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PM and Miliband lock horns over AV

PM to share platform with Labour’s John Reid, while opposition leader joined by Vince Cable David Cameron will today declare that he is opposing the alternative vote from gut instinct as much as from rational argument as he goes head to head on the issue of voting reform with Ed Miliband. The prime minister and the Labour leader are due to make speeches on the subject at rival events at almost exactly the same time. With coalition and Labour splits on full display, Cameron will be joined by John Reid, the former Labour home secretary, while Miliband will be accompanied by Vince Cable, the business secretary. Cameron has not shared an anti-AV platform with a Labour politician before and he will insist that he and Reid “don’t agree on much”. Reid is expected to reciprocate the sentiment, but will say “some issues are so important that they transcend party politics” and that he and Cameron are opposed to AV because they are “united in believing that politicians are the servants of the people”. The campaign has, at times, become particularly acrimonious, with Lord Ashdown, the former Lib Dem leader, accusing George Osborne and other Tories campaigning for a no vote in the AV referendum of “cynical smears and scaremongering”. But Cameron and Miliband are expected to seek to raise the tone of the debate by focusing more on the respective merits of the existing first-past-the-post voting system and AV. Claiming the debate on AV too often involved “a language of proportionality and preferences, probabilities and possibilities”, Cameron will say: “For me, politics shouldn’t be some mind-bending exercise. It’s about what you feel in your gut – about the values you hold dear and the beliefs you instinctively have. And I just feel it, in my gut, that AV is wrong.” The prime minister will argue that AV will take power away from the people. “I want a system that lets you, as the Americans say, ‘throw the rascals out’,” he will say, claiming AV would “damage our democracy permanently” and lead to more hung parliaments. This assertion was disputed by the deputy prime minister, Nick Clegg, who told the BBC’s Politics Show that AV would not lead to more coalition governments. “More hung parliaments have been delivered under first past the post than have been delivered under AV in Australia,” the Lib Dem leader said. But Cameron said the coalition would survive whoever won the referendum: “Whoever is on the losing side, as it were, will just have to pick themselves up and say: well, it was a fair argument, a fair fight, a fair referendum, the country has decided and now we have got to get on with all the things that really matter so much.” The PM also found himself defending his chancellor after Osborne was singled out for attack in a particularly strongly worded article by Ashdown. Osborne infuriated AV campaigners last week by suggesting the Electoral Reform Society should not be funding the yes campaign because its subsidiary, Electoral Reform Services Ltd, a company that organises elections, could profit from a switch to AV. The ERS says it is completely untrue but Five days ago, lawyers for the ERS sent a letter to journalists saying that although ERSL makes money from election administration, the type of election system used is “entirely irrelevant” to the provision of these services and “a change in the voting system would, therefore, have absolutely no impact on any of the revenue earned by the ERSL.” Osborne said its involvement in the funding of the yes campaign “really stinks”, prompting Ashdown to accuse him and other anti-AV campaigners in an article in the Observer of resorting to “smears, deliberate misrepresentations and sometimes even downright lies”. On Sky News, Cameron said: “The point George Osborne made, that the Electoral Reform Society is a big funder of the yes campaign, that it has an organisation that could make money out of it, that’s a fact, and I think there’s nothing wrong with bringing that fact out,” he said. But although this seemed potentially provocative, Ashdown subsequently praised the prime minister for focusing in his Sky interview largely the substantial issues at stake in the campaign. Cameron also insisted that the coalition would survive whoever won the referendum. said yesterday: “Whatever the result on May 5, this is a five-year government, Nick [Clegg] and I are absolutely committed to taking the government and its programme forward,” he said. “Whoever is on the losing side as it were will just have to pick themselves up and say: well, it was a fair argument, a fair fight, a fair referendum, the country has decided and now we have got to get on with all the things that really matter so much.” AV referendum Alternative vote Electoral reform Conservatives David Cameron George Osborne Labour David Miliband John Reid Liberal Democrats Nick Clegg Vince Cable Paddy Ashdown Liberal-Conservative coalition Andrew Sparrow guardian.co.uk

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Patients ‘denied key NHS treatments due to cuts’

Open letter accuses health trusts of letting public down by branding some elective surgery ‘lower value’ Read the FSSA’s letter Growing numbers of patients are being wrongly denied a new hip, a weight loss operation or even cancer treatment because of NHS cost-cutting, the leaders of Britain’s surgeons have warned. Increasing rationing of operations is forcing patients to endure pain, injury or disability because NHS primary care trusts (PCTs) are ignoring evidence about the effectiveness of certain treatments simply to balance their books. The warning from the Federation of Surgical Specialty Associations (FSSA), which represents the nine major types of surgeon in the UK, is in an open letter passed to the Guardian. It accuses trusts of letting down needy patients by branding forms of elective surgery as of limited clinical value in order to help them cope with the NHS’s tough financial climate. The FSSA, which represents about 15,000 surgeons, says it is “concerned that lists of surgical procedures and interventions, deemed of low clinical effectiveness or of ‘lower value’, are being used by PCTs to limit access to certain procedures … Review of the lists reveals that there is little or no evidence to support the view that many of the procedures are of limited value to individual patients”. The unprecedented statement goes on: “For example, the lists include types of hip, spinal, ENT [ear, nose and throat], dental, bariatric [obesity] and cancer surgery for which there is overwhelming evidence of benefit. The only justification for these lists can be that they are a means of reducing expenditure at a time when the NHS faces a financial crisis.” The surgeons’ move highlights the fact that PCTs across England are increasingly delaying or denying patients access to surgery to repair a hernia, replace an arthritic hip or knee, and remove cataracts, infected tonsils, gallstones, wisdom teeth, adenoids and varicose veins. Some are even restricting the number of patients who can have a hysterectomy or have their baby in a planned caesarean section. Surgeons, heath charities and patients’ groups are increasingly frustrated that PCTs are introducing what they regard as arbitrary lists of treatments of supposedly low or no clinical value despite medical evidence that many help relieve patients’ symptoms. The joint statement says the FSSA is concerned the evidence for the lists is “very poor and it is therefore inappropriate for them to be used to determine patient care without the involvement of the Specialty Associations”. Many PCTs, which commission and pay for healthcare, are struggling with the fact that, after a decade of budget increases averaging 7% a year, the NHS in England has to find £20bn in “efficiency savings” by 2015 and cope with close to zero annual rises during the same period. While they are rationing care, many hospitals and ambulance services are shedding staff. Peter Kay, chairman of the British Orthopaedic Association (BOA), the largest of the letter’s nine signatories and to which 4,000 surgeons belong, said: “This growing rationing is unfair because it is leaving more and more patients in pain, discomfort and misery. But it’s also a false economy because it stops some people from getting back to work and costs the state unnecessarily in welfare benefits for others. Plus conditions like arthritic knees, hernias and varicose veins don’t get better by waiting – they get worse and can cost more to treat when the patient is eventually treated.” Kay said he deplored refusing senior citizens a new hip or knee. “Older people are easy targets. Arthritis means they may be hobbling around and become virtual prisoners in their own home, dependent on friends and relatives, if rationing means they do not get the operation they need.” Surgeons’ leaders have been talking to the Department of Health (DH) since last autumn about the increasing use of the lists. The DH has voiced concern but so far failed to intervene or produce a single national list for England of treatments which can be restricted because agreed evidence shows they have limited effect. “Many tens of thousands” of patients, and potentially as many as 200,000 a year, are affected by the rationing, Kay believes. “This all makes a mockery of [health secretary] Andrew Lansley’s mantra that for patients, there should be ‘no decision about me without me’, as patients are not involved and PCTs aren’t assessing the severity of their condition.” Lansley’s radical reorganisation of the NHS is partly to blame, Kay said. “PCTs are doing anything they can to balance their books by the time that the new GP commissioning consortiums take over in 2013. I think that’s what’s driving this.” The trend would exacerbate existing postcode lotteries in the availability of certain treatments, he added . Last week the Audit Commission said PCTs could save up to £500m a year by carrying out far fewer operations which it said had limited clinical use. The King’s Fund thinktank also urged the NHS in some places to stop removing so many children’s tonsils or varicose veins in order to help it meet what it called “the biggest financial challenge in its history”. The Patients Association has been receiving a growing number of calls from patients who have had elective surgery delayed or denied. One with an arthritic knee told them in January: “I have been to my GP begging for them to speed up my knee replacement, but he says there is no funding and I will have to wait until April. I can’t do anything, not even go to the shops, and it’s so painful if I put any weight on it I scream.” The health department said: “We welcome the leadership of top surgeons and value their commitment. We share their passion for the NHS. We have invested an extra £11.5bn in the NHS and have been clear there is no excuse for waiting times to increase.” The shadow health secretary, John Healey, said: “Short-term decisions are being taken across the health service, in part because of David Cameron’s NHS reorganisation plans. Faced with a huge upheaval and greater financial uncertainty, PCTs are now cutting back on services. People are starting to see the NHS go backwards again under the Tories, with waiting times rising, operations blocked and frontline posts going. So much for David Cameron’s promise to ‘protect’ the NHS.” On Sunday, in a Sky interview, Cameron said that there would be “proper and substantive changes” to the bill setting up the new GP-led consortiums at the end of the two-month pause in its passage through parliament. Stressing that he took “absolute responsibility” for the legislation, Cameron signalled that the fresh consultation now taking place would lead to the membership of the consortiums being widened. NHS Health policy Public sector cuts Public services policy Public finance Health Andrew Lansley David Cameron Liberal-Conservative coalition Denis Campbell guardian.co.uk

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Congress is “absolutely” going to raise the debt ceiling, says Tim Geithner, because to do otherwise would be “catastrophic” and “the responsible people understand.” “We’d tip the US economy and the world economy back into recession, depression,” he said. “It would make the last crisis look like a tame, modest…

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JJ Abrams’s mystery project

The news that Lost creator JJ Abrams is to publish a novel has got rumour mill working overtime A series of phone calls announce the imminent arrival of an untitled manuscript to several unsuspecting publishers; a book arrives, but with different words deleted in each copy; no one else has any idea about the contents aside from rumours of a reclusive novelist, a love story and a high-concept notion about changing the way we think about books for ever . . . News that JJ Abrams will have a book out next year was delivered in a way that wouldn’t feel out of place in one of his TV shows or films: part corporate espionage; part copyright paranoia; total entertainment. So what do we know so far? As well as directing Super 8, writing Mission Impossible 4, and producing Star Trek 2, JJ Abrams, the co-creator of Lost, Alias and Fringe has found time to write his first book. Or rather, he’s found time to “create” it – novelist Doug Dorst is also on board for some, if not all, of the actual typing. It’s no surprise Abrams is turning his hand to literature. Lost was littered with literary allusions, from characters named after philosophers such as Locke, Rousseau and Hume, to Bad Twin, a spin-off novel supposedly written by “Gary Troup” – one of the ill-fated passengers on board Oceanic 815, which crashed at the start of the series. It remains to be seen whether or not the Hollywood uber- producer will “reinvent the reading experience” as his UK publisher suggested, “explode the bonds of the novel in ways no book has ever done” as the US publisher hopes, or just, you know, put his name on a novel. But one thing is clear. He has managed to turn the anticipation of every “Untitled JJ Abrams Project” into a fine art. Both Cloverfield and this summer’s Super 8 first appeared on the geek radar as UJJAPs – riding the buzz (“Ooh, what is it?”) before the answer (“Oh, it’s an alien”). The long process of anticipation – from teaser trailer to finished article – has become part of the way we consume entertainment. Sometimes it’s even the most satisfying moment. When all you have got are tiny spoilers, there is nothing inconvenient like the whole show, film or book to spoil the possibility that the latest UJJAP might just be as good as it sounds. JJ Abrams Lost Television Drama Fantasy US television Richard Vine guardian.co.uk

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JJ Abrams’s mystery project

The news that Lost creator JJ Abrams is to publish a novel has got rumour mill working overtime A series of phone calls announce the imminent arrival of an untitled manuscript to several unsuspecting publishers; a book arrives, but with different words deleted in each copy; no one else has any idea about the contents aside from rumours of a reclusive novelist, a love story and a high-concept notion about changing the way we think about books for ever . . . News that JJ Abrams will have a book out next year was delivered in a way that wouldn’t feel out of place in one of his TV shows or films: part corporate espionage; part copyright paranoia; total entertainment. So what do we know so far? As well as directing Super 8, writing Mission Impossible 4, and producing Star Trek 2, JJ Abrams, the co-creator of Lost, Alias and Fringe has found time to write his first book. Or rather, he’s found time to “create” it – novelist Doug Dorst is also on board for some, if not all, of the actual typing. It’s no surprise Abrams is turning his hand to literature. Lost was littered with literary allusions, from characters named after philosophers such as Locke, Rousseau and Hume, to Bad Twin, a spin-off novel supposedly written by “Gary Troup” – one of the ill-fated passengers on board Oceanic 815, which crashed at the start of the series. It remains to be seen whether or not the Hollywood uber- producer will “reinvent the reading experience” as his UK publisher suggested, “explode the bonds of the novel in ways no book has ever done” as the US publisher hopes, or just, you know, put his name on a novel. But one thing is clear. He has managed to turn the anticipation of every “Untitled JJ Abrams Project” into a fine art. Both Cloverfield and this summer’s Super 8 first appeared on the geek radar as UJJAPs – riding the buzz (“Ooh, what is it?”) before the answer (“Oh, it’s an alien”). The long process of anticipation – from teaser trailer to finished article – has become part of the way we consume entertainment. Sometimes it’s even the most satisfying moment. When all you have got are tiny spoilers, there is nothing inconvenient like the whole show, film or book to spoil the possibility that the latest UJJAP might just be as good as it sounds. JJ Abrams Lost Television Drama Fantasy US television Richard Vine guardian.co.uk

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Daniel Barenboim: unstuffed shirts

His recent cameo at Tate Modern offended the piano purists, but Daniel Barenboim doesn’t care. He tells Alan Rusbridger what Arab revolution can teach classical music When Daniel Barenboim ‘s hands are not at the piano or holding a baton, they demand a cigar. It is the first thing he mentions as he bustles into Claridge’s Hotel on the afternoon of his recent cameo concert at Tate Modern. We will go upstairs to his suite, he explains, and then he can light up. As if reading his mind, a member of staff shouts down the corridor after him: “Now then, Maestro” (he really does call him Maestro). “No smoking

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Challenge to Maundy Thursday

Cambridge professor Sir Colin Humphreys claims Last Supper took place on a Wednesday, not a Thursday The vagaries of Easter, whose connection with the moon’s phases leads to much confusion over its annual change of date, are about to be compounded by a scientific challenge to Maundy Thursday. Astronomical data, textual research and the rediscovery of an ancient Jewish calendar have convinced a Cambridge academic that Christ and the disciples’ Last Supper actually took place on a Wednesday. Professor Sir Colin Humphreys, a metallurgist and materials scientist, claims to have solved what is described by previous researchers as the thorniest problem in the New Testament: the gospels of Matthew, Mark and Luke assert that the Last Supper coincided with Jewish Passover, while John claims it was the day before. The former account’s credibility suffers from the sheer number of events – from arrest to trial and conviction – that would have had to take place before Jesus’s crucifixion on Good Friday. Anomalies also include the fact that the Jewish Sanhedrin, or religious court, was not allowed to meet at night and the Wednesday of Holy Week is curiously absent from the gospels’ chronology. “Whatever you think about the Bible, the fact is that Jewish people would never mistake the Passover meal for another meal, so for the gospels to contradict themselves in this regard is really hard to understand,” said Humphreys. “Many biblical scholars say that, for this reason, you can’t trust the gospels at all. But if we use science and the gospels hand in hand, we can actually prove that there was no contradiction.” The missing piece of the jigsaw, argues Humphreys in a book, The Mystery of the Last Supper, lies in an overlooked Jewish calendar which Christ and his followers may have used as outsiders and intellectual rebels within their country’s strict religious framework. In 2007 the pope suggested Jesus may have followed the solar calendar of the Qumran community, used by the Essene sect and described in the Dead Sea Scrolls. “The problem with this is that under that system Passover would have fallen a week later, after both the Last Supper and Christ’s death,” said Humphreys. Instead, he suggests that a third calendar in use at the time, adapted from Egyptian usage at the time of Moses, dates Passover in AD33 to the Wednesday of Holy Week. “The gospels are full of examples of Jesus presenting himself as the new Moses, and use of this calendar would accord with that,” said Humphreys, whose previous theological studies include scientific analysis of the star of Bethlehem and the numbers involved in the Exodus. “By choosing the Wednesday of the Passover, he was again identifying himself explicitly with Moses, setting himself up as a deliberate parallel. He then died on Nisan 14th, just as the Passover lambs were being slain according to the official Jewish calendar as well. “These are deep, powerful symbolisms and through the use of this calendar they can be based on objective, historical evidence.” Changing Maundy Thursday to Wednesday in the church calendar would inevitably take years, but the effects would be felt more in social terms than theologically. Although the day is set aside for contemplation of Jesus’s homilies at the Last Supper, its best-known feature is Maundy Money, given by the Queen to “deserving senior citizens” – one man and one woman for each year of her age. Easter Christianity Religion The Bible Martin Wainwright guardian.co.uk

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The 111-year-old Philadelphia Orchestra is filing for Chapter 11 bankruptcy protection, citing a “tremendous decline” in audiences. The orchestra, made internationally famous by such great conductors as Stokowski and Ormandy, has $46 million in operating costs this year, but is expecting just $33 million in revenues, reports the AP . “I…

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The Justice Department is shutting down the Bush-era Obscenity Protection Task Force, reports Politico , and critics are bashing AG Eric Holder for not being tougher on porn and smut. “As the toxic waste of obscenity continues to spread and harm everyone it touches, it appears the Obama administration is giving…

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Jonathan leads in Nigeria’s election

Unofficial results from 30 of the country’s 36 states suggest the president has an unassailable lead over Muhammadu Buhari The Nigerian president, Goodluck Jonathan, is on course to retain power after an election intended to draw a line under decades of coups, violence and vote rigging. Jonathan had an unassailable lead as votes were tallied from around Nigeria, despite a strong showing by his rival Muhammadu Buhari in his mainly Muslim strongholds. Buhari, a former military ruler from the north, was hoping to at least force a second round against Jonathan, a Christian and the first head of state from the oil-producing Niger delta. That looked impossible, with a Reuters tally of results from 30 of 36 states across Africa’s most populous nation showing Jonathan on 20.3m votes to 10.4m for Buhari. There were not enough registered voters in the remaining states for Buhari to make up the difference. Jonathan’s officials said there would be no victory claim until results were announced by the independent national electoral commission, but they were clearly upbeat. Oronto Douglas, a senior adviser to the president, said: “This is no time for triumphalism. It is a time for deep reflection, for strengthening the bond of our union and for all of us to work together.” Jonathan, 53, a fedora-wearing zoologist from the south, inherited the presidency last year when Umaru Yar’Adua, a northerner, died during his first term. Some members of the ruling People’s Democratic party said another northerner should have be allowed to stand for what would have been Yar’Adua’s second term. As expected, the results revealed a geographical divide. Jonathan did particularly well in the predominantly Christian south, while Buhari swept many of the Muslim-dominated northern states. Since the end of military rule in 1999, Nigerian elections have been widely condemned for state-sponsored manipulation and fraud bordering on the farcical. Observers generally gave a clean bill of health to this year’s vote. The former president of Botswana, Festus Mogae, who leads the Commonwealth observer group, told the Associated Press: “In recent decades, Nigeria had come to be known for flawed elections. People outside and Nigerians themselves had come to believe that elections could not reflect the will of the people, but today people showed that they can change that. “We seem to be witnessing a giant of Africa reforming itself and putting its house in order.” A senior political source, however, told the Guardian he could see a different picture emerging from election monitor reports. “I’m afraid they’ll be singing a different tune,” said the source, who did not wish to be named. “I can see there are massive complaints, including the abandonment of collection centres. It’s very disquieting.” There were allegations of underage voting in the north and the snatching of ballot boxes in the south-east. Fearing the ruling party would try to fiddle the results, Buhari supporters took to the streets in some northern cities. Bello Ar-Adam, a representative of Buhari’s Congress for Progressive Change, told Reuters: “Rigging is the stock in trade of the PDP. A leopard doesn’t change its spots.” Trouble flared in isolated areas. Police said a bomb was detonated at a hotel in the city of Kaduna, wounding eight people on Saturday night. A PDP official’s house was burned down in the town of Azere. Shots were fired in Bauchi and a car thought to be carrying fraudulent ballots was set ablaze in what turned out to be a case of mistaken identity. Young men stalked the streets armed with bows and arrows. There were signs that young people had voted in record numbers. Chude Jideonwo, the co-founder of EnoughisEnough Nigeria (EiE), a youth voter registration campaign, said: “Young people came out massively to vote across the country, including in rural areas. This election disappointed the cynics and defied even our expectations.” Jideonwo added that, curiously, social media sites such as Twitter had seemed to indicate a likely victory for Buhari, but now results suggested Jonathan would win. “Goodluck Jonathan spent five or six months trying to engage young people in various ways. “His strategy was to emphasise his likeability by being positive and reluctant to criticise. A week ago I would have said it’s too passive, but now it seems to have been a good strategy.” Jonathan, whose PDP lost seats in a parliamentary election last week, cast his ballot in his home state of Bayelsa in the Niger delta and hailed the election as a “new dawn in Nigeria’s political evolution”. “If the ballot paper means nothing then there is no democracy,” he said. “Nigeria is now experiencing true democracy where we the politicians have to go to the people.” Nigeria David Smith guardian.co.uk

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