check or monitor Elective Home Education, because Section 7 of the Education Act and the Elective Home Education Guidance for Local Authorities already adequately cover this area. Local authorities can make inquiries of such families only where it appears a child may not be in receipt of an efficient full-time education as set out in Section & and the EHEGLA Guidance. Further checking and monitoring of home educating families may be damaging to their wellbeing and their children's interest in learning. The wording "where it appears" bears no relation to the term parents who the local authority believes are not securing a suitable education for their child. The former having specific legal meaning and the latter being quite arbitrary and therefore open to misinterpretation. I would like this guidance to state that when a parent states the child is home educated, the Elective Home Education Guidance for Local Authorities should be followed. I do not think the proactive seeking out of such families for checking or monitoring purposes is an accurate interpretation of section 436A of the Education Act.

The above nine points will form the main part of my email response to the consultation.

Source: http://sometimesitspeaceful.blogspot.com/2013/02/mission-creep-warning-cme-guidance.html

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Downton Abbey, Season 3

Rob James-Collier as Thomas Barrow

Photograph courtesy of ? Giles Keyte/Carnival Film & Television Limited 2012 for Masterpiece

Last night?s episode of Downton Abbey has turned Slate commenters into historians. Dozens of readers are arguing about the credibility of the plot line that saw Thomas? misunderstanding with Jimmy the junior footman result in his receiving a promotion rather than a jail term or a horsewhipping.

The most unlikely part of this story line is that Thomas would sneak into Jimmy?s room and kiss him while the latter appeared to sleep. Servants in great houses were generally expected to live celibate lives. As we saw in Season 1, below stairs the men?s quarters are separated from the women?s rooms by a locked door, whose key Mrs. Hughes keeps guarded on a heavy metal key ring. In recent weeks, when Alfred invited Ivy to accompany him to the movies, Mrs. Patmore allowed the outing only on the condition that they not go alone. If servants in great houses did wed, there was an expectation that they would leave service. Since there was no room for married couples below stairs, and given the masters? round-the-clock demands, nonresident maids and valets would provide less than adequate service.

The Crawleys, of course, have made an exception for Anna and Bates, finding a cottage for them on the estate. As Robert?s former soldier-servant from the Boer War, Bates? situation is far from typical. But Thomas, who has resented Bates ever since his arrival denied him the job of Lord Grantham?s valet, has been forced to watch his rival enjoy a happy love life.

O?Brien effectively manipulated Jimmy into stifling his natural responses to Thomas? caresses, then she got Thomas to believe that his most deeply held desire?for an reciprocated romantic relationship with a class-appropriate guy who also happens to be drop-dead gorgeous?was on hand. Should Thomas have kissed Jimmy while he was sleeping? No. Would he have believed O?Brien?s stories of Jimmy ?talking soppy? about him to Alfred? Not absent any other evidence. But the fact that Jimmy had never complained about Thomas? touches would have served, to a desperate man in 1920, as that other evidence. As Thomas told Mr. Carson, ?When you?re like me ? you have to read the signs as best you can, because no one will speak out.? Those commenters saying that Thomas should?ve gained Jimmy?s consent before kissing him are asking more than history will allow. Men have been sleeping with other men for millennia; they?ve been talking about it for considerably less.

Actor Rob James-Collier did a great job of conveying Thomas? struggle. After years of loneliness and contempt, love seemed to be calling from across the hall. He knew the risks?a beating, dismissal, jail?but he gave in to his romantic side and kissed the man he had been told was mooning over him. There was no suggestion of Thomas forcing himself on Jimmy, who is physically strong and an independent thinker; he was simply making the first move.

But is there any chance that in 1920, lord and servant alike would?ve been cool with Thomas? homosexuality? Let?s stipulate, first of all, that Julian Fellowes? creation is far from a paragon of historical accuracy, especially in regards to social attitudes. Having Carson reject Thomas? ?revolting world? and call him foul is an inadequate stand-in for society?s institutional homophobia, but as I wrote earlier this week, I give Fellowes credit for finding dramatically convincing explanations for everyone?s tolerance.

Lord Grantham?s acceptance of the predatory nature of Eton life (and let?s not forget that the vast majority of those stolen kisses would?ve come from boys who grew up to lead heterosexual lives) is one of the few things that isn?t anachronistic about Downton Abbey. Would Robert have been content to employ a ?body servant? whom he knew to harbor homosexual urges? If the man did his job well and observed all the appropriate proprieties, as Thomas Barrow apparently did, Lord Grantham would put up with a great deal. It is overt challenges to established rules of propriety?inappropriate evening attire, marrying into the wrong religion, women expressing opinions in public forums?that bother Lord Grantham. (And, yes, Thomas is very good at cricket, but if that really mattered, perhaps we?d have learned who won the match.)

Jimmy and Alfred are both worried that no one should think them gay?much of that concern having been ginned up by O?Brien?but all the other characters have credible reasons for wanting Thomas to keep his job. After his wrongful imprisonment, Bates is fighting for justice. Mrs. Hughes believes Thomas to be a war hero. None of the servants want to believe that anyone they know could be dismissed without a reference, since that?s tantamount to destitution. Let?s face it, Thomas is a nasty piece of work?the servants have no shortage of reasons to dislike Mr. Barrow without bringing his sexuality into it?but he?s good at his job, which buys a lot of forbearance in this world.

Would there have been gay society within Thomas? cruising range? It?s hard to know how much real-life exactitude to bring to Julian Fellowes? invented world, but the chances are very slim. George Chauncey?s Gay New York: Gender, Urban Culture, and the Making of the Gay Male World 1890-1940 describes the signals that New Yorkers used to announce themselves as ?fairies?: Gay male attire included ?green suits, tight-cuffed trousers, flowered bathing trunks, and half-lengthed flaring top-coats.? Gay men were also known to wear ?excessively bright feathers in their hat-bands.? According to Chauncey, the most famous signal of gayness was a red necktie. In faraway Northern England, it?s hard to imagine circumstances in which a working-class man like Thomas, so proud of the fine black suit his position as a valet permits him to wear, would be able to obtain, much less wear, such items.

I could find no chronicles of gay life in Yorkshire in the 1920s, but in the 1980s, Terry Sanderson, a working-class gay man from Rotherham, South Yorkshire, described his coming out in the 1970s in an essay in the British collection Radical Records: Thirty Years of Lesbian and Gay History. It?s a story of an active but hidden world. Sanderson describes being measured for his first suit by a man who ?lingered over my inside leg and when he realized I wasn?t going to object, gave me a comprehensive fondling,? which brings to mind Thomas? unslapped hands on Jimmy?s shoulders and legs. Later Sanderson got a job at a camera shop managed by a gay man, which received regular visitors from various pillars of the community who were living secret lives: ?I came to realize that the twilight world actually existed unseen, but in parallel, with everyone else?s world,? he writes. Even 40 years ago, few had any concept that a gay relationship was a possibility. ?Many of them had had sex with other gays, but few of them accepted that you could make a way of life out of it.?

Thomas? gay pride?or at least his refusal to hate himself?may be anachronistic, but as long as he didn?t say too much about the love that dare not speak its name, it?s easy to believe that how well he did his job would count for more than whom he pined for.

Source: http://feeds.slate.com/click.phdo?i=ba4a50024e21a48e0e71e4472b24aa47

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