Last week amateur chefs everywhere were absorbing instructions on how to cut an avocado, after a post-brunch A&E influx of injuries sustained while trying to prepare the fruit (Pass notes No 3,853: Avocado hand, G2, 11 May). Now I hope the nation might broaden their knowledge further by learning how to help someone having an epileptic seizure. It’s National Epilepsy Week, and our new YouGov poll shows that two-thirds of UK adults with no experience of epilepsy would not know how to help. This is worrying when London Ambulance Service alone attends 40 epileptic seizures a day. Taking two minutes to read our seizure first aid steps – www.epilepsysociety.org.uk/10-first-aid-steps-for-convulsive-seizures – could make all the difference in a crisis. Clare Pelham Chief executive, Epilepsy Society
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Only a week ago I told a patient there would be a scandal soon about our over-prescribing of opioid medication for chronic pain. What comes across in your article (Doctors call for action after prescriptions for addictive painkillers double in decade, 6 May) is the absence of any sense of the profession’s complicity in this process. I suggested to a colleague a few years back that we prescribed too much Valium (diazepam) and opioids. “About the same as everyone else,” was the reply. We are effectively legalised pushers and should acknowledge this because, in doing so openly with patients, we shoulder some of the blame for their habit. I also remember helping a woman in her 50s wean herself off diazepam, alcohol, co-codamol, antidepressants and cigarettes after 30 years of using these to block the pain of her second son being born with cerebral palsy and being taken into care. It was a struggle for her but it brought her back into her relationship with her husband: a few months later he tearfully related how he had re-met the woman he married 30 years before. This was only possible – I believe – because, at the outset, I said that it was we doctors who were responsible for her addiction. Dr Hugh van’t Hoff GP, Stonehouse, Gloucestershire, and director of Facts4Life
• As someone living with lifelong chronic pain, I was interested to read your article highlighting that opiate use had doubled in the last decade with associated risks of addiction and dependency. While I agree this is worrying, I would argue that it reflects the dominant biomedical model of pain management within the NHS. There is little or no science involved in matching an individual patient with the complex range of painkillers available. It is largely a case of try it and “see how you get on”. I have been on dozens of painkillers, including opiates, throughout my life. I found most have unbearable side-effects and limited impact on my pains. We need a holistic approach to pain that can offer comprehensive individual assessments and access to a wide range of treatments. Opiates and other painkillers can have an important but not a primary role in pain management. Martin Hoban Pontyclun, Rhondda Cynon Taff
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In your report on the mayoral elections in Greater Manchester (Manchester mayor puts focus on homelessness, 9 May) you highlight the financial challenges facing the region, including that local authorities have undergone cuts of around £2bn since 2010. We have just completed a study of the impact of austerity on devolution and growth in Greater Manchester and we find that, in addition to local government cuts, the post-2015 welfare reforms will take almost £13bn from claimants in the region by 2020-21 as a result of benefit cuts and changes. This is the equivalent of £690 per working-age adult per annum. And there are other cuts which devolution has to manage, such as to adult skills and health and social care, where there is a £2bn funding gap.
Andy Burnham’s intention to prioritise homelessness is important and is to be welcomed, but to donate some of his salary to a new fund can send out the wrong message. It is austerity which is reinforcing social inequalities and homelessness in Manchester and elsewhere. We propose that Andy Burnham should argue for a different type of devolution model that is not about devolving austerity, but genuine local control over policies, finances and resources that will realistically address the economic and social problems of Manchester. We argue for a public services and investment case for addressing both growth and social disadvantage, which, combined with more local control over finances, will go some way to addressing not only homelessness, but also poverty and inequality. Dr David EtheringtonMiddlesex University Professor Martin JonesStaffordshire University
• The concerns of Hartlepool residents at reductions in police numbers are well founded and regularly featured in over 430 community meetings I have attended in the area since my election in 2012 (Voices and votes, 9 May). The simple facts are that since 2010 the Cleveland area has lost £39m, or 36% of our policing budget, and the government, despite comments on ringfencing police spending, has taken another £1.2m off our grant settlement for this coming year (2017-18). We have implemented economies and efficiencies to maximise investment in neighbourhood policing, and to protect vulnerable people, but it is within a context of seven gruelling years of government-imposed austerity for communities like Hartlepool that impacts on the quality of life here. Barry Coppinger Police and Crime Commissioner for Cleveland
• While Polly Toynbee and David Walker are right to bemoan the cuts in services (Disparage, downgrade, downsize, G2, 9 May), surely the underlying issue is how to revive the local state – and in the process restore faith in building a fairer future? This means finding better ways of funding local services, rather than depending on unpredictable government grants. Most of the countries in the OECD do this by raising significantly more funding locally, from cities that cover much larger areas.
This can be achieved quite easily by reforming our anachronistic property rating system. Those with large land ownerships need to pay more, while small businesses, for example, should pay less. As a start councils can use parking charges to shift behaviour, as Nottingham has done in funding a third of the costs of its tram extensions through its workplace parking levy. Similarly, by building many more homes on public land, councils could plough the increases in land value back into improved local services, as Croydon, for example, is starting to do. People may no longer trust the national state to build utopia, but they will support measures that make sense locally. Dr Nicholas Falk Executive director, Urbed Trust
• Polly Toynbee and David Walker’s article on shrinking the state was right to mention evidence of rising child poverty. Our recent research shows that Britain has the third worst relative poverty of 21 developed countries, the fourth highest child mortality rate (CMR, 0-4 years) and an underfunded health service, as health expenditure fell from 9.4% of GDP in 2010 to 9.1% in 2015.
While CMR fell in every developed country, nine other nations had significantly bigger reductions than the UK, so we have an excess of child deaths. If we had the same CMR as Portugal, which previously had the highest rate, but which is now considerably lower than Britain, then we would have 1,300 fewer grieving parents. The link between relative poverty and CMR is again confirmed by our and other international research. Every parliamentary candidate should be asked what will they do to reverse relative poverty in Britain and perhaps match Portugal’s child mortality rate. Professor Colin Pritchard Bournemouth University
• It is government policy to reduce state spending, but billions of pounds of taxpayers’ money being channelled into private hands. Would a government really committed to lowering taxes and an economy based on free-market competition, spend £10bn a year to subsidise wages in private companies? Why would it be willing to give about £27bn a year to landlords, rather than imposing rent controls or building more homes? Why would it pay through the chancellor’s nose for private finance initiatives, now crippling NHS trusts? Plainly the government is only against state spending when it is on public services, not when it increases the private sector’s ability to make bigger profits. Derek Heptinstall Westgate-on-Sea, Kent
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Drs Mellon and Prosser explain (Letters, 6 May) why the opinion polls were wrong at the last general election – a failure to obtain representative samples. Specifically, pollsters did not contact enough people from hard-to-reach groups that do not vote in elections. What I want to know is, has this mistake been eliminated in the current polls, which are being respectfully reported, on voting intentions? Are the pollsters now doing the job properly? Can we trust these polls? Oliver Williams London
•I agree with Chris Birch (Letters, 9 May). Subtitles flash on and off, cover translations, appear at different places on the screen and sometimes continue over the following programme. Theresa May gabbles, Jeremy Corbyn has a beard, both impossible for lip-readers. It’s no wonder we retire to bed, exhausted. Jean Jackson Seer Green, Buckinghamshire
• I don’t find it at all strange that a teenager would have Margaret Thatcher’s picture on his bedroom wall (G2, 9 May). Our son had her picture on his dartboard. Barbara Freeman Leicester
• Richard Carden (Letters, 8 May) perhaps misses the point when he attributes English councils’ democratic deficit to first past the post. Since 2001, every council without an elected mayor has by law had a quasi-mayor (the leader) making almost all the decisions. In effect that’s one-person rule (give or take a small sofa cabinet chosen by the leader) irrespective of the council’s political balance. Nick Beale Exeter
• The correspondence regarding grandparents (Letters, passim) reminds me of a very old joke: My grandparents were called Pearl and Dean but we knew them as Grandma and Grandpapapapapapapapapapapa. Steve Vanstone Wolverhampton
• A friend of mine used to refer to his daughters’ long-term unmarried partners as his “sons-in-love” (Letters, passim). Dr Brigid Purcell Norwich
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The government attributes 40-50,000 premature deaths each year to the effects of airborne pollution; there are some 1 million cases of foodborne illness, which result in 20,000 hospital admissions and 500 deaths a year; and up to 50,000 people die each year as a result of injuries or health problems originating in the workplace (Enemies of the state: the 40-year Tory project to shrink public services, G2, 9 May). Yet the rate of inspection and enforcement actions for environmental health, food safety and hygiene, and health and safety have all been falling. The statistically average workplace now expects to see a health and safety inspector once every 50 years.
In the name of cutting red tape, governments of all political persuasions have attacked independent regulation and enforcement. Budget cuts in the name of austerity have compounded the problem – especially at the level of local authorities. There is now a plethora of schemes to outsource and privatise wholesale some regulatory and enforcement activities. Private companies are increasingly involved in “regulating” either other private companies, or themselves, or both. Such changes mark the beginning of the end of the state’s commitment to forms of social protection put into place since the 1830s. Steve Tombs Professor of criminology, Open University
• Recent reports say parts of the British Isles are in the early stages of drought, with less than normal amounts of rain in the past few months. South-east England is particularly affected. But hasn’t our climate often broken the norms in the last 40 years? Past performance is no guide to what will happen in the future. It would be a good time now, in this pre-election period, to ask our politicians what contingency plans they have for a prolonged drought lasting two or more years. Our survival may depend upon them. Geoff Naylor Winchester
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Whenever Theresa May finds herself in a corner over the NHS she repeats the mantra: you require a strong economy to have an NHS in the first place (Marr grills May, 1 May). That is a classic example of a necessary but not a sufficient condition. It obviously helps to have a strong economy but a nation has to get other decisions right.
The US has a strong economy but a seriously deficient public health service due to large reliance on insurance companies for facility and corporations providing health cover for employees.
Cuba has a weak economy but an excellent health service due to the right decision on prioritising public health.
In the UK the NHS is in difficulties due to the Tory government prioritising tax breaks for corporations and the better off instead of using the finance to meet the needs of an ageing population with increasing quantities and complexities of treatments required. PFI and privatisation have also not helped. Nigel de Gruchy Orpington, Kent
• The political shock-horror of the shortage of nurses misses the point of why so many NHS staff are not British or/and are leaving. At the weekend I had a cardiac physiologist to stay – ie, not a doctor or a nurse but an essential member of the team dealing with heart attacks on emergency call-out at night, and for checking heart problems during the day. The night on-call emergency rotas are made to follow a full day’s work, so no sleep for up to 24 hours is common. It is worse when you are sent home at about 4am and drop into an exhausted sleep only to be woken again to go to work an hour or two later (or not daring to sleep in case the phone rings). My guest says jobs are harder to fill in hospitals where you can be on call for a night in between two normal days – ie, up to 36 hours’ continuous working for patients who are in immediate danger of death.
These staff do not have the powerful BMA doctors’ union acting for them, and such practices have become normalised and in agreement with unions. Politicians claim to be making the best use of taxpayers’ money. Not in my name please! Sleep deprivation is the reason my guest and many others are looking to leave the job they otherwise found satisfying after years of training and building up their expertise. Name and address supplied
• I wish to point out the connection between the two articles on cancer drugs and end-of-life care in Friday’s paper. In the cash-constrained NHS, expenditure in any area means that money cannot be spent elsewhere. So when £1.27bn goes on very expensive new cancer drugs (Report, 28 April), not curative and with zero or marginal outcome benefit, it cannot be spent on specialist palliative care or “hospice at home” services. The consequence is that those same patients, within weeks, cannot be supported in their wish to die at home (Report, 28 April). Many more people would have been helped by the latter investment. Dr Charles Turton Burgess Hill, West Sussex
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The UK government now says that due to the election all e-petitions will be closed, though people can still read them. Petitions will have to be restarted after the election and signatures cannot be transferred. What a terrible way to treat the public. Some of these petitions have already reached the target of 100,000 and were due to be discussed, such as “Drivers over the age of 70 having to be tested every three years”. We should insist the new petitions committee ensures that the popular ones are discussed and do not have to start again. Ann Paterson Didcot, Oxfordshire
• Like Andrew Mayers’ brother (Opinion, 25 April) I had electroconvulsive therapy in 2006 after three years of “treatment-resistant” depression and it gave me my life back with minimal side-effects. When I had a relapse last year, the NHS psychiatrist had no hesitation in prescribing it again and I was completely well within a few weeks. It saddens me to think that Andrew’s brother was not offered that option. Surely the NHS should not hesitate to offer ECT immediately to anyone who has benefited from it in the past. Ian Arnott Peterborough, Cambridgeshire
• After years of hard training, Ellie Downie wins the Gymnastic European Championships. The Guardian honours her with the smallest article in the sports section (22 April). Perhaps she and all the other girl gymnasts should have been wearing high heels to work to get more recognition (Ministers accused of cop-out over refusal to outlaw rules on high heels, same edition). John Wilson (former gymnast and coach) Long Melford, Suffolk
• Regarding the rise of the robots putting jobs at risk (Report, 15 April and Letters, 25 April), Walter Reuther, the US union leader after the war, was shown around a Ford plant in Cleveland in 1954. A Ford official pointed to some automatically controlled machines and asked Reuther: “How are you going to collect union dues from these guys?” Reuther replied: “How are you going to get them to buy Fords?”. John Richards Oxford
• I can’t cope with any more bad news; first Brexit, then Trump and now Bananarama to make a comeback (G2, 24 April). Ken Balkow Sheffield
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While I applaud publicising and myth-busting the menopause (“I just coped, as others do: breaking the silence about the menopause”, In Focus), I am sorry that nowhere in the article did you mention diet as a means of dealing with menopausal side-effects.
The beginning of my menopause was a nightly sheet-wringing affair and daily having to pull over in the car to urgently strip off before I melted. About that time, I exchanged meat and dairy products for tofu and soya milk alternatives. Soon afterwards, the sweats subsided, then stopped. I thought I was one of the lucky ones, but I then learned that an oriental diet, low in meat and dairy and high in soya, which contains phytoestrogens, was the more likely reason. Menopause is not an illness, it’s a fact of life, and the reaction to administer drugs to treat the symptoms is sad.
In the early days of my transition, I found that suddenly stripping off in public places for an impending hot flush was best dealt with an: “Excuse me, I’m having a menopausal!” and laughing. Since laughing is infectious, everyone laughed with me (albeit sometimes nervously). Stephanie Fuger Matlock, Derbyshire
Nazis knew the BBC’s power
There has never been much doubt about the integrity and quality of the BBC’s wartime broadcasts to Nazi Germany. Their significance for that nebulous entity, “the German people”, is less certain (“How the BBC’s truth offensive beat Hitler’s propaganda machine”, News).
Nazi propaganda succeeded in seducing huge sections of the German population, especially among the young, while a draconian law passed at the outbreak of the war imposed such heavy penalties on listeners to foreign broadcasts, including capital punishment for passing on such information, that it was likely to discourage all but the most intrepid anti-Nazi.
Its most consistent and attentive listener was Hitler’s minister of information, Joseph Goebbels, who, sensing the potential danger, refused even high-ranking Nazi colleagues permission to listen to the BBC. Nazi terror ensured that even in the last stages of a clearly lost war “the German people” would stage no uprisings against their moribund overlords.
The BBC’s German Service failed in its mission to enlighten the misguided “German people”. The listeners to this splendid service were people like my Nazi-hating mother, who took huge comfort from the knowledge that beyond the confines of their now so deadly country was another world that cared and would fight to overcome the evil that gripped Germany. Carla Wartenberg London NW3
Heavy weather, Nick
It seems that whatever Nick Cohen writes about, he has set himself the task of inserting at least one gratuitous swipe at the left wing of the Labour party. If he was asked to write the Observer’s weather forecast, he’d probably find a way of blaming them for every approaching thunderstorm.
Last week, for instance, writing about George Soros and the Hungarian government, he managed to contrive a reference to what he described as “the Labour left’s claim that Hitler was a Zionist”. That’s quite a sweeping, damaging accusation, apparently aimed at the whole of the Labour left. Yet the recent crude, insensitive and provocative suggestion by Ken Livingstone that Hitler “was supporting Zionism” was widely condemned by Jeremy Corbyn, John McDonnell and most of that very same “Labour left”. John Marais Cambridge
MacKenzie is his own nemesis
I agree with Barbara Ellen’s piece “Read all about it. MacKenzie is no man of the people” (Comment). However, I would go further as Kelvin MacKenzie displays the classic symptoms of addictive behaviour, whereby someone has compulsive patterns of behaviour and cannot help themselves.
MacKenzie has made a few of these ill-advised stands, making ridiculous pronouncements since his terrible stance on Hillsborough and one has to have some compassion for the man who is on a self-destruct mission. These desperate attempts to keep himself in the frame are another form of attention-seeking. Of course, the management of the Sun should have put themselves, any sub-editors, the editor and any journalists party to the piece before publication on gardening leave immediately, without waiting to see the reaction. Martin Sandaver Hay-on-Wye
Enough of this codswallop
Your business leader column on corporate speak reminded me that it is not only the corporate world that suffers from meaningless jargon intended to fool the listener/reader into believing that something meaningful has been uttered.
Corporate speak is spoken by those who wish to exclude from their conversations those who are not deemed suitable to be admitted to their heady heights. Nowhere is this more manifest than in the corridors of government and civil administration. They are all talking codswallop to each other, but no one has the cojones to be the first to admit that they do not understand what has been said. Paul F Faupel Somersham, Cambridgeshire
In my view, those who try to come up with totalising explanations of mental health are misguided (Letters, 20 April). It’s neither purely social nor purely individualistic, though effective help should start from actually listening to and honouring the individual case. Often in practice it does not, and I would agree with Professor Read that a biogenetic medical model is generally inappropriate and can actually be damaging. It also goes radically unacknowledged that there are various different types of bereavement, some of which are far more traumatic than others, and are not directly comparable. The effects of traumatic sudden bereavement experienced in childhood or adolescence can last for years and ultimately for a lifetime, as the princes have now highlighted. It is known that this type of bereavement can sometimes result in lasting shock followed by delayed grief years later, yet there is often little or no acknowledgment readily available, never mind any effective support.
On top of this, and especially in a culture of competition, the bereaved are often subjected to cutting comments, judgments and dismissals. Sometimes these are from those who claim to know what it’s like because their grandparent or cat has died, while sometimes they are from people in medical or authority positions whose callous judgmental ignorance can be devastating. Why does it require the intervention of princes to highlight the issue? At least they get taken seriously. LE Collier Cheltenham, Gloucestershire
• It seems to me that a potential key to improving psychological provision for common human grief and misery (Freud’s term) is not only more better-trained, organised professionals, but also a more compassionate and empathic caring society attuned to the emotional needs of others. Where many families are so economically impoverished, they barely have the inner resources, strength and resilience left to attend to each other’s mental pain and suffering. What chance this election gives us all an opportunity to change our minds about the material hardship and distress we are causing those most in need of help, so they can move on? Ya’ir Z Klein London
• Keith Farman asks whether bereavement is a mental illness. Before answering, note that Harry says he suffered from denying grief when his mother died, not from the grief itself. While grief is a normal reaction to loss that cannot be blamed on others or self, its first stage is usually denial, which may help deal with events following the loss and which I believe is an illness. However, as confidence recovers, fear should subside and a second stage of grief usually occurs when the rage or fear roused by the loss is normally expressed. This is not evidence of mental illness. Alison Sesi says children cannot yet express their feelings effectively. This should not be so. But they may not experience grief but the simpler hate, sadness, anxiety or rage. I suggest that when our species acquired verbal language, most societies came to believe in gods and devils. Though later religions used these to help sustain laws and customs, they do not exist. So mental illness has long been endemic. George Talbot Watford, Hertfordshire
• Professor Samuels never misses an opportunity to take a swipe at the evidence-based psychological therapy now available on the NHS. Prince Harry is at liberty to choose whatever sort of therapy he wishes and his comments, which seek to normalise and reduce the stigma attached to mental health problems, are very welcome. We don’t know what sort of therapy Prince Harry had, but scientific evidence suggests that had he attended eight to 12 sessions of cognitive behavioural therapy (CBT) at his local GP surgery for the traumatic bereavement he experienced, the outcome would have been a good one. Hal Westergaard (Cognitive behavioural therapist), Bath
• It was with interest that I read Andrew Molodynski’s comments regarding ECT as a useful option for treatment resistant major depressive disorder (Shock treatment on increase again in NHS, 18 April). I have experienced this horrible illness along with anorexia for a number of years. I underwent a significant number of ECT treatments. Apart from some short-term memory loss, it is painless, and one is unconscious for a very short period. For me it was life-saving. I don’t think I would be alive today without it. If the need arose I would willingly have it again. Although medical treatments may help the many symptoms of severe depression, it frequently returns time and time again.
The causes of this life-altering illness need to be untangled if treatments are to succeed. This is where psychologists/psychotherapy may have the answers. In an underfunded and understaffed mental health service, therapy can be difficult to access. I have been one of the fortunate ones. Let no one underestimate the distress of severe depression on the individual and their loved ones, and the challenges it presents to mental health staff. ECT is an important life-saving treatment for people like myself. Sheila Cook London
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While experts are right to congratulate Prince Harry (Harry praised for telling of ‘chaos’ over Diana’s death, 18 April), and call for more spending on mental health, there is an elephant in the room. Mental health services are dominated by an outdated, simplistic medical model of distress that is rather at odds with the prince’s views. While he makes the obvious link between painful life events and mental health difficulties, our services are still telling distressed people that they have illnesses, like major depressive disorder, caused by chemical imbalances – an unsubstantiated drug company creation – and by inferior genes that make them more vulnerable than others to depression, anxiety, psychosis etc.
Unlike Harry’s psychosocial approach, this socially blind bio-genetic model actually increases prejudice, by using stigmatising labels and exaggerating differences. It has also led to over 62m prescriptions of antidepressants annually in England, at a cost of about £800m a day to the NHS. Our children too are being labelled and drugged at an equally alarming rate. Time for psychiatric services to move on from the failed diagnose-and-medicate approach and start asking us what happened to us, and what we actually need. Professor John Read University of East London
• Is bereavement a mental illness? Does grief require medical treatment? It is a profound mistake to treat such essential aspects of the human condition, and our responses to them, as purely personal “in-the-mind” medical crises, evidence of “ill-health”.
It is the overwhelming assault of our culture on our sense of personal space, time to be, not just to do; that generates much of the distress. The shame and stigma won’t be removed from this distress until we realise that it is not simply an individual, personal illness – though sometimes it becomes that – but a social, cultural malaise that will be deepened, not alleviated, by pills or sometimes misdirected talk therapies. Keith Farman St Albans, Hertfordshire
• Although Prince Harry’s revelations have rightly been praised by mental health experts, it would be helpful to focus on the particular issues surrounding those of us who have been bereaved in childhood.
First, the adults around us do not know how to approach us; second, we are commonly isolated in terms of the experience within our peer group; third, we have not yet developed the means to express our feelings effectively to the adult world around us. Add to that the “scorched earth of English repression”, as Richard Beard so brilliantly described it (Family, 8 April), and the fact that you miss out on natural processes in relationships that are part of growing into adulthood, and you may well finish up with a toxic foundation of anger within you.
Those bereaved in childhood have been widely misunderstood and ignored; the prince’s remarks allow us at least to start a debate as to how we should treat this most vulnerable group. Alison Sesi Billericay, Essex
• Suzanne Moore writes (Harry got help. Many others deserve it too, 18 April) that no one touched the two young princes during their mother’s funeral service. But why would anyone want to display public emotion, knowing that columnists were looking down on them? The family she saw that day was no different to other families who do not show their emotions at a funeral. Many people, frozen in grief, cognitive processing and exhaustion, are paralysed when it comes to being on display while they deconstruct and reconstruct what is in the coffin in front of them.
One message of the royals’ Heads Together campaign is not to judge other people, because you don’t know their circumstances. Miriam Fitzpatrick Dublin, Ireland
• Prince Harry is fortunate to have had what is increasingly being called “real therapy”, meaning in-depth and enjoying a trusted relationship with the “shrink” (to use his word). This kind of private practice therapy has almost completely vanished from the NHS and the public sector because all funding is being sucked up by the Improving Access to Psychological Therapies scheme. In this manualised and medicalised state therapy system, with economic rather than psychological goals, it takes a long time and much judgmental evaluation before a few get even cognitive behavioural therapy. We can be pretty sure that CBT is not what was offered to the prince.
It is time for the Department of Health to acknowledge that the old-style psychotherapy and counselling did a lot of good, and that it is still possible to restore it. Professor Andrew Samuels Centre for Psychoanalytic Studies, University of Essex
Non-contact boxing can help people with mental health issues, says Martin Bisp. Photograph: VisitBritain/Getty Images
• I read, with interest and admiration, Prince Harry’s comments regarding how boxing helped him (Report, 18 April). This is something we, at Empire Fighting Chance, already know. We have had massive success with our own non-contact boxing programme for people with mental health issues, often engaging those that traditional services fail.
My co-founder and I have spoken at numerous all-party parliamentary groups about how it is possible to help those most in need by offering something different. However, there seems a real reluctance to invest in and integrate credible, community-based programmes.
Yet everyone can benefit from a community intervention: treatments are not class, race or postcode dependent. Deprivation is a huge factor for poor mental health and the poorer you are the less likely you are to know about or access services. Having something based in your community, provided by a name you know and trust, works. People are not embarrassed to attend – in our case they are proud to say they are going to the boxing gym. Once in it, they train like everyone else, they are not “on display” in some sterile leisure centre, so we get better results.
Finally in a time where funding is hard to come by, budgets are stretched and the health service is under tremendous pressure, we must recognise the role within that sports-led community projects can offer and look to innovate delivery. Resourcing them adequately appears to make sense from a business and, much more importantly, human angle. Martin Bisp Chief executive officer, Empire Fighting Chance
• Today’s underfunded NHS is unlikely to increase access to the support needed by those processing emotional trauma. I and many others, in UK and internationally, have found help from co-counselling, a peer-support system that, after a 40-hour training course, gives access to lifelong listening support that is comfortable with emotions. Pills and professionals have their place, but, as Harry said, listening is more helpful than advice for working through emotional issues that are an inherent part of being human. Jean Brant Birmingham
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The government’s statement that there are 11,200 more doctors and 2,100 more nurses on the wards since 2010 (Hospitals offer doctors £95 an hour as staffing crisis grows, 15 April) is not the experience of those of us in frontline NHS work. Last year 30% of foundation doctors (those who have finished medical school and are at the point of choosing the specialty to train in up to consultant level) chose not to apply for specialist training straight away and went off to do something else. Many will come back, but many won’t. This year the reluctance to carry on rose to 50%. It appears Jeremy Hunt has been the best recruiter for the Australian and New Zealand medical services. People who chose to train as doctors are clearly reviewing their options.
Why this has happened is plain to see. An underfunded NHS, a new contract imposed on the junior medical workforce, increased tuition fees at medical schools and subsequent debt have, together with Brexit, produced a perfect storm of unhappiness and uncertainty about the future in the NHS and in the country. The fallout from Brexit is that there are 10,000 NHS doctors who qualified in the European Economic Area – and a recent British Medical Association survey found that 42% plan to leave.
The UK already has fewer doctors per person than other leading European economies at 2.8 per 1,000 people: Germany has 4.1, France 3.3 and Italy 4.2. If you think that waiting two weeks for a GP appointment or more than four hours in A&E is unacceptable at the moment, then just wait for 2019 when we finally do Brexit. There will be no extra £350m a week for the NHS as promised on the side of a bus. Dr Michael Maier London
• The junior doctor contract reforms had their roots in providing a “seven-day service” – a reasonable idea given many hospitals run a skeleton staff over the weekend. A smaller hospital with a staff of 10 or 15 junior doctors for 150 inpatients would cut down to three or four at the weekend. I dreaded the weekend ward cover: patients and nurses clamouring for attention and emergencies requiring you to be in several places simultaneously.
This laudable idea has been mangled into a catastrophe. Alterations of weekend pay rates and caps on maximum number of days worked means staffing now suffers globally and continuity of patient care becomes a casualty of doctors being shoved from one post to another. The gaps reduce quality of life, meaning jobs are unfilled and the situation worsens.
Can you blame someone wanting high rates to cover a shift with massive responsibility, no breaks and the risk of GMC suspension and lawsuits if they slip up in an impossible workload? The NHS, in trying to iron out gaps and make staffing cheaper, is paying out more in danger money to those brave or foolish enough to take it. Dr William Watson Cambridge
• Katie Johnston is right (How to start a social care revolution in seven easy steps, 10 April). If we want value for money in the NHS, to continue spending more and more on hospitals – the most expensive component of the service – to the relative exclusion of other, more widely used parts, is doomed to failure. Hospitals need help, but a key way to do that is to invest elsewhere. That requires a change in strategic approach far greater than the initiatives currently being pursued by NHS England.
It means using digital technology to allow people to be more involved in accessing and managing services without leaving home. It means investment in expanding general practice and other primary care facilities. And it means building intermediate care and social care facilities as a matter of urgency, not least to reduce demand on hospitals and to allow the timely discharge of patients. Currently, our acute hospitals are receptacles into which we tip ever more medical and social care. And then we wonder that hospitals cannot cope.
These changes would reduce demand on hospitals, provide better value for money and offer a greatly improved service for us all, whether or not we need hospital care. Most patients do not. Andrew Willis Chester
• Perhaps Jeremy Hunt would like to explain why he picked a fight with junior doctors over the imposition of a new contract, ostensibly to allow safer staffing at weekends, when hospitals are now increasingly unable to fill rota gaps without resorting to imploring doctors to provide additional cover at exorbitant pay rates.
Labour has gained plaudits for its proposal on provision of free school meals. Is it not time for a comparable initiative on health? The party should cease its internecine warfare, remind the electorate that the last Labour government increased NHS spending five times faster than the coalition and set up a commission to gain general agreement on a bold plan for a permanent solution to the NHS funding crisis. Dr Anthony Isaacs London
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“Most refugees sent to the poorest parts of the UK” (Front page headline, 10 April). Here are suggested headlines for the remainder of the week: “Lowest life expectancy in the poorest parts of the UK”; “Proportionately highest levels of indirect taxation…”; “Worst maintained private and public housing…”; “Highest levels of prescription drugs…”; “Highest attendance at A&E departments…”; “Least investment in schools…”; “Highest number incarcerated…”; and more.
Condescending notions such as “responsibilisation” are used to deflect the political, economic, structural dynamics and suffering of poverty. Zero-hours contracts are recast as “flexible and adaptive working”; low-waged health support workers are declined travel time; part-time contracts without holiday pay or security underpin; essential services are cut to the bone. The list is endless.
On estates of poverty-induced resentment, the comparatively few refugees and asylum seekers entering Britain are warehoused and managed by private, profit-driven companies with, at best, questionable track records – G4S and Serco to name but two. The lack of coherent, integrated, humanitarian policies and interventions is the outworking of inadequately funded public authorities, reflecting a cynical and divisive betrayal by central government of those most in need, whether citizens, refugees or asylum seekers. Professor Phil Scraton School of Law, Queen’s University, Belfast
• I was saddened but not surprised by your front page. An asylum seeker living with me has told me how he was initially sent to a hostel in Manchester after his arrival in Kent, but when he put in his asylum application, he was transferred to a house in a remote suburb of Liverpool. Unable to afford public transport, he had to walk for an hour or more to shops or to meet people: “it was like being in prison,” he says.
The charities I have been in contact with tell me there are enough potential hosts to house all the asylum seekers they are dealing with, but they lack the resources to assess their suitability. Why can’t the government work with these charities to enable more asylum seekers to be housed with people who are keen to help them learn English and find out more about life in the UK? Cary Bazalgette London
• Yvette Cooper and the home affairs select committee are absolutely right to criticise the government’s policy on asylum seekers, and in particular its reliance on private sector providers of accommodation. In Newcastle some years ago, one such provider housed Iranian and Iraqi refugees in the same premises. More recently, the change from the provision of accommodation and support by Your Homes Newcastle (a public sector body leading management of the issue in the north-east) to G4S and its subcontractor Jomast, coupled with a reduction in funding, has effectively led to the disappearance of support services.
Treating the issue as a matter of housing alone is unsatisfactory, both for the asylum seekers and refugees and for the other residents of what tend to be the most disadvantaged areas of towns and cities in the least prosperous parts of the country. Jeremy Beecham Labour, House of Lords
• Your front page says the home affairs select committee is calling for changes to the “appalling” system of sending these hapless people to the poorest parts of the country. Since government policy for their dispersal has been framed around the inability and unwillingness of local councils to provide education, health and other services for them, the outcome of location in impoverished ghettoes is inevitable. These same blanket policies mean that private hospitality, widely and generously offered, is effectively prevented from being taken up. Thus a Kindertransport scheme was made impossible.
Keith Vaz, as its previous chairman, presided over a select committee on the Shaw report, which highlighted many of the shortcomings in government policy but was kicked into the long grass.
The Home Office claims the UK has a proud history of granting asylum to those who need our protection. We now seem to be at the end of history. Tommy Gee Wingfield, Suffolk
• Zoe Stewart (Passport checks for patients is an abandonment of NHS principles, theguardian.com, 7 April) is right to say that health tourism costs the NHS a relatively small amount (0.3% of a £130bn annual budget or some £330m). That is still the cost of a new hospital, so not insignificant, but she misses the bigger issue entirely.
The NHS, social housing and all of our public infrastructure were built by previous generations, out of their taxes, with an expectation that not only they but their descendants would benefit. The reason that “health tourism” sticks in the craw is that it breaks the implicit promise of “social goods” being passed on from generation to generation. People do have a sense of ownership over great public enterprises, and with that there is resentment of newcomers who are perceived as not having contributed to the development of the “common weal”, and who are then perceived as taking their jobs, houses and healthcare.
Proclaiming the “universality” of rights or benefits, while attractive as a principle, only really works in stable, homogenous societies. Immigration, of any variety, can dent that sense of communal solidarity, and hence “cracking down on health tourism”, an important though relatively minor financial amelioration, has a wider and justifiable significance. Simon Diggins Rickmansworth, Hertfordshire
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The assertion by Professor Dave Goulson (Farmers could slash pesticide use without losses, research reveals, 6 April) cannot go unchallenged. He says that pesticides are massively over-used because farmers are advised by agronomists working on commission to sell products.
The Agricultural Industries Confederation represents the majority of businesses that supply both agronomy advice and crop protection products to UK farmers. Farmers can elect to pay separately for agronomy advice and crop protection products. Farmers also have access to information from agrochemical manufacturers as well as independent agronomy research organisations – much of it free online. In many instances, those delivering advice do not receive commission.
The UK crop protection industry is focused on ensuring optimum, rather than maximum, use of crop protection products to ensure the farming industry delivers safe, wholesome and affordable food. It is a legal requirement that agronomists selling crop protection products are highly trained and kept up to date with agronomic developments to deliver advice to ensure efficient production and environmental protection. Hazel Doonan Head of thecrop protection and agronomy sector, Agricultural Industries Confederation
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The findings in your article (Hundreds of thousands of children being exposed to illegal levels of damaging air pollution from diesel vehicles, 4 April) are scandalous. We are storing up huge unknowns in terms of the future of our children’s lung health. We need urgent action. The government must bring in a fair and ambitious Clean Air Act with targets to ensure pollution levels are monitored around every school and nursery located close to busy roads, arming parents and teachers with the information they need to take action to protect children’s health. Traffic emissions are the main culprit, but we know people bought their old diesel cars in good faith. A targeted scrappage incentive scheme would be a positive step, which could persuade drivers to switch quickly to cleaner vehicles. The Guardian and Greenpeace’s investigation shows our children’s lung health demands action now. Dr Penny Woods Chief executive, British Lung Foundation
• Your article highlights diesel fumes in London.In Hampstead, north-west London, pleas to Camden council to take account of the EU air quality directive and limit developments with massive lorry movements have not been heard. The council accepts that if it complied with the directive it will have to stop developments, and it is just not going to do that. Some 12,500 children go to schools in Hampstead every day, many under the age of seven. Development after development is approved by Camden and government planning inspectors right next to schools where children are exposed to lorry diesel fumes. One such development will see 2,000 lorry movements.
Cycle superhighway 11 will shut five out of 10 lanes on the main north-south corridor used by 40,000 vehicles a day. Transport for London confirmed that traffic will fan out into our narrow residential streets causing congestion and pollution, with up to an extra 475 vehicles an hour on one of our roads which has two primary schools with kids aged from two. Parliament passed laws to enable HS2 to pollute our area with 800 lorry movements a day. The continuing assault on air quality by local councils and government authorities shows that they pay only lip service to improving our air quality. Jessica Learmond-Criqui London
• Schools should be especially concerned as air pollution has been shown to cause a range of adverse effects including obesity, asthma, infant mortality, low birthweight babies, and depressed IQ.
All schools keep a record of asthma inhalers brought to school and over two decades ago, the late Dr Dick van Steenis proposed that “every county conduct a survey of primary schools to ascertain the proportion of children taking inhalers to school, and that any area with high proportions be investigated locally. This would be quick, cheap and effective.” (Airborne pollutants and acute health effects, The Lancet, 8 April 1995).
As far as I know, no council bothered to do so. Perhaps this will change now that Sadiq Khan is mayor of London and an asthma sufferer who’s determined to tackle air pollution, but who seems to have overlooked the impact of incinerator emissions. Will Khan publish the percentages of children in Years 3 to 6 in each London school who bring in asthma inhalers? Michael Ryan Shrewsbury, Shropshire
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As a baby boomer I am ashamed of many of my generation (My generation fought to be free. What happened to us?, 4 April). We are the luckiest generation of the 20th century. Born after the war into the NHS/welfare state, too young for national service, and the first teenage generation to have disposable income. We were witness/participants of the revolution of the 1960s. If we went to university, we had a grant. When we left school, there was almost full employment. Money has followed us as we got older. Yet many of my generation must have voted for Thatcher, Cameron and Brexit. The Tories should not have survived the 19th century, let alone the 20th, and now once again seem the dominant party.
I have voted in all three referendums involving England and found myself on the losing side each time. I voted out in 1975 but subsequently changed my mind when I found out that the only protection for workers during the Thatcher years was Europe. I voted for a change to the electoral system, and finally remain last year. When I was young we were proud of the welfare state. When did welfare get replaced by benefits and become such a dirty word to many of my generation? When will my generation wake up and remember their radical past and recognise that, as Harold Macmillan said, they “have never had it so good”? Richard Ascough Thames Ditton, Surrey
• Polly Toynbee wonders what happened to us. Being of a similar age, I also remember a 1950s childhood followed by the optimistic 1960s. The greater equality and better living standards that many enjoyed then may have obscured far more significant changes abroad. After the independence and partition of India in 1947, most of Britain’s vast empire disappeared between 1957 and 1968, while from 1961 to 1973 the UK was actively attempting to join the European common market.
The subsequent arrival of people from former colonies, of refugees from post-imperial conflicts, and then Europeans entitled to join them, all profoundly changed the daily experience of many urban citizens. Because we have not had to face our chequered history the way others (such as Germany) were obliged to, there is little collective consciousness of the close connection between revolutionary political events half a century ago and current cynical despair. That is what did not happen to us. Dr Sebastian Kraemer London
• Polly Toynbee asks why a generation that fought hard for equality and the liberalisation of attitudes is responsible for denying the same opportunities to those coming behind. I am a member of that generation and one who, along with everyone else I know, voted remain. I feel now that as well as a T-shirt announcing I am one of the 48%, I should have another to say I am one of those who have no wish to bring back the rope, cane or pre-decimal currency. Could it be that those who want to turn the clock back to the 1950s are simply grieving for their lost youth and hoping that by “taking back control” they can have the benefits of being young combined with the knowledge and experience of old age? Wave your blue passport in the air and jingle the pennies and florins in your pocket as much as you like, you will never be 16 again. We’re old, it’s not our time any more. To coin a phrase, get over it. Lynne Copley Huddersfield
• Polly Toynbee reminds me that I was born in the era of the ration book. I grew up in the era of live now, pay later. As we liquidated the empire and repaid the American lend/lease debt in its entirety, the “never had it so good” generation was funded by accumulating debt. Deregulation of the banking system allowed us to pretend debt could expand indefinitely. Politicians never found the courage to tell their constituents to live within their incomes. Austerity is the pay later era of live now.
Older people who want to bring back hanging, flogging and the rest of the 1950s nostalgia want to go through the last 70 years all over again because they cannot see any workable alternative. How we might pay for it all, with the debt already accumulated, is another matter. May and the Brexiteers are getting spiteful because they have seen the figures and know they don’t add up for everyone. Martin London Henllan, Denbighshire
• As I walked along Park Lane, as part of the march for Europe, I remembered that 49 years ago I had been a few streets away in Grosvenor Square, protesting about the Vietnam war. I was amused to notice that half of the EU supporters were old enough to have been there as well. We were vocal then and now, but never a majority. Perhaps what Polly forgets is that our generation was not one entirely made up of hippies and beatniks; there were also the mods, rockers, skinheads and diligent conventionalists. I suspect that baby boomers’ attitudes have not become significantly more or less selfish. Martin Cooper Bromley, Kent
• Polly Toynbee is right to feel ashamed of our generation opting for self-interest in voting out of the EU. I try to cast the smallest pebble into the biggest pond by wearing an EU badge on my coat on all occasions. Val Mainwood Colchester, Essex
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Your editorial (31 March) calling for repeal of the 2012 Health and Social Care Act is a transformative shift of position and potentially very significant. Repeal will save huge sums of money for the NHS with immediate effect. If sustainability and transformation plans are used to return to geographical areas, ending stand-alone hospitals, substantive returns in terms of integrated care will be easier to achieve. I hope Labour will soon commit to repeal the Act.
David Cameron admitted that this act was the coalition government’s biggest mistake. Theresa May should remove it from the statute book as an economy measure. David Owen House of Lords
• The NHS was designed to serve a more or less cohesive, class-based society where there was a political will to provide jobs and homes for all. Illness was due to bad luck and everyone deserved treatment.
We now know that bad luck is not random: unjustifiable inequalities set relatively disadvantaged people on an unhealthy path. The fact that resilient individuals will buck the trend merely fuels public scorn for people who cannot help themselves.
Without public investment in egalitarian family and social provision from the start of life, the NHS will seem increasingly irrelevant to citizens who have swallowed the idea that you can’t rely on the state to look after you, and expect to pay for everything they get.
The “flexible, efficient organisation” that you call for will never be able to care for a demoralised population with diminishing opportunities for good health. The NHS is cornered in a retail world that has no concept of socialism. Dr Sebastian Kraemer London
• Replacing routine operations with non-surgical treatments implies that 60 years of NHS funding, staffing and competence crises arose from a system clogging itself up with unnecessary operations (Deborah Orr, 1 April). If avoiding them can significantly reduce the workload, removing targets should not be necessary. The danger of removing waiting time targets is that it will allow the stream of unnecessary work to continue unmonitored, to the great reward of the medical profession, relieved of the risk of being challenged about what they are doing at taxpayers’ expense. John Hall Bristol
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As one of the thousands of people waiting for a hip replacement, I’d like to highlight some of the consequences of longer waiting lists (NHS axes key 18-week target for operations, 31 March). I am 66 and until last June was fit and active. I have reached 19 weeks on the waiting list and am hoping to get notified of a cancellation any day. I have had to give up a range of volunteering activities and also my fitness classes. The pain, despite medication, prevents me from getting out much and increases social isolation. I fear that even after my operation I will be out of the habit of being active and it will take a lot of willpower to get back to how I was.
Longer waiting lists will lead to us “active older people” being unable to undertake community volunteering. Has the cost of this ever been factored in? The impact will be exacerbated by the rising retirement age. Younger retired people will disappear from the ranks of volunteers. Many people delay seeing their GP until pain levels are intolerable. Those in the know will go early and pressurise GPs for referral for orthopaedic assessment, to get into the system. The local waiting list is based on time, not on need. The government needs to consider more sophisticated measures of need for elective surgery and to take into account the wider impact on society of longer waiting lists.
I feel lucky that a new hip is even possible. Had I lived in my grandparents’ time this would be a life sentence of pain. I would be willing to pay more tax to fund the NHS and social care. Time for government to grasp that nettle. Sue Craythorne Exeter
• In addition to the consequences of later retirement covered in Amelia Hill’s splendid piece (A world without retirement, 29 March), what about the holes currently filled by volunteers in a range of services? In my borough, Haringey, the parks department has only skeleton staff. Our unique nature reserve, Queen’s Wood, is looked after entirely by volunteers. Local parks and green corners are also looked after by an army of volunteers. How about the local food bank and soup kitchen? They are volunteer-run. And in many boroughs, library opening hours are maintained only because of volunteers. I could go on. Alison Watson London
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Saturday 1 April marks the fourth anniversary of NHS’s medical director Bruce Keogh’s scathing report on the regulation of cosmetic procedures. It concluded that dermal fillers are a crisis waiting to happen – and said they should be classified as a prescription-only medical device.
Yet today little has changed. As an NHS reconstructive surgeon, I am frequently called on to fix the mistakes of unqualified beauty consultants.
Understanding the intricacies of facial anatomy and physiology has taken me half a lifetime of rigorous medical training to master. Yet flimsy regulation means an individual can jump on to YouTube, watch a couple of “how-to” clips, order supplies online and set up as a bona fide consultant.
The dangers are clear. I have seen around 50 women in the past few years, some with allergies to filler, others with filler pouring out of their faces – many in need of multiple, complex procedures to restore their features. And it is clear numbers are increasing.
Health minister Philip Dunne recently said that the majority of these products were intended to be used in reconstructive surgery, and regulated medical professionals are bound by professional standards and terms of registration. But what of the budding hairdresser turned beauty consultant? Who is there to regulate these rogue practitioners?
The non-surgical cosmetic procedures market is worth £3.6bn. And non-surgical procedures account for 90% of all cosmetic interventions. Individual filler sessions can cost £300. Such clear financial incentives are unlikely to dissuade the let’s-give-it-a-go brigade. Regulation is key. The General Medical Council has compiled a guide for physicians to establish standards. But binding regulation is needed. Other non-medical organisations such as Save Face have also tried to direct the public to practitioners with appropriate training.
As a plastic surgeon who works in the NHS, I have a team of colleagues who reconstruct the faces of children and adults with facial deformities.
Sadly, a new group of patients are emerging whose features have been changed, sometimes irreversibly, by non-surgical cosmetic procedures. It is essential that anyone receiving these treatments has confidence in their practitioner, and we must encourage patients not to be lured by quick fixes and unbelievable deals. Simon Eccles Member, British Association of Plastic, Reconstructive and Aesthetic Surgeons
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The government must do everything in its power to combat obesity (Supermarkets must stop discounting unhealthy foods to tackle childhood obesity, say MPs, 27 March). Obesity is a public health disaster inextricably enmeshed with cardiovascular disease, obstructive sleep apnoea, gout, type 2 diabetes, hypertension, stroke, gallstones, cancers, osteoarthritis, breathing problems, dental decay and gum disease. The obesity statistics are staggering. The Lancet reported this year that around 700,000 new cancers caused by overweight are predicted by 2035 and that the number of those afflicted with diabetes in the UK alone has topped 4 million. The costs to the NHS are projected to reach £9.7bn by 2050.
Obesity is a vivid example of the link between general and oral health. Sugar is the main culprit in the unabated increase in obesity and dental decay. A holistic, comprehensive and sustainable approach is needed that transcends medicine and dentistry, challenging the avoidable consequences of modern lifestyles. Dr Munjed Farid Al Qutob London
• People in this country are consuming too many calories, many of them from sugar, which is contributing to unacceptably high levels of obesity. The government has published sugar reduction guidelines for certain types of food to bring overall sugar levels down, while still allowing people to enjoy their favourite foods. This is an important step and must form part of a broader range of initiatives to help individuals and families towards better diets and healthier lifestyles. To play their part, responsible food and drink manufacturers, retailers, restaurants, cafes and takeaways will adapt recipes and take action to encourage consumers towards low- and no-sugar options. In some foods, portion-size reductions will be necessary. Producers will keep consumer tastes and preferences at the heart of this work.
Health charities and professional bodies will support this ambitious agenda by providing clear advice, backed by robust science, and helping to combat often confused messaging around nutrition and health. As well as pushing for full and continuing industry engagement, these groups can also help to create an environment where recognition is given to companies’ efforts, challenges and achievements. This will encourage the sustained industry engagement that is needed. Ian Wright Food and Drink Federation Tam Fry National Obesity Forum
• The Commons health select committee has released a report admonishing the government’s plans to fight obesity, claiming that proposed measures do not go far enough to tackle the crisis. The committee argues that ministers had ignored recommendations from health bodies to regulate price promotions of unhealthy food and drinks aimed at children. Research from Oliver Wyman shows that 81% of UK shoppers have noticed that sugary products are more often on promotion in their supermarket than healthy options – and 60% of consumers say it is their supermarket’s responsibility to help them be healthier.
Rather than waiting for the regulatory hammer to fall, supermarkets in the UK should redefine themselves as health and wellbeing brands, by simplifying choices and building customer loyalty through healthy living programmes. By showing customers how their activity and shopping habits feed into their health outcomes and helping them make informed decisions and trade-offs, supermarkets can influence habits in a way that is positive for their business while also delivering health benefits. Duncan Brewer Oliver Wyman Consulting
• New NHS statistics show that one in four adults are inactive and levels of obesity have more than tripled since the 1990s (One in four adults take less than 30 minutes of exercise every week, 31 March). An easy solution to our sedentary lifestyle is getting more people walking their short, everyday journeys and yet the report shows that one in four adults aren’t even walking for half an hour a week. Getting off the bus a stop earlier, going for a lunchtime walk or choosing to park further away and walk the rest of the way are all easy ways to get moving more and can make a big difference to our health and happiness.
The report also shows that more than a third of children are overweight by the time they leave primary school. Creating safe walking routes and encouraging more children to walk to school will help the whole family get more active and ensure children develop healthy habits for life. This is vital if we’re going to protect the future of our health service. It’s Living Streets’ National Walking Month in May and we’re encouraging people to fit 20 minutes of walking into their day. We know from people who took part last year that it’s an achievable way to get active and stay healthy. Jenni Wiggle Living Streets
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The news that the NHS is to remove certain medications from its list of prescribed items (Report, 28 March) may come as a shock to some, but for anyone working in healthcare the step is an obvious one, which may act as a much-needed pressure release valve.
According to government data, each 11.7 minute trip to the GP costs the NHS £45; add to that the cost of prescribing (£3.83 per item) and we are nearing £50. Now compare that with the price of purchasing one of the items listed, directly from a pharmacy, eg Omega 3 capsules (you can get 30 for £6.65). It doesn’t take a genius to see why the NHS is struggling to cope.
The NHS will review 10 items, in the first instance including travel vaccines (these should arguably be self-funded as they fall into the lifestyle category), and erectile dysfunction medication (affordable non-branded options are available from your pharmacy). Access to gluten-free food was once restrictive, but it’s now in all major supermarkets. As a pharmacist, I welcome this move: it saves money, puts the onus back onto the patient to take responsibility for their own health and reiterates that pharmacies should be the first port of call for minor ailments. But we mustn’t forget that, while the price of these items may be affordable for some, for others, paying for their medication is just not an option – one size does not fit all, so exceptions will need to be made. Stuart Gale Frosts Pharmacy, Banbury
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