Category Archives: Beauty & Care

Losing my mum to breast cancer defined my radiography career

As my mum fought against breast cancer, I decided I wanted to spend my life seeking it out in others.

My mum was diagnosed following a routine mammogram in 2007. At that point I had started working as a diagnostic radiographer. As she went through treatment – surgery, then chemotherapy and radiotherapy, it started to become clear that I wanted to specialise in breast cancer.

She had a way of talking to me about her treatment that was matter of fact, at times brutally honest, but always reassuring. I realised I wanted to be like her. I wanted to be the person sitting someone down and reassuring them, helping them to feel prepared the way my mum had done for me.

When she was in the midst of her treatment, I knew I wanted to spend my life tackling the disease she was fighting – not just at the point of diagnosis, but all the way through. I chose the disease that had chosen my mum.

Briony Bishop’s mum who died of cancer


Jeanette Bishop died of cancer in 2015, eight years after a routine mammogram led to her initial diagnosis. Photograph: Briony Bishop

After she finished her treatment I started working in mammography image interpretation in a hospital in Oxford and was looking at signing up for a master’s in breast imaging, which would allow me to work as a consultant radiographer.

Five years after her initial diagnosis, my mum found another lump. Her GP dismissed it, but I examined the lump and made sure she went back to the GP and got it thoroughly investigated. As I feared, the cancer had come back. She had more surgery and chemotherapy, but in 2014 she was diagnosed with metastatic bone cancer.

Despite more chemotherapy, the surveillance scans showed that it had spread to her liver and she was given a prognosis of six to nine months.

Mum was determined to enjoy what time she had left. Like me she loved the outdoors and being active. She was a retired PE teacher, so we decided to walk the Devon and Welsh coastlines and she had a wonderful trip to Lundy Island with her closest friends.

A few months after we came home, she went into a hospice in Plymouth and I took unpaid leave to spend time with her.

Those final few weeks were hard. I’d go out for runs along the coast to clear my head and give me strength. By then I’d worked with cancer patients for nearly eight years and I drew strength from those experiences to help me cope.

When my mum died in July 2015, at the age of 68, I really struggled with grief. I couldn’t run, I couldn’t really do anything. Looking back now I don’t remember much about that time; it was a painful blur. I went straight back to work – on reflection I probably needed time, but I was running on automatic. I continued studying for my MSc in breast imaging, using my time in the hospice with mum to write case studies.

Eighteen months after she passed away, I got my dream job as a consultant breast radiographer at the Royal Marsden hospital in central London.

Every day I meet patients like my mum and families just like my sister and me. I see women who, hopefully, following an ultrasound and mammogram, can be told they don’t have cancer. Then there are obviously days when I have to give the news that it is cancer.

Sometimes, I’m able to reassure patients that we’ve caught it early, that they’ve followed the correct procedures by going to see their GP and that they have plenty of treatment options available to them. Other times I might have to say that the treatment isn’t working, and explain what the scans might show.

Thanks to my mum’s direct approach, I’m not scared to talk to people about how they’re feeling, and I try to reassure them the way she did me. I can see they’re anxious and, like everyone at the Royal Marsden, I do my best to ensure they have the very best care possible.

I’m running the London Marathon on Sunday in memory of my mum and for the Royal Marsden Cancer Charity, which funds so much of the research, treatment and care where I work. The training has forced me to take up running again for the first time since mum was in the hospice, and it’s changed my mood so much.

I know on the day it’s going to be really emotional but I just hope that mum is looking down on me and feeling proud, not just of me running the marathon but of the person I have become.

Briony Bishop is fundraising for the Royal Marsden Cancer Charity.

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Patients with multiple conditions not getting best possible care, say experts

Millions of people in the UK and many more across the world are suffering from multiple long-term illnesses and may not be getting the best possible treatment from health services that focus on one disease at a time, say experts.

A team from the Academy of Medical Sciences in the UK says this is a growing problem and a huge potential burden on the NHS and other health services. “Clusters” of diseases are becoming more common, they say, such as type 2 diabetes, high blood pressure, osteoarthritis, depression and chronic obstructive pulmonary disease of the lungs.

Specialised hospital doctors treat each one of these conditions individually. Patients may have one problem treated and then have to wait months to see a different specialist for another condition. The experts are calling for a greater role for the GP, who can look at the whole person, but needs more time than a 10 minute consultation.

Prof Stephen MacMahon, principal director of the George Institute for Global Health and chair of the Academy’s steering group on multimorbidity said the best evidence on the numbers came from Australia, but there was no reason to think other countries would be different. “Among Australians seeing a general practitioner, half have two diseases or more, a third have three or more and 10% have six diseases or more,” he said. “This is not a small problem.”

In the UK a study published in 2016 showed that the numbers of patients over the age of 50 with multiple conditions rose over the decade from 2002/3 from 31.7% to 43%. The Royal College of GPs said its own analysis has shown that the number of people living with more than one serious, long-term condition in the UK will increase by nearly one million to 9.1 million by 2025.

These people are more likely to die early, be hospitalised, suffer disability and have a poor quality of life, said the Academy. They could be on dozens of pills each day, raising the chances of interactions and side-effects.

“If you have multiple conditions, any one of those conditions is likely not to be treated as well as it might be of you were treated for one condition alone,” MacMahon said.

Mental and physical conditions go hand in hand, say the experts. Heart disease patients may have depression. People with dementia may develop other physical illnesses. There were links between depression and heart attacks. People with depression were more likely to smoke – or not give up smoking – and more likely to become obese, said Martin Prince, professor of epidemiological psychiatry at King’s College London. People with mental health conditions were less likely to adhere to their medication.

The experts say there is not enough evidence to know why there is such an increase in multiple conditions and call for more research, but an ageing population and the effects of modern lifestyles in obesity and alcohol and smoking-related disease must all play a part.

The most dramatic surge around the world has been in type 2 diabetes, which is obesity-related. The numbers are projected to reach 630 million, said Melanie Davies, professor of diabetes medicine at the University of Leicester. “That is nearly one in every 10 people on the planet,” she said.

Those people often had other health problems. “Under the age of 65, you have a mean of three long-term conditions. Over-65 you have seven other conditions.” She is now seeing many young people with a disease that was almost unheard of in their age group 20 years ago. Now there are 500 children with type 2 diabetes in the UK.

Many of those young people had other conditions as well. “We need to rethink how we deliver care,” she said, involving pharmacists for their multiple drugs as well as social workers and care co-ordinators.

Prof Helen Stokes-Lampard, chair of the Royal College of GPs said: “GPs play a major role in looking after patients living with multimorbidities, but often find ourselves coming up against barriers to their care. A lack of research, as this study highlights, into the extent of the crisis is one; another is understanding how best to treat patients living with both physical and psychological conditions – and having access to the most appropriate services to manage this in the community.”

Patients with multiple conditions not getting best possible care, say experts

Millions of people in the UK and many more across the world are suffering from multiple long-term illnesses and may not be getting the best possible treatment from health services that focus on one disease at a time, say experts.

A team from the Academy of Medical Sciences in the UK says this is a growing problem and a huge potential burden on the NHS and other health services. “Clusters” of diseases are becoming more common, they say, such as type 2 diabetes, high blood pressure, osteoarthritis, depression and chronic obstructive pulmonary disease of the lungs.

Specialised hospital doctors treat each one of these conditions individually. Patients may have one problem treated and then have to wait months to see a different specialist for another condition. The experts are calling for a greater role for the GP, who can look at the whole person, but needs more time than a 10 minute consultation.

Prof Stephen MacMahon, principal director of the George Institute for Global Health and chair of the Academy’s steering group on multimorbidity said the best evidence on the numbers came from Australia, but there was no reason to think other countries would be different. “Among Australians seeing a general practitioner, half have two diseases or more, a third have three or more and 10% have six diseases or more,” he said. “This is not a small problem.”

In the UK a study published in 2016 showed that the numbers of patients over the age of 50 with multiple conditions rose over the decade from 2002/3 from 31.7% to 43%. The Royal College of GPs said its own analysis has shown that the number of people living with more than one serious, long-term condition in the UK will increase by nearly one million to 9.1 million by 2025.

These people are more likely to die early, be hospitalised, suffer disability and have a poor quality of life, said the Academy. They could be on dozens of pills each day, raising the chances of interactions and side-effects.

“If you have multiple conditions, any one of those conditions is likely not to be treated as well as it might be of you were treated for one condition alone,” MacMahon said.

Mental and physical conditions go hand in hand, say the experts. Heart disease patients may have depression. People with dementia may develop other physical illnesses. There were links between depression and heart attacks. People with depression were more likely to smoke – or not give up smoking – and more likely to become obese, said Martin Prince, professor of epidemiological psychiatry at King’s College London. People with mental health conditions were less likely to adhere to their medication.

The experts say there is not enough evidence to know why there is such an increase in multiple conditions and call for more research, but an ageing population and the effects of modern lifestyles in obesity and alcohol and smoking-related disease must all play a part.

The most dramatic surge around the world has been in type 2 diabetes, which is obesity-related. The numbers are projected to reach 630 million, said Melanie Davies, professor of diabetes medicine at the University of Leicester. “That is nearly one in every 10 people on the planet,” she said.

Those people often had other health problems. “Under the age of 65, you have a mean of three long-term conditions. Over-65 you have seven other conditions.” She is now seeing many young people with a disease that was almost unheard of in their age group 20 years ago. Now there are 500 children with type 2 diabetes in the UK.

Many of those young people had other conditions as well. “We need to rethink how we deliver care,” she said, involving pharmacists for their multiple drugs as well as social workers and care co-ordinators.

Prof Helen Stokes-Lampard, chair of the Royal College of GPs said: “GPs play a major role in looking after patients living with multimorbidities, but often find ourselves coming up against barriers to their care. A lack of research, as this study highlights, into the extent of the crisis is one; another is understanding how best to treat patients living with both physical and psychological conditions – and having access to the most appropriate services to manage this in the community.”

Two-thirds of NHS healthcare assistants doing nurses’ duties, union finds

Almost two-thirds of healthcare assistants (HCAs) are performing roles usually undertaken by nurses, such as giving patients drugs and dressing their wounds, in the latest illustration of the NHS’s staffing crisis.

The apparently growing trend of assistants acting as “nurse substitutes” has sparked concern that patients may receive inferior or potentially unsafe care because they do not have the same skills.

Of the 376,000 assistants in the NHS in England, 74% are taking on extra tasks, according to findings by the union Unison.

In a survey of almost 2,000 mainly hospital-based HCAs across the UK, 63% said they were providing patient care with worryingly little help from doctors and nurses, and 39% said they were not confident the patients they look after were receiving safe care.

Q&A

Does the UK have enough doctors and nurses?

The UK has fewer doctors and nurses than many other comparable countries both in Europe and worldwide. According to the Organisation for Economic Co-operation and Development (OECD), Britain comes 24th in a league table of 34 member countries in terms of the number of doctors per capita. Greece, Austria and Norway have the most; the three countries with the fewest are Turkey, Chile and Mexico. Jeremy Hunt, the health secretary, regularly points out that the NHS in England has more doctors and nurses than when the Conservatives came to power in 2010. That is true, although there are now fewer district nurses, mental health nurses and other types of health professionals.

NHS unions and health thinktanks point out that rises in NHS staff’s workloads have outstripped the increases in overall staff numbers. Hospital bosses say understaffing is now their number one problem, even ahead of lack of money and pressure to meet exacting NHS-wide performance targets. Hunt has recently acknowledged that, and Health Education England, the NHS’s staffing and training agency, last month published a workforce strategy intended to tackle the problem.

Read a full Q&A on the NHS winter crisis

“On my first day I was shown how to do tasks like taking pulses and blood pressures by another HCA,” said Nicole, an HCA in Greater Manchester and Unison member.

One healthcare worker who asked to remain anonymous said: “They said they’d never been trained properly how to do it and weren’t really sure if they were doing it properly. HCAs are doing electrocardiograms and taking bloods. That’s a lot of responsibility.”

In the survey, 51% of HCAs said they had not been properly trained to dress wounds, give out medication or change stoma bags.

“Healthcare assistants are being left to fill staffing gaps and do vital tasks without recognition or reward. It’s bad for them and bad for patients”, said Unison’s head of health, Sara Gorton. “It’s clear the pressures on them to act as nurse substitutes have increased over the winter.”

A majority of respondents (57%) said they had to perform extra tasks last winter as the NHS came under its most intense pressure ever, and 41% said they were asked to act beyond the usual limits of their roles, and without proper training more often than the previous winter.

The creeping expansion of HCAs’ roles, linked to the NHS in England’s shortfall of 40,000 nurses, risks leading to “nursing on the cheap”, the Royal College of Nursing said in response to the findings.

“As the shortage of nurses continues to bite, shifts are increasingly filled with more unregistered care staff,” said the RCN’s general secretary, Janet Davies. “Support workers play an extremely important role, but they should supplement the work of nurses, not replace them.

“It’s unfair on HCAs to expect them to deliver care they have not been trained for. It’s also unfair on patients,” she added. “Health outcomes improve with more registered nurses on duty. The government must not allow nursing on the cheap, and increasing the supply of registered nurses must be a priority.”

Jonathan Ashworth, the shadow health secretary, said: “The situation is getting worse year by year, putting patient safety at risk. It’s totally unacceptable to expect healthcare assistants to fill in, effectively acting up while denying them the training and support they deserve for taking on extra responsibilities.”

The policy director at the Nuffield Trust health thinktank, Candace Imison, said the findings were worrying. She said: “We know that across the NHS, staff – from healthcare assistants to clinicians – are being stretched beyond their capacity daily as the health service grapples with staff shortages and growing numbers of sick and frail patients.”

My life became entwined with a stranger in a tense mid-air drama | Ranjana Srivastava

“If there is a doctor on the flight, please …”

The call for a doctor reflexively ejects me out of my seat and towards the sick patient.

One flight in every 600 incurs a medical emergency – until recently I used to pack my own, trusted stethoscope that could actually hear a thing or two amid the din of the plane, but it felt too much like inviting illness.

Leaving my stethoscope behind is the first thing I regret.

In the center seat is a sallow-looking, slightly built woman who says in soft, accented English that she feels a bit faint. Except she looks terrible.

“I am a doctor, here to help you”, I say.

“Thank God”, she says fervently as her head sinks into the lap of her startled co-passenger, jammed against the window.

“Not yet”, I think grimly, with moments to gather my senses and a history.

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She has diabetes and renal failure. She woke up very early for dialysis before boarding the cross-country flight to visit her son. She had felt dizzy, no different to usual. But now, hours later, she is sweaty and uncomfortable. I have been groping her wrist the whole time; locating the faint thread of a pulse, I tell the flight attendant to summon help.

Reinforcement arrives in the form of a man in whom I long to find an emergency worker because I suspect the patient is having a silent heart attack.

“I am an oncologist”, is my way of conveying that it’s been a long time since I resuscitated something other than a dummy.

“Me too”, he says, almost apologetically. We look at each other in dismay.

Airway, breathing, circulation, I repeat to no one in particular as a sparse medical kit appears. He connects her to oxygen while I rummage for an aspirin, which I can’t find.


‘Thank you’, she says once, and I can’t help but feel moved, and a little scared, by her show of faith in me

“I think you might be having a heart attack. Do you carry aspirin?”

“I can’t have aspirin”, she replies.

Before I can ask why, she is already unconscious.

The blood pressure cuff works but the stethoscope is tinny and useless.

“What do you think?” an anxious attendant asks.

“She might arrest.”

“The captain says we are landing in an hour, do your best.”

A nurse has heard the commotion and has made her way to help. But she doesn’t feel confident inserting an IV amid the mild turbulence and I don’t blame her.

The patient opens her eyes, allowing the frightened window-seat passenger to scuttle from her seat. To prevent crowding, the other oncologist returns to his seat and the nurse takes a seat across the aisle. I put my mouth close to the patient’s ear.

“I know this must feel frightening, but I won’t leave you.”

I turn my attention to her husband, pale-faced and utterly silent, riven with apprehension and foreboding.

“I didn’t know this would happen.”

“You can’t predict these things”, I reply sympathetically.

Having made my promise to the patient, I slide into the window seat and put her head in my lap as she curls against the other two seats. Pretending to read a book, I keep a grip on her elusive pulse. “Stay with me”, I whisper after every paragraph and she flutters her eyelids in response.

“Thank you”, she says once, and I can’t help but feel moved, and a little scared, by her show of faith in me. In this confined space, my knowledge seems useless. Instead, all I have to give is the reassurance of my presence and the comfort of a human touch. My mind scoffs that this isn’t enough. My heart says it’s better than nothing. Her pulse can’t agree, skipping too many beats for my liking. I fake calm with my senses on high alert.

With 20 minutes to land, I lose her pulse, forced to confront the scenario that was only ever meant to be a simulation – a patient without a pulse and me as the first responder. There is a yawning silence before the nurse shouts the blindingly obvious: “No pulse? Start CPR!”

CPR in a row of economy seats? How? With stricken passengers watching? And a husband who has begun grieving? I clamber awkwardly on to the middle seat, my head hitting the ceiling. And then, miraculously, just as my hands are about to bear down on her chest, the nurse exclaims, “Wait, I feel a pulse!”

I breathe.

“Doctor”, the attendant whispers conspiratorially. “We are running out of oxygen.”

The landing can’t come soon enough, causing my patient to vomit.

“The paramedics are here”, I soothe her, wiping her face.

As she is bundled up, I seize the opportunity to prepare her husband.

“There will be a lot going on, but you are in safe hands.”

He seems unconvinced. Looking as if he is about to lose a tenuous connection, he asks desperately, “But how will I find you again? How will I let you know?”

His genuine gratitude in the midst of palpable fear moves me although I am aware of how little I have actually done. I want to say that her arriving alive is my reward, but I scribble down some details and hurry him in the direction of the rushing paramedics.

A week passes, then a month and more. I keep hoping for some news but there is no word from him and no medical record for me to quietly look up, as I realise I don’t even know her full name. In time, she turns into a rare entity in this hyper-connected world of ours – a complete stranger whose life became entwined with mine in a tense mid-air drama before we parted ways.

The lack of closure goes both ways – I still find myself thinking about the patient when I am about to fly and console myself with the old adage, no news is good news, while I ponder whether or not to pack my stethoscope.

Ranjana Srivastava is a Guardian Australia columnist and oncologist

Students on how they are getting a raw deal | Letters

I am an MA student on the journalism course at Birkbeck, University of London, fighting for compensation for lectures lost due to the staff strike. We paid £3,000 last term for services that were not provided. I wrote to the master of the university, David Latchman, about this and received no reply. I then wrote to the registrar and got this back: “Your tuition fees contribute towards your entire learning experience and are not directly linked to specific contact or teaching hours. Your tuition fees also cover infrastructure such as buildings, library and IT.” How can it possibly be stated that my entire learning experience is not diminished by a lack of lectures?

The university have taken my money and banked what they have not paid the lecturers, it seems. We have been told that the strike may affect lectures for the first two weeks of next term and could be ongoing. I have just been asked to pay my fees for the summer term. I don’t intend to throw more money at the university unless I get a promise of compensation if the strike is ongoing. I wonder if I’ll be thrown off the course?
Katrina Allen
London

As a student of English at the University of Southampton, I have been affected by the recent decision by the UCU that called for all of my lecturers to strike with the aim of retaining a favourable pension deal. At the end of my four-year course, I will have racked up debts in excess of £54,000, a sum that will increase at a rate of interest of approximately 6% (why didn’t I ask the banks for a loan instead?). I understand that lecturers are feeling frustrated about their pension cut, especially when the pay of the vice-chancellor of my university is £433,000. This is a perfectly legitimate concern. But without trying to mount a pedestal of moral authority, I would not be going on strike were I a lecturer. The work that goes into the six hours of lectures and seminars that I am entitled to each week is admirable. Oh, and the one hour per week during which I am able to arrange a 10-minute meeting with my tutor to discuss my progress.

If this was back in the days of free tuition, I might even have joined the staff on the picket lines. But unfortunately, I wasn’t born in the same decade as my baby-boomer parents, and I am paying £9,250 per annum for tuition alone. I hope that the lecturers don’t win this battle.

If vice-chancellors were to now bend and snap against their principles (however much I might disagree with whatever they are), it would set a dangerous precedent that students are legitimate pawns to take advantage of in industrial disputes. And we are not.
Ben Dolbear
Southampton

I am about to sit my GCSEs. I am surrounded by many bright young women every day, some who excel in examinations and others who do not. However, one thing we all have in common is our strong feelings towards standardised testing. Every year thousands of 15/16-year-olds are forced to sit GCSEs. What education ministers do not realise is the harm this pressure causes young people. It leads to high stress levels, a loss of interest in education and, in many cases, mental health problems: approximately one in 10 children have them.

I have seen the harmful effects of this robotic exam system which leaves no room for creativity. We need students to feel that there is more to life than exam grades. This can be achieved by encouraging universities to look at the whole person rather than just grades, and to value experiences and extracurriculars, like the US education system. The most successful people did not get straight A*s.

The exams should also lend themselves to all kinds of students, not simply those with the ability to memorise, testing true intelligence rather than artificial intelligence. We are growing up in an age of robots; surely we should be raising humans who can do what robots cannot do: be creative. The government should scrap GCSEs and focus on A-levels – maybe if the school system did not burn so many people out, then people would stay on. At least ministers should realise that, as Einstein (the cleverest of them all) said: “Everyone is a genius. But if you judge a fish on its ability to climb a tree, it will live its whole life believing it is stupid.”
Romy McCarthy
London

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

Read more Guardian letters – click here to visit gu.com/letters

Students on how they are getting a raw deal | Letters

I am an MA student on the journalism course at Birkbeck, University of London, fighting for compensation for lectures lost due to the staff strike. We paid £3,000 last term for services that were not provided. I wrote to the master of the university, David Latchman, about this and received no reply. I then wrote to the registrar and got this back: “Your tuition fees contribute towards your entire learning experience and are not directly linked to specific contact or teaching hours. Your tuition fees also cover infrastructure such as buildings, library and IT.” How can it possibly be stated that my entire learning experience is not diminished by a lack of lectures?

The university have taken my money and banked what they have not paid the lecturers, it seems. We have been told that the strike may affect lectures for the first two weeks of next term and could be ongoing. I have just been asked to pay my fees for the summer term. I don’t intend to throw more money at the university unless I get a promise of compensation if the strike is ongoing. I wonder if I’ll be thrown off the course?
Katrina Allen
London

As a student of English at the University of Southampton, I have been affected by the recent decision by the UCU that called for all of my lecturers to strike with the aim of retaining a favourable pension deal. At the end of my four-year course, I will have racked up debts in excess of £54,000, a sum that will increase at a rate of interest of approximately 6% (why didn’t I ask the banks for a loan instead?). I understand that lecturers are feeling frustrated about their pension cut, especially when the pay of the vice-chancellor of my university is £433,000. This is a perfectly legitimate concern. But without trying to mount a pedestal of moral authority, I would not be going on strike were I a lecturer. The work that goes into the six hours of lectures and seminars that I am entitled to each week is admirable. Oh, and the one hour per week during which I am able to arrange a 10-minute meeting with my tutor to discuss my progress.

If this was back in the days of free tuition, I might even have joined the staff on the picket lines. But unfortunately, I wasn’t born in the same decade as my baby-boomer parents, and I am paying £9,250 per annum for tuition alone. I hope that the lecturers don’t win this battle.

If vice-chancellors were to now bend and snap against their principles (however much I might disagree with whatever they are), it would set a dangerous precedent that students are legitimate pawns to take advantage of in industrial disputes. And we are not.
Ben Dolbear
Southampton

I am about to sit my GCSEs. I am surrounded by many bright young women every day, some who excel in examinations and others who do not. However, one thing we all have in common is our strong feelings towards standardised testing. Every year thousands of 15/16-year-olds are forced to sit GCSEs. What education ministers do not realise is the harm this pressure causes young people. It leads to high stress levels, a loss of interest in education and, in many cases, mental health problems: approximately one in 10 children have them.

I have seen the harmful effects of this robotic exam system which leaves no room for creativity. We need students to feel that there is more to life than exam grades. This can be achieved by encouraging universities to look at the whole person rather than just grades, and to value experiences and extracurriculars, like the US education system. The most successful people did not get straight A*s.

The exams should also lend themselves to all kinds of students, not simply those with the ability to memorise, testing true intelligence rather than artificial intelligence. We are growing up in an age of robots; surely we should be raising humans who can do what robots cannot do: be creative. The government should scrap GCSEs and focus on A-levels – maybe if the school system did not burn so many people out, then people would stay on. At least ministers should realise that, as Einstein (the cleverest of them all) said: “Everyone is a genius. But if you judge a fish on its ability to climb a tree, it will live its whole life believing it is stupid.”
Romy McCarthy
London

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

Read more Guardian letters – click here to visit gu.com/letters

Alfie Evans’ parents return to court amid Alder Hey protests

The parents of a boy at the centre of a life-support treatment battle are to launch another legal challenge.

Tom Evans, 21, and Kate James, 20, will ask court of appeal judges on Monday to allow their 23-month-old son, Alfie Evans, to continue to receive treatment.

Alfie Evans


Alfie Evans. Photograph: PA

The couple, from Liverpool, have already lost cases in the high court, court of appeal, supreme court and European court of human rights.

The latest challenge came as the hospital where Alfie is being treated for a rare degenerative brain disease said it had employed extra security personnel because of demonstrations in support of the toddler’s parents.

Evans has said doctors at Alder Hey children’s hospital, in Liverpool, refused to let him remove Alfie from the premises. The parents want to move him to a hospital in Rome or Germany.

Alder Hey said noise from protesters outside the hospital on Sunday night had disturbed other young patients.

“We would ask that noise levels outside the hospital are kept to a minimum and for example car horns are not sounded,” it said in a statement. “Loud and constant noise, such as from car horns, affects sleep and raises anxiety levels for our patients, especially when recovering from procedures, so please bear them in mind.”

Shortly after the statement, Evans posted a video on Facebook of Alfie’s hospital room, from which he said patients could only hear the noise outside if the window was opened. Car horns and cheering could be heard when Evans did so.

Alder Hey advised visitors that there would be more security inside the hospital “and a more controlled approach to access to certain areas”.

Last week, the high court judge Mr Justice Hayden endorsed a detailed plan put forward by Alder Hey doctors for withdrawing life-support treatment.

He said details of that plan could not be revealed because Alfie was entitled to privacy at the end of his life.

The Christian Legal Centre, a group that fights for Christians’ rights and is helping Alfie’s parents, said appeal court judges would be asked to overturn at least one decision made by Hayden last week.

Alfie’s parents last week said their son had improved in recent weeks and they had asked Hayden to allow a new assessment, but he refused. The judge said the unanimous view of medical experts was that Alfie’s brain had been eroded by disease and further assessment was pointless. They also suggested that Alfie was being unlawfully detained at Alder Hey, but the judge dismissed that suggestion.

Appeal court officials said an appeal court judge had decided that Alfie should continue to receive treatment pending the outcome of the hearing that begins on Monday.

Judges have heard that Alfie is in a “semi-vegetative state” and has a degenerative neurological condition that doctors had been unable to diagnose definitively.

Alfie Evans’ parents return to court amid Alder Hey protests

The parents of a boy at the centre of a life-support treatment battle are to launch another legal challenge.

Tom Evans, 21, and Kate James, 20, will ask court of appeal judges on Monday to allow their 23-month-old son, Alfie Evans, to continue to receive treatment.

Alfie Evans


Alfie Evans. Photograph: PA

The couple, from Liverpool, have already lost cases in the high court, court of appeal, supreme court and European court of human rights.

The latest challenge came as the hospital where Alfie is being treated for a rare degenerative brain disease said it had employed extra security personnel because of demonstrations in support of the toddler’s parents.

Evans has said doctors at Alder Hey children’s hospital, in Liverpool, refused to let him remove Alfie from the premises. The parents want to move him to a hospital in Rome or Germany.

Alder Hey said noise from protesters outside the hospital on Sunday night had disturbed other young patients.

“We would ask that noise levels outside the hospital are kept to a minimum and for example car horns are not sounded,” it said in a statement. “Loud and constant noise, such as from car horns, affects sleep and raises anxiety levels for our patients, especially when recovering from procedures, so please bear them in mind.”

Shortly after the statement, Evans posted a video on Facebook of Alfie’s hospital room, from which he said patients could only hear the noise outside if the window was opened. Car horns and cheering could be heard when Evans did so.

Alder Hey advised visitors that there would be more security inside the hospital “and a more controlled approach to access to certain areas”.

Last week, the high court judge Mr Justice Hayden endorsed a detailed plan put forward by Alder Hey doctors for withdrawing life-support treatment.

He said details of that plan could not be revealed because Alfie was entitled to privacy at the end of his life.

The Christian Legal Centre, a group that fights for Christians’ rights and is helping Alfie’s parents, said appeal court judges would be asked to overturn at least one decision made by Hayden last week.

Alfie’s parents last week said their son had improved in recent weeks and they had asked Hayden to allow a new assessment, but he refused. The judge said the unanimous view of medical experts was that Alfie’s brain had been eroded by disease and further assessment was pointless. They also suggested that Alfie was being unlawfully detained at Alder Hey, but the judge dismissed that suggestion.

Appeal court officials said an appeal court judge had decided that Alfie should continue to receive treatment pending the outcome of the hearing that begins on Monday.

Judges have heard that Alfie is in a “semi-vegetative state” and has a degenerative neurological condition that doctors had been unable to diagnose definitively.

Love Island and other shows ‘encourage teenagers to smoke’

Contestants’ cigarette habits in the reality TV show Love Island and Winston Churchill’s cigars in the Oscar-winning film Darkest Hour inspire children to take up smoking, anti-tobacco campaigners have warned MPs.

Action on Smoking and Health (Ash) and the UK Centre for Tobacco and Alcohol Studies said children in the UK are still exposed to significant amounts of on-screen smoking. They cited a rise in smoking in Oscar-nominated films and research that showed cigarettes appeared in Love Island every five minutes on average, with the Lucky Strike brand appearing 16 times.

This year, 86% of Oscar-nominated films contained someone smoking, up from 60% four years ago, the groups told the Commons science and technology select committee. Just over half of the nominated actors depicted smokers, the highest level in several years, research found.

Given Love Island’s popularity with young people, last summer’s series left 47m “gross impressions” of smoking on children under 16, the campaigners told the MPs in a submission to the parliamentary inquiry into the impact of social media and screen use on young people’s health.

The campaigners want the communications regulator, Ofcom, and the British Board of Film Classification to monitor youth exposure to depictions of tobacco use on screen, to discourage any depictions of tobacco use and require broadcasters or cinemas to run anti-smoking adverts during presentations that feature smoking.

Smoking is banned in UK advertising, but not in programmes. Craig Lawson, a former Love Island contestant, told the Sun last year that every islander was given at least 20 cigarettes a day by producers, if they wanted them.

“Ofcom and the BBFC, which regulate these sectors, need to take the necessary steps to warn parents of the risks and protect our children from the harmful effects of tobacco imagery,” said Deborah Arnott, the chief executive of Ash.

Arnott said that while Churchill was a famous cigar smoker and to show him smoking was justified, the majority of the smoking roles on biographical films were taken by fictional characters who the film-makers had chosen to show smoking.

The pro-smokers’ group Forest said Ash was mounting “an attack on artistic freedom”, adding that there is “no significant evidence that smoking on TV or film encourages teenagers to smoke”.

Ash responded that multiple academic studies had proved causality and said Forest was funded by the Tobacco Manufacturers’ Association.

Forest is supported by companies including British American Tobacco, which makes Lucky Strike and Camel cigarettes.

The submission to MPs includes figures from Cancer Research UK, showing that between 2014 and 2016 about 127,000 children a year started smoking for the first time. That research shows more than 60% of those who try smoking become regular smokers.

“The introduction of standardised packaging of tobacco products, backed up the complete ban on advertising, leaves smoking in the entertainment media as the main way smoking is promoted to children,” said George Butterworth, a senior policy manager at Cancer Research UK.