Tag Archives: health

Health Podcast – The Elephant in the Room

In the latest of the Green Book podcasts we’ve looked at health, not from the usual angle of the NHS itself but at the health of the UK population.  If you missed it last month, you can still catch up

Why is it that we have one of the unhealthiest populations amongst developed countries? What might that mean in terms of demand and costs in the NHS, apart from all the wider social and economic consequences?  

It’s not as if this is news, as it has been covered in detail by people like Sir Michael Marmot, with his reports going back to 2010, and others before that.  Is it just about more money and resources for the NHS – or are we missing something in how and where we tackle the problems?

Norman Lamb chaired the session, having been a Lib Dem MP and health minister as well as the current chair of a health trust.  Joining him was Wendy Taylor who was a clinical oncologist as well as a current councillor in Newcastle with a particular interest in public health. Joining them we had two guests who are currently writing a book on the subject, which they have loosely titled ‘The Elephant in the Room’.  Roy Lilley and Ed Smith both have business backgrounds but have led and worked extensively with health trusts and both public and private health bodies.  Whilst being strong supporters of the NHS, they see the impossibility of dealing with the ever-escalating demands of an unhealthy population.  

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The culture war of the “gender-critical” has broken the NHS

The Cass Report, billed as an independent review into NHS provision of transgender provision for adolescents was published today. I’ve read the summary and recommendations (the whole report runs to over 300 pages), and running throughout it are the scars of the so-called “culture war”—a social movement where transphobes who hold so-called “gender critical” beliefs have been campaigning to marginalise trans people and roll-back hard won protection in equality law.

The report itself acknowledges the toxicity of debate around transgender healthcare. I’m going to try and be fair to the report here and deal with it as neutrally as I can. Transphobia does not seem to be seeping out of its pores in the same way that a recent Department for Education consultation did, which explicitly framed the discussion through the lens of the “gender critical” philosophy.

It is undeniable the harm that the culture war fuelled by transphobia has caused, and this comes through in the report.

Anti-trans campaigners are litigious and well-funded (allegedly by far-right American fundamentalists), and using these legal weapons has been effective in securing their campaign goals in places with a management culture focussed on risk management and minimisation.

The result of this atmosphere of fear created by the anti-trans movement is one the review describes as a situation where other services in healthcare are scared to do anything when gender dysphoria is present. Instead, everyone is referred to the specialist gender services for unrelated or co-existing conditions, which they might not be able to deal with. This is well-known in the trans community as “trans broken arm syndrome“. This is true in both children and adults.

There is no doubt that in part this is due to the fear within the healthcare community of being dragged into the frontline of the culture wars, which has had the chilling effect of marginalising trans people so that only the gender clinics can help.

The Cass Review strongly advocates moving away from single specialist centres to a regional model of trans healthcare, closer to primary care. This is also something many trans people and advocates (including myself) believe would be a better system of healthcare delivery, but it describes the current situation as far from that. Other recommendations in the report are fair assessments of the current situation. In the void left by the failure of NHS healthcare, private providers like GenderGP have emerged, but their standards of care fall short of best practice (trans streamer F1nn5ter recently did a video about this). The Cass Report is right to be critical of this, and this is one of the biggest indicators of how current NHS provision fails.

Much is made in the report of the lack of quality research covering transgender health. Transgender health has often been seen as at best niche, and at worst, something to be actively destroyed. During Nazi rule, the world’s first and leading research centre was ransacked and the research burnt, as well as trans people being among the identities targeted in the holocaust. Other research has overly focussed on transgender women and bears an undercurrent of the fetishisation that we’re often targets of, yet remained influential in the field for decades.

One example of this is that there has never been a longitudinal study of the impact of progesterone alongside estrogen in feminising hormones, which are routinely denied due to evidence showing no effect on breast growth, but anecdotally has an effect on mental health, which has never been evaluated. The assumption of medical researchers that trans women are only interested in breast development, and not in the mental health benefits of the hormone which is available to cis women, is one example of research being rooted in trans misogyny.

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Why we need good Cancer care

I’m grateful to see the motion on Cancer care passed at Conference  but  I am sorry to my core that it had to be written in the first place.

I’m coming from a slightly different place than you might expect, partly because that place is Scotland and I know what is called for wouldn’t apply, but I wanted to tell a story which whilst does not have a happy ending, it had a happy-ish journey.

My mum died of cancer just over 18 months ago. She was diagnosed in December, and left us in the following July.

There wasn’t much time for the system not to work for her.

I would be lying if I said there were things in terms of her care I wouldn’t change, but I don’t want the perfect to be the enemy of the good, and I’m lucky enough to be able to speak to the positives of our experience.

She spent a lot of her time in a specialist palliative care unit. Somewhere which was welcoming and spacious, with the most beautiful garden to look out on and spend time in.

If you were to look up kindness or heart or positivity in the dictionary there you would see all of the doctors and nurses we encountered.

They were always there. We never had to worry about that. We laughed and we shared fruit the children of one of the nurses had picked earlier that day. They genuinely brought us a lot of joy.

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Lib Dems unveil plan to improve Cancer care in the UK

Cancer will affect virtually all of it. The first time I saw it in all its awfulness was with my mother in law back in the 80s. By the time it had been discovered, she had no chance. And even with pretty good home care and wonderful support from Macmillan nurses, it was brutal for all of us.

This week the Lib Dems have unveiled a plan to boost Cancer care in the UK, which includes:

Make the UK a world leader in cancer research by:

  1. Passing a Cancer Survival Research Act that would require the Government to coordinate and ensure funding for research into the cancers with the lowest survival rates, including lung, liver, brain and pancreatic cancer.

  2. Saving the National Cancer Research Institute. The Government is presiding over the closure of the National Cancer Research Institute, which was established in 2001 and plays a vital role in coordinating cancer research, due to uncertainty over research funding. Its closure has been described by one oncology professor as like “turning off air traffic control and hoping the planes will be fine”.

  3. Halving the time for new treatments to reach patients. It takes an average of 11 months for a new medicine or medical technology to be approved and available to patients in England, compared to just 4 months in Germany. We will expand the MHRA’s capacity to speed up that process.

Boost treatment capacity to ensure survival rates are in line with the best in the world by:

  1. Introducing a two-month cancer treatment guarantee: a new target for 100% of patients to start treatment for cancer within 62 days from urgent referral, with this right written into law. Currently this is only a government pledge, and 36% of patients wait longer than 62 days.
  2. Boosting access to radiotherapy: replace ageing radiotherapy machines and increase their number, as well as widening access so that no one has to travel too far for treatment.

  3. Improving support for patients and their families: recruit more cancer nurses so that every patient has a dedicated specialist supporting them throughout their treatment. Ensure patients and their families are given information about charities, patient support groups and financial support at every key stage: referral, diagnosis and starting treatment.

This is particularly timely given today’s shocking research showing that Cancer survival rates in the UK are 10-15 years behind similar countries.

Ed Davey said:

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Earl Russell highlights lack of mental health support for children and young people

Improving mental health has been a priority for the Liberal Democrats long before it was fashionable.

Our elected representatives at every level raise it whenever they can. Norman Lamb as health minister did so much to improve access to services but it’s been a long 8 years since he was in office.

Recently, our Earl Russell secured a debate in the House of Lords to highlight how appalling provision is for children and young people. Waiting times are horrendous. Imagine the impact on your education if you have to wait a year to even be seen. It’s then a long recovery and before you know it, that’s half your secondary education gone. And imagine the suffering if, like too many, CAMHS won’t even accept your referral.

For parents and carers, watching their young person struggle is one of the worst things to endure. And the anxiety of wondering if they will still be there in the morning, every day, takes its toll.

The debate is covered here on Today in Parliament, from about 20:10 in, and below are Earl Russell’s speeches. We’ll cover the contributions by Richard Allan, Claire Tyler and Mike Storey tomorrow.

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Scotland needs urgent action on overdose prevention centres

It is not often that an announcement from a Scottish Government appointee makes me cheer, but the news that the Lord Advocate has finally given the green light to proceed with Overdose Prevention Centres did just that.

The fight to tackle Scotland’s drug death crisis has been a long and often fractious one. Too often, it has been dragged into the constitutional quagmire that bogs so much progress down. Both of Scotland’s Governments have let the victims of this crisis and their families down too many times. Whether it was the Scottish Government’s decision to decimate rehab budgets or the stubborn refusal of the Tories to accept the evidence that mass criminalisation is failing the most vulnerable.

So, finally, we have a ray of light after the Lord Advocate has said that it is not in the public interest to prosecute these much-needed services. Quite why it has taken this long to arrive at that conclusion is anyone’s guess, but this is a welcome step nonetheless.

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Why health is the theme for the Lib Dem local election launch

The Liberal Democrats have been analysing the latest data from the NHS. It shows that there are 547 fewer GP practices in England compared with 2019 – during a period when patient numbers have been rising. Now some of those could be due to mergers of practices, but not all, because we also know that GP numbers have fallen as well.

In fact, there are now 850 fewer NHS GPs than four years ago. Remember that in the last election (in 2019) the Tories promised to recruit 6000 more GPs.

Rural communities suffer most from losing their medical centres. There are 206 villages where patients have a journey of more than 5 miles to see a doctor – this figures is up on previous years as well.

We all know that the NHS is in crisis – appalling ambulance waiting times, long waits for transfer from A&E to hospital beds, unnecessary waits for discharge, unprecedented waiting lists for hospital appointments and for surgery.  On top of that there are huge pressures on GP practices, who are the first point of contact for anyone with a medical worry. It seems that over the last year 29% of UK adults have tried and failed to get a GP appointment.

There is clearly widespread anger and anxiety, although most people realise that none of this is the fault of the medical professionals.

Our simple policies of recruiting 8000 more GPs, and giving patients a legal right to see a GP within seven days, will go some way towards addressing the problems.

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Ed Davey to launch Lib Dem local election campaign

Ed Davey will today launch the Lib Dem campaign for this year’s local elections, which take place on 4th May.

And he’s already getting some good coverage. The theme for today is health, as that is what people are raising most with us on the doorstep. We are calling for an extra 8000 GPs to fill the massive gaps in coverage and service.

Here’s Ed talking to BBC Breakfast this morning:

From the BBC:

Lib Dem leader Ed Davey called on the government to create a legal right for patients to see a GP within seven days.

May’s council elections are the “final chance” to send a message to the government before a general election, Mr Davey will add.

On 4 May, 230 councils across England will hold an election.

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Wera Hobhouse calls for action to tackle eating disorders

Anyone who has supported a loved one with an eating disorder will appreciate Wera Hobhouse’s tireless efforts to get better support and services for those living with these terrible and distressing conditions.

I know first hand how horrendous it is to watch someone suffering in this way. The agony that my loved one went through will stay with me forever, as will all the related anxiety. And I really appreciated that Wera drew attention to eating disorders in men for that reason.

What made things much worse is that there was so little in the way of practical support available. It is great to know that we have a champion in Parliament who gets this and who is fighting for more.

This Eating Disorders Awareness Week, Wera held a Westminster Hall Debate. She called for action to tackle an epidemic of eating disorders. She asked for a targeted strategy for eating disorders to tackle the waiting times for treatment for children and adults, provide training for health and education staff to recognise the signs that an eating disorder might be developing, earlier intervention and evidence based treatments.

The full text of her speech is below:

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186 days – my misadventures with Long Covid

186 days. Not far off half a year. That’s how long it’s been since I first had Covid symptoms.

We had tried very hard to avoid it for 26 months, but our son going to a Marina and Diamonds concert in Dublin at the end of May was always going to be a high risk endeavour. Within days we were all suffering. At first I was the best off of all of us so I was running round after everyone else. Then on 5th June, I could barely get up.

The salutary tale from my experience is that if you are election agent for multiple wards in your local area, get your expenses done immediately after the election. Mine were all done and signed by the candidates before I became ill. I just had to print off my declarations, sign and submit before the deadline on 10th June. I could, thankfully submit them online, but that simple task was herculean and broke me on several occasions before I finally managed it.

Since then, I haven’t got that much better. The cough may have disappeared after a month, but I have yet to manage to spend a whole day out of bed, and if I overdo it, the punishment is vicious. Eight days ago, I went out for a special family lunch. I did get home a couple of hours  later than I’d planned but I didn’t recover from that until midweek. I had a meeting to attend online on the day after but I couldn’t speak reliably. Words were getting lost somewhere between my brain and my mouth.  I had to message someone else and ask them to make the point I needed to make.

The crushing, all-encompassing fatigue is the absolute worst, but it has a backing chorus of pain, nausea, dizziness, breathlessness and gastric issues which, seemingly randomly, throw themselves into the spotlight on any given day.

I reckon that on a good day, I’m operating at about 25-35% of my pre Covid capacity. On a bad day, I am flat out.

Being able to do something one day is absolutely no guarantee that you will be able to do it the next. Some days I can write well in small bursts, but there was one day recently when it took me an hour to put up a relatively simple post on here.

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Does your hospital have dedicated baby loss facilities?

Imagine you have just heard the news that every parent to be dreads – that you are losing your much wanted baby.

Then, you have to give birth, or support your partner giving birth on the labour ward in your hospital. You can hear the sounds of newborn babies crying and the associated sounds of joy, intensifying the agony you are going through.

When that happened to Louise Caldwell from Lanarkshire, she determined to change things. Her campaign for dedicated baby loss facilities has already been successful in her local hospital and the Gilbert Bain Hospital in Shetland where she also experienced the loss of a baby.  The Scottish Government has said that all hospitals will have these facilities within two years.

Next week she’ll be in Westminster talking to MPs about her experience and her campaign in the hope that such facilities will be introduced across the UK?

From the Daily Record:

Louise, from East Kilbride, told Lanarkshire Live : “I never imagined when I started the campaign that I, a mum from East Kilbride, would be speaking to MPs at Westminster.

“To achieve the new unit at Wishaw – which will hopefully open in the coming months – is a fantastic achievement but there is still so much to do – and I can’t do it on my own.

“I want to see the promise by the Scottish Government to have these facilities in hospitals elsewhere fulfilled and I want to see them replicated across the UK.

Shetland’s Lib Dem MSP Beatrice Wishart was the first to raise this issue in the Scottish Parliament and she recently talked about it during Baby Loss Awareness Week.

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The Conservatives fail because they think they know best.

One of the characteristics of this awful government is that they manage to present even ideas with a modicum of sense in a way which ensures they will be unpopular.

Yesterday we had a classic example in the news that the new Health Secretary, Thérèse Coffey as part of her ‘Plan for Patients’ is planning to allow pharmacies to prescribe antibiotics (and other drugs) in some cases. It has also come out that she has said that she has handed out her own antibiotics to friends who were feeling unwell in the past. Reaction to this news has been swift – Stephen Baker, Professor of Microbiology at Cambridge said widening access to antibiotics was ‘nuts’ and Professor Penny Ward, of the Faculty of Pharmaceutical Medicine was equally scathing: “The Health Secretary really should take the time to familiarise herself with what is a difficult topic”

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Lord help us all….Lib Dems react to new Cabinet

So Liz Truss is now ensconced in Downing Street appointing her new Cabinet. And it looks like it is going to be one of the most socially as well as economically conservative governments in over quarter of a century. This is somewhat surprising given that she is the first Prime Minister of my lifetime who is younger than me.

After a 1000 mile round trip to see the Queen, she went  to her private Commons office  to send Rishi Sunak supporters Grant Shapps, Steve Barclay and Dominic Raab packing.

Every time a new Conservative PM announces their top team, you think it couldn’t get any worse. Remember when Theresa May appointed Boris Johnson as Foreign Secretary? And then when Boris in turn made Priti Patel Home Secretary.

So far, Liz Truss has made some very worrying appointments.

First of all, someone who opposes abortion and same sex marriage to health:

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Ed Davey’s speech to Conference: Lib Dems can defeat this awful Government

A powerful selection on Ukraine, a call for Priti Patel to be sacked, a celebration of Chesham and Amersham and North Shropshire, a tribute to Lib Dem by-election stalwart Erlend Watson, a decent gag about Dick Turpin, an evisceration of the Tories over sleaze and partygate (including a call for a public enquiry into Boris Johnson’s relationship with Lebvedev) and an attack on Tory MPs for keeping Boris Johnson in power, setting out what the Lib Dems offer for health and education and a look forward to the local government elections in May…all this and more delivered by Ed Davey to Lib Dem members gathered in York.

 

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A whole systems approach to solving the health and social care crisis

The Health and Social Care Bill currently in the House of Lords is intended to:

  1. sort out the under-funding of social care;
  2. remove the need for people to sell their houses to pay for their care;
  3. promote joined-up service delivery;
  4. replace the competitive model with a collaborative one.

Sadly, as I wrote here, it appears to be a quick fix component level response to a whole systems problem which will simply “kick the problem on for a few more years”. There is little point putting more and more money into the first aid camp at the bottom of the cliff without building a fence at the top.

The cap on the amount which can be spent on care home fees will favour the rich in that people who do not have sufficient savings will still have to sell their house to pay for their care.

The “Integrated Care Systems” and “Integrated Care Partnerships” will be very costly and appear more concerned with preserving:

  • the current configuration of local authorities and NHS Trusts, and;
  • the purchaser / provider split and commissioning;

than they do the provision of integrated care.

Successive Governments have tried to get health, social services, police, education and housing to work together, but none has grasped the nettle of different geographical areas, different funding streams and different lines of accountability, which have been the main impediments.

Since the 1990 National Health Service and Community Care Act the “contract culture” has led to:

  1. a “minding” rather than a “mending” service with social workers increasingly used to assess the eligibility to specific services rather than using relationship and therapeutic counselling to resolve problems;
  2. further fragmentation with different components of a “package of care” bought from different providers, and;
  3. “self-funders” (a dreadful term) being waived away denying them an “independent verification of their wishes” and their families the help and support they need.

There is a wealth of empirical evidence on the “social determinates of health” which have demonstrated the correlation between income and demand upon the NHS.

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Why waiting times matter in mental health

18 weeks. That’s the target waiting time, often missed, from referral to being seen.  From now in deepest darkest December to  Mid April, what an age that is. It’s hard on adults. Arguably harder when that’s how long some of our most distressed young people have to wait for support. 18 weeks or  4 months is a very long time if you are 13. If you are being bullied, if life is becoming more complex and you feel ill equipped to cope. It’s more than a school term, it’s too long and that’s the best on offer. Too often, currently for  1600  children,  the wait was over a year. Let’s be realistic, any child that has asked for help and waits over a year will undoubtedly experience that response as  No, there is no help.

The last 18 months has seen very few of us untouched by the pressures of the pandemic and the impact on the mental health of both adults and the young has been significant. From a self-reported rising anxiety across the population generally to increased rates of disordered eating and self harming amongst young people.  

In my work as Counsellor I have seen this in the increased waiting lists for our third sector services, parents seeking private services for children to avoid waiting times that seem to be never ending and referrals to online services. Even before Covid we were in trouble. One young person I worked with, told me what she’d learnt from 5 years bouncing between referrals from her GP  to the private sector, to CAMHS and to online services as she now transitioned to adult services.

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European health policy and the Conference on the Future of Europe

On the 23rd of October, the Liberal Democrats Abroad and the Liberal Democrats European Group held a discussion session with Irish Senator Timmy Dooley about the Alliance of Liberals and Democrats for Europe’s contribution to the Conference on the Future of Europe. Mr Dooley underlined the importance of hearing British views on Europe’s future, to help learn the lessons from Brexit, meet citizens’ expectations, and shape the EU into an organisation that the British people would be excited to rejoin.

In health, he mentioned the disillusionment caused by an initially slow response to vaccine procurement. Things have vastly improved since then, although, this is an important opportunity to take stock of what Europe does in health – and what else we might like it to do.

Firstly, on pharmaceuticals. Manufacturers can apply to the European Medicines Agency for EU-wide marketing authorisation for their products, but that doesn’t  automatically mean they’ll be available across the EU. Medicine pricing and reimbursement decisions are up to the Member States of the EU. Some have joined together to evaluate the impact of these newly available medicines and decide pricing, such as the Beneluxa group. Is there more Europe can do in this area? Should such coalitions expand to include other EU members – and could the UK get involved?

Europe also offers manufacturers incentives, based on market exclusivity for their new product for a period of time before competing medicines can come into play. The European Commission is examining changes to the rules, which could make these incentives conditional on EU-wide product availability or meeting health needs not yet addressed by existing products. At the same time, it seeks to make the process of getting market authorisation more efficient and less expensive, while maintaining high standards. Should it reform these incentives to influence manufacturers’ behaviour, and if so, how can the EU balance those two issues in a way that works for manufacturers and patients?

The Commission is also reviewing the rules on children’s and rare disease medicines, for similar reasons – how can we incentivise these treatments and make sure patients can access them?

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Dismissing Dysmenorrhea

So, if you have never had bad period pain, how can I convince you that it really is horrible?

You know what bad toothache can be like?

That sort of immersive pain experience that completely consumes you.

There is very little you can do to get relief.  Painkillers barely take the edge off.

Concentrating on anything is virtually impossible.

Thankfully, bad toothache doesn’t come along too often.

But period pain, which is kind of like toothache in the abdomen comes along roughly once a month. I know people who are in absolute agony for a couple of days.

On the Hysteria podcast last week, former White House aide Alyssa Mastramonaco described her lifelong search for the optimum combination of methods of relief for her horrible monthly pain.

When I was a teenager, I used to get such bad pain that I would be sick and sometimes I was at the point of passing out.

This is seriously nasty. And research into alleviating Dysmenorrhea, to give it its medical name, has been relatively sparse and not very well funded.

I was once sent home from school because it was so bad, but I never did that again after getting warned within an inch of my life by my mother.

I was lucky that it got a bit better when I got into my twenties, but some people suffer all the way through their menstruating years.

If you are one of the unlucky ones, you can have 40 years of monthly hell. You have to go through that pain almost 500 times.

It is definitely frowned upon to take time off work for it, although 73% of people surveyed by Bloody Good Period, reported in Glamour Magazine said they had struggled at work because of their periods.

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LibLInk: Christine Jardine on the perfect storm that shows up our bad Governments

In her Scotsman column this week, Christine Jardine looks at the “perfect storm” of food and fuel shortages, health service crisis, Covid and high energy prices we are facing at the moment. She argues that the show how bad both UK and Scottish Governments are – and we shouldn’t let them away with blaming Covid and Brexit for our current travails. They were failing long before then:

It must be tempting for those responsible for the well-being of the NHS to blame its current predicament on all the other elements of the storm. That somehow the crisis which has necessitated calling in the Armed Forces to support our ambulance service is purely the result of the circumstances we find ourselves in. That they can look to the example of our energy industry which is defending itself with evidence of an unusual lack of wind and solar resources and a fire on an interconnector.

But that would be to ignore the reality which we have all experienced in different ways over recent, pre-pandemic years. The damage done by the increasing centralisation of public services and decision-making in Scotland.

On top of everything else, the FLu jag programme has been a nightmare this year.

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Tories backtracking over new Powys Hospitals shows lack of honesty with voters

The admission by the Conservatives that their manifesto pledge to build two new hospitals in Powys won’t be fulfilled has been described as a disappointing breach of trust by the Liberal Democrats.

The Conservative manifesto pledges on both the inside cover and on page two that they will build “five new hospitals.” However Welsh Conservatives have now admitted that only two new hospitals will be built, neither of which will be in Powys and instead that existing hospitals in Newtown and Llandrindod will be upgraded.

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Rennie: Tackle drug addiction with compassion and treatment, not imprisonment

Liberal Democrats care about people being able to fulfil their potential and getting the care and support they need to recover from illness and addiction. That’s why our Scottish manifesto highlights the need to take a public health approach to addiction. Scotland has the highest drug deaths rate in Europe, something which became very real to a friend of mine recently when her son died after taking street valium. Typically, she thought of others before herself and allowed the BBC to film his funeral.

Willie Rennie said today that the next Scottish Government will only end the drug deaths crisis through compassion and health treatment, not prosecution, as he revealed new figures showing 605 people convicted of possession without intent to supply being sent to prison.

Meanwhile, only 108 people received a Drug Treatment and Testing Order during the same three year period (2016/17 to 2018/19).

1264 people died of drug related causes in 2019. Each of them were individuals with talents and skills. Each of them loved and had people loving them. Pretty much 3 people a day lose their lives and each one of them, with the right intervention, could still be alive today.

So the Scottish Liberal Democrats, looking to the best evidence, has the following measures to tackle the harm that drug addiction causes to people and communities that are focused on help and support. The party will:

  • Reduce the misery of drug abuse with compassion and health treatment rather than prosecution.
  • Take radical steps with the prosecution authorities and the Lord Advocate to help establish heroin assisted treatment and safe consumption spaces.
  • Establish new specialist Family Drug and Alcohol Commissions to help provide wraparound services and to take a holistic approach to those reported for drug offences, learning from best international practice such as that in Portugal.
  • Divert people caught in possession of drugs for personal use into education, treatment and recovery, ceasing imprisonment in these circumstances.
  • Protect and enhance drug and alcohol partnership budgets, and adopt the principle that individuals and families shouldn’t have to pay for the care and treatment of those at risk of death from drugs or alcohol.
  • Use emergency housing funding to help people keep their homes and tenancies while they undergo treatment and rehabilitation.

Willie Rennie said:

The SNPs failure was more than just a political failure, it was a failure that cost the lives of hundreds of people.

Not only did the SNP fail to take the necessary action to save lives, they made it worse by cutting the alcohol and drug partnership budgets, surrendering services and expertise.

It was admitted in 2017 that essential drug reforms weren’t pursued because it wasn’t seen as a vote winner. This is political negligence of the highest order.

Scottish Liberal Democrats will put recovery first. We will reduce the misery of drug abuse with compassion and health treatment rather than prosecution. After years of being told no, Scottish Liberal Democrats have just won cross-party agreement for that important principle.

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Build Back Fairer: the new mantra for now

Embed from Getty Images

This title is about health equity issues, however, not building better houses. Professor Sir Michael Marmot, author of the Marmot Review – Health Equity in England Ten Years On which was published in February this year, has led a follow-up study called Build Back Fairer: The Covid-19 Marmot Review.

The new report highlights how inequalities in social-economic conditions before the pandemic contributed to the high and unequal death toll from Covid-19.

The enduring social and economic inequalities in society mean that the health of the public was threatened before and during the pandemic and will be after. Just as we needed better management of the nation’s health during the pandemic, so we need national attention to the causes of health inequalities.

Professor Marmot is as unflattering here about the present state of affairs as he was in his ten-year report. He writes, “Poor management of the pandemic was of a piece with England’s health improvement falling behind that with other rich countries in the decade since 2010”. That, he recalled, was for several reasons including that “the quality of governance and political culture did not give priority to the conditions for good health”, that there was increasing inequality in economic and social conditions, a rise in poverty among families with children, plus a policy of austerity and consequent cuts to funding of public services.

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Munira Wilson gets another PMQ – and calls for removal of “draconian” Coronavirus law

Some MPs never get to ask the Prime Minister a question at the most hotly contested parliamentary event of any week.

Munira Wilson has been an MP for just 9 months, and has had two opportunities in the path month to ask a question at PMQs.

This week she asked him to work cross-party to get a consensus on the laws and powers around Coronavirus, calling the current measures “draconian.”

His response was as dismissive as you would expect:

We are making sure that everybody in our society gets all the protections they need. I am aware of the easements in the Care Act 2014 that the hon. Lady refers to. It was necessary to put them in temporarily, and we now need to make sure we give everybody the protection that they need. That is what this Government will do.

And here’s a reminder of Munira’s debut at PMQs last month when she took Boris Johnson to task over his government legislating to break international law.

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LibLink: Vince Cable Disbanding Public Health England is the last thing the Government should be doing right now

Writing in the Independent this week, Vince Cable condemned the Government’s decision to shut down Public Health England.

He suggested that it was the scapegoat for the Government’s policy failings before setting out why it is such a bad idea:

Aside from practical questions about who is to deal with other public health issues like obesity and sexual health, the long-term challenge for the new agency and its network of local public health officers is to make Britain better prepared for serious pandemics in future. They must be ready, too, for the more predictable annual rounds of flu, which though they are sufficiently understood to be countered by vaccination still affect 15 per cent of the population, and each year kills 10,000 people in the UK and a quarter to half a million people worldwide.

He talks of the need to look at environmental factors at an international level to limit future pandemics:

But prevention cannot be achieved by any one country working alone when we are considering the complex origins of zoonotic viruses which have jumped species. Blame for Covid is placed on Chinese wet markets and dietary preferences which fits the politically convenient narrative of Chinese culpability. But there are deeper problems.

Some scientists point to the impact of deforestation which is bringing humans and domesticated animals into closer contact with previously unknown species and viruses. As forest cover disappears, the species face mass extinction but the viruses contained in the fauna can strike back. And once new, dangerous, viruses are in circulation, growing connectivity means that local outbreaks become global very quickly. Worryingly, there is little sign that the necessary lessons about unsustainable lifestyles are being drawn.

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Making a drama out of a crisis? Taking the harm out of the virus!

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If we believe in anything, it is the Harm Principle of John Stuart Mill. People should be at liberty, to make their own choices, unless they do harm, to others, or to themselves, if in ways that might harm others too. The bar for the deciding of what is a harm, is set higher or lower, according to whether you are a Liberal or a Libertarian. Mill was a Liberal. He believed the state, the government, needed to exercise authority, on, for example law and order. The balance, is what is to be considered. The preamble to the constitution of this party refers to that as “between the fundamental values, of liberty, equality and community.

I have often put it this way. I am a Classical Liberal, on liberty related issues, a Social Liberal, on equality related issues, a Social Democrat, on community related issues. I am of the view that there has rarely been an issue that combines all these and more, and requires strong thinking and action, than Covid19.

I have just written an article for the Ustinov Prejudice Awareness Forum, an organisation of which I am a member and writer. The article is titled “Viral Expertise“, in which I look at greater word length and in different ways, from a more international perspective, at what I want to say here, from a UK Classical Liberal, Social Liberal and Social Democrat point of view. The importance of this issue, is such, that I would very much welcome colleagues visit the link too.

I, we, surely must subscribe to support policies that reveal and encourage, personal responsibility and public good. For all , responsible, for goodness sake, more needs to be done at home and abroad to combat this virus and act as a rehearsal for, an ongoing effort where the world performs better.

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“Society has stopped improving”

That is the bleak message of Professor Sir Michael Marmot in his major new report on health inequality. Entitled ‘Health Equity in England: the Marmot Review 10 Years On’, it assesses lack of progress in the last decade, since his review in 2010 entitled ‘Fair Society, Healthy Lives’.

He writes:

Since 2010 life expectancy has stalled: this has not happened since at least 1900. If health has stopped improving it is a sign that society has stopped improving.

This damage to health has been largely unnecessary.

Health is closely linked to the conditions in which people are born, live, work and age, and inequities in power, money and resources.

He repeats the well-understood expectation that, “The more deprived the area, the shorter the life expectancy”, but finds that inequalities in life expectancy have increased. “Among women in the most deprived areas, life expectancy fell between 2010/12 and 2016-18.” For both men and women, he continues, the largest decreases in life expectancy were seen in the most deprived 10% of neighbourhoods in the North-East, and the largest increases in the least deprived 10% of neighbourhoods in London.

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Santa Rennie delivers festive lump of coal to SNP

It wouldn’t be an election without Willie Rennie doing something eye-catching.

And today, he took part in a Santa dash in Glasgow.

 

He placed the SNP firmly on the Naughty List for the decline in public services since they have been in government and suggested that they’d be getting a lump of coal on Christmas morning.

The only reason that the SNP want to talk about Brexit is because their domestic agenda is truly abysmal.

Hundreds of children are waiting far too long for mental health treatment, the third Police Authority chair in three years has resigned and we are falling down the international education rankings.

This Christmas the SNP deserve a lump of coal for the way they’ve mishandled these services. Our teachers, nurses and police officers are working hard day in day out but they don’t get the support they deserve from an SNP government which has independence on the brain.

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PREVIEW: Luisa Porritt MEP’s Brexit Reality film

London LIb Dem MEP Luisa Porritt has made a film about the reality of Brexit and how it affects the NHS. It’ll be out later this week.

Here’s a preview:

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Is there a scientific basis for the sugar levy?

Discussion of the sugar levy has focused on effectiveness and moral/political hazards. I want to focus on one problem that makes those redundant: Does it make scientific sense?

Not obviously.

A popular narrative: In the past, we thought obese people were that way because they lacked willpower and ate too much food, particularly fat, which obviously made you “fat” – it’s called fat! Then, scientists who had previously been silenced by the nutrition science establishment (which was in Big Sugar’s pocket) bravely spoke up and educated us on the Science!™, and now we know that it’s sugar, not fat, that makes you obese.

Reality is more complicated.

The supposedly debunked “fat = evil” paradigm was never a scientific consensus, but merely a pop-science one. It was less the work of the nutrition scientists than of sugar companies and the makers of low-fat diet products. The supposedly triumphant “sugar = evil” paradigm also has little support amongst nutrition scientists. At best, they are marginally more concerned with the impact of sugar on health than they were 50 years ago, and marginally less concerned about fat.

It isn’t hard to blow the simplistic anti-sugar position out of the water. This graph does it impressively, and should make everyone update their beliefs significantly away from thinking that sugar is a major cause of obesity, and should absolutely torpedo the simplistic “sugar = evil” position that has taken hold in many parts of the population and, seemingly, in government.

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Sugar Tax is nothing more than a money spinning effort

I’ve recently lost a substantial amount of weight. That’s not a humblebrag, it’s going to be relevant, I promise. It’s taken the best part of 20 years to find something that works for me, and I’ll come back to that later. How our society discusses diet and weight was mostly to blame for why it’s taken so long. When I was a teenager, I used to voraciously read women’s magazines while keeping out of the sun during the hottest hours of the day on holiday. Oh, the diet articles in some of those. It was awful. Everything was egg whites and Ryvita. Everything.

And then, imagine, you see something like those Cancer Research adverts. You’ve already seen in the media that a bland diet is something to aspire to, a good way to lose weight, and now you’re seeing that if you’re fat you’ll die. Can you blame a teenager for coming to the conclusion that living longer on miserable food isn’t actually that great a deal? Especially when cheese, chocolate, and chips exist. (Not together, although I did go there on a dare once.)

This is where the recent party proposals on food and drink taxation come in. So, imagine you’re a young adult now, and your understanding of diet is (still) that you can have nice food and be fat or have boring food and be thin. Is a tax going to change your mind about that? Or will you just spend more of your student bursary on that chocolate bar? It’s anecdotal, but that’s how people respond to ‘sin taxes’ more generally. Denmark had a fat tax, and gave up on a proposed sugar tax, because people literally preferred to go to shop in Germany than to pay it. Just process that, for a second: people actively chose to go and shop in a different currency to avoid the kind of tax our party is proposing a consultation on.

In reality, changing the way you eat can’t be done in the short term with nudge policies. Back to what worked for me. It was the concept behind the programme ‘Cook Yourself Thin’. You can eat whatever you like. You don’t have to cut out any food groups. You certainly don’t have own a cupboard full of Ryvita and live on steamed vegetables. What you can do is make lower-calorie substitutions for the things you love. The cookbook’s got a chocolate truffle recipe in it. It even recommends swapping a cookie for Jaffa cakes.

You have to do something which is sustainable for you. Otherwise you simply will not be able to keep it off. Most people put the weight they lose back on again. A sugar tax is nothing more than a money-spinning measure: if you have the spare cash, you’ll still buy it. It won’t make you successfully change the way you live. That’s far more personal and complex than most people like to think. 

Posted in Op-eds | Also tagged and | 43 Comments
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