The NHL lockout and stalled negotiations are so dire that federal mediators are entering the fray in an attempt to spark an agreement for the dispute that has claimed the first 2 1/2 months of the season and the league’s annual all-star game.George Cohen, director of the Federal Mediation and Conciliation Service, said Monday the parties had agreed to use the agency. He assigned three mediators to assist negotiations – deputy director Scot Beckenbaugh, director of mediation services John Sweeney and Commissioner Guy Serota.“While we have no particular level of expectation going into this process, we welcome a new approach in trying to reach a resolution of the ongoing labor dispute at the earliest possible date,” NHL deputy commissioner Bill Daly said.Cohen has worked with the players’ associations for Major League Baseball, helping end the 1994-95 strike as an outside counsel, and the NBA. He was an adviser to the NHL players’ union before joining FMCS three years ago.“We look forward to their involvement as we continue working to reach an equitable agreement for both the players and the owners,” said Donald Fehr, executive director of the NHL Players’ Association.Cohen mediated during the 2010 negotiations in Major League Soccer and 2011 talks in the NFL and NBA, along with this year’s dispute between the NFL and its on-field officials.Hockey players and management have not negotiated since last Wednesday. The NHL has canceled more than one-third of its regular season, including all games through Dec. 14, the New Year’s Day outdoor Winter Classic and the All-Star weekend scheduled for Jan. 26-27 at Columbus, Ohio.“I have had separate, informal discussions with the key representatives of the National Hockey League and the National Hockey League Players’ Association during the course of their negotiations for a successor collective bargaining agreement,” Cohen said in a statement.“Due to the extreme sensitivity of these negotiations and consistent with the FMCS’s longstanding practice, the agency will refrain from any public comment concerning the future schedule and/or the status of the negotiations until further notice.”
Whether it’s witnessing the towering moonshots of Aaron Judge or Scooter Gennett’s four-homer game, every baseball fan has had a moment of home run shock this season. In the span of a few short years, MLB has gone from the age of the pitcher to the era of the dinger, and the evidence for why the shift occurred keeps pointing back to the baseball.The baseball itself was initially identified as the most likely culprit for the spike in homers through a process of elimination. Ben Lindbergh and I documented the home run surge in detail last year, testing every hypothesis for its cause, including weather, performance-enhancing drugs, and the fly ball revolution. Each theory was rejected, leaving a solid trail of statistics that only a change in the ball would seem to explain. But identifying any alterations in the baseball becomes a problem of sample size. Without having a crate of game-used balls from each month of the season since July 2015, it’s difficult to find a concrete answer to baseball’s juiced-ball mystery.In a recent article for the Ringer, Lindbergh and Mitchel Lichtman made some headway despite these constraints. They experimented on three dozen game-used baseballs and found evidence that the ball became bouncier during the 2015 season, which explains about half of the home run surge.Lindbergh and Lichtman also found that, since 2016, the balls became smaller and their seams got lower — changes that ought to make the ball smoother and subject to less air resistance. When air resistance — also known as drag — decreases, a batted ball will go farther. High or low drag can mean the difference between a lazy warning-track fly out and a ball that lands a few rows into the seats.The findings in the data have anecdotally been supported by several players and coaches. New York Mets manager Terry Collins said in an interview with the Orange County Register, “The seams on the ball are definitely lower. … And there’s no question that the ball is harder.” Collins joined a chorus of established veterans who claim that the ball has changed this year, including Justin Verlander, Andrew McCutchen and Jake Arrieta.But a few irregular baseballs and a handful of grumpy veterans is not enough to prove that there has been a widespread change in the way balls are made. In a normal laboratory experiment, we’d need to spend tens of thousands of dollars to shoot countless balls out of an air cannon to establish beyond any doubt that the baseball’s air resistance had decreased.But it turns out there was an experiment in progress under our noses all along. Baseball’s camera- and radar-tracking technologies measure the speed of the ball shortly after the pitcher releases it and then again when it crosses the plate. By examining how much speed it loses between those two locations, we can calculate its air resistance (as measured by drag coefficient). For example, the average pitch loses about 7.4 mph on its way to the plate. The exact amount of velocity lost depends on the thickness of the air (which varies with temperature, weather and elevation), but a high-drag ball tends to lose about 8.7 mph on the way to the plate, while a slicker ball would lose only 6.5 mph.With some help from baseball physicist Alan Nathan, I used those measurements to estimate the air resistance on the ball in each full month of MLB action since 2013, accounting for weather and altitude. If the ball has a lower drag coefficient, it ought to lead to longer fly balls and more dingers. Sure enough, you can see a strong correlation between the drag coefficient and the rate of home runs per fly ball in a given month1I examined only four-seam fastballs to eliminate any potential influence of pitch type.: In total, the changes in ball drag explain about 25 percent of the variation in the ratio of home runs to fly balls over the last four years.2The correlation was r=-0.52, p=.006. Wind and weather can also influence drag, and although I controlled for those when I calculated the league-wide numbers, I also double-checked my analysis by looking only at Tampa Bay’s stadium, which is indoors and air conditioned. In the Rays’ home park, I found an even stronger correlation between home run rates and the ball’s drag coefficient.3The correlation for just games played in Tampa was r=-0.70, p<9*10-6. It doesn’t exactly come as a shock, but this is clear confirmation that air resistance influences home run rates.I also found a significant decrease in the drag on the ball in general over the past few seasons, with the MLB-wide average drag coefficient dropping by about 0.01 from 2015 to 2017.4Pitch-tracking changed over from PITCHf/x to Statcast in 2017, but the data I used corrects for the switchover by keeping the release point constant. That might not sound like much, but Nathan’s calculations show that even a change that small can add up to 5 feet of distance on a well-hit fly ball,5We’re defining a “well-hit fly ball” as one with a 103 mph exit velocity that’s hit at 28 degree launch angle. which in turn would be enough to make 10 to 15 percent more balls leave the yard in a given season.It’s highly unlikely that we’d see that kind of difference by chance without a real change to the ball: The monthly variation in estimated drag coefficients in the past five seasons varied from around 0.34 to 0.355, a far wider range than we’d expect from random variance alone.6To prove this, I built bootstrapped confidence intervals on the monthly average drag coefficients. The 99 percent confidence interval for each full month typically spanned only 0.001 in each direction, about one-fifteenth of the range of month-to-month variation. In total, the practical effect of shifting from a high-drag month to a low-drag month could be around a 30 percent difference in home run rates.From their low in 2014 to their high this year, home runs have jumped about 47 percent. About half of that increase occurred suddenly in the middle of the 2015 season, probably because the balls became bouncier, as Lindbergh and Lichtman found. The other half has been spread out over the 18 months since opening day of 2016. Some of the home run spike might be the result of players gearing their swings to hit more fly balls, but it’s clear that diminished air resistance also played a big role. About one-quarter of the home run spike could be attributable to decreased drag.So far, we’ve only focused on how changes in drag have affected batted balls. As for how the changes to the ball might affect pitches, we still don’t know. Hurlers generate movement on breaking pitches by orienting the seams to spin the ball. If those seams are lower, as Lindbergh and Lichtman found, pitchers could be less able to grip the way they’re used to. It’s difficult to see any effect on pitch spin in the data, however, and according to Nathan, for a given amount of spin, small changes in seam height aren’t likely to change the aerodynamic properties of breaking balls very much. Measurements of break have been much less consistent from month to month than those for drag, and MLB’s new pitch-tracking system, Statcast, has struggled to accurately gauge movement.7The technical issues that have plagued Statcast do not appear to extend to its velocity measurements, which means that my drag calculations ought to be comparable from season to season. So whatever effect the altered ball might have on pitches, we can’t reliably measure it yet.Like the proverbial butterfly flapping its wings and causing a hurricane, a handful of new hires at the Costa Rican factory where baseballs are made could have changed the history of America’s pastime.Before anyone gets too worked up, it’s important to note that this is hardly the first time MLB has seen a change in the ball’s drag coefficient. Even before the home run spike began, the ball’s air resistance regularly drifted up and down, and the rate of dingers ebbed and flowed with it: In the five-season stretch from 2010-14, well before anyone suspected a juiced ball, monthly MLB-wide drag coefficients were also clearly linked to the home run to fly ball rate.8r=-0.43, p=0.02.Those long-term fluctuations in air resistance mean that there’s probably nothing nefarious behind this home run spike. Tiny variations in manufacturing can send the ball’s drag up or down seemingly at random. But small changes can still make a real difference between a ball slugged into the stands and one dropped into an outfielder’s glove. And the last three years appear to have featured a series of variations in the ball’s bounciness and air resistance that ended up causing the largest, fastest home run increase in history. Like the proverbial butterfly flapping its wings and causing a hurricane, a handful of new hires at the Costa Rican factory where baseballs are made could have changed the history of America’s pastime.MLB declined to comment on the story, except to note that the league regularly tests the balls to make sure they fall within a defined range of standards. (Rawlings, the manufacturer of MLB’s baseballs, did not respond to a request for comment.) MLB’s statement might be true,9To my knowledge, MLB has not defined an acceptable range for drag coefficient, but it has done so for characteristics like ball circumference that help to determine air resistance. but it is hollow: The range of acceptable measurements is so wide that, according to a 2000 report commissioned by MLB, two balls could both pass inspection even if they were constructed so differently that one would be hit 49 feet further than the other. My own research shows that drag alone could lead to a 30 foot difference in fly ball distance, which fits the results of controlled experiments on official baseballs. Nathan found that just a 7 foot difference in batted-ball distance is enough to raise home run rates by 25 percent, which means that MLB’s standards are so broad that they could permit a 100 percent change in home run rates without the commissioner ever finding a ball outside the acceptable range. To say that baseballs are still within the permitted specifications is like noting that a race car and a minivan are both automobiles: It’s not wrong, but if you pit them against each other in a drag race, a Ferrari would still beat a Dodge Caravan every time.If the changes that made the ball bouncier and slicker are truly random, then baseball’s home run era could end just as suddenly as it began. MLB Commissioner Rob Manfred has said that fans like home runs and strikeouts. As the numbers of both whiffs and long balls are close to all-time highs, this must be baseball’s golden era. But to keep it that way, Manfred will likely have to impose tighter control over the ball’s construction than has been used in the last three years. The same random manufacturing changes that might have made it bouncier and slicker could just as easily make it stiff and air resistant — bringing back the year of the pitcher, and rendering all our juiced-ball detective work for naught.Thanks to Alan Nathan, Ben Lindbergh, Mitchel Lichtman, Harry Pavlidis and the Baseball Prospectus Statistics Group for their help.
For Pirates outfielder Andrew McCutchen, this weekend was one of highs and lows. McCutchen launched a pair of home runs off of Dodgers starter Kenta Maeda during Saturday’s 6-1 Pittsburgh win; he also, well, take a look for yourself at what happened Sunday: Dave Parker1980222.214.171.124 Travis Jackson1932285.01.71.9 Andre Dawson1984295.02.72.1 Edgar Martinez1993305.20.74.4 Andrew McCutchen2016295.40.9— Joey Votto2014305.22.24.8 When bad seasons happen to previously great players Fred Lynn19812126.96.36.199 WAR PER 600 PLATE APPEARANCES Hank Greenberg1941306.22.25.7 Pete Reiser19482188.8.131.52 On the 2016 season, McCutchen has had more lows than highs. Going into Monday’s game, he was hitting only .240 with an OPS (on-base plus slugging) 3 percent worse than the major-league average — easily the weakest batting numbers of his career — and he’s also been one of the worst statistical center fielders in baseball. Pro-rating his wins above replacement to 162 team games, McCutchen is on pace for a measly 1.1 WAR, which would be 68 percent worse than his previous career-low (3.4 as a rookie in 2009). His struggles rank among the main reasons Pittsburgh is under .500 with very little chance of getting back to the playoffs.Up to this point, it wasn’t a stretch to say McCutchen looked like a future Hall of Famer. He’d been baseball’s third-best player by WAR over the previous seven seasons, stretching back to his MLB debut in 2009, and ranked 46th all-time in WAR through age 28. Pittsburgh fans could see in him the reflections of a young Barry Bonds; like Bonds, McCutchen through 28 also ranked in the top quarter of major-leaguers in power, speed and patience. So it’s exceedingly rare for a player this great to suffer a season this poor, smack dab in the middle of what should be his prime: Arky Vaughan1942306.12.54.3 Joe Cronin1935285.23.04.1 Lance Berkman20052184.108.40.206 Joe Mauer20112220.127.116.11 Scott Rolen2005305.63.04.0 Nomar Garciaparra2004305.52.50.5 Andruw Jones2007305.53.01.3 Snuffy Stirnweiss1947285.73.01.1 PLAYERYEARAGEPREVIOUS CAREERSEASONFUTURE CAREER Evan Longoria2014218.104.22.168 Frank Thomas1998306.12.52.7 Art Devlin1910305.32.72.2 Lowest WAR/600 plate appearances at age 28, 29 or 30 for players with ≥ 5 WAR/600 plate appearances in previous career, 1901-presentSource: Fangraphs.com Snuffy Stirnweiss1948295.12.7-0.4 Joe Torre1969222.214.171.124 Ralph Kiner1953305.42.52.0 Goose Goslin1929285.02.53.1 Darrell Evans19752126.96.36.199 In baseball’s modern era, McCutchen’s unexpectedly bad 2016 season ranks as one of the most shocking single-season mid-prime declines ever. If there’s any good news, it’s that most of the players in this group did manage to recover and play at a more respectable level going forward than during their down seasons. But even so, they were typically shadows of their former selves: The average player on the list above had 5.4 WAR per 600 plate appearances before his “bad” season, against only 2.8 over the remainder of his career (and only 3.0 over the very next three seasons).Perhaps most concerning of all is that McCutchen’s decline has come virtually across the board, in every phase of his game: Although he’s also been slightly unlucky on balls in play, McCutchen’s numbers suggest a downturn in his underlying skill set. Even among the more fine-grained statistics, he’s hitting the ball more softly than ever and popping up more infield flies than ever. His average exit velocity is down, and he’s connecting on fewer swings than at any point in his career.Even great players can suffer bad seasons sometimes, and it’s not unprecedented for them to recover and play well after a down year. So maybe McCutchen will bounce right back to his previous Hall of Fame form. But what we’re seeing from McCutchen now is the bad kind of history: one of the worst seasons ever to land in the middle of a great player’s prime.
OSU junior goaltender Christian Frey stops a shot during an exhibition game against Brock on Oct. 3 at the Schottenstein Center. OSU won 4-0.Credit: Kaley Rentz / Asst. Sports DirectorMiami freshman forward Jack Roslovic, the first Columbus-born and bred hockey player to be selected in the first round of an NHL draft, torched his hometown team for game-winning goals on consecutive nights over the weekend.In Game 1 between Ohio State (0-4) and No. 18 Miami (Ohio) (2-1-1) in front of a crowd of 5,405 at the Schottenstein Center, OSU senior captain Anthony Greco took a feed from junior forward David Gust in front of the crease and powered it home past the left pad of RedHawks senior netminder Ryan McKay to tie the game at two with 2:45 left in the game.OSU’s other senior captain, Craig Dalrymple, also assisted on the Greco goal.One minute and 12 seconds later, Roslovic found a rebound off of the right pad of OSU junior goaltender Matt Tomkins and buried it in the back of the net to give Miami a 3-2 win.For OSU coach Steve Rohlik, it was a tough lesson for his young team to learn.“You tie (the game) up and you give yourself a chance,” Rohlik said. “You have a breakdown and (the puck) is in the back of your net. It’s disappointing but certainly something you’ve got to build on.”Tomkins, who made 27 saves on the night, gave his team a chance to win, but was still concerned about the last goal.“I thought that’s a save I could make,” Tomkins said. “Definitely a big save, but one that I’m capable of making.”His counterpart in McKay made 25 stops as the Scarlet and Gray were outshot 30-27.Game 2 at Steve Cady Arena in Oxford, Ohio, saw the Buckeyes and RedHawks all squared at one until the 13:56 mark of the second period when it was Roslovic again hammering home the eventual game winner, as Miami went on to win 3-1.The Winnipeg Jets draftee leads the RedHawks in points through four games with three goals and two assists.OSU freshman forward Mason Jobst scored his first collegiate goal 5:22 into the middle frame assisted by Gust and sophomore Luke Stork.Tomkins and McKay were the starters again for their respective teams. Tomkins made 38 saves on 41 Miami shots while McKay stopped 27 of the 28 shots sent his way.The power play was an issue for the Buckeyes this weekend as it was against Bowling Green last weekend. OSU went a combined 0-for-7 with the man advantage and is now 1-for-16 this season.OSU’s penalty kill, which was perfect until Saturday night, got nicked up, as the RedHawks went 2-for-5.The Scarlet and Gray are next set to travel to Providence, Rhode Island, to take on the No. 2 Providence Friars for two games next weekend.Although his team heads into another tough matchup winless, Rohlik saw some silver linings against Miami.“We made steps but we’re a long way away,” Rohlik said. “That’s going to be the fun part about this team. I think we’ve got so much room for improvement and I know the guys want to do it and I know the guys want to put the effort in.”
Coach Jim Tressel has said repeatedly that his team isn’t always a first-half team. In a nail-biting 20-17 victory over the Hawkeyes, it showed. “It wasn’t the prettiest offensive game that we’ve had,” wide receiver Dane Sanzenbacher said. Ugly is the word he’s looking for. The Buckeyes were down 7-3 at halftime, but Tressel said his halftime speech wasn’t “anything to write home about.” “I thought we did some good things,” Tressel said. “It’s a lot easier to block them on the chalkboard than it is out here. It’s hard to be consistent against them play after play.” With 8:36 left in the third quarter, quarterback Terrelle Pryor found tight end Reid Fragel for a 5-yard touchdown, the first of Fragel’s career. The Hawkeyes answered back with Mike Meyer’s 31-yard field goal to settle the score at 10-10. It was all tied up going into the fourth quarter in Iowa City, Iowa, in a game that prompted flashbacks to last year’s meeting. The Buckeyes hosted the Hawkeyes on Nov. 14 last season and, in similar fashion, were tied 10-10 going into the fourth quarter. However, in 2009 the Buckeyes sealed a 27-24 victory over the Hawkeyes with a Devin Barclay field goal in overtime. This year, haunting memories turned the pressure on OSU. The threatening misstep that could have cost the Buckeyes the game was quarterback Pryor’s deep pass to Sanzenbacher, picked off by corner Shaun Prater. Running back Marcus Coker fed off Pryor’s mistake and rushed 27 yards in two plays for an Iowa touchdown. The pick “was kind of B.S.,” Pryor said. “It kind of bounced off Dane and bounced up. They made a great play on that.” Sanzenbacher converted his first four receptions for first downs but soon fell flat. “I dropped one out there,” Sanzenbacher said. “I, by no means, played a great game. There are obviously plays you wish you had back, and we’re in a spot where you have to have a short memory.” Trailing 17-13 with just less than six minutes left, Pryor looked to DeVier Posey in the end zone. But Posey dropped a would-be touchdown, a mistake that could have lost OSU the game. Forced to go for it on fourth-and-10, Tressel stacked the offense. “You want to get (Pryor) back with options,” he said. “You send five receivers out so you have five options there, plus you have the option to run it. That’s about as many options you can get for a fourth-and-10.” The team stepped up. “I don’t know how many guys in the conference or in the country could have made that play,” Iowa coach Kirk Ferentz said. “He converted and it was just a great effort on his part.” Pryor’s 14-yard rush, coupled with two Sanzenbacher receptions for 29 yards, gave the Buckeyes a first-and-goal. The Buckeyes saved their best for last, running back Dan Herron said. “Hey, we’re comeback kids.”
Ohio State hoops remains undefeated on the young season as the women’s basketball team followed up the men’s 85-50 thrashing of North Florida on Monday by knocking off Howard, 73-50, Tuesday night at the Schottenstein Center. Buckeye basketball has a record of 7-0 to begin the season, with the third-ranked men at 4-0 and the 3-0 women, who moved up to No. 18 and No. 19 in the latest AP and USA Today rankings, respectively. Freshman forward Kalpana Beach, making her third-straight start to begin her career, was a force on the boards, notching 12 rebounds in 18 minutes of play. Sophomore forward Darryce Moore was just as impressive offensively, contributing 15 points to go along with 7 rebounds in her 18 minutes off the bench. Redshirt junior guard Amber Stokes, who scored nine points, said that Moore has taken a big step forward after not seeing much action during her freshman season. “You can see a big difference compared to last year,” Stokes said. “She’s more confident and she’s going to the basket, she’s doing nice moves, nice passes, she’s patient. I think it’s helping us a lot. We need our post players, it can’t always be the guards.” The production from the younger players was a big help as senior guard Samantha Prahalis had somewhat of a down game, shooting 3-of-12 from the floor for 8 points, well below her 18.5 per game average. However, she did contribute a team-high seven assists. OSU began the game on a 10-0 run, but Howard, aided by 12 points off of 11 first-half turnovers by the Buckeyes, kept pace the rest of the half as OSU entered halftime leading 37-28. Coach Jim Foster said that Howard was playing an unconventional zone defense and that OSU switched from running its zone offense in the first half to its man-to-man offense in the second half to adjust to the unique look. “I think we were just throwing some long passes, our spacing wasn’t what it needed to be (in the first half),” Foster said. “And that’s why we went to what we went to and I think it made a big difference.” The difference was apparent in the Buckeyes’ ability to take better care of the ball, committing just five turnovers. The defense was sharp, holding Howard to 23.5 percent from the field in the second half, allowing OSU to extend its lead. The Buckeyes continue non-conference play with two home contests this weekend, a Friday game against Stony Brook at 2 p.m. followed by a Sunday matchup against No. 20/23 LSU at 5 p.m.
Dr Mark Porter, chairman of the British Medical Association (BMA), said: “It is important that costs are recouped from patients who are not eligible for NHS treatment, but systems to charge migrants and short-term visitors need to be practical, economic and efficient and must not jeopardise access to healthcare for those who need it.”A doctor’s duty is to treat the patient in front of them, not to act as a border guard.”Sick and vulnerable patients must not be deterred from seeking necessary treatment, otherwise there may be serious consequences for their health and that of the public in general.”A spokesman from Barts Health NHS Trust said: “We make every effort to recover costs from eligible patients. We use hand-held card readers to obtain funds from patients at their bedside, and have recently improved our internal processes to more quickly identify paying patients.”Our four major hospitals include the largest cardiovascular unit in the country, a major trauma centre and one of the largest dialysis units in the UK and care for some of the most seriously unwell patients in London.” If this money was reinvested in the NHS it could mean the difference between hiring more nurses or paying for additional equipmentKatherine Murphy, Patients Association chief executive Want the best of The Telegraph direct to your email and WhatsApp? Sign up to our free twice-daily Front Page newsletter and new audio briefings. Several NHS trusts provided figures for the last four years, showing they are now owed a backlog of millions of pounds.In London, Barts is owed £10,340,322 from the last four years, while Imperial College Healthcare NHS Trust is owed £5,509,733.Guy’s & St Thomas’ NHS Foundation Trust and London North West Healthcare NHS Trust are also owed around £5 million each for the last four years.Some trusts are still trying to chase the money from overseas patients while others have written a portion off as bad debt.The true amount owed is likely to be far higher as the figures only relate to those people identified as being chargeable. Many other overseas patients, including those who are able to give UK addresses, are never asked to pay.The investigation suggests that just over £21 million was recovered by trusts in 2015/16. The departments most commonly used by overseas visitors included maternity and general medicine.Eight hospital trusts in London are owed more than £1 million and a further 21 across England are owed at least £100,000. These include hospitals in Liverpool, Birmingham, Oxford and Sheffield.Barts and The London NHS Trust topped the list in 2015/16 for its unpaid bill, with £4,987,190. The trust managed to recover £6,754,000 in the same year. A Department of Health spokeswoman said: “The NHS is a national – not an international – health service and we are determined to stamp out abuse of the system to ensure it remains free at the point of need in this country.”We consulted earlier this year on extending the charging of migrants and visitors using the NHS.”We will set out further steps in due course to ensure we deliver on our objective to recover up to £500 million a year by the middle of this Parliament.”What do you think? Join the debate by leaving a comment below. London North West Healthcare NHS Trust is owed £1,433,018 from 2015/16. In 2015/16 it invoiced 438 overseas patients for £1,578,289. Almost £40,000 was billed to Americans, who also owed the trust £38,297 in 2015/16.Some £473,310 was billed to people from India, with Indians also owing the trust £423,151 in 2015/16. The single biggest bill for one patient from India was £28,487. A further £50,455 was billed to people from Nigeria, with Nigerians also owing the trust £45,191 in 2015/16.People from Pakistan accounted for a bill of £122,887 in 2015/16, with unpaid bills in the same year among people from Pakistan reaching £119,487.Meanwhile, King’s College Hospital NHS Foundation Trust recovered £1,232,990 in 2015/16 but has written off £2,217,311 for the same year. University College London Hospital is owed £2,393,000.St George’s Hospital in Tooting, South London – which has hit the headlines after pregnant health tourists went there to give birth – managed to recover £159,012 in 2015/16 but had an unpaid bill of £347,019. In total, it is owed £2,550,059 from the last four years.A spokesman said the figure only represents patients who have been identified as chargeable before, during and after their treatment.It does not include patients admitted for complex care and prolonged admissions. St George’s said it expected its bill to rise “year on year” and it estimates that overseas patients who do not pay actually cost in the region of £4 million to £5 million per year. Overseas patients have left the NHS with an unpaid bill of almost £30 million in just one year, an investigation has found.Patients who were not entitled to free treatment on the health service owed £29,530,378 in 2015/16, according to data obtained under the Freedom of Information Act.More than 120 NHS trusts were asked to provide details on overseas patients who were billed for NHS care and who were exempt from reciprocal arrangements with the UK.Some 104 trusts across England responded, with the results suggesting the unpaid bill is rising year on year. Of 92 trusts that were also able to give data for 2014/15, the outstanding debt in that year came to £15,907,018. Katherine Murphy, chief executive of the Patients Association, said: “It is shocking that so many costs are left unpaid by overseas patients using the NHS.”If this money was reinvested in the NHS it could mean the difference between hiring more nurses or paying for additional equipment.”Patients have very strong feelings about overseas visitors, and understandably, patients feel that an NHS with diminishing resources should be prioritising UK citizens first and foremost.”The money owed to London NHS trusts alone is jaw-dropping.” A doctor’s duty is to treat the patient in front of them, not to act as a border guardDr Mark Porter, BMA chairman More than 100 NHS trusts provided details on overseas patients who were billed for NHS careCredit:Peter Byrne/PA
Rob Titchener (TIMOTHY WATSON) and Helen Archer (LOUIZA PATIKAS)Credit:Pete Dadds/BBC Want the best of The Telegraph direct to your email and WhatsApp? Sign up to our free twice-daily Front Page newsletter and new audio briefings. Watson admits Titchener, a successful dairy farmer who arrived in Ambridge in early 2013, became one of the most loathed characters in radio history, deservedly attracting the hostility not only of his fellow Ambridge residents, but also that of the series’ listeners for his treatment of Helen.But as he points out, for many weeks people could not make up their minds about his true-self, such was his ability to deviously hide behind a mask of civility and sophistication, as well as tenderness towards his stepson son, Henry.“For a good eighteen months people would come up to me and say ‘I haven’t quite made my mind about you’,” Watson said during a BBC listeners question and answer session.“We called them ‘good-Rob’ and ‘bad-Rob’ episodes. He’d say something where everyone would say “ooh that’s really worrying” and then there’d be a couple of weeks where he’d be just charming, loving, helpful, very caring and nurturing of Henry.”He added: “Whilst I completely understand and agree with the clamouring for Rob Titchener to get his comeuppance and to be thrown in jail and prosecuted for what he did… in the long term, people like him need to be helped to find out why it is that they came to behave as they did.”One of the most gripping Archers storylines in recent years climaxed with Helen being tried for attempted murder after stabbing her husband, following months of abuse, when he tried to prevent her from leaving him.After a trial at Borchester Crown Court the jury found Helen not guilty of all the charges, leaving Titchener an outcast in the village, nurturing his resentment until making a final attempt to control Helen’s life by taking her baby..Welfare groups described the story as a compelling account of the situation in which many abused women find themselves trapped, in some cases for years and all too often with no means of escape.Watson says of his character: “I would hope for his sake that he will seek help. If there’s one thing I’ve learned in this process – there’s a question that’s asked a lot, ‘why did they stay for as long as they did?’ And a question that’s asked rather less is ‘why did the abuse happen?’”Whatever the answer to that, the ordinary country folk of Ambridge, and those who listen to their story, may yet find that Titchener’s voice returns to haunt them.”I don’t know what is going to happen to Rob,” said Watson. “But I’m keeping my fingers crossed that at some point in some guise he might return.” He was vilified as the controlling husband who raped his wife Helen after mounting a prolonged campaign of psychological abuse against her.But the actor who plays Rob Titchener in the long-running radio drama The Archers has said he was not a villain, but a “fascinating and complex character”.(Warning: Spoiler follows)Timothy Watson’s controversial comments came after the surprise departure of Titchener from the series, at the end of Friday’s episode, following a failed attempt by him to snatch the baby boy he had with Helen.Watson said of Rob Titchener: “I’ve never thought of him as a ‘villain’. I think that undermines the complexity of the process. I think of him as a very, very fascinating and complex character who has committed a whole series of heinous wicked things.“There’s a spectrum – a huge spectrum – of narcissism and he is right at the very top of it.It’s a very sad fact, as we’ve come to discover during the telling of this story, that this is such a tragically widespread problem.”
In 2015-16 there were more than 525,000 admissions where obesity was recorded as a primary or secondary diagnosis, with two thirds of the patient number made up of women.This was despite there being more obese men, 68 per cent, than women 58 per cent, in that year.Rates of obesity, which is defined as having a body-mass index of 30 or higher, have risen from 15 per cent of adults in 1993 to 27 per cent in 2015.Meanwhile, the prevalence of morbid obesity has more than tripled since 1993, to reach 2% of men and 4% of women in 2015.The report also showed high numbers of children being overweight, with more than one in five children in Reception class being overweight or obese in 2015/16, and more than one in three in Year 6.Yesterday, Public Health England (PHE) published new voluntary targets for the food industry to reduce sugar levels by 20% by 2020 in nine categories of food popular with children. In 2015-16 there were more than 525,000 admissions where obesity was recorded as a primary or secondary diagnosisNHS Digital Three quarters of adults are failing to eat the recommended five portions of fruit and vegetables each day, official figures have revealed.The annual NHS review of obesity and eating habits in England found that in 2015 the number of adults eating fewer than three portions a day was in fact higher than the total who followed Government advice.Young adults aged between 16 and 24-years old were the age group least likely to consume the officially recommended quantity, although more than half of younger teenagers were complying with the guidelines. Want the best of The Telegraph direct to your email and WhatsApp? Sign up to our free twice-daily Front Page newsletter and new audio briefings. The 5 A Day campaign is based on advice from the World Health Organization, which recommends eating a minimum of 400g of fruit and vegetables each day to lower the long-term risk of serious health conditions such as heart disease, stroke and some cancers.Most fruit and vegetables, although not potatoes, count towards the recommended total, which can be made up of a combination of both, rather than five of each.Experts have warned, however, that increasing numbers of people are turning away from a balanced diet in favour of a growing dependence on high-calorie and high-salt readymeals and fast food.In February a study from Imperial College London suggested that adults should really be eating 10 portions of fruit and vegetables a day to keep healthy, however senior nutritionists argued against updating the official advice because it risked putting “too much pressure” on people.Today’s new statistics also reveal that the number of obesity-related hospital admissions in England has more than doubled in the last five years, with the rate increasing by 20 per cent in the last year alone.
Want the best of The Telegraph direct to your email and WhatsApp? Sign up to our free twice-daily Front Page newsletter and new audio briefings. Mr Rowley said: “I so wish I could say we will definitely solve it but a small number of cases sadly don’t get solved.”Madeleine was abducted from her parents’ holiday apartment in the Portuguese resort of Praia da Luz on the evening of May 3 2007.The case sparked an unprecedented level of media interest but a decade later there have still been no definitive breakthroughs and her fate remains unknown.For the last six years a team of Scotland Yard detectives have painstakingly reviewed every piece of evidence in the case and have pursued all outstanding leads. Gerry and Kate McCann in Praia da Luz in 2007Credit: EDDIE MULHOLLAND As a result officers examined more than 40,000 documents and investigated around 600 people of interest. In 2013 four potential suspects were identified and interviewed by police in Portugal, but they were all subsequently eliminated from enquiries.Police also undertook a dig at site close to the apartment from where Madeleine disappeared, but nothing of significance was found.Mr Rowley said the anniversary brought into sharp focus the pain and agony being endured by Kate and Gerry and the rest of their family.He said: “As an investigation team we are only too aware of the significance of dates and anniversaries. Whatever the inquiry, we want to get answers for everyone involved.”The disappearance of Madeleine McCann is no different in that respect but of course the circumstances and the huge public interest, make this a unique case for us as police officers to deal with.”In a missing child inquiry every day is agony and an anniversary brings this into sharp focus. Our thoughts are with Madeleine’s family at this time – as it is with any family in a missing person’s inquiry – and that drives our commitment to do everything we can for her.” He said: “Where we are today is with a much smaller team focussed on a small number of remaining critical lines of inquiry that we think are significant. Show more Mr Rowley said while there were now only four detectives now working on the case full time, there was still useful work to do. Detectives investigating the disappearance of Madeleine McCann ten years ago are still pursuing “critical lines of inquiry” and remain committed to providing her parents with answers, the officer in charge has said.In an interview to mark the tenth anniversary since she went missing, Scotland Yard’s Assistant Commissioner, Mark Rowley, said his team would never give up hope of finding out what happened to the youngster.He said there remained a number of critical lines of inquiry including one lead which “could provide an answer”, but said it was important to be realistic as the months turned into years. “If we did not think they were significant we would not be carrying on, but we think they are significant.”He went on: “We don’t have evidence telling us if Madeleine is alive or dead. It is a missing person’s inquiry but as a team we are realistic about what we might be dealing with – especially as months turn to years.”He added: “Our mission here is to do everything reasonable to provide an answer for Kate and Gerry McCann. “I’d love to guarantee that we will get to an answer, sadly investigations can never be 100 percent successful, but we will do everything we can do reasonably to find an answer to what has happened to Madeleine.”He added: “We solve more than 90 per cent of serious cases here at Scotland Yard. I so wish I could say we will definitely solve it, but a small number of cases sadly don’t get solved.”The initial Portuguese police investigation was closed in 2009, but two years later the British government provided the Metropolitan Police with funding to review the case.