Public service professionals" hopes for the next government

In the run up to the general election on June 8, we asked professionals working across public services what they think are the biggest problems in their sector at the moment, and what they want to see from the UK’s major political parties.

Here’s what those working on the frontline in housing, local and central government, healthcare, social care, and the voluntary sector had to say.

‘I want to see compassion’

There is a lack of mental health services, a lack of supported housing projects and just a lack of resources generally. Homeless people who are lucky enough to find accommodation are hit on day one with letters about council tax, water rates, bin collections … It’s too much for someone who may have been rough sleeping for months and in temporary B&Bs for years before that.

I want to see compassion. I don’t believe people should “sponge” off the government but punishing people with sanctions is not the answer. Some people need a little more support then others and I believe if they get this they will have more chance of putting back into the coffers in the future. We need to care about each other, not penalise and punish those who struggle the most.

Anonymous, homeless charity worker

‘Address the reasons why doctors are leaving in droves’

A&E departments are increasingly stretched as patient demand outstrips what the NHS provide. Doctors are leaving in droves to work abroad or change career. We desperately need more nurses – but scrapping the bursaries for nursing students, a real terms pay cut and Brexit is disastrous for recruitment. GP numbers are falling, despite the government’s promise to appoint 5,000 new GPs.

Several things could be done. Guarantee the NHS budget for the next five years as a percentage of GDP (such as 8%), increase social care budgets so hospitals don’t have to keep patients longer than is medically necessary and reinstate the bursary for nursing students.

I certainly don’t want to see the introduction of the proposed conscription of doctors to four years in the NHS after medical school. Any government coming in needs to address the reasons why doctors are leaving (low morale, long hours, poor training, feeling undervalued, increasing workloads, increasing weekend work for less pay, demonisation by the media) rather than simply forcing them to stay.

Tom Palmer, 31, A&E doctor

‘I’d like to see national insurance breaks on health and future care provision insurance’

People are not planning for their future health, financially or
physically. The cost of a care home is astronomical and while taxpayers’
money is being thrown at it now, it’s going to get a lot worse
. I’d like to see national insurance breaks on health and future care provision insurance.

Fiona, 44, finance manager for a charity that provides care homes

‘We need rent caps and more social housing urgently’

The housing crisis is all-consuming and has a dramatic impact on virtually every other area of policy. The benefit cap, for example, punishes vulnerable people for not having access to social housing which successive governments have sold off. It is because families are forced to rent at high costs from the private sector that their benefits end up so high. That is the fault of landlords, not claimants. We need radical overhaul of the benefit system – I see things worsening on a daily basis.

I’d like to see a tenants’ union given the right to collectively bargain rent levels

There has been some focus on the insecurity of tenancies in the private sector. This is an important point, but what the increasing number of evictions boil down to is that landlords evict because they want to charge higher rents or because tenants cannot afford the rents they are already charging. We need rent caps. Other western European countries do this. I’d also like to see a tenants’ union given the right to collectively bargain rent levels at national and regional levels. The bottom line is we need to build more accommodation – especially social housing – very urgently.

Greg, housing adviser

‘I want a recognition that poverty contributes to social problems’

Social work is is overstretched and increasingly technocratic. The trend towards family therapy ignores socio-economic problems and seeks to reconcile parents to their current condition. I want to see a recognition that poverty is a contributing factor to social problems.

Many of our clients experience overcrowded housing conditions. There are fewer and fewer opportunities to remain in the area they grew up in, where their children go to school and where their family and friends can offer a support network. Many are unemployed and resigned to poverty. Very few are politically engaged.

After that we need investment in community solutions to social problems, such as increased funds from local authorities to youth arts and sports projects, as well as a firm commitment to social housing projects.

Arthur, 25, child protection social worker

‘Cuts have dramatically and irreversibly damaged local government’

Significant efficiencies have been achieved in local government since 2009, and it is certainly arguable that this – rather than increasing council tax – should have been done anyway prior to the recession. But eight years later there is no fat left to trim. Cuts have dramatically and irreversibly damaged local government.

If the new government does not reinstate a fixed central government grant (as opposed to fixing spending according to the level of council tax and business rates collected, which discriminates against poorer parts of the country) then very soon the Local Government Association’s warning that councils will need to make deep cuts to essential services will come true.

Finally, wages were frozen for three years, followed by five years of 1% rises. Give staff a pay rise, even if only at the level of CPI inflation. Five more years of pay freezes will force many talented members of staff to permanently leave the sector.

Anonymous, local government lawyer

‘Most police problems can be solved with more money for NHS and social services’

The police suffer from a chronic shortage of detectives, while overworked response officers get hardly any time off, or even time to adequately investigate at a crime scene. Most police problems can be solved with more staff and more money for the NHS and social services.

We need funding to recruit more detectives, and increase salaries for those detectives as an incentive to take on more stress and responsibilities. Then we need vastly more money for the NHS and social care; there is an overwhelming dependence on the police to deal with mental health crises, having cut social care to the bone and beyond. I would support a separate NHS tax.

We should h​​elp people to change their lives rather than imprison them

Vastly improving rehab programmes would prevent re-offending. Our current system costs millions and achieves nothing. This would involve legalising drugs and treating addiction as a medical problem not a crime. We should help people to change their lives rather than imprison them and make a life of crime more likely. Legalising and taxing drugs will save us a fortune in the long run.

Anonymous, police officer

‘We may need the return of housing inspectors’

Government policy does not reflect the realities of the housing market. Firstly, we need to increase supply. Quadruple council tax for all properties left empty for more than six months, rising to ten times if left empty for three or more years. This will prevent private landlords “going on strike”. A land tax designed to make land-banking extremely unprofitable should be followed by commitment to building council-owned homes for rent that are genuinely affordable. Councils are accountable to the public and elected representatives of their communities in a way that other providers are not. Right to buy should be extended to housing association tenants, but the properties must be sold at market value, no more discounts, and all proceeds used to build new homes to rent and for low-cost home ownership.

Then we need to raise standards, by putting in place mandatory registration and licensing of all privately rented accommodation. Housing association regulations should include housing management and value for money – we may well need the return of housing inspectors! Repeal the 2016 Housing and Planning Act and regulate rents – the amount of money being sucked out of the wider economy by ever-rising rents is damaging to the overall state of our country.

Andy, 52, retired head of housing in the West Midlands

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Public service professionals" hopes for the next government

Cuts can"t stop genuine people power, but professionals can | Richard Wilson

It is becoming increasingly clear that many of our public service systems undermine people power.

Problems like obesity, depression, addiction and finding a job require us each to take individual action. Of course there are all kinds of support to help us keep fit, ace job interviews, or live without drugs, but control always lies with the individual, not the state. We decide what food to put in our mouths or whether to go to the gym.

But this vital truth seems to have been absent in designing our public services.

Take, for instance, a GP appointment. Most last 10 minutes; the GP asks a few questions and then tells you either to take some medicine, adopt new habits or see someone more qualified. The trouble is, we don’t do what we’re told. The World Health Organisation has estimated [pdf] that only 30%–50% of us take our medication as prescribed, in what is being described as an “epidemic of non-compliance”. Many of the changes required are intimately connected to our sense of who we are and what others think of us – and it’s very hard to change a habit. Anyone who’s tried having a “dry January” will know the challenge.

Ideas about co-producing public services, with professionals and users working together, have been around for years. What’s interesting right now is the new movement of practitioners delivering “people-powered services” that aim to improve self-efficacy at a low cost and with high impact.

One example is homelessness charity Groundswell, which provides peer support to people experiencing homelessness to help them address their health needs. Athol Halle, Groundswell chief executive says that when you provide support in this way, there are health benefits for individuals – and cost savings for the NHS. That’s why Groundswell receives in the region of £500,000 from health commissioners. It is not alone. Club Soda is working to reduce alcohol dependence, Brightside Trust is working in youth unemployment, Community Catalysts in adult social care, and Self Management UK in health. All of these organisations are based on putting users in charge of their service.

However, this is much easier said than done. Supporting people to take control is a subtle discipline in which most people working in public services have not been trained.

Here are five basic principles of how to help people take control that you can adapt according to your circumstances:

• Accept the user wherever they are.


• See users as having all the resources they need to start taking action.


• Change is only possible if the user wants it.


• Users’ solutions are the best solutions.


• Never assume users think like you.

At first glance these five principles might seem plain wrong. Not everyone has all the resources they need, especially in this era of deep cuts.

But for services where individual action is a requirement, the essential ingredient is user motivation. So whether they do in fact have everything they need is not what’s important; what matters is that they believe in themselves enough to make a start.

For most professionals it takes a fundamental reorientation to start supporting individuals to take action themselves. Anand Shukla, chief executive of Brightside Trust, says it is often quite a leap for professionals to support people to make decisions and to take action. What’s crucial, says Shukla, is to identify right from the start people’s priorities and wishes, rather than jump in and tell them what you, as a professional, think they should do.

These principles need to inform not just conversations between service professionals and users but the whole way public services are designed: system design. Without that, the work of people like Halle and Shukla will be stifled by systems that claim to want people power but, in fact, work against it.

If you’re a public service professional working in people-powered services – or an individual taking action – drop us a line and tell us how you’ve got on: public.leaders@theguardian.com

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Cuts can"t stop genuine people power, but professionals can | Richard Wilson

Five Christmas miracles shared by healthcare professionals

The patient who called in tears to say a new kidney had been found

I used to be a clinical nurse specialist in kidney transplantation. Prior to that I had been in charge of home heamodialysis and cared for many patients in remote areas. On Christmas Eve I had been working and went to bed around midnight. At 1am I had a call from a patient of mine whom I had looked after on home dialysis. A kidney had become available and he had been called in for a transplant. He was in tears. He told me he had been waiting for this moment for six years but now that the time had come he felt so sad. He was sad that a family was devastated at the loss of a loved one on Christmas Day but happy to have the chance of a new life. I reassured him that the family who had lost a loved one would be comforted that the kidney was being gifted to such a wonderful man who would use the opportunity to lead a full life.

He then told me that he would remember this Christmas Day for the rest of his life and that, on receiving the call, I was the first and only person he wanted to talk to. He said: “You are an outstanding nurse. Wish me luck. Hopefully this is my last day of needing dialysis. Thank you for always being there. I never thought I would say this but I’ll miss you!” He had a transplant that day and had over a decade of healthy kidney function. That Christmas was one of my best ever.

Director of nursing education, Abu Dhabi

The baby born while a choir sang carols outside

While I’m always a little sad to be away from my family, I’m lucky enough to be part of a wonderful work team. We have our own traditions and put lots of effort into celebrating Christmases spent together. We’ve won the best decorated ward three years running, we all wear Christmas jumpers and eat our NHS Christmas dinners in the canteen together. Our receptionist even comes in on Christmas morning dressed as Santa to deliver our secret Santa gifts. As we work in maternity, anyone who can’t be discharged home to be with family is normally more than happy to be spending their Christmas with us as they’re getting one of the best gifts delivered on Christmas Day. Last year when we started the Christmas Day shift we only had one woman in labour; she needed to be delivered by caesarean section and was taken into theatre. At the same time the brass band and choir had arrived on the ward to sing carols. They stood just outside the theatre and performed When a child is born and Away in a manger while our first baby of that Christmas was born. While all births are wonderful to be a part of, this one was unforgettable; there wasn’t a dry eye in the theatre.

Midwife, London

The Christmas dinner that brought warring colleagues together

This year will be my first Christmas off this century. I’ve spent the last 15 working with people with learning disabilities in residential care homes. It’s always a great day. Life and bodily functions go on, but the Christmas spirit is always wide and the enthusiasm of the people we support is contagious. Being left in an empty London and watching everyone I know make their way back home is strangely liberating. I’ll feel odd moving with the crowds this year.

One year I was managing a home where there had been a lot of issues with staff and staff tension. It was my first Christmas there and I was determined to make it a special day for everyone. We made so much effort to make it work. We were all eating together with Christmas songs in the background; everyone was wearing a paper hat and a colleague and I burst into tears as a result of what we had achieved.

Treat Me Right! manager, London

The girl who survived life-threatening injuries from a car crash

Over 30 years ago on Christmas Eve morning a teenage girl was transferred from a district general hospital to the regional cardio-thoracic intensive care unit where I worked, having sustained serious chest injuries in a car crash. I was in charge of the unit for the late shift on Christmas Day, and looked after her for the shift. She was on a ventilator and heavily sedated. I can remember her parents at her bedside and explaining every procedure I was carrying out to keep them as well informed as possible and to de-mystify an often frightening environment for families. It was touch and go and she had numerous life threatening emergencies over the next few weeks. No one knew whether she was going to make it, but she did and was discharged a few months later. She returned to the hospital where she had originally been admitted to thank the staff for her initial care. We received a letter from the consultant there telling us he couldn’t believe she’d survived her injuries and praising us all to the skies. I bumped into her a few years later; she was doing her nurse training and wanted to specialise in intensive care.

Senior staff nurse, intensive care, London

The elderly woman who shared Christmas lunch with her family for the first time in years

I no longer work over Christmas, but my favourite memory of doing so was learning that one of my clients, who was over 100 years old, had a daughter who lived around the corner from the sheltered scheme. Her daughter was too elderly and unwell to collect her mother, so I arranged to take her to her daughter’s house where she had Christmas lunch with her daughter, grandchildren and great grandchildren. It still makes me happy to think of it.

Sheltered scheme manager, London

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Five Christmas miracles shared by healthcare professionals

My colleague"s suicide showed how vulnerable medical professionals can be

I stood in front of the ambulance bay door. My badge clutched in my hand, knuckles white, jaw clenched. I questioned my attempt at returning to work on this day. I stood in front of the doors grappling with a burning feeling in the pit of my stomach. I knew then, right there, that my career in the emergency department was over.

A quiet swollen presence of pain ran down every corridor. The night before, we lost a colleague to suicide. Some of us found the body. Some of us carried out the post mortem care. Some of us stood there as family filed in to the room. Some of us made the calls alerting fellow staff. Some of us, all of us, changed forever that night.

For some vocations, a bad day at the office means: “I dropped a carton of eggs” or “I broke the copier”. Some are more serious of course: “I really messed up a haircut” and the infamous “I crashed the company car”. In medicine, however, a bad day usually means, “We lost a toddler”; “A young family lost their baby”; “She will never walk again”; and “Time of death …”. The list could go on and on; the point is, the magnitude at which we affect the world of each individual person in healthcare is far different than most jobs. We take on the world, we attempt heroic measures, forgetting, we are indeed, so very human.

We study for years, sometimes decades, focusing our skill, perfecting it, to heal, to save, and to comfort. The team we do all these things with becomes a sort of family. You are all present on the worst days together. You share the sorrow, the shock, and the deep regret that everything you have dedicated your life to studying has failed you. You failed together. You failed in the worst way, but you have one another. You can share that dark humour, the memory of this fleeting moment. You can share together the memory of watching the doctor whisper something comforting, or that nurse hold the deceased family member’s hand. Each of you knows what it feels like, to pronounce a patient dead in one room, and in the very next room, moments later, help a three year old change into a hospital gown so that they can be evaluated thoroughly. You do all this with a smile on your face, never for a second letting on that in the next room, a tragedy they can’t imagine has just unfolded.

Eventually, it eats little holes in your soul. Sometimes there are nightmares, other times you stand in a quiet trauma room and feel the presence of every lost soul standing behind you as you scrub down a stretcher. Bigger and bigger it creeps, into you, never though are you afforded the right to go and lament to your friends over drinks, or weep at your place of worship. Never can you post on public media and share your sorrow. Never can you truly convey what it feels like to have dedicated your life to becoming an expert, but when you have a bad day, someone dies. You cannot ever make someone, who isn’t sunken knee deep into the profession, understand what that means.

The kinship you establish with those with whom you share this camaraderie cannot be duplicated. They are a family that knows all your secrets of trauma and sorrow. There is something indescribably comforting in having these people know you at your worst moments, exhausted, angry, and sad.

The secrets within the hospital walls bonding us together are the same web, that when one of us succumbs to the beast of depression, is torn apart forever. None of us knows what cost our colleague and dear friend their life, it was never made clear. But our family, if you will, was severed to the core, doing the thing we did well together, without them, to them.

I still practise, in a different forum. I think of emergency department life every day. Now I realise how human each of us really is, there are no superheroes among us. Now when my team is becoming saturated, I actively seek out ways to alleviate that pressure, for myself, and for my team. On good days someone gets to live another day, but this doesn’t make the really bad days any easier.

• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here. If you would like to contribute to our Blood, sweat and tears series which is about memorable moments in a healthcare career, please read our guidelines and get in touch by emailing sarah.johnson@theguardian.com. If you’re a healthcare professional affected by the issues raised in this article, help and support is available from Support 4 Doctors.
  

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My colleague"s suicide showed how vulnerable medical professionals can be

British doctors and health professionals call for rapid coal phase-out

Groups representing Britain’s 600,000 doctors and health professionals say it is “imperative” to phase out coal rapidly to improve health and reduce NHS costs.

The doctors and nurses say tackling outdoor air pollution from traffic and power stations would cut climate emissions, reduce air pollution, and deliver a powerful boost to the nation’s health.

“Climate change and air pollution are both major health threats,” says the UK Health Alliance on Climate Change in a report. “They share a common driver: the combustion of fossil fuels. Pollution from coal plants alone costs the UK as much as £3.1bn each year in human health impacts.”

The group of 15 health bodies includes seven royal colleges of medicine and the British Medical Association.

Pollution from coal plants causes many serious health conditions including stroke, coronary heart disease and lung cancer. It disproportionally affects children and kills more people than road accidents , says the report.

The government has said it intends to phase out coal power plants by 2025 but the doctors say they are alarmed that no consultation papers looking at how this could be achieved have been published in more than a year.

“Ending the use of coal is a simple, no-regrets public health intervention. The rapid phase-out of coal fired stations is an imperative first step. Coal is the most carbon-intensive source of power generation, and is a key focus for reducing the risks of climate change.

“In the UK, burning coal is linked to 1,600 premature deaths, 68,000 additional days of medication, 363,266 working days lost and more than 1m incidents of lower respiratory symptoms,” says the report.

It urges politicians not to tackle air pollution and climate individually, as has been done in the past. “The UK has witnessed … policies that encouraged the use of diesel cars which inadvertently worsened air quality. Considering air pollution and climate change together can limit adverse health effects.

“Some strategies can be good for both air quality and climate change, for instance wind, solar and tidal energy. Acting on ones that are beneficial to both is advantageous to health. Indeed, joining up policies on health, air pollution and climate change can offset the costs of climate mitigation policies through the health benefits that they bring.”

Air pollution is the second biggest public health threat in the UK after smoking and kills 40,000 people a year in Britain, said Prof John Middleton, president of the Faculty of Public Health. “Coal-fired energy is particularly damaging through its invisible particulates and because it is a driver of climate change,” he said.

“The phase-out of coal use is an essential step towards creating a sustainable energy policy for the UK,” said Dr Richard Horton, editor-in-chief of the Lancet medical journal. “It is also a vital co-benefit for health – ending coal use will deliver long-lasting health and dividends for the British population. Life expectancies will be prolonged, disease and disabilities reduced, and future risks to health diminished. This is an opportunity to be seized.”

Jonathan Griggs, professor of paediatric respiratory and environmental medicine and fellow of the Royal College of Paediatrics and Child Health said that children were particularly vulnerable to burning coal.

“Air pollution from burning coal has been linked to low birth weight and pre-term delivery as a result of maternal exposure during pregnancy,” he said. “The phase-out of coal is a double win for tackling the twin health threats of air pollution and climate change.”

“Tackling air pollution and climate change will have numerous health benefits but it requires a joined-up approach from government to ensure the health impacts are better recognised and fully realised,” said Janet Davies, the Royal College of Nursing’s chief executive and general secretary.

British doctors and health professionals call for rapid coal phase-out

Health professionals: what should we be writing about?

Healthcare professionals often complain that they never read or hear of many success stories. It would seem sometimes that the media’s only emphasis is on the NHS being in a state of disarray, what with the ongoing battle over the junior doctors’ contract and nurses’ bursaries, recruitment problems, ever diminishing resources … the list goes on.

While mental health nurses bemoan not being able to provide compassionate care, GPs complain of burnout and staff at all levels lament the lack of integration in all aspects of their work, many more people are engaged in trying to address, fix or circumvent the mammoth problems facing the healthcare sector.

We want to highlight the partnerships that have an impact on the lives of healthcare professionals and patients. Whether it’s a charity working in collaboration with one part of the NHS (locally or nationally), an app or technological innovation, professionals partnering with patients, or simply a great example of collaboration, we want to hear about it.

Please share your suggestions of stories, projects, innovations and people you’d like to see included in a new series on partnerships in the form below.

Health professionals: what should we be writing about?

Medical professionals who back Owen Smith for the Labour party leadership | Letters

As healthcare professionals we welcome Owen Smith’s bid to lead the Labour party and his commitment to the NHS. The NHS is at a crossroads, and under continued Tory control its future as a world-class, universal healthcare provider, free at the point of use, is at risk.

Owen will invest £60bn more in the NHS than the Tories and is calling for an immediate halt to Tory privatisation and the reversal of their catastrophic reorganisation.

At a time when accident and emergency departments are closing, junior doctors are striking to protect their patients and waiting times are soaring, the need for a Labour government has never been so clear.

Despite savage Tory cuts to public services and the risk of a faltering economy post-Brexit, the Labour party under Jeremy Corbyn’s leadership is languishing behind the Conservatives in poll after poll. Owen leads Jeremy among the electorate, with 62% of people thinking he would make a better prime minister compared with Jeremy’s 38% in a recent BMG poll. It is Owen who can form a Labour government and deliver the leadership that the NHS and the country desperately needs.

It doesn’t matter how many thousands of supporters Jeremy addresses at rallies; if he cannot win over the millions of people who once saw Labour as their natural home, then the fate of our public services will be left to the Tories.

A Labour government is an essential step in providing the NHS with the resources and leadership it needs so we can deliver the world-class care that the people of the UK deserve.

Nothing less will do. That’s why we are backing Owen Smith.
Dr Sarah Clark CT2 Medicine, London & Holborn and St Pancras CLP women’s officer
Dr Martin Edobor National chair, Young Fabians
Prof Liz Lightstone Professor of Renal Medicine, London
Dr Daniel McGuinness ST5 Nephrology, London
Mr Keith Seymour Consultant surgeon, Northumberland
Dr Reena Aggarwal ST6 Obstetrics & Gynaecology, London
Dr Ratesh Bajaj ST4 Cardiology, London
Dr David Jones Consultant intensivist and anaesthetist, Merthyr Tydfil
Dr Thomas Oates NIHR clinical lecturer, London
Dr Zoe Kantor Neonatology SHO, London
Lindsay Gordon Community nurse, Reading
Dr Lucy Bradbeer GP ST1, London
Ruth Hodson Theatre scrub nurse, north Wales
Karen Cousins Retired specialist nurse practitioner, Northumberland
Dr Brian Morrissey ST1 Radiology, Aberdeen
Dr Nicola West CT2 Medicine, London
Stephen Naulls Medical student, London & Cleethorpes CLP Youth Officer
Dr Chloe Fairbairns FRCA, anaesthetic registrar, Leeds
Dr Alexander Scott Consultant in anaesthetics and intensive care, West Yorkshire
Jenny Davies Specialist podiatrist, Cardiff
David Davies Occupational therapist, Merthyr Tydfil
Julie Wintrup Occupational therapist, Newbury
Dr Sarah Dickson ST1 ACCS, London
Dr Thomas Halstead GP ST1, West Cambridgeshire
Andy Hill Nurse assessor, Birmingham
Dr John Mullany ST3 Clinical Radiology, Liverpool
Dr Neeraj Singh ST7 Anaesthesia and Intensive Care, Eastbourne
Ivana Bartoletti NHS information professional, London
Maria Coleman Renal Nurse, Cardiff
Dr Thomas Fox ST6 Psychiatry, Bromley
Sam Charlton Student nurse, Preston
Dr Lynn Miller Consultant cardiologist, Fife
Dr Lucy Carter Clinical research fellow, Oxford
Nikki Williams Registered nurse, Cottingham
Bryan Neale Retired registered nurse
Alexandros Onoufriadis Research fellow, London
Vasanthi Prathapan Clinical trials manager and research nurse, London
Sharon Jones NIHR BioResource co-ordinator, London
Dr Marc Osterdahl CT2 Medicine, London
Dr Jeff Unsworth ST6 Acute Medicine, Liverpool
Julie Goldie Senior nurse, London
Anna Lynch Quality improvement nurse, London
Dr Michael Northend Haematology registrar, London
Dr Sophie Edwards Care of the elderly consultant, London
Dr Jane Roberts Consultant child and adolescent psychiatrist, London
Felicia Olney Psychotherapist, London
Dr Sebastian Kraemer Consultant psychiatrist, London
Dr Prathap Pillai Respiratory Medicine, London
Rhanya Chaâbane Clinical trials practitioner, London
Terry Baker Carer, UK
Bridget Langstaff Deputy regional manager, National Treatment Agency, PHE
Dr Justin Shute Psychiatry consultant, London
Paola Di Meglio Senior investigator scientist, Francis Crick Institute, London
Debbie Boyes Former registered nurse, Bridport
Dr Ben Caplin Senior clinical lecturer and honorary consultant, London
Lewis Atkinson Surgery services manager, Tyne & Wear
Monika Temple Retired nurse and DOH civil servant, London
Dr Iain McCullagh Consultant anaesthetist and intensivist, Newcastle
Joanne Barber Newly qualified nurse, Wigan, Wrightington & Leigh
Dr Rachel Stanbrook CT2 Medicine, Leicester
Curtis McLellan Student occupational therapist, Coventry
Gillian Black Retired nurse and former director of community nursing services, Lambeth
Dr David Owen Consultant physician, London
Dr Mike Mclaughlin A&E registrar, London
Dr Andrew Stein Consultant in renal medicine, Coventry & Rugby
Dr Harriet Nerva Core medical trainee, Croydon
Joseph Wright Senior IT manager, London Ambulance Service
Dr Sean Morris GP trainee, London
Laura Drake Health visitor, Bristol
Dr Tim Fallon Consultant ophthalmologist, London
Candida Coghlan Research nurse, International Centre for Circulatory Health, London
Dr Peter Dilworth Retired GP, Liverpool
Dr Harry Costello CT1 Psychiatry, London
Dr Sophie Nocton GP trainee, London
Dr Jane Young Consultant radiologist, London

• Join the debate – email guardian.letters@theguardian.com

Medical professionals who back Owen Smith for the Labour party leadership | Letters

Social care professionals: what is your biggest fear?

It’s no secret that the social care sector is under huge pressure and staff are expected to juggle never-ending caseloads.

When the most vulnerable make the news, from people living with severe mental health problems or children who suffer at the hands of violent parents, they will probably be known to the social care system.

Social care professionals, social workers and carers can’t be with service users all the time, so what measures do you put in place for when you’re not there? What do you worry might happen in your absence?

Perhaps it’s the woman with dementia who you worry will accidentally start a fire at home, or maybe it’s the mother who can’t leave her violent partner, or that child with mental health problems who can’t access the care they need to keep them safe?

We want to hear from foster parents, carers, social workers, occupational therapists and peer support workers about your biggest fears.

Share your worries by filling in the form below. We’ll use a selection in our reporting.

Social care professionals: what is your biggest fear?

Thousands of new medical professionals opting for a better existence abroad

Doctors who are newly competent kind a growing proportion of the thousands of British medics searching for jobs abroad every year, triggering issues that the NHS is heading for a staffing crisis.

Expert recruitment agencies and GPs’ leaders say medical professionals, many of whom have just finished their training, are becoming disillusioned with the state of their occupation and in search of fresh commences in nations this kind of as Australia, in which they can earn double what they are paid in Britain. Figures offered to the Observer by the Common Healthcare Council show that an regular of 2,852 certificates enabling British medical doctors to function abroad had been issued annually among 2008 and 2014 – a total of 19,522.

So far this yr the council has issued a additional two,008 certificates of great standing, the document that enables doctors to register with an overseas regulatory entire body or employer, taking the complete who have applied to operate overseas in the last eight years to almost 22,000. “Medicine is a worldwide occupation and the United kingdom has extended relied on doctors coming to perform in the United kingdom from other countries and some United kingdom-skilled medical professionals have taken the chance to knowledge functioning overseas,” said Niall Dickson, chief executive of the GMC.

“Annually in excess of the past six many years, far more than two,500 doctors who graduated from a Uk health-related school have been issued with a certificate of existing professional standing, which they require if they want to register to operate in an additional country. We do know that not all of these medical doctors will truly go and operate abroad.”

The reality that the figures, which do not include the 1000′s of medical professionals from overseas working in the Uk, demonstrate no sign of diminishing is a concern at a time when the NHS is striving to fill vacancies. Anecdotal proof suggests that youthful doctors, whose coaching can value the taxpayer up to £1m, now comprise an ever greater proportion of people seeking work abroad.

Man Hazel, the managing director of austmedics.com, which appears to location British doctors in posts in Australia, mentioned he receives among thirty and forty enquiries a month, several from young physicians. “They are newly competent medical doctors, reassessing their potential, saying ‘this does not seem like my cup of tea’, and who are now searching for alternatives abroad,” mentioned Hazel. “Not each and every medical doctor can pick up sticks and fly to Australia – they have children in school or elderly dad and mom, for illustration, but younger doctors are far more most likely to have the versatility.”

He extra that a amount of variables have been prompting British physicians to think about moving abroad. A single was anger at the overly bureaucratic revalidation procedure, in which all physicians regularly undergo a series of checks so that they can retain their licence to practise.

Another was the concern of medical indemnity insurance coverage, which Hazel stated costs among six and twelve instances much more in the United kingdom for a GP than in Australia. “While this cost is ‘covered’ by the NHS for salaried GPs, freelance GPs would require to cover this themselves,” Hazel explained. “A total-time GP can expect to pay amongst £5,000 to £12,000 for insurance, whereas in Australia they would pay underneath A$ 2,000 (£1,000). And the Australian insurance policy covers significantly much more in terms of procedures than a United kingdom policy.”

Hazel stated he at the moment had three positions for consultant radiologists in Perth, Western Australia, with salaries paying £250,000. Somebody in the exact same occupation in the NHS would get all around £100,000.

Changes to the way in which British GPs will be expected to perform is yet another push element. “I have 40 positions in all the major capital cities in Australia for GPs, all earning close to £160,000 with no out-of-hrs operate,” Hazel mentioned. “The NHS gives a salaried GP around £80,000.”

Hazel pointed out that home prices are also reduce in states this kind of as Western Australia. “For £500,000 you get a home with a double garage, swimming pool and 4 to five bedrooms,” he stated. “Petrol is 60p a litre and you really don’t commit a whole lot on heating bills.”

Stemming the exodus abroad would aid the Department of Well being to meet its commitment to filling GP vacancies. GP leaders not too long ago warned the government that its programs to recruit five,000 new GPs and introduce 7-day opening at surgeries are undeliverable. They highlighted figures released by the GP National Recruitment Office that demonstrate much more than 600 locations are at the moment unfilled, meaning that about 1 in five GP trainee places are left vacant.

“GPs encounter increasingly tough and nerve-racking perform environments, due to a combination of increasing demand and falling assets,” mentioned Dr Richard Vautrey, deputy chair of the British Medical Association’s GP committee. “The consequence has been fewer junior medical professionals deciding on general practice as a profession, a lot more senior GPs deciding on to retire early and more medical doctors selecting to perform abroad.” This has contributed to a workforce crisis and signifies current medical professionals are struggling to meet the requirements of the growing amount of patients walking via their surgical treatment doors. To stem this issue we urgently need to tackle issues around workload pressures, resourcing and operate-existence stability.”

Case Study THE OZ Element

Dr Ben Molyneux, 31, a London GP, pictured going to Sydney, is debating regardless of whether to move to Australia

“There are a variety of pull elements: an increasing quantity of my buddies and families have emigrated, tons of them physicians. It has a comparable healthcare model, so it would be effortless to fit in and the education setting is much better than in the United kingdom and the pay out is greater and the weather is far better.

“In my practice we come to feel we are caught in a hamster wheel. I see about 50 or 60 men and women a day on my on-call day. It is really challenging to do that in a sustained vogue with no acquiring actually fatigued. I really do not want to be a tired and grumpy doctor. I want to be the variety of doctor who enjoys what they are undertaking, but at times you can’t do that simply because you are also exhausted.

“The workload is going up at a price of knots. We have eight,000 patients at our practice. We employed to do 24,000 consultancies a yr now it is 50,000. After, if you had a cold, a household member would give you guidance. Now men and women do not know who to ask, don’t seem to be to be resilient sufficient to cope themselves.

“I get pleasure from my task. I have to function genuinely difficult, but come to feel privileged that I get to do what I do. I’d be actually sad to depart my sufferers, but I feel guilty jumping ship when all my peers are here fighting on a sinking ship. there is tiny positivity amid all doctors at the second. It is a quite adverse surroundings.”

Thousands of new medical professionals opting for a better existence abroad

The Best-Paying Jobs For Medical professionals

All physician salaries carry on to rise with primary care medical professional compensation outpacing professionals somewhat last 12 months. Main care doctors reported $ 241,273 in media compensation in 2014 and professionals reported $ 411, 852, in accordance to the MGMA (Healthcare Group Management Association) 2015 report card. How considerably does your physician make?

Photo: © 2015 Bloomberg Finance LP

The Best-Paying Jobs For Medical professionals

"Soft touch" medical professionals ought to be disciplined for in excess of-prescribing antibiotics

‘Soft touch’ physicians must encounter disciplinary action for handing out too numerous antibiotics, the director of the overall health watchdog has stated, as he warned that pointless prescribing has now reached crisis level.

Professor Mark Baker, director of the Centre for Clinical Practice at the National Institute for Overall health and Care Excellence (Good) mentioned millions of ‘frequent flyer’ sufferers have been turning into addicted to the thought of antibiotics, frequently touring surgeries and A&ampE wards right up until they received a prescription.

Nowadays Nice launches a new raft of recommendations telling medical professionals to delay remedy to see if signs clear up on their personal and quit giving medication for minor illnesses like sore throats and urinary tract infections.

Professor Baker said people who fail to adhere to the guidance ought to be brought before the Basic Healthcare Council. Although disciplinary action would most most likely lead to retraining, medical professionals who continued to willfully misprescribe antibiotics could encounter getting struck off the health care register. Prof Baker explained prescriptions ought to start off carrying diagnoses so that pharmacists could challenge doctors’ guidelines and so needless prescribing could be monitored.

“This is truly hazardous practice, and if essential, of program (they ought to be brought ahead of the GMC)” he mentioned.

“It’s entrenched in our society. There are folks who are addicted to the concept of getting antibiotics.

“If they know there’s a soft-touch doctor then they go to them. Usually they’ll go to their GP and then consider another a single, and then go on to an A&ampE department.”

Research has found that 9 out of 10 GPs really feel pressurised to prescribe antibiotics and virtually all (97 per cent) individuals who inquire for them get them, several for situations like colds and hayfever. Some resort to acquiring capsules above the web if they can’t get them from a medical professional.

Nationally 41.six million antibiotic prescriptions have been issued in 2013/14 at a price to the NHS of £192 million. But a quarter of them are probably to be inappropriate or unnecessary.

In 2013, Nice issued advice asking physicians to cease prescribing antibiotics for respiratory tract infections like colds or sore throats. It was supposed to bring down the number of prescriptions by 22 per cent, but the past two years prescriptions have actually risen by around 3 million every 12 months.

Antibiotics  Photograph: ALAMY

Prof Baker stated it is down to other bodies this kind of as Public Overall health England and NHS England to now translate the latest Nice advice into “resources that will result in actual action and a adjust in the degree of antibiotic prescribing”.

“If we don’t do it now then we’ll have to rethink the total basis of medicine since we’ve invested 60 many years assuming that most infections will be cured by antibiotic drugs,” he advised a briefing in central London. “If they no longer perform then we’ll have to rediscover and relearn how to treat infections surgically and I don’t think any individual needs to be in that position.”

Nevertheless doctors hit back at the suggestion they could face disciplinary action for handing out as well several medicines, claiming they had been under a huge sum of strain from patients.

“These can be quite tough and demanding conversations for GPs to have,” said Dr Tim Ballard, Vice Chair of the Royal College of GPs.

“We require a societal modify in attitudes in the direction of the use of antibiotics and any suggestion that hard pressed GPs – who are currently trying to do their jobs in more and more hard situations – will be reported to the regulator is counter-productive and unhelpful.

“If this have been to happen, we would be searching to the Basic Health-related Council to assistance any GP or other health specialist who finds themselves on the acquiring finish of complaints or criticism about selections created more than the prescribing of antibiotics.”

The GMC explained that sanctions had been presently in spot to stop physicians wrongly prescribing medicines but was unable to confirm that anybody had ever faced disciplinary action for above prescribing antibiotics.

“Doctors can, and do, face sanctions for misprescribing, though the law dictates that every case has to be regarded as on its merits to establish whether the doctor’s actions pose a danger to individuals or self-confidence in physicians,” mentioned Niall Dickson, Chief Executive of the Common Health-related Council.

The Nice guideline suggests that GPs and other overall health experts go over the harms and benefits of taking antibiotics with individuals, and make clear why prescribing an antimicrobial may possibly not be the ideal alternative for them.

Next yr the watchdog intends to concern guidance for members of the public.

Antibiotics have been the mainstay of treating infections for far more than 60 years but despite the fact that a new infectious condition has been discovered practically every 12 months above the past thirty many years, no new antibiotics have come to market for 15 years.

The chief healthcare officer Dame Sally Davies has warned that antibiotic resistance as huge a chance to Britain as terrorism.

Dr Tessa Lewis, a GP and vice chair of the Guideline Advancement Group, said: “The far more we use antibiotics, the significantly less successful they turn out to be. Infections can evolve and turn into resistant to existing medicines.

“Resistance to antibiotics is growing and there have been really handful of new antibiotics produced in latest years, so we require to make confident that as well as searching for new antimicrobial medicines, we use the ones we presently have in the most successful way.”

A Division of Well being spokesperson stated that the overuse of antibiotics effects was the duty of sufferers, physicians, dentists and vets, not just GPs.

“In purchase to make positive we have successful antibiotics for generations to come, we are raising global awareness of the dangers of resistance to antibiotics and offering equipment for GPs to help prescribing choices,” extra a spokesman.

"Soft touch" medical professionals ought to be disciplined for in excess of-prescribing antibiotics

Chelsea Manager Jose Mourinho Displays Why Teams Should not Employ Medical professionals

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If Chelsea club physician Eva Carneiro had not tended to the player when the match official called for healthcare attention, beyond something about simple human decency, she would have violated the simple ethics and responsibility of the healthcare occupation.

Chelsea Manager Jose Mourinho Displays Why Teams Should not Employ Medical professionals

Video urges health-related college students to become family medical professionals

Alongside the video, which demonstrates the varied position a GP plays in health care practice with some even doing work on cruise ships or in prisons, the RCGP will up coming week launch a series of regional recruitment roadshows.

The East Midlands, North West, North East of England and Yorkshire and Humber are some of the areas with the biggest shortage of GPs across the Uk.

Dr Maureen Baker, the RCGP chairman, who final year wrote to health care college students urging them to take into account a job in general practice, explained there is a “media perception” that GPs have a significantly less fascinating job than those who operate in other places this kind of as emergency medicine.

Dr Baker explained: “This video – and the GPs who seem in it – present that nothing at all could be even more from the reality.

“Getting a GP is thrilling, varied and challenging, as properly as currently being the only function in the NHS that delivers care for the entire person over their lifetime.

“GPs are now doing procedures each and every day in our consultation rooms that a decade ago would immediately have been referred to hospital professionals.

“We hope the video will attain out to the medical students and trainee medical professionals who are thinking about the direction of their future careers and demonstrate them what a brilliant occupation basic practice actually is.”

While Dr Baker mentioned the profession has been hit by many years of funding cuts, she added that GPs will play a enormous component in the future of the NHS and a get in touch with has been created to improve its share of the wellness service price range by almost 3 per cent to 11 per cent by 2017.

Dr Baker explained: “After years of under-investment in general practice and the emphasis on hospital care, there is now a actual push for much more resources into standard practice and to create up the GP workforce.

“We are turning the tide on funding for standard practice, with pledges from politicians across the United kingdom that it is time to reinvigorate standard practice, in order to provide large quality and price-efficient care to our patients in the neighborhood.

“The potential of the NHS lies not in hospitals but in general practice. With more investment and far more medical professionals, we can decrease waiting occasions for GP appointments and provide a lot more care for patients closer to home, where they want it most.”

Dr Daniel Poulter, the wellness minister, stated: “We previously have 1,000 a lot more GPs given that September 2010 and growing trainees so that GP numbers carry on to expand more rapidly than the population. We have also set out clear programs to train five,000 more GPs by 2020.”

Dr Clare Taylor from the RCGP mentioned the causes why much more healthcare students are not picking to specialise in general practice are not understood fully, but stated portion of it is to do with the exposure they get at health-related schools to hospital specialities – as effectively as Television displays.

Speaking to Sky News she stated: “I consider some of the dramas on tv can portray hospital medicine perhaps in a slightly much more glamorised light.”

Dr Taylor explained it is a “amazing occupation”, including: “I consider all of us would really, really like far more time with our individuals, and to be capable to supply even a lot more services. And the only way we’re going to do that is to have far more individuals coming in.”

Video urges health-related college students to become family medical professionals

Edward Snowden urges professionals to encrypt client communications

Hyperlink to video: Edward Snowden: ‘If I finish up in chains in Guantánamo I can live with that’

The NSA whistleblower, Edward Snowden, has urged lawyers, journalists, doctors, accountants, priests and other individuals with a duty to shield confidentiality to improve safety in the wake of the spy surveillance revelations.

Snowden explained specialists were failing in their obligations to their customers, sources, sufferers and parishioners in what he described as a new and tough globe.

“What final year’s revelations showed us was irrefutable proof that unencrypted communications on the internet are no longer safe. Any communications need to be encrypted by default,” he mentioned.

The response of specialist bodies has so far been patchy.

A minister at the Home Workplace in London, James Brokenshire, stated during a Commons debate about a new surveillance bill on Tuesday that a code of practice to safeguard legal skilled privilege and other people requiring specialist secrecy was below evaluation.

Snowden’s plea for the professions to tighten protection came in the course of an comprehensive and revealing interview with the Guardian in Moscow.

The former National Protection Company and CIA pc professional, desired by the US below the Espionage Act right after leaking tens of thousands of prime secret paperwork, has provided only a handful of interviews given that seeking short-term asylum in Russia a yr in the past.

Edward Snowden during his interview with the Guardian in Moscow. Photograph: Alan Rusbridger for the Guardian

Throughout the seven hrs of interview, Snowden:

• Stated if he ended up in US detention in Guantánamo Bay he could dwell with it.

• Supplied uncommon glimpses into his day-to-day lifestyle in Russia, insisting that, contrary to reports that he is depressed, he is not sad and does not have any regrets. He rejected different conspiracy theories surrounding him, describing as “bullshit” ideas he is a Russian spy.

• Mentioned that, contrary to a declare he operates for a Russian organisation, he was independently safe, living on savings, and income from awards and speeches he has delivered on the web round the planet.

• Created a startling claim that a culture exists inside the NSA in which, in the course of surveillance, nude photographs picked up of people in “sexually compromising” scenarios are routinely passed all around.

• Spoke at length about his future, which appears destined to be invested in Russia for the foreseeable long term soon after expressing disappointment over the failure of western European governments to provide him a home.

• Stated he was holding out for a jury trial in the US rather a judge-only one, hopeful that it would be difficult to discover 12 jurors who would convict him if he was charged with an offence to which there was a public curiosity defence. Negotiations with the US government on a return to his nation appear to be stalled.

Snowden, who recognises he is nearly surely stored beneath surveillance by the Russians and the US, met the Guardian at a hotel inside strolling distance of Red Square.

The 31-year-previous unveiled that he works on the web late into the evening a solitary, digital existence not that dissimilar to his earlier life.

He stated he was using portion of that time to function on the new concentrate for his technical abilities, creating encryption equipment to help pros such as journalists defend sources and information. He is negotiating foundation funding for the venture, a contribution to addressing the dilemma of professions wanting to safeguard consumer or patient data, and in this situation journalistic sources.

“An unfortunate side impact of the growth of all these new surveillance technologies is that the work of journalism has turn out to be immeasurably tougher than it ever has been in the previous,” Snowden stated.

“Journalists have to be specifically conscious about any kind of network signalling, any sort of connection, any sort of licence-plate reading gadget that they pass on their way to a meeting level, any spot they use their credit score card, any area they take their phone, any e-mail make contact with they have with the supply because that really initial make contact with, before encrypted communications are established, is sufficient to give it all away.”

Journalists had to ensure they manufactured not a single mistake or they would be putting sources at danger. The identical duty utilized to other professions, he stated, calling for coaching and new standards “to make certain that we have mechanisms to make sure that the average member of our society can have a sensible measure of faith in the skills of all the members of these professions.”

He extra: “If we confess one thing to our priest inside a church that would be private, but is it any various if we send our pastor a private e mail confessing a crisis that we have in our lifestyle?”

The response of professional bodies in the Uk to the challenge varies, ranging from calls for legislative alterations to construct in safety from snooping, to apparent lack of concern.

Ross Anderson, professor of security engineering at Cambridge University, stated he shared Snowden’s issues about the vulnerability of the professions to surveillance by spy and law enforcement agencies.

“If you feel your HIV status is secret from GCHQ, overlook it,” he stated. “The resources are obtainable to shield information and communications but only if you are important sufficient for your doctor or lawyer to care.”

Timothy Hill, technologies policy adviser at the Law Society, which represents United kingdom attorneys, mentioned the occupation was concerned.

“Legal professional privilege – the proper to seek the advice of a legal adviser in confidence – is a extended established common law appropriate. Its basic role in our legal method demands to be reasserted.”

The society is pressing to have present legislation rewritten to contain explicit safety for legal expert privilege from government surveillance.

“There needs to be a debate about the implications of the Snowden revelations for expert privilege in the digital age,” Hill mentioned. “It is not taking place. This is not getting debated in parliament.”

He said the society was in search of to strengthen law firms’ cybersecurity awareness but that a more powerful statutory framework was vital.

Michelle Stanistreet, the Nationwide Union of Journalists general secretary, echoed the considerations. “For democracy to function, it wants to have a free press and journalists who are in a position to do their work without worry or hindrance. But this is turning out to be increasingly underneath risk.”

She extra: “Last year’s revelations show that unencrypted communications can indicate that journalists may possibly be unwittingly handing more than their contacts, footage or material, towards their will.”

The Basic Medical Council gives advice to Uk doctors about safeguarding details towards improper disclosure.

Niall Dickson, the GMC chief executive, said: “Modern day communication provides massive advantages for patients in terms of analysis, entry to pros, as effectively as speed of care and remedy. But of program it also carries threat, and confidentiality and believe in are at the heart of the physician-patient relationship.

“We recognise that trying to keep up with advances in engineering and its implications for confidentiality are tough for all healthcare experts. We do have guidance which explains what doctors need to have to do if they are concerned about the protection of private information or methods they have been given to use. But in this rapidly shifting location, we also require to keep on leading of this ourselves, and we do frequently review our guidance to get account of alterations in the external setting.”

Edward Snowden urges professionals to encrypt client communications

Edward Snowden urges professionals to encrypt client communications

Hyperlink to video: Edward Snowden: ‘If I end up in chains in Guantánamo I can reside with that’

The NSA whistleblower, Edward Snowden, has urged attorneys, journalists, medical professionals, accountants, priests and other people with a duty to shield confidentiality to improve security in the wake of the spy surveillance revelations.

Snowden said professionals have been failing in their obligations to their clients, sources, patients and parishioners in what he described as a new and challenging planet.

“What final year’s revelations showed us was irrefutable proof that unencrypted communications on the world wide web are no longer secure. Any communications should be encrypted by default,” he explained.

The response of specialist bodies has so far been patchy.

A minister at the Home Workplace in London, James Brokenshire, said during a Commons debate about a new surveillance bill on Tuesday that a code of practice to safeguard legal professional privilege and other individuals requiring skilled secrecy was underneath overview.

Snowden’s plea for the professions to tighten safety came throughout an comprehensive and revealing interview with the Guardian in Moscow.

The former National Safety Agency and CIA laptop professional, needed by the US under the Espionage Act after leaking tens of 1000′s of leading secret paperwork, has offered only a handful of interviews given that looking for temporary asylum in Russia a 12 months ago.

Edward Snowden for the duration of his interview with the Guardian in Moscow. Photograph: Alan Rusbridger for the Guardian

In the course of the seven hrs of interview, Snowden:

• Said if he ended up in US detention in Guantánamo Bay he could live with it.

• Presented rare glimpses into his daily life in Russia, insisting that, contrary to reports that he is depressed, he is not unhappy and does not have any regrets. He rejected numerous conspiracy theories surrounding him, describing as “bullshit” recommendations he is a Russian spy.

• Explained that, contrary to a declare he performs for a Russian organisation, he was independently secure, residing on financial savings, and funds from awards and speeches he has delivered on-line round the globe.

• Made a startling claim that a culture exists inside the NSA in which, in the course of surveillance, nude images picked up of individuals in “sexually compromising” scenarios are routinely passed close to.

• Spoke at length about his future, which looks destined to be invested in Russia for the foreseeable future after expressing disappointment more than the failure of western European governments to offer you him a residence.

• Said he was holding out for a jury trial in the US rather a judge-only one, hopeful that it would be challenging to find twelve jurors who would convict him if he was charged with an offence to which there was a public interest defence. Negotiations with the US government on a return to his nation appear to be stalled.

Snowden, who recognises he is virtually certainly stored beneath surveillance by the Russians and the US, met the Guardian at a hotel within strolling distance of Red Square.

The 31-12 months-previous revealed that he performs on the web late into the evening a solitary, digital existence not that dissimilar to his earlier lifestyle.

He mentioned he was using component of that time to function on the new focus for his technical abilities, developing encryption tools to aid specialists such as journalists shield sources and data. He is negotiating foundation funding for the undertaking, a contribution to addressing the problem of professions wanting to defend client or patient data, and in this situation journalistic sources.

“An unfortunate side effect of the advancement of all these new surveillance technologies is that the perform of journalism has grow to be immeasurably tougher than it ever has been in the previous,” Snowden stated.

“Journalists have to be especially aware about any type of network signalling, any kind of connection, any type of licence-plate reading through device that they pass on their way to a meeting level, any area they use their credit card, any spot they consider their cellphone, any e mail get in touch with they have with the supply simply because that very very first speak to, prior to encrypted communications are established, is adequate to give it all away.”

Journalists had to guarantee they manufactured not a single blunder or they would be placing sources at threat. The exact same duty applied to other professions, he mentioned, calling for instruction and new requirements “to make confident that we have mechanisms to ensure that the regular member of our society can have a affordable measure of faith in the expertise of all the members of these professions.”

He added: “If we confess anything to our priest within a church that would be personal, but is it any distinct if we send our pastor a private email confessing a crisis that we have in our daily life?”

The response of professional bodies in the United kingdom to the challenge varies, ranging from calls for legislative alterations to develop in protection from snooping, to apparent lack of concern.

Ross Anderson, professor of safety engineering at Cambridge University, explained he shared Snowden’s concerns about the vulnerability of the professions to surveillance by spy and law enforcement agencies.

“If you consider your HIV standing is secret from GCHQ, fail to remember it,” he mentioned. “The equipment are obtainable to shield information and communications but only if you are critical sufficient for your doctor or lawyer to care.”

Timothy Hill, technology policy adviser at the Law Society, which represents United kingdom lawyers, said the profession was concerned.

“Legal expert privilege – the proper to seek advice from a legal adviser in self-assurance – is a long established frequent law right. Its fundamental role in our legal technique demands to be reasserted.”

The society is pressing to have current legislation rewritten to consist of explicit safety for legal specialist privilege from government surveillance.

“There requirements to be a debate about the implications of the Snowden revelations for professional privilege in the digital age,” Hill stated. “It is not happening. This is not being debated in parliament.”

He mentioned the society was searching for to strengthen law firms’ cybersecurity awareness but that a more powerful statutory framework was crucial.

Michelle Stanistreet, the National Union of Journalists general secretary, echoed the concerns. “For democracy to perform, it requirements to have a free press and journalists who are capable to do their task without worry or hindrance. But this is turning into more and more below threat.”

She extra: “Last year’s revelations demonstrate that unencrypted communications can indicate that journalists might be unwittingly handing in excess of their contacts, footage or materials, towards their will.”

The Standard Healthcare Council offers guidance to Uk medical professionals about safeguarding data towards improper disclosure.

Niall Dickson, the GMC chief executive, said: “Modern day communication provides massive rewards for patients in terms of study, accessibility to specialists, as effectively as speed of care and therapy. But of program it also carries chance, and confidentiality and trust are at the heart of the medical doctor-patient partnership.

“We recognise that maintaining up with advances in technological innovation and its implications for confidentiality are tough for all healthcare specialists. We do have guidance which explains what physicians need to have to do if they are concerned about the safety of private details or systems they have been offered to use. But in this quickly altering spot, we also want to preserve on leading of this ourselves, and we do regularly overview our advice to get account of changes in the external environment.”

Edward Snowden urges professionals to encrypt client communications

Edward Snowden urges professionals to encrypt client communications

Link to video: Edward Snowden: ‘If I end up in chains in Guantánamo I can live with that’

The NSA whistleblower, Edward Snowden, has urged lawyers, journalists, doctors, accountants, priests and others with a duty to protect confidentiality to upgrade security in the wake of the spy surveillance revelations.

Snowden said professionals were failing in their obligations to their clients, sources, patients and parishioners in what he described as a new and challenging world.

“What last year’s revelations showed us was irrefutable evidence that unencrypted communications on the internet are no longer safe. Any communications should be encrypted by default,” he said.

The response of professional bodies has so far been patchy.

A minister at the Home Office in London, James Brokenshire, said during a Commons debate about a new surveillance bill on Tuesday that a code of practice to protect legal professional privilege and others requiring professional secrecy was under review.

Snowden’s plea for the professions to tighten security came during an extensive and revealing interview with the Guardian in Moscow.

The former National Security Agency and CIA computer specialist, wanted by the US under the Espionage Act after leaking tens of thousands of top secret documents, has given only a handful of interviews since seeking temporary asylum in Russia a year ago.

Edward Snowden during his interview with the Guardian in Moscow. Photograph: Alan Rusbridger for the Guardian

During the seven hours of interview, Snowden:

• Said if he ended up in US detention in Guantánamo Bay he could live with it.

• Offered rare glimpses into his daily life in Russia, insisting that, contrary to reports that he is depressed, he is not sad and does not have any regrets. He rejected various conspiracy theories surrounding him, describing as “bullshit” suggestions he is a Russian spy.

• Said that, contrary to a claim he works for a Russian organisation, he was independently secure, living on savings, and money from awards and speeches he has delivered online round the world.

• Made a startling claim that a culture exists within the NSA in which, during surveillance, nude photographs picked up of people in “sexually compromising” situations are routinely passed around.

• Spoke at length about his future, which seems destined to be spent in Russia for the foreseeable future after expressing disappointment over the failure of western European governments to offer him a home.

• Said he was holding out for a jury trial in the US rather a judge-only one, hopeful that it would be hard to find 12 jurors who would convict him if he was charged with an offence to which there was a public interest defence. Negotiations with the US government on a return to his country appear to be stalled.

Snowden, who recognises he is almost certainly kept under surveillance by the Russians and the US, met the Guardian at a hotel within walking distance of Red Square.

The 31-year-old revealed that he works online late into the night; a solitary, digital existence not that dissimilar to his earlier life.

He said he was using part of that time to work on the new focus for his technical skills, designing encryption tools to help professionals such as journalists protect sources and data. He is negotiating foundation funding for the project, a contribution to addressing the problem of professions wanting to protect client or patient data, and in this case journalistic sources.

“An unfortunate side effect of the development of all these new surveillance technologies is that the work of journalism has become immeasurably harder than it ever has been in the past,” Snowden said.

“Journalists have to be particularly conscious about any sort of network signalling, any sort of connection, any sort of licence-plate reading device that they pass on their way to a meeting point, any place they use their credit card, any place they take their phone, any email contact they have with the source because that very first contact, before encrypted communications are established, is enough to give it all away.”

Journalists had to ensure they made not a single mistake or they would be placing sources at risk. The same duty applied to other professions, he said, calling for training and new standards “to make sure that we have mechanisms to ensure that the average member of our society can have a reasonable measure of faith in the skills of all the members of these professions.”

He added: “If we confess something to our priest inside a church that would be private, but is it any different if we send our pastor a private email confessing a crisis that we have in our life?”

The response of professional bodies in the UK to the challenge varies, ranging from calls for legislative changes to build in protection from snooping, to apparent lack of concern.

Ross Anderson, professor of security engineering at Cambridge University, said he shared Snowden’s concerns about the vulnerability of the professions to surveillance by spy and law enforcement agencies.

“If you think your HIV status is secret from GCHQ, forget it,” he said. “The tools are available to protect data and communications but only if you are important enough for your doctor or lawyer to care.”

Timothy Hill, technology policy adviser at the Law Society, which represents UK lawyers, said the profession was concerned.

“Legal professional privilege – the right to consult a legal adviser in confidence – is a long established common law right. Its fundamental role in our legal system needs to be reasserted.”

The society is pressing to have existing legislation rewritten to include explicit protection for legal professional privilege from government surveillance.

“There needs to be a debate about the implications of the Snowden revelations for professional privilege in the digital age,” Hill said. “It is not happening. This is not being debated in parliament.”

He said the society was seeking to strengthen law firms’ cybersecurity awareness but that a stronger statutory framework was essential.

Michelle Stanistreet, the National Union of Journalists general secretary, echoed the concerns. “For democracy to function, it needs to have a free press and journalists who are able to do their job without fear or hindrance. But this is becoming increasingly under threat.”

She added: “Last year’s revelations show that unencrypted communications can mean that journalists may be unwittingly handing over their contacts, footage or material, against their will.”

The General Medical Council provides guidance to UK doctors about protecting information against improper disclosure.

Niall Dickson, the GMC chief executive, said: “Modern communication offers huge benefits for patients in terms of research, access to professionals, as well as speed of care and treatment. But of course it also carries risk, and confidentiality and trust are at the heart of the doctor-patient relationship.

“We recognise that keeping up with advances in technology and its implications for confidentiality are challenging for all healthcare professionals. We do have guidance which explains what doctors need to do if they are concerned about the security of personal information or systems they have been given to use. But in this rapidly changing area, we also need to keep on top of this ourselves, and we do regularly review our guidance to take account of changes in the external environment.”

Edward Snowden urges professionals to encrypt client communications

Edward Snowden urges professionals to encrypt consumer communications

Link to video: Edward Snowden: ‘If I finish up in chains in Guantánamo I can live with that’

The NSA whistleblower, Edward Snowden, has urged lawyers, journalists, physicians, accountants, priests and other individuals with a duty to defend confidentiality to improve security in the wake of the spy surveillance revelations.

Snowden stated specialists had been failing in their obligations to their clientele, sources, patients and parishioners in what he described as a new and challenging world.

“What last year’s revelations showed us was irrefutable proof that unencrypted communications on the world wide web are no longer secure. Any communications ought to be encrypted by default,” he explained.

The response of expert bodies has so far been patchy.

A minister at the Home Office in London, James Brokenshire, said for the duration of a Commons debate about a new surveillance bill on Tuesday that a code of practice to safeguard legal skilled privilege and other people requiring expert secrecy was below overview.

Snowden’s plea for the professions to tighten protection came during an extensive and revealing interview with the Guardian in Moscow.

The former Nationwide Protection Company and CIA computer professional, wanted by the US beneath the Espionage Act after leaking tens of 1000′s of leading secret documents, has offered only a handful of interviews since looking for short-term asylum in Russia a year ago.

Edward Snowden for the duration of his interview with the Guardian in Moscow. Photograph: Alan Rusbridger for the Guardian

In the course of the seven hrs of interview, Snowden:

• Mentioned if he ended up in US detention in Guantánamo Bay he could live with it.

• Presented uncommon glimpses into his day-to-day existence in Russia, insisting that, contrary to reviews that he is depressed, he is not sad and does not have any regrets. He rejected numerous conspiracy theories surrounding him, describing as “bullshit” ideas he is a Russian spy.

• Stated that, contrary to a claim he operates for a Russian organisation, he was independently secure, living on savings, and cash from awards and speeches he has delivered on the web round the planet.

• Created a startling claim that a culture exists inside of the NSA in which, in the course of surveillance, nude pictures picked up of men and women in “sexually compromising” circumstances are routinely passed close to.

• Spoke at length about his long term, which looks destined to be spent in Russia for the foreseeable future soon after expressing disappointment in excess of the failure of western European governments to provide him a home.

• Said he was holding out for a jury trial in the US rather a judge-only one particular, hopeful that it would be difficult to uncover 12 jurors who would convict him if he was charged with an offence to which there was a public curiosity defence. Negotiations with the US government on a return to his nation appear to be stalled.

Snowden, who recognises he is practically certainly kept below surveillance by the Russians and the US, met the Guardian at a hotel within strolling distance of Red Square.

The 31-year-outdated uncovered that he works on-line late into the evening a solitary, digital existence not that dissimilar to his earlier existence.

He said he was making use of portion of that time to function on the new target for his technical skills, developing encryption resources to help pros such as journalists protect sources and information. He is negotiating foundation funding for the task, a contribution to addressing the problem of professions wanting to shield client or patient information, and in this case journalistic sources.

“An unfortunate side effect of the improvement of all these new surveillance technologies is that the function of journalism has grow to be immeasurably more difficult than it ever has been in the past,” Snowden said.

“Journalists have to be notably conscious about any kind of network signalling, any sort of connection, any type of licence-plate reading through device that they pass on their way to a meeting point, any place they use their credit score card, any place they take their cellphone, any electronic mail get in touch with they have with the supply because that very initial make contact with, ahead of encrypted communications are established, is enough to give it all away.”

Journalists had to make sure they produced not a single blunder or they would be putting sources at danger. The identical duty applied to other professions, he said, calling for coaching and new requirements “to make positive that we have mechanisms to make certain that the regular member of our society can have a sensible measure of faith in the skills of all the members of these professions.”

He extra: “If we confess one thing to our priest inside a church that would be private, but is it any various if we send our pastor a personal e-mail confessing a crisis that we have in our life?”

The response of specialist bodies in the United kingdom to the challenge varies, ranging from calls for legislative adjustments to create in protection from snooping, to obvious lack of concern.

Ross Anderson, professor of security engineering at Cambridge University, said he shared Snowden’s considerations about the vulnerability of the professions to surveillance by spy and law enforcement companies.

“If you feel your HIV standing is secret from GCHQ, overlook it,” he explained. “The equipment are offered to protect data and communications but only if you are essential ample for your medical doctor or attorney to care.”

Timothy Hill, technologies policy adviser at the Law Society, which represents United kingdom attorneys, explained the profession was concerned.

“Legal specialist privilege – the right to seek advice from a legal adviser in confidence – is a prolonged established common law correct. Its basic part in our legal program demands to be reasserted.”

The society is pressing to have present legislation rewritten to include explicit protection for legal professional privilege from government surveillance.

“There demands to be a debate about the implications of the Snowden revelations for specialist privilege in the digital age,” Hill stated. “It is not taking place. This is not currently being debated in parliament.”

He said the society was searching for to strengthen law firms’ cybersecurity awareness but that a stronger statutory framework was essential.

Michelle Stanistreet, the National Union of Journalists general secretary, echoed the issues. “For democracy to function, it requirements to have a totally free press and journalists who are ready to do their work with no dread or hindrance. But this is becoming increasingly below threat.”

She extra: “Final year’s revelations show that unencrypted communications can suggest that journalists may possibly be unwittingly handing over their contacts, footage or materials, towards their will.”

The Basic Health care Council provides advice to Uk medical professionals about safeguarding information towards improper disclosure.

Niall Dickson, the GMC chief executive, explained: “Modern communication offers large rewards for patients in terms of study, access to specialists, as properly as speed of care and remedy. But of program it also carries danger, and confidentiality and believe in are at the heart of the physician-patient connection.

“We recognise that retaining up with advances in technologies and its implications for confidentiality are difficult for all healthcare experts. We do have guidance which explains what medical doctors want to do if they are concerned about the safety of private information or programs they have been given to use. But in this quickly changing location, we also need to have to maintain on prime of this ourselves, and we do often evaluation our advice to take account of adjustments in the external surroundings.”

Edward Snowden urges professionals to encrypt consumer communications