Appalling footage of a mentally ill woman stumbling around a NSW hospital, covered in faeces and falling over at least 25 times before she died of a brain injury, has shocked the public and politicians.
Footage released by the coroner shows the woman, mother-of-two Miriam Merten, locked in a seclusion room for more than five hours at the Lismore Adult Mental Health Inpatient Unit on 1 June 2014.
A nurse unlocks Merten’s room the next morning, before she is left to stumble around the hallway naked, eventually collapsing in a corner before an emergency crash cart is rushed in by staff.
Merten died at Lismore base hospital on 3 June 2014.
A coronial inquest found she died of “traumatic and hypoxic brain injury caused by numerous falls and the self-beating of her head on various surfaces, the latter not done with the intention of taking her own life”.
A senior nurse at the facility was aware Merten had been sedated with psychotropic drugs and fallen on at least one occasion, but failed to take appropriate action, the coroner Jeff Linden found.
A second nurse was also involved.
“The lack of care and compassion showed to the deceased was monumentally disgraceful and appeared to emanate from an: ‘Oh, it’s just Miriam’s mentality,” Linden said in his inquest findings.
“To see a mentally ill person in 2014 at a public hospital in NSW treated in such an appalling manner is really beyond comprehension.
“While this appears not to be a system failure it is clearly a serious human failure.”
The New South Wales Labor party on Friday called for an urgent parliamentary inquiry into the state’s mental health facilities.
Opposition mental health spokeswoman Tania Mihailuk says the incident is a “Don Dale moment” for the NSW mental health system and demonstrates “abhorrent mistreatment and abuse”.
Mihailuk said the government should apologise to Merten’s family and conduct a full and transparent review.
The federal health minister Greg Hunt said the two nurses “are no longer in service”, and the state government had Canberra’s “full support for the strongest possible steps against what was completely unacceptable”.
“I have (seen the footage) … it is deeply distressing,” Mr Hunt said in Sydney on Friday.
The NSW premier Gladys Berejiklian echoed that view.
“We’ll do everything we can to make sure this never happens again,” she told reporters.
A bad deal on Brexit would be “a disaster” for the NHS, Jeremy Hunt has said, as he accused the European commission of deliberately interfering in the general election to undermine the Conservatives.
Ramping up the rhetoric of Theresa May, who last week accused the commission of leaking an unflattering account of talks at Downing Street to disrupt the election, the health secretary warned that a good Brexit negotiation was vital for the NHS.
“We’ve got 27 countries lined up against us,” Hunt told BBC1’s Andrew Marr show. “Some of them appear to think that for the EU to survive, Britain must fail.”
He said of the impact on the health service: “If we don’t get a good Brexit outcome, and we don’t protect the economic recovery, the jobs that so many people depend on, whose taxes pay for the NHS, if we get a bad Brexit outcome, that would be a disaster for the NHS.”
However, pressed on the issue, Hunt refused to specify what sort of bad deal this might involve, or to say whether the UK leaving the UK with no deal and defaulting to World Trade Organisation tariffs, would also affect the NHS.
“We’ve been very clear that no deal is better than a bad deal,” he said, adding: “I’m saying that a good deal would be best for the NHS, but obviously, a bad deal would be the worst possible outcome for all our public services. It would be bad for the country.”
On Wednesday, May used an address outside Downing Street launching the election campaign to accuse the European commission of seeking to influence the election.
“The European commission’s negotiating stance has hardened. Threats against Britain have been issued by European politicians and officials. All of these acts have been deliberately timed to affect the result of the general election which will take place on 8 June,” she said.
May did not specify who this interference was intended to assist. But pushed on the matter, Hunt said he assumed the commission wanted to undermine the Conservatives and help Jeremy Corbyn’s Labour party.
“Well, you’ll have to ask them why they chose to do that, but I think the answer is very clear, that they are trying to leak reports that undermine Theresa May’s position,” he said, when asked who the commission favoured.
Asked specifically if the aim had been to harm the Conservatives, he said: “That must be the presumption, and what we’re saying is that they should not be doing that, because it’s an election for the British people to decide.”
May’s accusation baffled Brussels, where the European commission’s chief spokesman, Margaritis Schinas, dismissed the allegations as electioneering.
“We here in Brussels are very busy, rather busy, with our policy work,” he said. “We have enough on our plate.”
The European council president, Donald Tusk, said the stakes of the Brexit talks were “too high to let our emotions get out of hand”.
He added: “We must keep in mind that, in order to succeed, we need today discretion, moderation, mutual respect and a maximum of goodwill.”
Jeremy Hunt has broken the law by not forcing the NHS to ensure that patients receive hospital treatment within the stated maximum of 18 weeks, according to legal advice obtained by Labour.
The counsel’s opinion says the health secretary is acting illegally by not obliging NHS England to compel hospitals to treat the required 92% of patients within 18 weeks of being referred by their GP.
The advice, by James Goudie QC, is potentially embarrassing for Hunt as it draws attention to the NHS’s increasingly poor performance against key waiting time targets for A&E care, cancer treatment and ambulances’ responses to 999 calls, as well as the referral to treatment (RTT) requirement. It specifies that at least 92% of all those waiting for non-urgent hospital treatment, such as hip or knee replacement or cataract removals, should wait no more than 18 weeks.
Controversy erupted last month when Simon Stevens, NHS England’s chief executive, announced that he was relaxing the 18-week target so that under-pressure hospitals could focus on more important priorities, in a move critics said meant it was being scrapped. The Royal College of Surgeons accused the NHS of “waving the white flag” on the target and condemning patients already in pain to further suffering due to the extended delays they would now face to get surgery.
Labour peers commissioned the 12-page opinion from Goudie, a barrister specialising in public law and employment law at 11 King’s Bench Walk chambers in London. It says: “I am asked whether the SoS [secretary of state] acted unlawfully by failing to include the 92% RTT target in the mandate to NHS England for 2017-18. My answer is: ‘Yes’.”
It goes on to explain: “This is because the 2012 Regulations and the NHS constitution have the effect that this must be included. The annual mandate cannot lawfully be used to circumvent or undermine by omission the absolute statutory and sub-statutory requirements.”
The mandate is the detailed annual document in which the Department of Health spells out precisely what key priorities it wants NHS England to fulfil in the coming year.
Labour claimed Goudie’s advice showed the government’s NHS plans were “in total chaos”. The party planned to use a motion in the House of Lords on Thursday to try to force ministers to explain what it says is a fundamental breach of patients’ rights under the NHS constitution. Philip Hunt [no relation], Labour’s health spokesman in the Lords, will also challenge ministers to publish the legal advice they have taken surrounding the 18-week target.
“Tory plans for the NHS are in total chaos. Legal advice commissioned by Labour confirms that the government have acted unlawfully in failing to deliver the 18-week treatment target for patients,” said Jonathan Ashworth, the shadow health secretary.
“Almost 4 million people are now on waiting lists because of the neglect and underfunding of this Conservative government and now this year’s NHS mandate is at risk of legal challenge. The government are failing to deliver the standards of care to which NHS patients are legally entitled,” he added.
Labour is now considering what its next move should be in light of Goudie’s advice, including whether it should seek a judicial review to challenge the legality of Jeremy Hunt’s actions over the 18-week target. No decision has yet been made on possible legal avenues it may pursue.
But Hunt last night insisted that he had done nothing wrong and that he had ordered NHS England to start hitting the 92% target again, which hospitals have missed every month since March last year at a time when the total number of patients awaiting treatment has crept up to almost 4 million.
“We do not believe there is a case to answer,” a Conservative spokesman said.
“Indeed, we wholeheartedly reject any suggestion that the government is not committed to the 18-week target, and as the mandate itself clearly states, we are specifically requiring the NHS to return to delivering that standard,” he added. The NHS is now carrying out record numbers of operations and treating 5,000 more people a day than in 2010, the spokesman added.
Hospitals breached the 92% target for the first time in December 2015 since its introduction in 2010. After meeting it again in the next two months, performance slipped to 91.5% last March and has stayed below 92% since. It hit an all-time low of 89.7% last December. In February, a total of 367,094 patients waiting for treatment had already waited for more than 18 weeks, according to the most recent NHS data.
Tim Gardner, a senior policy fellow at the Health Foundation thinktank, said: “The failure of the NHS to treat patients within the 18-week target is a symptom of wider pressures on the system. NHS hospitals are running at or near capacity to cope with growing demand for emergency care, and this limits their ability to perform planned procedures. If funding pressures continue to increase, the NHS will increasingly be forced to make trade-offs to live within its means.
“The government must ensure there are adequate levels of investment to maintain good standards of care in every part of the health and care system.”
More than two thirds of people living in Mexico, Chile and Ecuador are overweight or obese, costing their economies tens of billions of dollars every year, driving rates of disease and straining health services, according to a new UN report.
While the number of hungry people in Latin America and the Caribbean has halved in the last 25 years, the region is now struggling to combat an obesity epidemic.
Changing diets, including more processed food that are high in salt, sugar and fat, along with more sedentary lifestyles have triggered a rising tide of obesity, experts say.
“The implications for the future of countries are frightening … undernutrition is declining, but overnutrition is expected to become the largest social and economic burden in the region,” the UN World Food Programme (WFP) said in a statement.
The report by the WFP and the UN’s Economic Commission for Latin America and the Caribbean (ECLAC), said over the next six decades people being overweight and obese would cost Mexico an estimated $ 13bn a year, Ecuador $ 3bn and Chile $ 1bn.
Undernutrition, when people do not get enough food, and obesity – itself a form of malnutrition – are two sides of the same coin, and together they inflict a so-called “double burden” of disease on people and economies, the report said.
Undernutrition impairs child growth and brain development, while obesity can led to type 2 diabetes, cancer and heart disease.
“We now witness a worrying trend among vulnerable communities with cases of undernourishment and overweight simultaneously within the same families,” said Miguel Barreto, WFP’s regional director said in a statement.
“Both undernourishment and overweight represent a serious burden for the health of those families, that eventually translates into losses in productivity, and in pressure on the health and education systems in the country where they live.”
According to the World Health Organisation, obesity is an epidemic worldwide, killing 2.8 million adults every year, and obesity-related conditions now cause more deaths than hunger.
In Latin America, obesity is increasingly affecting the region’s poor, particularly women.
In Mexico, a country that faces one of the world’s most acute obesity crisis, 74% of women are obese or overweight compared with 70% of men, the report said.
The report urged food companies to play a greater role in combating obesity.
“The food industry has the opportunity to ensure the production, availability and accessibility of healthier food products,” it said.
Governments should also do more to promote exercise and health eating and place greater controls on food labelling.
The report noted Chile’s efforts to combat obesity, including an 18% tax on sugary drinks introduced in 2014 – one of the world’s highest – along with laws that restrict the advertising of unhealthy foods targeting children.
In 2014, Mexico also introduced a 10% tax on fizzy drinks, and 2016 research by the British Medical Journal found that the sugar tax led to as much as a 12% reduction in sales during the first year it was implemented.
Police cannot continue to pick up the slack for cuts in other public services, especially the shortage in mental health provision, Her Majesty’s chief inspector of constabulary has warned.
In an annual state of policing report, Sir Tom Winsor highlights a “modern tsunami of online fraud” and increased police awareness of crimes against the elderly and child sexual exploitation as among the increasing daily pressures facing officers.
“The police are considered to be the service of last resort. In some areas, particularly where people with mental health problems need urgent help, the police are increasingly being used as the service of first resort. This is wrong,” says the chief inspector.
Winsor, who was appointed by Theresa May when she was home secretary, says the failures of other public services, especially in respect of children’s and adolescent mental health, too often leave the police to fill the gaps long after the chances of effective intervention have been lost.
His annual report identifies 18 of the 43 forces where the need for improvement has been highlighted in at least one of HMIC’s inspection themes of effectiveness, efficiency and legitimacy. Only one, Bedfordshire, was rated as “inadequate” for one category.
Winsor says that in many cases, police leaders are “still too sluggish” to ensure their plans are sound to the new demands on their forces. He says for too long a culture of insularity, isolationism and protectionism has prevented chief constables from making the most effective use of new technology: “The blinkers have to come off,” he says.
Winsor also warns that the police are behind many other organisations in their use of technology, saying it should be giving them unprecedented ability to exchange, retrieve and analyse intelligence.
“The provision of mental healthcare has reached such a state of severity that police are often being used to fill the gaps that other agencies cannot. This is an unacceptable drain on police resources and it is a profoundly improper way to treat vulnerable people who need care and help,” he says.
“The obligation of the police is to prevent crime. This is not only because this makes society safer – both in reality and in perception – but also because it is far cheaper to prevent a crime than it is to investigate and arrest the offender after the event. The same is true of mental ill health, which is not a crime.
“It is an old adage that an ounce of prevention is better than a pound of cure, and this is particularly true when the cure fails and an emergency intervention is required to protect the safety of an individual in distress and, often, people nearby.
“By the time depression or some other mental disorder has been allowed to advance to the point that someone is contemplating suicide, or engaging in very hazardous behaviour, many opportunities to intervene will have been missed by many organisations.
“When that intervention takes place on a motorway bridge or railway line, or when someone is holding a weapon in a state of high distress, the expense to all concerned is far higher than it should be. The principal sufferer is the person who is ill, especially when it is realised that his or her suffering could have been much less or even avoided altogether,” concludes Winsor.
Michael Bublé’s wife, Luisana Lopilato, has said their son is recovering and well in her first public comments since the couple announced last year that the three-year-old had cancer.
The Canadian singer and Lopilato, an Argentinian actor, have returned to her home country after Noah, their eldest son, had medical treatment in Los Angeles.
Speaking at a press conference in Buenos Aires for her latest film on Monday, Lopilato, 29, thanked those who had offered their support to the family.
She told reporters: “When things like those that happened to us occur, your take on life changes. It happened to us. Now I value life much more, the now and the today. Thank God, my son is well.”
She went on: “It’s difficult for me to speak about this. It’s very recent and I’m still a bit sensitive about the subject. But the love is daily, when people stop me in the street. It’s wonderful to know that you’re accompanied in life and that people love you.”
Bublé, 41, and Lopilato put their careers on hold following the diagnosis, but she said seeing Noah “grow and being happy” gave her the strength to finish her forthcoming film, Those Who Love, Hate.
Noah was diagnosed in November 2016. Earlier this year the couple released a statement on Facebook saying he was “progressing well” and doctors were optimistic about his future.
The NHS is putting diabetic patients at risk of serious illness by rationing test strips that monitor blood glucose levelsin an attempt to save money, a charity claims. A survey carried out by Diabetes UK found that one in four complained of restrictions placed on the number of test strips they were prescribed by GP practices.
People with diabetes need to test their blood glucose regularly to monitor the condition. If not managed properly, diabetes can lead to health complications such as heart disease, strokes, blindness and amputations.
More than half of those professing problems had type 1 diabetes. Government guidance says this group should test themselves at least four times a day. Older people and those on low incomes were also affected, the charity found. Many said they felt they needed to buy test stripsonline, where quality cannot always be guaranteed.
People with diabetes were given a variety of reasons for the reduced number of strips prescribed, according to the charity. Some respondents to the survey said they had been told they should test less often. Some were told there were “budget constraints”, while others were told it was because they were testing too frequently.
“They said I had my allowance for the month,” said one respondent. Another said: “I was told they were expensive and we should test less. Only need to test four times a day. We use a pump, so need to test every two hours.”
Some said they were having to ask for repeat prescriptions more often. “I now need to order and collect a prescription monthly, or sooner, depending on any issues that crop up,” wrote one. Often when people complained to the practice, their normal prescription was reinstated. But Diabetes UK said they were concerned that people had to challenge the GP practice to get an essential piece of equipment.
Many clinical commissioning groups (CCGs), which have come under fire for rationing other NHS services, have guidance on how often people should test their blood glucose levels and how many boxes of strips should be issued each month. They have also urged GPs to switch patients to cheaper blood glucose meters and strips, sometimes against the patient’s wishes.
Diabetes UK said the rationing was a false economy because the cost of dealing with complications caused by poorly managed diabetes is far higher.
The findings came just weeks after Simon Stevens, the chief executive of NHS England, announced that the health service would stop prescribing some drugs and gluten-free foods to cut spiralling costs.
Diabetes UK’s policy manager, Nikki Joule, said: “These shortsighted cost savings cause people real anguish and potential financial distress. It also means people are struggling to manage their diabetes, which can lead to serious consequences for their health.”
Norman Lamb, the Liberal Democrats’ health spokesman, agreed. “This is more evidence of an insidious creeping retreat of the NHS without any public debate,” he said. “It makes no sense to undermine good preventive care in this way. More people will end up unnecessarily with their health deteriorating.”
It makes no sense to undermine good preventive care in this way
Testing strips are part of a kit used to check the condition. Diabetics prick their finger and put drops of blood on a strip, which then goes into a meter that measures blood glucose levels.
Dr Stephen Lawrence, clinical lead for diabetes for the Royal College of GPs, said: “£24m of the scarce NHS budget is spent on diabetes care every day, and it would be irresponsible not to make the most appropriate use of limited resources.”
He added that the need for strips varied between individuals and that doctors should sit down and discuss appropriate treatments with patients. “We urge NHS England to deliver on the pledges made in its GP Forward View for greater investment in general practice – including more GPs – so that we can give more time to all our patients, including those with diabetes,” Lawrence said.
The charity agreed that decisions on testing and access to strips should be made jointly between a patient and their GP. But their research suggested this did not always happen.
Colin Frampton, an 86-year-old pensioner with type 2 diabetes from Winchester, Hampshire, told Diabetes UK he was paying for test strips out of his pension after being restricted to 50 for the year – enough to test his blood glucose just once a week. He said: “If I didn’t challenge my GP, I’d still have to take money out of my pension to help me manage my condition.”
One pregnant woman, who is type 1 diabetic, saw her strips reduced from 300 to 50 a month, although the National Institute of Health and Clinical Excellence (Nice) guidelines suggest testing for pregnant women of 10 times a day or more.
The report also found that family doctors were overburdened and that receptionists and other surgery staff were increasingly preparing prescriptions. Some of these lacked the necessary understanding of diabetes. When a prescription was restricted, it was usually reinstated once challenged.
The charity said it was concerned that some people with type 2 diabetes who would have benefited from testing had been advised they did not need it, and called for a review of government guidance on this.
Professor Jonathan Valabhji, NHS England’s national clinical director for diabetes and obesity, said: “Ultimately, these are decisions for CCGs, but should be informed by best evidence and national guidance where appropriate. We need to ensure adequate provision and that clinicians take into account widely recognised Nice guidelines, which are clear about the need for test strips to support people in particular with type 1 diabetes.”
Cases of depression have ballooned almost 20% in a decade, making the debilitating disorder the leading cause of disability worldwide, the World Health Organization (WHO) has said.
By 2015, the number of people globally living with depression, according to a revised definition, had reached 322m, up 18.4% since 2005, the UN agency said on Thursday.
“These new figures are a wake-up call for all countries to rethink their approaches to mental health and to treat it with the urgency that it deserves,” WHO chief Margaret Chan said.
According to the agency’s definition, depression is a “persistent sadness and a loss of interest in activities that people normally enjoy, accompanied by an inability to carry out daily activities for two weeks or more”.
Lack of energy, shifts in appetite or sleep patterns, substance abuse, anxiety, feelings of worthlessness and thoughts of self-harm or suicide are also common, and can affect entire families.
Jamal Edwards breaks taboos around men’s mental health
The drop in productivity, and other medical conditions often linked to depression, also takes a financial toll, with the global cost estimated at $ 1tn annually, the WHO said.
Shekhar Saxena, head of the agency’s mental health and substance abuse department, said both psychosocial and medical treatments could be highly effective, insisting on the importance of reaching more of those in need.
Even in the most developed countries, about half of people suffering from depression are not diagnosed or treated, and the percentage soars to between 80-90% in less developed nations.
Treatment can be difficult to access, while a fear of stigma also prevents many people from seeking the help required to live healthy and productive lives, the agency said.
According to the WHO, every dollar invested in improving access to treatment leads to a return of $ 4 in better health and productivity.
And “early identification and treatment of depression is a very effective means of decreasing death by suicide,” Saxena said.
There are about 800,000 suicides worldwide every year, amounting to one every four seconds. And the link to depression is clear.
Saxena pointed to studies showing that 70-80% of people who kill themselves in high-income countries, and around half of those in low-income countries, suffer from mental disorders, of which depression is the most common.
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
Drinking in moderation helps protect heart, with study finding it lowers risk of many conditions compared with not drinking
Moderate drinking can lower the risk of several heart conditions, according to a study that will further fuel the debate about the health implications of alcohol consumption.
The study of 1.93 million people in the UK aged over 30 found that drinking in moderation – defined as consuming no more than 14 units of alcohol a week – had a protective effect on the heart compared with not drinking.
Related: Life-saving alcohol services face devastating cuts
A high carbohydrate diet of rice, plantain, manioc and corn, with a small amount of wild game and fish – plus around six hours’ exercise every day – has given the Tsimané people of the Bolivian Amazon the healthiest hearts in the world.
It may not be a life that everyone would choose. The Tsimané live in thatched huts with no electricity or modern conveniences. Their lives are spent on hunts that can last for over eight hours covering 18km for wild deer, monkeys or tapir and clearing large areas of primal forest with an axe, as well as the gentler pastime of gathering berries.
But as a result of this pre-industrial lifestyle, the Tsimané have hardly any hardening of the arteries. Heart attacks and strokes, the biggest killers in the US and Europe, are almost unknown.
The study published in the Lancet medical journal and being presented at the American College of Cardiology conference shows that an 80-year-old Tsimané man has the vascular age of an American in his mid-50s.
Researchers, who investigated the lifestyles of the Tsimané and checked out their arteries with CT scanners, say that there are lessons for those of us who live sedentary lives in urban areas and eat packaged foods.
“This study suggests that coronary atherosclerosis [hardening of the arteries] could be avoided if people adopted some elements of the Tsimané lifestyle, such as keeping their LDL cholesterol, blood pressure and blood sugar very low, not smoking and being physically active,” said senior cardiology author Dr Gregory S Thomas from Long Beach Memorial Medical Centre in the US.
“Most of the Tsimané are able to live their entire life without developing any coronary atherosclerosis. This has never been seen in any prior research. While difficult to achieve in the industrialized world, we can adopt some aspects of their lifestyle to potentially forestall a condition we thought would eventually effect almost all of us.”
Coronary atherosclerosis is the build-up of plaque in the arteries leading to the heart, which slows the blood flow and can cause blood clots – which may in turn lead to a heart attack. The researchers found that almost nine out of 10 of the 705 Tsimané adults who took part in the study had no risk at all of heart disease; 13% had a low risk and only 3% – 20 individuals – had moderate or high risk.
Even in old age, 65% of those aged over 75 had almost no risk and only 8% (four out of 48) had a moderate to high risk. By contrast, in the US, a study of more than 6,800 people found that half had moderate to high risk – five times as many as among the Tsimané people – and only 14% had no risk of heart disease at all.
In the Tsimané population, heart rate, blood pressure, cholesterol, and blood glucose were also low. The study suggests that genetic risk is less important than lifestyle. “Over the last five years, new roads and the introduction of motorised canoes have dramatically increased access to the nearby market town to buy sugar and cooking oil,” said Dr Ben Trumble, of Arizona State University, US. “This is ushering in major economic and nutritional changes for the Tsimané people.” Those whose lifestyle is changing have higher cholesterol levels than others who stick to hunting and fishing.
Senior anthropology author Prof Hillard Kaplan, from the University of New Mexico, said the loss of subsistence diets and lifestyles could be classed as a new risk factor for vascular ageing. “We believe that components of this way of life could benefit contemporary sedentary populations,” he said.
Tsimané people are more likely to get infections than those in the US, but even so, he said, “they have a very high likelihood of living into old age.”
The researchers cannot yet say whether diet or the active lifestyle is the more important component, said Kaplan, but they want to go on to investigate that by following those of the community whose lifestyles change with exposure to the town. “My best guess is that they act and they interact,” he said.
And it could be as much the foods that the Tsimané do not eat that gives them healthy hearts as the food that they do. Their diet is high in unrefined carbohydrates (72%) with about 14% protein and it is very low in sugar and in fat – also 14%, which amounts to about 38g of fat a day including 11g of saturated fat. “In the evolutionary past, fat and dense energy in the form of sugar were in short supply,” Kaplan said.
A controversial chemical used in Monsanto’s Roundup weedkiller has been judged safe for public use by the European Chemical Agency (Echa).
Glyphosate has been the subject of a relicensing battle which split governments, regulators and scientists, with one arm of the World Health Organisation linking the substance to cancer, while another denied any risk.
Echa was asked to assess its toxicity after EU countries failed to agree on a reauthorisation for the best-selling herbicide last summer, despite a positive recommendation from the European Food Safety Authority.
Today, the agency decided that “the available scientific evidence did not meet the criteria to classify glyphosate as a carcinogen, as a mutagen or as toxic for reproduction”.
“This conclusion was based both on the human evidence and the weight of the evidence of all the animal studies reviewed,” Tim Bowmer, the chairman of Echa’s Committee for Risk Assessment, said in an online briefing.
A classification that glyphosate causes serious eye damage and is toxic to aquatic life will remain in place. The controversy over its health and environmental effects though, looks set to rumble on.
The new Echa opinion now faces an internal check before it is submitted to the European commission which will restart EU discussions so that a final decision can be reached by the end of the year.
“This is not the end of the process,” a commission spokesperson said.
The Echa team responsible for the study was itself accused of conflicts of interests by Greenpeace, as several of its members had either undertaken consultancy work for chemical firms, or worked for institutes that had.
Greenpeace EU’s food policy director, Franziska Achterberg, said: “Echa has gone to great lengths to sweep all evidence that glyphosate can cause cancer under the carpet. The data vastly exceeds what’s legally necessary for the EU to ban glyphosate, but Echa has looked the other way.”
Industry groups heartily welcomed the assessment. “Science prevailed,” said Graeme Taylor, of the European Crop Protection Agency. “Glyphosate is not carcinogenic. We expect the European commission to move swiftly with the registration process for the substance in the EU and grant a 15-year approval.”
Just hours before today’s ruling was announced, unsealed documents in a long-running US federal suit by non-Hodgkins lymphoma sufferers raised new questions about Monsanto’s relations with Environmental Protection Agency (EPA) regulators.
These suggested that the US agriculture giant was given a heads up by Jess Rowland, an EPA deputy division director, about an International Agency for Research on Cancer report linking glyphosate to cancer, allowing it to mount a pre-publication PR offensive. Rowland also allegedly told a Monsanto executive that he would try to prevent a separate government probe of glyphosate, saying: “If I can kill this, I should get a medal.”
In a statement in the New York Times, Monsanto said: “Glyphosate is not a carcinogen.” Monsanto also rebutted criticisms concerning the academic research it underwrites.
Other documents revealed in the US suit include an extraordinary letter from Marion Copley, an award-winning EPA scientist, who said it was “essentially certain” that glyphosate caused cancer.
Copley, who was herself dying of cancer, made several conflicts of interests allegations.
“I have cancer and I don’t want these serious issues in HED [health effects division] to go unaddressed before I go to my grave,” she wrote in her valedictory letter. “I have done my duty.”
Almost half a million people have signed a petition, started in February, calling for a European ban on glyphosate, regulatory reform and mandatory targets for reducing pesticides use.
If the number of signatories reaches a million, the European commission will have to consider a legislative proposal under its citizen initiative rules.
Philip Hammond has played down the significance of the spring budget and denied he plans to surprise parliament with big spending plans or tax reforms.
This was always going to be a “just in case” budget, only bursting into life should the public finances need rescuing from a further slowdown in the economy. But the economy is performing strongly, even as it slows, leaving the chancellor to continue where he left off in the autumn statement: focusing on relatively limited measures to improve the UK’s infrastructure, skills and education.
Austerity will continue to drive down government spending to levels not seen since before the financial crisis, while the tax burden is on track to reach its highest level as a proportion of GDP in 30 years.
What does that mean for the public finances and the choices the chancellor has before him?
The economic outlook
Growth The Office for Budget Responsibility (OBR) – the Treasury’s independent forecaster – is expected to take an optimistic view of the short-term growth prospects, possibly raising the target from 1.4% this year to nearer the Bank of England’s 2% forecast. This could prove controversial. Critics say the recovery from the Brexit vote is built on consumer spending, which is about to face a squeeze from slowing wages growth and higher inflation. The OBR may also be forced to downgrade last year’s growth from its own estimate of 2% to the Office for National Statistics’ 1.8%. In March last year the OBR forecast 2017 growth at 2.2%.
Wages How much the OBR expects wages to slow will be crucial. Average annual pay slipped in the final three months of 2016 from 2.7% to 2.6%, according to the latest figures. The most recent report for the Bank of England showed that average wage rises could slip from 2.7% down to 2.1% by the end of the year. Slowing wages growth would rob the economy of its main engine.
Inflation Until now the OBR has said it expects this year’s inflation rate to be no more than 2.3% and then to peak at 2.5% in 2018. However, these forecasts are now among the lowest around and are likely to be revised upwards amid strongly rising food and petrol prices – probably to 2.6% this year.
Business investment The OBR has always believed business investment will return to pre-crisis norms, whatever the evidence. It has mostly been wrong. But it is unlikely to drop its optimistic forecasts at such a delicate political moment, ahead of the article 50 negotiations, and risk accusations from Brexit campaigners that it is supping with the remain camp. It was forecast in November to remain negative this year, but pick up dramatically for the rest of the decade.
Trade The lower pound means exports are likely to pick up and imports to decline. The OBR in November was considered by some to be conservative in forecasting a 0.3% increase in net trade this year. The new estimate could be higher.
The public finances
Deficit Viewed from the economic depths in November last year, the forecast for this year’s government’s budget deficit will look rosy. The spending shortfall could be as much as £12bn less than previously feared, reducing the forecast budget deficit for 2016-17 from £68bn to about £56bn. This would offset upward revisions to borrowing over the next five years that the OBR said followed the decision to leave the European Union. Extrapolated over the next four years, it could put up to £40bn more in the chancellor’s pocket than he expected in November. The Resolution Foundation has pencilled in a conservative £29bn.
Demonstrators in Parliament Square on 4 March protesting against cuts to NHS funding. Photograph: Daniel Leal-Olivas/AFP/Getty Images
Social care and the NHS Social care has suffered a series of cutbacks, especially to local authority provision, despite rising need. Hammond is expected to loosen the purse strings, but possibly only to get him through the next six months before announcing a more substantial review in the autumn. Increases in NHS England’s budget, which amount to about 11% in real terms by 2020, are partly offset by cuts in other spending by the Department of Health. It is this cut – which ministers claim can be achieved by efficiency savings – that keeps spending in check.
Business rates This is based on commercial property rents and raises about £29bn. Hammond is under pressure to dampen the effects of a business rates revaluation, delayed from 2015, that will send bills in London and the south-east rocketing. Figures from the Valuation Office Agency show businesses in London face an average 23.7% rise in their business rate. Treasury sources indicate that the chancellor will adjust the complicated business-rate capping regime to make life easier for the worst-affected, but will refuse calls for a complete rethink.
Income tax The government wants to raise the income tax personal allowance to £12,500 and the higher-rate threshold to £50,000 by the end of this parliament. In April the personal allowance will rise to £11,500, and the basic rate limit will be increased to £33,500, meaning that the effective threshold for the 40p rate becomes £45,000.
Inheritance tax Osborne’s inheritance tax giveaway, which will allow estates with gains from property sales to pass on an extra £175,000 tax-free on top of the existing £325,000, is another costly item for the chancellor to endorse. The new rates will be phased in by 2019-20. Under rules allowing spouses to receive a tax-free inheritance from their deceased partners, children will then be able to receive £1m tax-free.
Whitehall departments Hammond has demanded further cuts amounting to £3.5bn, or 6%, by the end of the parliament. This sum is in addition to departmental cuts already going through the system and £12bn of welfare cuts targeted at housing benefit and tax credit claimants, which will deliver real-terms cuts in every year and maintain the combined cost of these two benefits at £50bn until 2019-20. The Treasury says there are efficiency savings to be made by the police and other government services. But the Institute for Public Policy Research thinktank says many of the savings are illusory and cuts will hit frontline services.
Education Theresa May has revealed plans for a new generation of free schools and grammar schools costing £320m. Meanwhile, schools in England face the first real-terms cuts to their funding since the mid-1990s, with spending per pupil due to fall 6.5% by 2019-20. The Institute for Fiscal Studies said cuts to sixth-form and further education funding will mean funding for 16- to 18-year-olds is no higher than it was almost 30 years ago.
Skills and trainingIn the autumn statement last November, Hammond said he wanted to rebalance spending towards long-term infrastructure projects. An apprenticeship levy on large employers comes into effect in April, which will bring £3bn into the exchequer. This money is supposed to go back to employers that carry out training, but initially it will be banked by the Treasury. Also, a new category of technical qualifications called T-levels will be introduced in an effort to improve skills in the British workforce and boost productivity. Hammond said an extra £500m would be made available by 2022 to improve the quality of training in schools and colleges and offset the loss of foreign workers after Brexit.
Self-employment In recent years self-employment has become synonymous with low pay and insecure employment, driven by firms seeking to cut their tax bills. Employers pay no national insurance when they commission work from someone who is self-employed and such workers pay a reduced rate of 9%, compared with the 12% paid by PAYE staff. Hammond could raise about £1bn from increasing the national insurance rate for the self-employed to 12%.
Pollution is responsible for one in four deaths among all children under five, according to new World Health Organisation reports, with toxic air, unsafe water and and lack of sanitation the leading causes.
The reports found polluted environments cause the deaths of 1.7 million children every year, but that many of the deaths could be prevented by interventions already known to work, such as providing cleaner cooking fuels to prevent indoor air pollution.
“A polluted environment is a deadly one – particularly for young children,” says Dr Margaret Chan, director-general of the WHO. “Their developing organs and immune systems – and smaller bodies and airways – make them especially vulnerable to dirty air and water.”
The harm from air pollution can begin in the womb and increase the risk of premature birth. After birth, air pollution raises the risk of pneumonia, a major cause of death for under fives, and of lifelong lung conditions such as asthma. It may also increase the risk of heart disease, stroke and cancer in later life.
Children play on an open stove used for smelting woods at an unregulated charcoal factory in Manila, Philippines. Photograph: Ted Aljibe/AFP/Getty Images
The reports present a comprehensive review of the effect of unhealthy environments and found 570,000 children under five-years-old die each year from respiratory infections such as pneumonia, while another 361,000 die due to diarrhoea, as a result of polluted water and poor access to sanitation.
The WHO estimates that 11–14% of children aged five years and older currently report asthma symptoms, with almost half of these cases related to air pollution. It also suggests that the warmer temperatures and carbon dioxide levels linked to climate change may increase pollen levels, making asthma worse.
“Investing in the removal of environmental risks to health will result in massive health benefits,” said Dr Maria Neira, WHO director of environmental and social determinants of health. For example, tackling the backyard recycling of electrical waste would cut children’s exposure to toxins which can cause reduced intelligence and cancer.
In October, the UN’s children’s agency Unicef made the first global estimate of children’s exposure to air pollution and found that almost 90% – 2 billion children – live in places where outdoor air pollution exceeds WHO limits. It found that 300 million of these children live in areas with extreme air pollution, where toxic fumes are more than six times above the health guidelines.
The WHO announced in May that air pollution around the world is rising at an alarming rate, with virtually all cities in poorer nations blighted by unhealthy air and more than half of those in richer countries also suffering.
Pupils from Bowes primary school in Enfield, north London, protesting about levels of air pollution outside their school. Photograph: Chris Radburn/PA
Research in 2015 revealed that more than 3 million people a year die early because of outdoor air pollution, more than malaria and HIV/Aids combined. Chan told the BBC on Monday that air pollution is “one of the most pernicious threats” facing global public health today and is on a much bigger scale than HIV or Ebola.
The state of the British economy, including low incomes, job insecurity, zero-hours contracts, unmanageable debts and poor housing, is putting people at increased risk of suicide, according to a report by the Samaritans.
The report, Dying from Inequality, says there is “overwhelming evidence of a strong link between socioeconomic disadvantage and suicidal behaviour”.
It says governments should place a stronger emphasis on suicide prevention as an inequality issue. It calls for national suicide prevention strategies to be targeted at the most vulnerable people and places, in order to reduce geographical inequalities in suicide.
Samaritans also calls on workplaces to put in place suicide preventions plans and provide better psychological support for employees experiencing job insecurity or affected by downsizing.
“Men in the lowest social class, living in the most deprived areas, are up to 10 times more at risk of suicide then those in the highest social class living in the most affluent areas,” the report says.
Recent research indicates middle-aged men are at higher suicide risk due to economic recession. Unemployed people are two to three times more likely to die by suicide than those with a job.
The least skilled occupations have higher rates of suicide, and a low level of educational attainment and no home ownership has been found to increase an individuals risk of suicide, the report says.
Suicide rates are two to three times higher in the most deprived neighbourhoods compared to the most affluent, and admissions to hospital after self-harm are two times higher.
Disadvantaged people are less likely to seek help for mental health problems and less likely to be referred by GPs to specialist mental health services after self-harm, the report says.
The Samaritans chief executive, Ruth Sutherland, said: “Living in poverty shouldn’t mean losing your life. Going through difficult times like losing your job or being in debt shouldn’t mean not wanting to live. But that is what’s happening in the UK and Ireland today. Suicide is killing the most disadvantaged and vulnerable people, devastating families and communities.”
Among the recommendations is better training of service staff in disadvantaged areas. “Government, public services, employers, service providers, communities, family and friends all have a role in making sure help is relevant and accessible when it matters most,” Sutherland said.
“Everyone can feel overwhelmed at times in their life. People at risk of suicide may have employers, or they may seek help at jobcentres or go to their GP. They may come into contact with national and local government agencies, perhaps on a daily basis. So, in the light of this report, we are asking key people and organisations from across society – for example, those working in housing, in businesses, medical staff, job centre managers – to all take action to make sure their service, their organisation, their community is doing all it can to promote mental health and prevent the tragedy of suicide.”
• 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.
Your urine can tell you more about your health than just how hydrated you are. Changes in color, smell, appearance, and even frequency can be the result of simple external factors or potentially more serious medical conditions.
Different urine colors and causes
While most people expect to see a familiar yellow hue when they look in the toilet bowl, your urine could change color for a variety of reasons that range from harmless external factors to more serious internal conditions. Some of the colors you may see are:
Transparent: Your urine looks like water, there’s no color to it at all. Not to worry, this is most likely because you’ve been drinking a lot of water recently and are very hydrated. You may want to cut back on your water intake to return your urine to a yellow color, though transparent pee is harmless.
Pale straw: If your urine is the color of pale straw, it means that you are healthy and well-hydrated. This is completely normal and no cause for alarm.
Transparent yellow: Again, you are completely normal, albeit slightly less hydrated than those whose urine is the color of pale straw.
Dark yellow: Everything is fine, but you may want to up your water intake. Darker pee is more concentrated, meaning you’re probably on the verge of dehydration.
Amber or honey: You’ve most likely reached the point of dehydration as your urine is very concentrated. Increase your daily water consumption to lighten your pee and become more hydrated.
Syrup or brown ale: Definitely a more disconcerting color to see, and while it could be due to severe dehydration, this color may also indicate liver disease. Try drinking more water, and if the color doesn’t lighten, seek the advice of your doctor.
Pink or reddish: This can be a scary thing to see, but it may not be as serious as you think. Foods like blueberries, beets, and rhubarb can turn your urine a pink or reddish color, so if you’ve recently eaten one of these foods, it is most likely the culprit. If you haven’t, then the color could be due to blood in the urine and you should seek the advice of your doctor—it may be a symptom of a more serious condition like kidney disease, tumors, a UTI, or issues with the prostate.
Orange: Orange urine can be the result of food dyes working through your system or a lack of water. However, if the hue sticks around even after increasing your water intake, check with your doctor as it may be caused by issues with your liver or bile duct.
Other factors and what they mean
In addition to color, the appearance and smell of your urine, as well as the frequency with which you urinate, may change and indicate potential medical conditions. Some common changes are:
Cloudy urine: Cloudy urine is often a symptom of a urinary tract infection and can be accompanied by an odor and a burning sensation when you urinate. A visit to your doctor and a urine test will have the problem diagnosed and treated by antibiotics.
Foamy urine: While foamy urine may be a result of urinating with more force than normal, it can also be due to the presence of protein in the urine, which is a symptom of issues with your kidneys. If you think the foaminess isn’t due to force, contact your doctor to have some tests run and gain a proper diagnosis.
Smelly urine: Urine with an unpleasant odor doesn’t usually relate to a medical condition, rather to the food you’ve eaten or medications you are taking. Asparagus is a prime example of how urine odor can be changed by food.
Frequent urination: Women over the age of 35 who experience frequent urination may have benign uterine tumors known as fibroids, while men with this issue may be experiencing problems with their prostate. Frequent urination has also been linked to diabetes, UTIs, and stroke recovery. Those who have suffered a stroke may have less control over their bladders due to weakened muscles and nerve damage, which can cause incontinence and frequent urination.
While the color, appearance, smell, and frequency of your urine can tell you many things about the state of your health, if there are any changes that you find concerning, it is always best to contact your doctor in order to determine the cause of your symptoms. You can consider using natural diuretic drinks to flush out those excess sodium and helps with water retention in your body.
One in four young men are turning to self-harm as a result of depression, anxiety and stress, according to a YouGov poll.
Of the 500 men aged 16 to 24 surveyed, 24% said they had intentionally hurt themselves. The poll commissioned by three leading youth charities – the Mix, Self-Harm UK and Young Minds – also found a further 22% said they had considered self-harming.
Many said that when they felt under pressure they would turn to exercising excessively, controlled eating, pulling out their hair, punching walls and abusing drugs. When asked how they cope with stress, 21% admitted to drinking heavily, while 19% said they had punched walls and 16% admitted to controlled eating.
Experts say the figures are further evidence that self-harm is not confined to young women. They support NHS figures obtained by the Guardian last year which showed a sharp rise in hospital admissions for self-harm over the past decade.
The charities said the figures may be even greater, as many young men are unaware some of their negative behaviour is self-harm.
Chris Martin, chief executive at The Mix, a charity for under-25s, said: “What’s shocking about these results is the percentage of young men who are self-harming. Lately, we’ve seen a rise in young men accessing our mental health content, services and self-help tools.”
Chris Curtis, the chief executive of Self-Harm UK, said the issue needed to be urgently addressed “to help teenage boys deal constructively with the pressures they face”.
Dr Marc Bush, senior policy adviser at Young Minds, said: “Young men can find it hard to express their emotions because they need to be with the lads and have a sense of belonging. But they can have lots of issues with self-esteem and then have difficulty processing their emotions.”
Bush noted that many young men struggle with self-esteem issues due to the pressure to have a certain type of body. “Ten years ago we were worried about starvation, over-exercise and yo-yo dieting among women, but now we are seeing this in men. Young men think that these bodies are achievable and are doing anything to get them.”
Bush said some men become obsessed about exercise to cope with anxiety, working out to the point of doing physical damaging. “There are cases of men over-exercising and acquiring an injury and then carrying on despite their body saying ‘you’re hurting me’. Lots of young men in their 30s and 40s have done damage that way so they cannot do sports that they used to. Over-exercise can be a injurious activity.”
He added that more needed to be done to raise awareness about men’s mental health concerns, so young people can to talk about their experiences and learn ways to cope.
James Downs, 27, from Cardiff, turned to controlled eating and over-exercising to deal with difficult emotions as a teenager.
He said: “I started to retreat more and more into my eating problems and self-harming behaviours as a way of avoiding having to cope with my feelings. It was to numb the emotional pain I felt with physical pain.Things got so bad that I lost my friends, had to leave school and gave up my university place. I felt like I was a failure and this only made my damaging behaviour worse.
“Instead of blaming myself and isolating myself with my feelings I wish that I had been able to open up to others without feeling ashamed. Mental health and self harm weren’t topics that were ever mentioned in school or at home. They weren’t on the radar and that there needs to be much greater awareness and openness of these issues so that people don’t have to cope alone.”
The survey findings come after a dramatic rise in the number of children and young people self-harming in the past 10 years. There have been major rises among boys and girls.
An NSPCC spokesperson said: “A frightening number of children and young people are being driven to self-harm as a way of dealing with unresolved feelings, tensions and distress in their lives. Last year 18,778 children and young people in England and Wales were admitted to hospital for treatment for self inflicted injuries – a 14% increase over the last three years.
Sir Simon Wessely, of the Royal Psychological Society said it was worrying that reliable data also showed rates of self-harm among young men steadily increasing since 2000.
Downs said: “Life for a young person today is full of challenges that our parents didn’t have to experience. It’s fast paced, competitive and puts immense demands on our ability to remain resilient and cope in positive ways.”
GPs are routinely failing to provide adequate care to patients with eating disorders, with one in three not referred for specialist assistance, a leading charity has warned.
Beat, the UK’s primary eating disorder charity, found that half of people with some experience of the condition rated GP care as “poor” or “very poor” and 30% were not referred to mental health services after their appointment.
The charity polled 1,700 people, the majority of whom had sought medical help for an eating disorder. Of the 1,267 who had gone to a GP for help, only 34% said they felt their doctor knew how to treat them.
This is despite National Institute for Health and Care Excellence (Nice) guidelines that say patients should “receive treatment at the earliest opportunity”.
It comes amid growing concern about eating disorder services in general and the help available for patients once they are referred. NHS data shows a 36% drop in the number of hospital appointments for eating disorders in England, leaving thousands of children and teenagers forced to wait months for help. Charities warned that some patients were essentially being told they would not get help unless they starved themselves further.
Beat’s warnings will add more pressure on the government to improve care for patients. The charity has called for better training for medical students specialising in general practice, as well as more funding for mental health services once referrals are made.
Andrew Radford, the chief executive of the charity, said: “Unfortunately many of our respondents identified poor care, with many GPs not knowing what the real signs and symptoms are.
“This isn’t about blaming GPs, it’s about enabling the 50% of GPs who didn’t provide good care to be as supportive of eating disorder sufferers as the 50% who did.”
Elizabeth McNaught, 25, a junior doctor who had eating disorders when she was younger, agreed training was not good enough. “Many doctors do not know enough about eating disorders because they don’t feature very highly in medical training. We had just two hours on the subject throughout five years of study.”
Eating disorder numbers among the young have risen over the years. While 658 under-19s in England needed a spell in hospital in 2003-04 to treat an eating disorder, by 2013-14 that number had increased to 1,791, up 172%.
At least 725,000 people in the UK of all ages, genders and backgrounds now have an eating disorder. Research has found 20% of anorexia sufferers will die prematurely from the illness.
Prof Helen Stokes-Lampard, chair of the Royal College of GPs, dismissed claims that family doctors were not trained to identify and treat eating disorders. She added that Nice guidelines did not recommend immediate referral for all patients who might have an eating disorder. “In some cases the condition can be dealt with effectively in primary care,” she said.
Stokes-Lampard said the figures did show the intense pressure GPs were under. She added that it was not always possible to assess the needs of complex patients in a 10-minute appointment, calling for more investment and longer consultations. She also said better mental health services in the community were needed.
The Guardian heard from several people who had trouble with their GP, including Matt Foster, 28. He said: “I had spoken to my GP before about mental health issues and they were unsympathetic.” Another person, who wished to be anonymous, said: “When I first asked my GP for help, he sounded bemused. He said throwing up your food is bad for you and you are hardly fat, so what do you have to worry about?”
Rhiannon Lambert, a nutritionist, said: “Approaching a GP will always be a vital move in treatment and more needs to be done to support patients. Eating disorders need to be taken seriously. While recovery is possible, they often last a lifetime or sadly take a life.”
As every parent of a newborn knows, sleep is a foreign country, a place that they happily visited a long time ago but fear they may now never experience again. The constant disruption to sleep patterns posed by a screaming baby can play havoc with relationships, waistlines and sanity, but it’s also having a deleterious effect on the nation’s finances. Until now.
In the first study of its kind, Joan Costa-i-Font and Sarah Flèche, of the Centre for Economic Performance at the London School of Economics and Political Science, have found that baby-induced fatigue is significantly undermining economic performance. Their work is to be presented at the Royal Economic Society’s annual conference in April.
They reached their conclusion after examining the Avon Longitudinal Study of Parents and Children dataset, which follows a sample of 14,000 British families from a child’s birth to the age of 25. The data contains precise information on the child’s quality of sleep, including whether they wake up at night and how often.
A one-hour increase in the amount of sleep a baby has increases the time a mother sleeps by 12 minutes. Every time a baby wakes up, a mother loses 30 minutes of sleep.
These results were then correlated against the parents’ employment experiences. Costa-i-Font and Flèche say: “The effects of parental sleep on economic performance are substantial.”
A one-hour increase in the amount of sleep a mother has improves their employment prospects by 4%. It also, they say, correlates to a 7% increase in the number of hours they work and an impressive 11% rise in household income. There is also a 1% increase in job satisfaction.
The effect of disruptive children on paternal sleep was found to be only half of that on maternal sleep.
Last week’s Great British Bedtime report by the Sleep Council found that a quarter of people are now using alcohol as a “sleep remedy”, compared to just 16% in 2013.
A royal commission should be set up to examine the long-term future of the National Health Service, a senior Tory peer has said.
Former Conservative chairman Lord Saatchi said a commission could take the issue out of politics and “detoxify” any changes that needed to be made.
His recommendation comes before the publication of a report that is expected to show the parlous state of English NHS finances.
In a paper for the Centre for Policy Studies thinktank, Lord Saatchi said: “There is a wide range of perspectives on the current performance of the NHS, and varied confidence in its long-term future, from the pessimistic view that the system is in crisis, to the optimistic position that its only threats are meddling politicians. A royal commission offers significant benefits regardless of the position taken.
“A royal commission is an opportunity to help reverse a deterioration in some clinical outcomes, to identify and eliminate barriers to equal access, and to ensure that trusts are adequately funded to cope with current demand pressures. The solutions it arrives at could help to avert the kind of distress seen throughout the system over the 2016-17 winter.”
Saatchi said the advantages of a commission, rather than any other sort of inquiry, included “the ability to secure the bipartisan support needed to embed lasting changes, to detoxify reforms that otherwise may be too politically dangerous to pursue, and to deploy its unique investigatory power to establish what reforms are needed to ensure that we have a world-class, 21st century, health system”.
“A commission’s investigatory powers and capacity to provide evidenced-based review, free from the constraints of the immediate political cycle, allow it to craft solutions that command the support of practitioners and politicians alike. When set up properly, its recommendations carry a unique legitimacy that could be essential to securing a lasting, bipartisan settlement on the NHS.
As the NHS approaches its 70th birthday he said it “would be reckless not to seek a full body check-up – the first in decades”.
On Monday, NHS Improvement’s figures for the third quarter of 2016-17 will be published.
NHS Improvement’s chief executive, Jim Mackey, has acknowledged that trusts would miss the £580m deficit “control target” and forecasters have predicted the combined hole in their finances could reach nearly £1bn by the end of the year.
Responses to the King’s Fund thinktank’s latest survey of NHS finance directors, carried out in late January and early February, made for “uncomfortable reading”, its director of policy, Richard Murray, said.
“They suggests that the forecast net deficit has risen by about 30% since the autumn, when NHS Improvement’s quarter two report showed a net deficit for the year of £669m. Simply applying one number to the other would give a 2016-17 net provider deficit somewhere between the £820m to £920m mark.”
Murray suggested it was a “big ask” to expect trusts to recover ground over the remainder of the year, given the scale of the winter crisis.
Bill Gates, the co-founder of Microsoft who has spent billions on philanthropic efforts over the past several decades, speaks at the Munich security conference on Sunday and says that the world must be on guard for bio-terrorism attacks. Telling the audience that “a synthetic version of the smallpox virus … or a super contagious and deadly strain of the flu” could kill more than 30 million people in a year, Gates says there is a “reasonable probability” that such an event could occur in the next 10 to 15 years
