Building more prisons is not the answer | Letters

Wednesday’s opposition day debate on prisons served to highlight the ongoing crisis in the system. At the same time, the government’s “prison-building revolution” is gathering pace, with plans to expand prison capacity by at least 10,000 places. This appears to be a revival of the “Titan prisons” policy opposed by penal reformers and mothballed in 2009. It should be halted immediately. For example, the new prison recently proposed for the site of HMP Wellingborough will more than treble its capacity to 1,600 and grand claims have been made about the opportunities that this will bring in terms of local jobs and financial investment. These plans are being rushed through without full public scrutiny and democratic debate.

The numbers of people criminalised and sent to prison have already spiralled out of control to a record high. Yet prisons do very little to address the needs of people experiencing harm or violence. Building more prisons is not the answer to the current acknowledged failings of the existing system. Rather than investing £1.3bn in building new prisons, the government should be prioritising policies that radically reduce the number of people in prison. This could include meaningful jobs, social housing, healthcare, education, transport – for all.

We are calling for an immediate moratorium on prison construction and a national debate about how to build a safer society and secure communities instead of continuing with a failed policy of criminal justice expansion. We need to build safe and healthy communities – not prisons.
Tom Kemp
Reclaim Justice Network
Professor Peter Squires
British Society of Criminology
Will McMahon
Centre for Crime and Justice Studies
Deborah Coles
Inquest
Andy Gregg
Race on the Agenda
Dr David Scott
Open University
Kate Paradine
Women in Prison
Jan Cunliffe
Joint Enterprise Not Guilty by Association
Jodie Blackstock
Justice
Dionne Nelson
Women’s Resource Centre
Chryssy Hunter
Bent Bars Project
Kevin Blowe
Network for Police Monitoring
Professor Phil Scraton
Dr Sarah Lamble
Birkbeck University
Professor Pat Carlen
Gina Stokes
Anawim WWT
Professor Joe Sim
Pazuzu Gaylord
Action for Trans Health
Ian Marder
Community of Restorative Researchers
Margaret Gardener
False Allegations Support Organisation
Dennis Eady
South Wales against Wrongful Conviction
Kushal Sood
Trent Centre for Human Rights
Annys Darkwa
Vision Housing Services
Gerry McFlynn
Irish Council for Prisoners Overseas

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Building more prisons is not the answer | Letters

Amazing Immunity Building Juice You Have Got To Try Right Now

Amazing Immunity Building Juice You Have Got To Try Right Now

Diversity, devolution, innovation: building an NHS fit for the 21st century

It was “the can-do crowd”, according to the NHS England chief executive, Simon Stevens. Those who gathered at the Health and Care Innovation Expo 2016 in Manchester were certainly hungry for the latest cutting-edge practice and the hottest technology on show.

But Brexit uncertainty, funding anxieties and the unresolved junior doctors’ dispute added a sharp edge to debate on how the health and care system can be transformed into one fit for 21st century purpose. And scarcely a session passed without warnings from patients’ and service-users’ representatives that people were feeling left out of the loop on plans for change.

Paul Baumann, NHS England’s chief financial officer and, as he said, “chief devolutionist” responsible for regional autonomy on health and care spending, set the tone for the reformers when he warned that the latest drugs and technologies would be unaffordable for the NHS unless it did “everything else differently”. This would require “bold innovation and bold leadership”.

But David Cartwright, a patients’ representative from Oldham, summed up the frustration of the opposing camp when he asked Baumann and leaders of the Greater Manchester devolution project: “When are you going to tell our communities what we are going to get and what we are not going to get?”

Public consultation on STPs assured

Stevens picked up on the mood and used his keynote speech to try to offer reassurance, particularly with respect to the 44 sustainability and transformation plans (STPs) being developed by local care leaders to transform systems across the whole of England.

He said he would be issuing a notice stressing the need for formal public consultation on the changes proposed by the STPs, which may include closure of hospital services. But he added: “I hope that people will give NHS and local government leaders the respect that what they are trying to do is incredibly difficult, but incredibly important.”

Matthew Swindells, NHS England’s national director for commissioning, said the aim was to get all plans for STPs “assured” by the end of December so that they could be aligned with operational plans effective from April 2017. Challenged on the tightness of the timescale, he said: “We don’t have time to take longer. Every day we decide to have another committee meeting rather than getting on with making hard decisions, we are not making optimal use of health and social care from the money available.”

Technology is the key

The health secretary, Jeremy Hunt, announced plans to create an “ivy league” of global exemplar hospitals to fast-track digital excellence.

Naming the initial 12 trusts each to receive up to £10m in funding, Hunt said the idea would be to “buddy up” each one with a leading US hospital such as the Cleveland or Mayo clinics to bring them up to the standard of the best in the world. Less tech-ready trusts would be prepared in subsequent waves. Hunt also promised “instant access” to personal online health records. He said: “This puts power back into the hands of the patients.”

These announcements came on the back of publication at Expo of the final report of the Wachter review of NHS digital readiness, highlighting the need for clinical input in achieving digital transformation.

The review’s author and professor at the University of California, Dr Robert Wachter, stressed the need to “reimagine tasks” rather then superimpose technology on old working methods. He said: “That is why we need to involve young people in this process. They need to look at workstreams and question why we do it that way, with fresh eyes.”

The digital revolution is, however, raising concerns about appropriate use of personal information. Dame Fiona Caldicott, the national data guardian, speaking about her review of public trust in the use of health and social care data, warned: “People no longer accept things being done to them without their knowledge.” Her review sets out 10 standards for data use, informing individuals and conditions for opting out.

Innovation needs to be implemented faster

There is no shortage of medical and health innovations to transform what NHS England’s medical director, Sir Bruce Keogh, described as the “biggest semi-integrated health system in the world”. But he pointed out that “ideas are only as good as their uptake”.

Discussing the challenge of achieving innovation at scale, Keogh outlined the NHS innovation accelerator programme (NIA) – the brain child of a junior doctor, Dr Mahiben Maruthappu. In its first year, the NIA funded 17 fellows whose ideas and processes were accessed by 3 million patients in six months, Maruthappu said, with a further cohort of fellows due to be announced in October, focusing on disease prevention, early identification and long-term conditions.

Devolution

Devolution plans are now being developed in areas covering some 55% of England, following Greater Manchester’s lead in setting up the NHS’s first devolved health and social care partnership, which came into being in April.

Jon Rouse, chief officer of the partnership, making his first speech after just 20 days in post, said no one should be under the illusion that devolution was “magic dust”. Although there was already satisfaction in the development of dementia-friendly pharmacies and Pride in Practice, a new standard of excellence in healthcare for gay, lesbian and bisexual patients, the biggest achievement so far was the bringing together of a strategic partnership of 37 NHS, local government and social organisations.

Rouse said: “Judge us later down the line by how we make progress on patient experience and clinical experience. Devolution is complex, it’s dynamic and difficult, but it’s worthwhile.”

People come first

Jane Cummings, chief nursing officer for NHS England, issued a call to arms to recognise and promote the diversity of the workforce. It was, she said, “frankly appalling” that there were so few black and minority ethnic directors of nursing. Making special mention of health workers from the rest of Europe, worried by Brexit, Cummings said: “Diversity makes us a better service.”

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Diversity, devolution, innovation: building an NHS fit for the 21st century

Building better mental health in cities from the ground up

The frenetic, isolating nature of city life can be a day-to-day struggle for millions of people. An environmental cocktail of densely packed streets and homes, cramped and lengthy commutes and noise pollution as well as significant pockets of poverty and deprivation can take their toll. As a result, mental ill health and urban life are inextricably linked.

With urban areas expected to house two-thirds of the world’s population by 2050 and some cities, such as in China, undergoing unprecedented expansion, the relationship between urban environments and mental health – and what to do about it – is rapidly coming to the fore.

“Public health is an important component of the built environment, but all too often this focuses only on physical health,” says Layla McKay, founder and director of the Centre for Urban Development and Mental Health. The thinktank was set up in 2015 to bring together researchers, policymakers and planners across the globe to push for urban space designs that create mentally healthier cities.

Projects paving the way

A well-designed urban space can have a positive influence on people’s wellbeing and help prevent mental health problems developing or becoming worse, according to McKay.

“Mental health plays a huge role in the overall burden of disease around the entire world,” she says. “It’s prevalent in every country. The statistics do tell us that people who live in cities have a 40% increased risk of depression, a 20% increased risk of anxiety and double the risk of schizophrenia.”

So far, projects paving the way have tended to be small. Examples include one in Sheffield, England, says MacKay, where a green space parks initiative, the Improving Wellbeing Through Urban Nature project, is aiming to promote well-designed urban green spaces as a cost-effective way to boost mental and physical health. Another is the network of Dementia Friendly Communities across the UK.

Urban living takes its toll

There is a considerable body of evidence (pdf) internationally suggesting that urban living, especially poorly designed environments, can have negative effects on mental health. For example, substandard, overcrowded, damp housing has been proven to affect people’s capacity to cope, while the lack of something as basic as a play area can influence children’s wellbeing.

Meanwhile, compared with non-urban areas, cities around the world have an increased prevalence of acute mental illnesses, as well as other problems such as stress and isolation.

A recent report (pdf) from the Mental Health Foundation (MHF) in the UK concluded that cities becoming more crowded and the rising proportion of people living alone (up from 6% in 1972 to 12% in 2008) contributes to higher levels of loneliness, which is a risk factor for mental ill health.

Another study, Poverty and Mental Health, published by the MHF for the Joseph Rowntree Foundation emphasised the adverse connections between mental health and deprivation, which tends to be most concentrated in urban areas. The report’s recommendations included that policymakers consider mental health as a core part of the urban planning process, saying it “should be promoted as good practice”.

The role of planners and architects

It makes sense, McKay says, to take into account, for example, that improving street lighting and housing layout might reduce fear and anxiety about safety. The same goes for using urban design to produce plentiful open, green spaces (pdf) that encourage regular interaction in “pro-social spaces” and “a sense of community” with the goal of reducing isolation.

“[There] is a real opportunityfor for people who work in the planning, architecture and urban-focused professions to have an impact on mental health,” she adds.

Experts at the WHO Collaborating Centre for Healthy Urban Environments at the University of the West of England (UWE), which works in tandem with the World Health Organisation’s international Healthy Cities Project, concur that urban planning could have a substantial role to play in cities being designed with mental wellbeing in mind.

Related: Is city living bad for your health?

Sarah Burgess, senior lecturer in the department of architecture and built environment at UWE, says there is definitely momentum towards mental wellness becoming a greater priority for planners globally. She points to the popularity of happiness indices internationally and to initiatives such as Happy City in Canada, which promotes wellbeing as a legitimate goal of urban design, as examples of a growing appetite for new approaches.

But when it comes to individual cities spearheading attempts to put mental wellbeing at the centre of planning strategies, Burgess concludes that they are rare.

According to Daniel Black, an urban planner and fellow at the WHO Collaborating Centre, while planning professionals and researchers are increasingly becoming advocates for prioritising mental health in planning decisions, there is still some way to go before decision-makers in governments catch up.

“Mental health is still lagging behind,” he says. “Even physical health is only beginning to get on the radar. How those in control of urban development are integrating health into development is negligible.”

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Building better mental health in cities from the ground up

Vasectomy can enhance risk of building lethal prostate cancer

Prostate cancer is the most typical cancer in guys, affecting forty,000 a year in the Uk and causing ten,000 deaths. One in eight males will build the disease inside of their lifetime, with the huge bulk of circumstances occurring soon after the age of 65.

The bulk of circumstances are “slow growing” and health care advice typically advises maintaining the ailment underneath surveillance.

Many males who suffer from the cancer will suffer no harm from it, even though therapy alternatives, including surgery and radiotherapy, can have critical side results, such as erectile dysfunction and incontinence.

Researchers at Harvard Healthcare School tracked 50,000 males, who were aged amongst 40 and 75 and the commence of analysis, in excess of a 24 yr time period from 1986 to 2010.

The findings, published in the Journal of Clinical Oncology, located during this time that 25 per cent of men had vasectomies and six,023 cases of prostate cancer were diagnosed.

In complete, fewer than two per cent developed the most aggressive type of the illness, the study located.

Some previous scientific studies had suggested a connection amongst sterilisation and cancer, but the new review is the 1st to remove “bias factors”, such as that males who have a vasectomy are much more frequently diagnosed since they are far more probably to have standard checks.

Professor Malcolm Mason, Cancer Investigation UK’s prostate cancer professional, mentioned : “This is an really essential study, the largest one particular of its kind seeking at the website link among vasectomies and prostate cancer.

“Importantly, the further threat of establishing prostate cancer following getting a vasectomy seems to be little but of the few that do go on to create the condition, a higher number will build an aggressive form.

“Vasectomy is still an important choice for contraception, but this data must type portion of the discussion just before a guy tends to make an informed decision as to whether or not it is correct for him.

Close to a single in six males in Britain decide to have vasectomies. Authorities mentioned it was not clear why the method would have an effect on cancer incidence, but stated it was achievable that it relates to odds in proteins in semen right after a vasectomy.

Analysis author Lorelei Mucci, associate professor of epidemiology at Harvard School of Public Wellness mentioned the findings recommended increased risks amid these who had the method ahead of the age of 38.

She mentioned: “We noticed that in males who had a vasectomy earlier in lifestyle there was a greater risk of developing advanced or lethal varieties of the disease. This may be because of the timings and the influence on the prostate, anything may possibly be occurring in earlier lifestyle that can boost this danger when alterations are made.”

Despite the fact that the relative increase in the threat linked with vasectomy was significant, because the most aggressive kind of prostate cancer is least widespread, the absolute chance remained little, researchers explained.

Cancer charities mentioned that the improved threat in aggressive situations, although higher in relative terms, did not translate to a large complete amount of instances.

Dr Iain Frame, Director of Investigation at Prostate Cancer Uk stated: “We want to be cautious about how the outcomes are interpreted despite the fact that there seems to be an increase in aggressive prostate cancer in males who have previously had a vasectomy, it translates as a fairly modest enhance in the number of males who really create aggressive prostate cancer.”

Vasectomy can enhance risk of building lethal prostate cancer

Weight problems soars to "alarming" amounts in building countries

There are some 900 million obese men and women in building nations, data demonstrates. Photograph: Jose Luis Pelaez/Getty/Mix Photographs

The extent of the world’s weight problems epidemic has been thrown into stark relief as a report from the Overseas Growth Institute (ODI) puts the number of obese and obese grownups in developing countries at far more than 900 million.

Long term Diets, an analysis of public information about what the world eats, says there are nearly twice as a lot of obese people in bad nations as in wealthy ones. In 2008, the figures have been 904 million in developing nations, in which most of the world’s people dwell, compared with 557 million in industrialised nations.

“The growing charges of obese and weight problems in creating nations are alarming,” stated the report’s writer, ODI analysis fellow Steve Wiggins. “On existing trends, globally, we will see a enormous enhance in the quantity of folks struggling particular varieties of cancer, diabetes, strokes and heart attacks, putting an huge burden on public healthcare programs.”

The report warns that governments are not undertaking enough to tackle the increasing crisis, partly due to politicians’ reluctance to interfere at the dinner table, the strong influence of farming and meals lobbies and a massive gap in public awareness of what constitutes a healthful diet plan.

In accordance to the report, obese and obesity prices since 1980 have almost doubled in China and Mexico, and risen by a third in South Africa, which now has a higher fee than the United kingdom. Regionally, north Africa, the Middle East and Latin America all have overweight and obese prices on a par with Europe.

Workers set up lights on a giant McDonald’s sign in Beijing. Diet programs in China are proportionally richer in animal products than in the 1960s. Photograph: AP

“The evidence is properly established: weight problems, collectively with the extreme consumption of body fat and salt, is linked to the growing worldwide incidence of non-communicable ailments, which includes some cancers, diabetes, heart condition and stroke,” says the report. “What has transformed is that the vast majority of men and women who are obese or obese these days can be found in the developing rather than the produced world.”

The report highlights a paradox in the building globe. As properly as obesity, under-consumption remains a problem for hundreds of hundreds of thousands of folks in bad nations, where progress on decreasing stunting – reduced height to age – has been slow. Up to a third of infants in the creating globe are stunted.

Variables behind the boost in weight problems include rising incomes and urbanisation, which have a tendency to lead to diets wealthy in animal create, fat, salt and sugar and the a variety of influences of globalisation, amid them advertising and the media, on diets. But the report cautions against jumping to conclusions that nationwide diet programs are converging on a single international norm.

In China, for instance, diet plans, are proportionally richer in animal products and vegetables than in the 1960s, but sugar consumption remains lower. In contrast, Thailand has skilled an enhance in the per-head consumption of starchy roots and pulses as effectively as fruit, which Thais consume far more than animal goods.

This selection in diet plans carries specified implications, the report argues. Globalisation will not – in the medium term – location enormous restrictions on the scope for policy action, and policy needs to start where folks are, in terms of their preferences and traditions. “Trajectories are not preordained there is scope to influence the evolution of diet to get far better outcomes for health and agriculture,” says the report.

Yet, Wiggins acknowledges that governments have been timid in staking out positions on diet plan. “Who desires to take on the foods business?” he explained. “Then there is the moral and ethical dimension: individuals would not like the government to inform us what to place on the dinner table.”

Thai villagers sell fruit at a floating industry in Ratchaburi. Fruit consumption has risen in Thailand, the report says. Photograph: Apichart Weerawong/AP

This is not to conclude that diet regime policy have to be timid, says the report, even if that is, apparently, the public mood. It contrasts government reluctance to act on diet programs with robust action to restrict smoking. Although diet program is a much more diverse concern than smoking, says the report, there may be scope for governments to get more incremental measures that could pave the way for the public to accept some thing wants to be completed if potential health costs are to be contained.

Some governments have managed to alter diet programs for the better. South Korea has enhanced fruit and vegetable consumption through a publicity, social advertising and marketing and training campaign, like coaching of ladies to put together classic minimal-excess fat, large-vegetable meals. Denmark banned trans fats, which have made its McDonald’s amid the healthiest in the planet. Further back, the introduction of rationing in the United kingdom for the duration of the 2nd world war ensured that the poorest individuals have been capable to consume a balanced diet regime.

But these are the exceptions. For the most part, diet plans are increasingly unhealthy – with an increase in the consumption of sugar. Sugar and sweetener consumption has risen around the world by more than a fifth per individual from 1961 to 2009.

Less than a third of nations are consuming significantly less than the advisable prime limit of 50g of sugar a day per man or woman, and 69 countries have common per capita sugar consumption of a lot more than double this suggested upper limit. The world’s prime sugar consumers incorporate the US, Belgium, the Netherlands, New Zealand, Costa Rica and Mexico.

Fat consumption remains a concern. Amongst creating countries the highest consumption of excess fat is in east Asia and southern Africa. Even so, industrialised countries even now have considerably greater amounts of body fat consumption – often much more than double their building counterparts.

Weight problems soars to "alarming" amounts in building countries