Category Archives: Health

50 New Radicals for 2018: how you can make a difference

When the Observer first joined forces with the innovation foundation Nesta to single out and celebrate 50 organisations “doing radical, useful things, below the radar of the media”, the UK was a very different place from the country it is today.

It was 2012, and the coalition government’s programme of austerity was only just under way. Now, six years on, and local authorities across the country are bursting their budgets. Homelessness rose for the seventh consecutive year in 2017, up 15% on the year before. Britain is preparing to leave the EU, throwing us into the economic unknown. Yet while services are cut, awareness and understanding of issues around mental ill health, gender and sexuality continue to evolve.

Nominations are now open to find 2018’s New Radicals – initiatives and organisations developing creative and practical ways of tackling society’s biggest challenges. The deadline for entries is 11.59pm on 29 April and a panel of judges, which includes the actor Michael Sheen and the novelist Kerry Hudson, will announce the finalists in September.

The New Radicals project was born out of a feeling that the British media focused too much on the negative, channelling its energies into stories of the rich and famous. “This creates a vicious spiral where people think much less is possible than actually is,” says Geoff Mulgan, CEO of Nesta. “It’s disempowering and really corrosive.”

While the word “radical” has taken on negative connotations with its recent association with religious extremism, Mulgan says the New Radicals project seeks to recognise those who are continuing Britain’s long tradition of progressive radicalism. The aim is to seek out those who are “not only challenging the status quo, but are showing alternatives in practice”.

Celebrating “radical” activity in the UK is all the more meaningful in the centenary of the Representation of the People Act, which enfranchised all men over 21 and women over 30 who met certain property qualifications. The New Radicals programme is about trying to find the people who, – as the suffragettes did 100 years ago – embody that “bloodyminded, bolshie, can-do radicalism”.

“I suspect that a lot of people wouldn’t say they are being radical, when they actually are,” says Yvonne Roberts, the Observer’s former chief leader writer and one of the founders of the New Radicals programme. “Meals on Wheels was radical when it started because nobody had thought of joining up the new arrival of cars with hungry and isolated old people.”

One of the challenges the New Radicals programme has had in the past is to encourage people to see what they are doing as worthy of celebration, she says. “People often don’t recognise that what they are doing is innovative and that others can learn from it. They think: ‘Well, we’re just trying to make a difference.’”


Anisa Haghdadi (left), founder of Beatfreeks, a with Raza Hussain and Rochaé Stephens-Morrison.

Anisa Haghdadi (left), founder of Beatfreeks, with young leaders Raza Hussain and Rochaé Stephens-Morrison. Photograph: Andrew Fox for the Observer

It’s a Tuesday evening in a co-working space on the outskirts of Birmingham city centre and about 15 under-25s have gathered to tell the Heritage Lottery Fund what they think of the word “heritage”. “The only reason I know anything about my own heritage is because I’ve learned it for myself,” says one girl, whose family is from Jamaica. “There isn’t enough information out there.”

The event is the work of Beatfreeks, a collective of young people that, among numerous other things, seeks to influence the way organisations work so that they better understand and cater to under-30s. Founded by 27-year-old Anisa Haghdadi in 2013, the collective was included in the 2016 list of 50 New Radicals, and has since gone from strength to strength.

“Institutions have the resources and power to change the world, so I got to this hypothesis – young people need these institutions and these institutions need young people,” says Haghdadi. The collective facilitates paid work and training for young people so they can work with organisations that come to Beatfreeks for help.

Birmingham had all these creative young people but no channel to help them do something positive

Anisa Haghdadi, founder, Beatfreeks

Beatfreeks has worked with organisations as diverse as Birmingham city council, Unilever, Selfridges and YouTube. Last year, part of the collective was awarded £700,000 to contribute to the Heritage Lottery Fund’s Kick the Dust project, which seeks to get more young people involved in the fund’s work.

Haghdadi says the organisation is very much a product of the second city’s unique characteristics. Birmingham is Europe’s youngest city, with 40% of its population under 25. “Beatfreeks exists because it responded to what Birmingham needed,” she says. “It had all these creative young people but no channel to help them do something positive,. Then there’s the breakdown in trust which is happening nationally between young people and institutions.

“I think there’s a major opportunity in the power of young people. The way that young people think is incredibly diverse,” says Haghdadi. “It is naturally and organically very innovative and there’s a wasted resource there.”

Street Doctors

Volunteers from StreetDoctors, a 2012 new radical that teaches young people potentially lifesaving first-aid skills.

Volunteers from StreetDoctors, a 2012 new radical that teaches young people potentially lifesaving first-aid skills. Photograph: Katherine Anne Rose for the Observer

In 2008, trainee doctors Nick Rhead and Simon Jackson were teaching a first-aid course at the Liverpool youth offending service when they asked the group of young people how many of them had witnessed a stabbing. All of them put their hands up. This inspired the pair to create a project, now called Street Doctors, which was featured in the first list of New Radicals in 2012.

The organisation recruits medical students as volunteers to provide specialised first-aid training to young people at risk of violence – young offenders or those living in areas with high rates of youth violence.

“We try to equip young people with the practical skills to act, but more than that, we are trying to get them to join up the dots between a serious injury and carrying a weapon, so they start to see that it’s not just about death or glory,” says Jo Broadwood, chief executive. “You’re also just as likely to end up with a colostomy bag or a long-term disability or serious blood infection.”

Since winning the New Radicals award Street Doctors has set up as a national charity and has grown from six to 18 teams across the UK.

“Last year, 2017, a young man was stabbed and was bleeding really badly. Then one young man stepped forward and stopped the bleeding, called the ambulance and waited with him until the ambulance arrived,” says Broadwood.

“We found out afterwards that he was a young offender who had attended a [Street Doctors] youth offending centre session the week before in west London. To be honest, he probably saved [the victim’s] life.”

End Youth Homelessness Cymru

Michael Sheen with the homelessness charity Llamau in Cardiff.

Actor Michael Sheen with the homelessness charity Llamau in Cardiff. Photograph: Llamau

“With the rise in the number of homeless people sleeping rough, we saw that one of the best ways to address the problem was to address youth homelessness,” says Sam Austin, deputy CEO of Welsh youth homelessness charity Llamau.

The organisation was one of five – including Adref, Gisda, Dewis and Swansea Young Single Homeless Project – to join forces to create the End Youth Homelessness Cymru partnership, which was listed among the 2016 New Radicals.

The campaign worked to raise awareness that homeless young people were being housed in B&Bs alongside recently released offenders, putting them at unacceptable risk of abuse or exploitation. After visiting one homelessness organisation, actor Michael Sheen launched a petition calling for an end to the practice, which was signed by more than 100,000 people.

After meeting with representatives of the campaign, the Welsh government changed its guidance for local authorities around the use of B&B accommodation, specifying that it should only ever be used as a last resort.

Austin says the campaign does not end there. The organisations have worked with young people who found themselves homeless across Wales to develop a plan for a 24-hour dedicated helpline, for which they hope to have secured funding by this summer.

She says the campaign’s inclusion in the New Radicals list was invaluable for their success. “It validated the work that we were doing. It made the Welsh government take notice and got the first minister involved. It’s been a really big deal.”

‘My body was rapidly unravelling’: living with motor neurone disease

I was sitting on the commode getting washed on Wednesday morning when I heard the news about the death of Stephen Hawking. Although, like him, I have an impressive case of motor neurone disease (MND) and can no longer walk nor talk, I never really felt we had the same illness: his long life, not to mention his genius and academic career, seemed to put him in a different category to me. It was still a shock, though, so maybe I had identified with him more closely than I thought.

I was diagnosed with MND in May last year, 16 months after the fingers on my left hand started getting mysteriously stiff and a year from my first visit to the GP. This is entirely normal with MND, which is tricky to diagnose, but the months of inconclusive tests are horribly stressful. My body was rapidly unravelling, yet I still had to try to negotiate my life and maintain some semblance of authority as a secondary school classics teacher. To the anxious newcomer, MND presents an extremely unappetising vision of the future. Media coverage tends to be quite sensationalised, especially when dealing with people arguing for euthanasia. Journalists often focus voyeuristically on the horrors of the physical symptoms, which can make researching the illness quite a traumatic business.

This, in addition to the unpleasant fact that for my generation “spastic” was the playground insult of choice, made the months leading up to my diagnosis by far the most difficult and stressful part of the experience so far. I have been attempting to reclaim the word spastic, as spasticity is one of my chief symptoms, but it still provokes shock and denial.

Trying to keep pace with my rapidly deteriorating limbs was a challenge: I felt that MND kept moving the goalposts unfairly. I discovered the brilliant invention of a device called a key turner, which spared me the impossible task of putting the key in the lock, but soon I was unable to raise my arm enough to use it. Social services installed grab-rails around my house, but it wasn’t long before I couldn’t open my fingers enough to grab them. Lastly, a raised toilet seat preserved my independence for a while, but eventually my weakened thigh muscles banished me to a commode and a hoist.

It was my friends, colleagues and family who supported me during this time. We developed a kind of dance to get me out of cars, everyone developed their spoon feeding and nose-wiping skills and I learned that the friends and family members who you want in your life are the ones who will unflinchingly help you get up off the loo and pull your pants up. My lovely pupils also played an important part as they willingly got into the habit of carrying my books, logging on to my laptop and occasionally teaching their own lessons if I was having a meltdown. Thanks, boys – you are a kind and classy bunch. Finally, my employers were unbelievably sympathetic and made all kinds of thoughtful adjustments to my working life until the terrible day when I was declared unfit for work and embarked on my new career as a professional invalid.

As my speech slurred into a spastic sludge and I collapsed into a wheelchair I found that in the eyes of the world, my IQ halved and I ceased to be an adult. People started speaking to me loudly and clearly and became prone to murmuring “bless” as I rolled past. My shoulder gets patted and my cheek and hand are stroked; on occasion, people ask “how is she?” right in front of me, and once someone patted my arm and told me I’d done really well after I had performed the astonishing feat of drinking a cup of tea. I’m no Stephen Hawking but I’m far from stupid and I find this kind of patronising attitude utterly enraging and dispiriting.

My life has been saved – in a manner of speaking – by my Smartbox, a nifty little computer with a clever voice synthesiser which allows me to “talk” to people. I control it with a mouse attached to my glasses and it enables me to access the internet and change the world through the writing of my blog.

It’s difficult to respond to a prognosis of “about a year”: people with terminal illnesses often write that they were inspired by their diagnosis to maximise the remainder of their time and to purge themselves of evil or petty thoughts. I have had no such revelation nor, sadly, have I received a burst of divine wisdom from the jaws of death: I just bumble on in the same time-wasting manner as I have always lived. I feel I’m not really facing up to the truth of my situation, but I don’t know how to. I haven’t discussed it with my family either – how do you start a conversation like that?

From a global perspective, I’m aware that I am in an enviable situation. I have enough to eat, my house seems unlikely to be shelled in the near future and I have access to excellent healthcare for free. And yet, global situation apart, it’s incredibly painful to mourn your life in advance. One of the hardest things is worrying about the effect it will have on my family. I have nightmares about one of my nieces or nephews cracking up with depression because of Auntie Helen’s death. Each one of their birthdays I forget, I know it’ll be the last time. Of course this thought makes me cry, but which of us can choose our own destiny?

Some Chinese ready meals found to have more salt than 11 bags of crisps

Chinese takeaways and ready meals should carry compulsory health warning labels on menus and packaging to alert consumers to “astonishing and harmful” salt levels, UK health experts have recommended.

The worst-offending Chinese takeaway dishes in a survey published on Tuesday by Action on Salt were found to contain as much salt as five McDonald’s Big Macs, while many had more than half an adult’s entire daily allowance.

Supermarket Chinese ready meals were also laden with salt, with some containing more than the amount found in two Pizza Express margherita pizzas, the report reveals. Some rice dishes contained more salt than 11 bags of ready salted crisps.

Action on Salt is leading a group of health experts in calling on Public Health England to set tough new salt targets, make front-of-pack labelling mandatory and to follow New York’s lead by requiring chains to put warning labels on high-salt dishes. They are also urging the food industry and restaurants to reduce salt by reformulating takeaways and ready meals.

Of 141 supermarket Chinese ready meals analysed, nearly half (43%) were high in salt – containing more than 1.5g/100g, or 1.8g per portion – which would trigger a red “traffic light” label.

Chines food graphic.

“Salt is the forgotten killer as it puts up our blood pressure, leading to tens of thousands of unnecessary strokes, heart failure and heart attacks every year,” said Graham MacGregor, the chairman of Action on Salt and a professor of cardiovascular medicine at Queen Mary University of London.

“Reducing salt is the most cost-effective measure to reduce the number of people dying or suffering from strokes or heart disease. We are now calling on Public Health England to take immediate action.”

Accompanying rice dishes, spring rolls and prawn crackers – and soy sauce – can pile on the salt in a Chinese meal. Iceland’s takeaway egg fried rice has a “shocking” 4.1g salt per 350g pack – more than in 11 bags of ready salted crisps.

Dishes from six Chinese restaurants were also analysed, with 97% found to contain 2g of salt or more. More than half (58%) contained in excess of 3g of salt per dish – half an adult’s maximum recommended daily intake.

At the start of salt awareness week, Action on Salt is calling on Public Health England to revive the UK’s salt reduction programme. The last set of salt targets drawn up under the Department of Health’s responsibility deal was published in 2014.

“The findings from the survey are very concerning,” said Hemini Bharadia of Blood Pressure UK. “We are all eating too much salt. This can lead to high blood pressure causing strokes and heart attacks, most of which could be avoided through better lifestyle choices.”

Quick guide

Processed foods

These are some of the UK’s best-selling ultra-processed foods

Mr Kipling Angel slices

Batchelors Super Noodles

McVitie’s digestive biscuits

Kelloggs Rice Krispies

Walkers cheese and onion crisps

Cadbury’s Crunchie

Haribo sweets

These are the ingredients in Mr Kipling Angel slices

Sugar Listed first, so it is the biggest ingredient. Each slice contains 13.2g of sugar, which is 15% of an adult’s recommended daily intake

Vegetable oils (rapeseed, palm) Rapeseed oil is healthy, but palm oil is a highly saturated fat, widely used in industrially-produced foods because of its very low cost

Wheat flour (with added calcium, iron, niacin, thiamin) Added vitamins but this is finely milled white flour


Glucose syrup Another form of sugar, made from maize in the USA, where it is called corn syrup, or from potatoes and wheat

Humectant (vegetable glycerine) Reduces moisture loss

Dextrose Another form of sugar

Dried egg white

Whey powder (milk) Gives texture

Vegetable fat (palm) Cheap form of saturated fat

Maize starch Often used as an anti-caking agent in sugars

Skimmed milk powder

Raising agents (disodium diphosphate, sodium bicarbonate)

Emulsifiers (mono- and diglycerides of fatty acids, sorbitan monostearate, polyglycerol esters of fatty acids, soya lecithin, polysorbate 60) Emulsifiers are additives used to stabilise processed foods

Tapioca starch Thickening agent derived from cassava roots


Stabiliser (xanthan gum) Made from fermented sugars. Prevents ingredients from separating

Preservative (potassium sorbate)

Milk protein Can be used in industrially-made sponge cakes to replace egg, giving volume, elasticity and texture


Gelling agent (sodium alginate) This is E401, extracted from brown seaweed and used as a stabiliser in cream

Colours (titanium dioxide, cochineal, lutein) Titanium dioxide is an additive used in paint but also massively in food to give a white colour. Cochineal is the red colouring derived from insects. Lutein is yellow colouring extracted from marigolds

Acid (acetic acid) A leavening ingredient in baked goods when combined with baking soda

Alison Tedstone, the chief nutritionist at Public Health England, said: “Our salt consumption has decreased over the last decade – a loaf of bread has 40% less than it used to. However, some products are still too high in salt and we know this can be reduced further.”

Seven ways … to manage irritable bowel syndrome

Irritable bowel syndrome may be inherited. It is linked to oversensitive nerves in the gut, causing debilitating pains and cramps among other symptoms. But there are ways to manage it and reduce its impact on your life.

Consider medication

Speak to your doctor about what is recommended for your particular type of IBS. If you have IBS with constipation (IBS-C), then laxatives could help. These range from osmotic laxatives, which increase water inside the colon, to cathartic laxatives, which stimulate the colon walls, although the latter may not be effective long-term. If you have IBS with diarrhoea (IBS-D), then over-the-counter medications such as loperamide can help control your symptoms.

Try probiotics

Research has suggested that changes in gut flora may trigger IBS by increasing inflammation and altering digestive motility. For some people, probiotics – available in capsules, powders and yoghurts – can alleviate symptoms, balancing gut flora by inhibiting the growth of disease-causing bacteria, slowing down bowel movements and fighting inflammation.

Move to a high-fibre diet

If you have IBS-C or IBS-D, then increasing dietary fibre with fruit, vegetables, beans, whole-grain breads and cereals may relieve symptoms. High-fat meals can cause problems by inducing vigorous colon contractions more rapidly than usual, which can trigger cramping and diarrhoea. However, IBS has quite a wide spectrum and only one in six IBS patients experience improvements from this diet. Others find that it worsens symptoms, and may benefit from a different regime such as a ketogenic (low carb) diet, aimed at reducing inflammation.

Take exercise

Research has suggested that 30 minutes of exercise, such as walking at a moderate pace, five days a week can significantly help to ease common symptoms such as constipation and abdominal cramps. It is best to consult your doctor about what exercise regime may be suitable, but try to keep a routine so you exercise at the same time each day and avoid exercising within an hour of meals.

Reduce your stress levels

Stress is widely thought to trigger IBS, partly because of the neural connections between the brain and the gut, and any external stressors make the mind more aware of painful colon spasms. IBS may be an auto-immune disorder, and the immune system is heavily affected by stress. Try to make time in your day for relaxation sessions and, if you have a stressful life, consider taking up yoga or meditation, or practise breathing exercises.

Keep a food diary

IBS patients have different triggers, so keep a daily diary of all the foods and drinks that make your symptoms flare up. If you experience bloating, you may want to try eliminating gas-producing foods such as resistant starch (found in cold potatoes and bread), beans, cruciferous vegetables such as cabbage, and carbonated drinks. Fructose, found in sweet vegetables and fruit, can also trigger diarrhoea, gas and bloating in IBS sufferers, and it is worth remembering that one in 10 IBS sufferers are lactose intolerant, so minimising dairy products can provide relief. Caffeine can make diarrhoea worse, so limit coffee and tea to three cups a day.

Try peppermint oil

Studies have shown that peppermint oil may be effective in reducing the severity of abdominal cramps and spasms, bloating and the intensity of bowel movement urgency and pain when passing stools, particularly in patients with IBS-D. Try purchasing enteric-coated peppermint oil, specially coated tablets that slowly release the oil in the small intestine.

Pro-choice campaign calls 40,000 Irish expats home for abortion vote

Up to 40,000 Irish citizens living abroad are being urged to return home to cast crucial votes in a historic referendum in May that could overturn the country’s ban on abortion. A campaign, Home to Vote, is calling on the Irish diaspora in the UK, Europe, north America and elsewhere to book flights and ferries to Ireland to exercise their democratic right.

Three years ago thousands of Irish citizens returned home to vote on same-sex marriage legislation, boosting the remarkable two-thirds majority for changing the law. Campaigners now hope to repeat the feat.

More than three-quarters of a million Irish-born people live in other countries – a significant number set against the resident population of 4.8 million. Only those who have been abroad for 18 months or less and intend to return to Ireland are eligible to vote. Those qualifying must register in advance and vote in person.

The referendum will ask whether article 40.3.3 of the Irish constitution – known as the eighth amendment – should be repealed. This gives a foetus the same rights to life as a pregnant woman, and has been in place since 1983, enshrining in the constitution a ban on abortion, even in cases of rape and fatal abnormality of the foetus.

If it is overturned in a referendum expected on 25 May, legislation giving women an unrestricted right to abortion up to the 12th week will be introduced. Since 1983 an estimated 170,000 Irish women have travelled to the UK to terminate their pregnancies, incurring high costs, logistical difficulties and emotional strain. In addition, up to 2,000 women a year end pregnancies by taking the abortion pill, illegally obtained online.

No one under 52 has had a chance to vote on this before. It’s a once-in-a-generation opportunity

Cara Sanquest, campaigner

Polls have shown a majority in favour of repeal, especially among young people, who form the majority of recent emigrants. The referendum is seen as another litmus test of liberalising social attitudes in Ireland and the declining influence of the Catholic church. “Lots of people have already pledged on Twitter to come home, saying they are booking annual leave and saving money for fares,” said Cara Sanquest of the London-Irish Abortion Rights Campaign, which is spearheading the effort.

“There is a huge Irish population in London but this is a global call for people to have their say in shaping the future of Ireland, a place where many will return to live at some point. No one under 52 has had a chance to vote on this before. It’s a once-in-a-generation opportunity. We’re asking people to make a journey in reverse that thousands of women are forced to make every year to have abortions.”

The Home to Vote website advises Irish citizens abroad of their rights and suggests ways of helping the campaign for those ineligible to vote. It also plans to raise funds for those struggling with travel costs.

Lianne Hickey, 26, who has been living and working in London for the past five months, has already booked flights and time off work. “Every vote counts, but it’s also important to send a message that Irish people want a fairer, safer world for Irish women, and are prepared to travel home for that,” she said.

“The referendum is just a recognition of reality: 11 women a day are forced to travel. We need to remove the shame and stigma, and allow women who need it to have a safe procedure in a familiar environment.”

In May 2015, Irish citizens travelled from as far as Australia to cast their votes in the equal marriage referendum. Hundreds posted pictures and accounts of their journey on social media under #HomeToVote, the same hashtag being used in the 2018 campaign.

NHS slashes funds for top homeless mental health team

NHS bosses are under fire for cutting back a team of doctors and nurses who provide mental health care to one of Britain’s largest groups of homeless people.

Camden NHS Clinical Commissioning Group (CCG) in north London is giving the Focus Homeless Outreach team £219,866 less a year starting on 1 April, a leaked CCG document reveals. One of the team’s two psychiatrists and one of its six nurses will lose their jobs as a result.

Critics say the decision makes a mockery of Theresa May and Jeremy Hunt’s repeated claims that NHS mental health services are receiving record amounts of funding to improve care. They fear it will lead to more rough sleepers suffering mental health crises and killing themselves, and that it will add to the already heavy demand for care being faced by hospitals and GPs in Camden.

The CCG is pressing ahead with the 42% cut to the £521,000 budget it gave the team this year despite a storm of protest from local GPs, psychiatrists, homeless charities and managers of hostels where rough sleepers sometimes stay. Camden had the third highest rate of rough sleeping in England in 2017, recent government statistics showed – more than Manchester, Bristol and Cornwall.

Focus, set up 25 years ago, helps treat the high levels of depression, psychosis and other mental health conditions found in rough sleepers, hostel dwellers and “sofa surfers”, including some asylum seekers and people who have been trafficked. Its budget is being reduced even though it is regarded by NHS, local council and social work bosses in London as a model of good practice of how to reach the kind of group that often shuns traditional NHS services.

Consultant psychiatrists at Camden and Islington NHS trust have privately criticised cutting Focus’s budget as a “terrible” blow to a “priceless” service. “Yes, there are unprecedented financial challenges, but it’s pretty appalling that a vulnerable and voiceless group would be left so unsupported,” said one.

Another said: “I find the decision extremely hard to understand, given the high number of homeless people in Camden. Without the Focus team, some of the worst-off members of society will lack proper access to psychiatric care.” Another warned that untreated mental health problems could also potentially lead to incidents of crime and violence.


What are the financial pressures on the NHS that have built up over the last decade?

Between 2010-11 and 2016-17, health spending increased by an average of 1.2% above inflation and increases are set to continue in real terms at a similar rate until the end of this parliament. This is far below the annual inflation-proof growth rate that the NHS enjoyed prior to 2010 of almost 4% stretching back to the 1950s. As budgets tighten, NHS organisations have been struggling to live within their means. In the financial year 2015-16, acute trusts recorded a deficit of £2.6bn. This was reduced to £800m last year, though only after a £1.8bn bung from the Department of Health, which shows the deficit remained the same year on year.

Read a full Q&A on the NHS winter crisis

Family doctors at Camden Health Improvement Practice, a GP surgery near Euston station which treats homeless people’s physical health needs, have told the CCG in a letter that they are in a state of disbelief about Focus’s budget cut. It gives essential mental health support to homeless people when they are arrested or admitted to hospital as an emergency, they said.

Prof Roland Littlewood, an emeritus professor of psychiatry at University College London who used to work with Focus, said: “The proposed cuts cannot be clinically justified and I would consider them quite dangerous. When we in the future contemplate the increased number of preventable deaths in the service, it will be too late.

“If May and Hunt are promising increased support for mental health services, then where is it? The homeless are the most vulnerable to declining social and medical support.”

Camden CCG originally planned to cut £421,000 (81%) of its funding to the team to help meet its savings target under the NHS-wide Quality, Innovation, Productivity and Prevention plan, but reduced that to £219,866 after opposition. It claims other services will provide support for the work Focus can no longer do, but failed to provide any details.

Senior figures at University College Hospital in Camden are worried that limiting Focus’s work will lead to more rough sleepers turning up at its A&E in a state of mental health crisis.

Saffron Cordery, deputy chief executive of NHS Providers, which represents NHS trusts, praised national health service leaders for giving mental health greater priority. But, she added, Camden CCG’s decision “confirms once again what mental health trust leaders have been telling us about the growing gap between the government’s welcome ambition for the care of people with mental health needs and the substantial challenges facing core mental health services.

“Money earmarked for mental health is not consistently reaching the frontline. It is particularly important that vulnerable people such as the homeless are able to access mental health services.”

Camden CCG said: “Due to significant financial challenges, the NHS is having to make difficult decisions and it has been necessary to reduce funding of the Focus homeless service. Camden CCG have worked with Camden & Islington NHS Foundation Trust to reconfigure the service so that it dedicates it efforts to helping those with the most complex needs. Those with less complex needs will be signposted to other suitable health and care services in Camden.”

NHS cuts and privatisation have brought no benefits | Letters

GPs have taken the unprecedented step of urging patients to write to their MPs about the funding crisis in the NHS (Complain to your MPs, top doctor tells patients amid worst ever A&E figures, 9 March). This situation, and the crisis in public services that has left councils at the point of bankruptcy, did not need to happen. Many of the cuts are a false economy that do not lead to savings.

A report from Policy in Practice showed that in Croydon the benefit cap, which was supposed to save the taxpayer money, led to evictions, and it calculated the cost of just one homeless application to the council to be around £8,000.

Private finance initiatives in the NHS will cost us approximately £199bn right through to the 2040s, despite the National Audit Office confirming that in London “the costs of services, like cleaning, are higher under PFI contracts”.

I’m also fed up of not seeing my wife until late at night because another of the supposedly efficient private sector trains she gets to London fails to show up.

Austerity overall has failed – it costs lives as well as taxpayer money.
Mark Murton
Wallington, Surrey

So ministers are set to offer NHS staff a 6.5% pay rise (Report, 9 March) on condition they give up a day’s holiday in return. Pay for MPs has risen by over 15% since 2014 (without any conditions). Pay for nurses, over the same period, has risen by 3%, and public sector workers have suffered a pay freeze.

Is the government unaware of how much we owe to the dedication and hard work of NHS staff, who are working under increasingly difficult conditions, and often work extra hours with no extra pay? To require them to give up a day’s holiday is petty and mean.
Angela Crum Ewing

Now that NHS workers have been offered a long overdue rise, will we see other employers dig deep and pay decent wages in other sectors in which there are staff shortages? Isn’t it strange that the money is found as the exploited low-paid eastern Europeans vote with their feet?
Jane Ghosh

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John McDonnell criticises ‘mean-spirited’ NHS pay deal

The shadow chancellor has said it would be “mean-spirited” of the government to ask nurses to give up a day’s holiday in exchange for a pay rise.

The Guardian revealed on Friday that ministers hoped to persuade 1 million non-medical NHS workers, including nurses, to surrender one day’s leave as part of a settlement that would increase their salary by 3% this year, and then 1%-2% in the following two years.

Delivering a speech in London, in advance of next week’s spring statement by the chancellor, John McDonnell said Labour and the trade unions could take the credit for the government’s decision to lift the 1% cap on nurses’ pay.

“The settlement that may come from this is the result of a campaign waged by the Labour party and the trades unions together, to force the government to scrap the pay cap,” he said.

However, he pointed out that 3% would only match inflation, after years of real-terms cuts, and condemned the proposal of giving up a day’s paid leave.

“I just think it’s mean-spirited to take a day’s holiday off these staff – they work long hours, they’re under pressure. I just think they deserve a decent holiday,” he said.

The chancellor, Philip Hammond, announced in his budget last autumn that the Treasury would make more funds available for a pay rise beyond the 1% cap imposed by George Osborne, amid widespread reports of staff shortages and low morale among NHS workers.

The deal the government is preparing to formally put to staff later this month, negotiated with 14 health unions including Unison, the Royal College of Nursing and the GMB, would give some NHS personnel pay rises of 10% and, in certain circumstances, well above that by 2021.

McDonnell’s speech focused on the human costs of government spending cuts on local authorities and their provision of key services including social care.

“We are calling on the chancellor, as a bare minimum, to plug the funding deficit in children’s services, social care and domestic violence services,” he said. “Inaction under these circumstances would not only be irresponsible but morally reprehensible.”

He predicted that Hammond would use next Tuesday’s statement, which the Treasury has stressed will not contain major policy announcements, to claim credit for the improved state of the public finances.

But McDonnell said Hammond was “absolutely blind” to the consequences of continuing spending cuts.

“There are innumerable personal tragedies behind the raw figures, but this isn’t some natural disaster. It’s the result of direct political choices made by Conservative-led governments to impose austerity, against all sound economic advice,” he said.

“It should be intolerable for all of us to live in a society like this, where the most vulnerable are the worst affected.”

McDonnell’s speech, delivered at the Institution of Civil Engineers in Westminster, also focused on familiar themes about reshaping Britain’s economy, boosting investment – and reversing some of the Conservatives’ tax cuts, including to corporation tax.

He was introduced by the shadow equalities minister, Dawn Butler, who called him, “the thinking man”.

Asked about Donald Trump’s plans to impose hefty tariffs on imports of steel from the EU, McDonnell said, “we hope he’ll pull back from that”.

My mental illness has always affected my work, but at last I feel supported

With public support from figures like Prince William and Prince Harry, there is a growing public acknowledgement that mental illness is nothing to be ashamed of. But it doesn’t always feel that way. Even in the charity sector, mental health conditions aren’t often well understood.

That’s despite the evidence that they are becoming more common. According to the mental health charity Mind, one in four people experience a mental health issue each year. In other words, up to a quarter of the voluntary sector workforce may be affected. Many people – regardless of their profession – deal with their mental illness behind closed doors, afraid that talking about it with their manager or colleagues could put their career at risk.

Certainly, this is how I was made to feel. I have been diagnosed with bipolar disorder, with emotional instability personality disorder, and faced extreme mood swings. The first psychiatrist I saw told me I’d never be well enough to live “a normal life”. He was one in a long line of people who told me not to expect too much from my career. I was young, my confidence was low and, naturally, I started to believe they were right. But I wanted so much to live an independent life.

When I started working – first in retail and then sales – life was very difficult. I tried to be honest and talk to my manager early on but his reaction stunned me: “Everyone gets sad,” he said. He didn’t give me any additional support and expected me to pull myself together. My colleagues also didn’t understand and began to comment on the amount of time I had to take off. They started calling me “sick notes”.

My colleagues didn’t understand and ​​began to comment on the amount of time I had to take off

Working in this environment inevitably worsened my condition and I was signed off work for about six months. I felt shaken by the experience and it was incredibly hard to build up my confidence to the point where I felt ready to give work another shot. Eventually I did, but when I took on another sales role with a different company, the same thing happened.

Having spent some time volunteering for Rethink, I applied for a position in the charity sector with HOME Fundraising. I knew that knocking on people’s doors to collect money for charity wasn’t going to be easy, but I wanted to do something positive at work.

I had intended to keep my concerns about my mental health to myself but found the culture was entirely different. At the start of my second week, I had severe anxiety and had to take a day off. Rather than the usual brush-off I’d experienced from past managers, my manager asked questions and sounded as if he cared.

From the start I was encouraged to share how I was feeling and to take time off when I needed to. I’m able to talk about changes in my mood and medication, and my line manager and I plan coping strategies together. I also get plenty of support from my team. They know if I say I need to go off for a few minutes that I just need a bit of space. It’s made a huge difference to what I feel I can achieve.

This doesn’t mean that life is easy. Mental health will always be a big part of my life and impact on my work. At times, depression can get the better of me and I have to work from home or in a quiet room at the back of the office. Manic episodes can also be hard to deal with, and I have to make an effort to slow down when talking, especially when discussing charitable beneficiaries. But I don’t have to brush my symptoms under the carpet. That is such a relief.

Mental health is a daily battle for many, but it shouldn’t define us. Being able to do my job – and being recognised for being good at it – has given me confidence to develop a career in fundraising. I’ve been promoted and now manage teams of fundraisers in Norwich.

All employers have a responsibility to make that a possibility for people living with mental health conditions. They need to prioritise creating a culture of understanding that provides support, rather than focusing on limitations. Until that’s commonplace, many people will never reach their potential. And that would be a waste of the huge amount of talent that makes our sector a diverse, creative and wonderful place to work.

  • Fran Holland is the deputy fundraising manager of HOME Fundraising’s Norwich office

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No hugging: are we living through a crisis of touch?

When did you last touch someone outside your family or intimate relationship? I don’t mean a brush of the fingers when you took your parcel from the delivery guy. I mean: when did you pat the arm or back of a stranger, colleague or friend? My own touch diary says that I have touched five people to whom I’m not related in the past seven days. One was a newborn and two were accidental (that was the delivery guy). Touch is the first sense humans develop in the womb, possessed even of 1.5cm embryos. But somewhere in adulthood what was instinctive to us as children has come to feel awkward, out of bounds.

In countless ways social touch is being nudged from our lives. In the UK, doctors were warned last month to avoid comforting patients with hugs lest they provoke legal action, and a government report found that foster carers were frightened to hug children in their care for the same reason. In the US the girl scouts caused a furore last December when it admonished parents for telling their daughters to hug relatives because “she doesn’t owe anyone a hug”. Teachers hesitate to touch pupils. And in the UK, in a loneliness epidemic, half a million older people go at least five days a week without seeing or touching a soul.

Sensing this deficit, a touch industry is burgeoning in Europe, Australia and the US, where professional cuddlers operate workshops, parties and one-to-one sessions to soothe the touch-deprived. At Cuddle Up To Me, a cuddle “retail centre” in Portland, Oregon, clients browse a 72-cuddle menu. Poses includes the Alligator, the Mamma Bear and, less appealingly, the Tarantino. In Japan, a “Tranquility chair” has been developed, its soft arms wrapping the sitter in a floppy embrace.

Is this what a crisis of touch looks like? And if so, what do humans risk losing, when we lose touch?

“Of course we are moving away from touch!” exclaims Francis McGlone, a professor in neuroscience at Liverpool John Moores university and a leader in the field of affective touch. He is worried. “We have demonised touch to a level at which it sparks off hysterical responses, it sparks off legislative processes, and this lack of touch is not good for mental health.” He has heard of teachers asking children to stick on a plaster themselves, rather than touch them and risk a complaint. “We seem to have been creating a touch-averse world,” he says. “It’s time to recover the social power of touch.”

Touch is commonly thought of as a single sense, but it is much more complex than that. Some nerve endings recognise itch, others vibration, pain, pressure and texture. And one exists solely to recognise a gentle stroking touch.

Illustration by Harriet Lee-Merrion

Illustration by Harriet Lee-Merrion

Known as c tactile afferents, this last is the one that McGlone has studied for years. To find it, a needle is inserted into the skin to “fish”. “It’s like sitting on the banks of the river,” McGlone says. “One’s a pain fish. One’s an itch fish.” Hours can pass before anyone catches a gentle touch nerve, but this elusive fibre has helped to teach scientists why humans need touch.

By watching the nerve’s discharge behaviour while the skin is stroked, scientists have learned that the optimum speed of a human caress is 3cm to 5cm a second.

This may sound like a diverting snippet of touch trivia, but its application is far-reaching. When a parent strokes a child, for instance, “they are writing out the script that was laid down by 30 million years of evolution,” McGlone says. “We are destined to cuddle and stroke each other at predetermined velocities.” The pleasantness encourages us to keep touching, nourishes babies and binds adults, and threads wellbeing into the fabric of our being. It could also teach us more about the touch-averse, including how and when autism and eating disorders develop, and even lead us to a cure for loneliness.

Last year, researchers from University College London showed that slow, gentle stroking by a stranger reduced feelings of social exclusion.

“Bang on!” McGlone says. “This nerve fibre is responsible for so many aspects of our wellbeing across our lifespan. I call it the Higgs boson of the social brain. The missing particle that glues everything social together.” Ironically, having been brought up in the 50s, when parental affection was thought to encourage mawkish children, he is himself sensitive to touch, and feels a gentle stroke “like an electric shock”.

As a society, we instinctively understand the power of touch. That is why, after the tragic shooting at his school, the head of Marjory Stoneman Douglas in Florida promised “to hug each and every one” of his 3,300 students. A single, small touch can change countless lives. Princess Diana knew this when she held the hand of an Aids patient in 1987. So did Barack Obama when he stooped to let a young black boy pat his hair, so that he could feel his own potential in the palm of his hand.

Tiffany Field founded the Touch Research Institute at Miami Medical School to study this neglected sense and its impact on health. She enjoys a weekly massage and happily lists the positive effects of being touched. “We know from the science of what goes on under the skin that when the skin is moved, pressure receptors are stimulated,” she says. This “slows down heart rate, blood pressure and the release of cortisol”, which gives people better control over their stress hormones.

Being touched increases the number of natural killer cells, “the frontline of the immune system. Serotonin increases. That’s the body’s natural antidepressant. It enables deeper sleep,” Field says. Her appraisal is borne out by the experience of Kira “Cuddles” from Cuddle Up To Me in Portland, who has to remind her clients to check for phone, keys, wallet. “They leave with a dose of oxytocin. They are floating on a cloud.”

Most basically of all, touch tells us who we are. That is why in the womb, McGlone says, “with the amniotic fluid washing over it, the brain inside begins to realise, ‘I’ve got my body, and that’s somebody else’s.’ That developing brain has that sense of me rather than something else out there. If that doesn’t happen, you get this almost locked-in syndrome.”

Mary Carlson is 78. She worked as a student assistant with the legendary scientist Harry Harlow, whose experiments with monkeys found that the hankering for touch is so innate that an infant, removed from its mother, would cling to a cloth-covered wire surrogate rather than a cold wire one with milk. It would choose to feel nourished rather than be nourished.

Carlson met Harlow as a freshman. At the first lecture she attended, “he came out hooting and running around on all fours”. In his laboratory, she witnessed monkeys that as infants had been deprived of their mother’s touch. In social groups, they would “go off in a corner, self-grasping, staring into space.” She saw similar patterns of behaviour in humans three decades later when she visited orphanages in Romania, a legacy of Ceausescu’s regime, where tens of thousands of infants were raised with minimal human touch.

For Carlson, touch is “a sort of species recognition”. Which suggests that without touch, humans may be, well, less human.

“You just don’t see people touching each other these days,” Field complains. She has just come from a restaurant. “And everybody was on their cellphones.” At LaGuardia airport recently, she walked around the waiting area. “Not a soul was touching another. Even two-year-olds were sitting in carriages with iPads on their laps.” (Getting touch from their touch screens.) Then, at the Coconut Grove art festival, “There were people bumping into each other because it was so packed. I heard people say, ‘I’m sorry! Excuse me!’ and move off in a way that made it look like they were really embarrassed.”

Field is planning studies in restaurants and airports “to document how little touch there is and how much distraction by social media”. There is as yet no scientific data to connect declining touch to the rise of mobile technology or social media, but Field’s descriptions of people wrapped in their own worlds rather than each other, sitting in isolation, bowed over screens, a huddle unto themselves, are evocative and familiar.

Do those atomised people who bounce off each other at art fairs before spinning away in shame, or those who sit day after day alone in their homes carry shades of Harlow’s monkeys self-soothing in the corner of their cages? And if so, where will our loss of touch lead us?

Kellie Payne, research and policy manager at the Campaign to End Loneliness, says that loneliness is fatal precisely because it puts people “into a kind of defensive state where the levels of cortisol are raised. Having had negative experiences, they anticipate that their connection with people will also be negative,” which makes it hard to reinstate contact. To add to the challenge for the elderly, touch sensation is in decline. According to David J Linden, author of Touch: The Science of Hand, Heart and Mind, “Humans have their strongest touch sensation at around 20, after which it goes down by a percent a year for your whole life”.

Field, meanwhile, is worried about the rise in paediatric pain syndromes, such as irritable bowel syndrome and fibromyalgia, previously common only in adults. She thinks this is due to stress and the absence of touch, and is also worried that “kids are getting more and more aggressive because there is less and less touch”.

“This is what I’m concerned about,” McGlone says. “If this evolutionary system is in any way disturbed or interrupted, brains are good at finding compensation. It could be drugs or alcohol … If you remove a reward system, the brain will try to find some other way to get that reward.”

Humans love touch. We love it so much that the word has the power to sell a heap of products from soft-touch pillows to velvet touch tights, expert touch saucepans and even smooth, perfecting touch face creams. But touching each other in an age of pervasive and historical sexual abuse and harassment no longer feels safe.

There is a hypervigilance of boundaries that makes it hard to find the right approach. “I think twice about hugging a colleague at work in a way that I didn’t a couple of years ago,” Linden says. “I’m thinking, maybe this is going to be misinterpreted. Maybe this is going to make somebody feel bad.”

Touch – even the gentlest kind processed by McGlone’s beloved c tactile afferents – is never only about affection, warmth and care, but also about power. (Just watch Donald Trump greet world leaders.) The so-called “Midas touch” studies which have shown that diners gently touched on the arm by their server will leave a generous tip, or that people in a care home eat more if touched, illustrate the power of touch to persuade. Touch can retract – as well as confer – agency. It is not a universal good. It can exacerbate the symptoms of those with autism, and those who have experienced trauma or abuse.

At her home in north London, I meet Anna Fortes Mayer, who has run Cuddle Workshop since 2010. We sit on her red sofa and talk about how to broach touch. She is not tactile, but then we are strangers and her sofa is large.

I tell her about my touch diary: by now my yoga teacher has patted me and I’ve collected a matchday hug from my daughter’s football coach. “It’s not much. It’s really not,” Fortes Mayer says, shaking her head. But what’s a person to do? How can we build more touch into our lives?

For a start, Fortes Mayer advises against “energetically leaning forward for a hug”. She dislikes the phrases “Do you want a hug?”, “Give us a hug” and “Can I have a hug?”; they are “all too, ‘Who takes ownership here?’” (This is the mistake Kesha made with Jerry Seinfeld.) She suggests instead, “Would you like to share a hug?”

Encouraging self-consciousness of the ways in which people offer and invite touch has many benefits. But this kind of touch can never be impulsive, immediate, if it comes with explanatory notes. And touch that breaks protocol can feel more affecting. Consider the excitement when Meghan Markle preferred a hug to a handshake, or Michelle Obama slipped an arm around the Queen’s back. Even McGlone, despite that 1950s upbringing, on a walk through the park, was tickled to see a “big rugby player type bloke” offer his wife and then him a hug. (He was so touched, he started to explain about c tactile afferents.)

In Fortes Mayer’s hall, I put my shoes back on and with my hands at my sides ask, “Anna, would you like to share a hug?” She says yes – and it feels good.

“I will often place my hand on someone’s shoulder,” Carlson says. “I believe in touch. There are ways you can do it so it isn’t demeaning.”

“Even stranger touch, when it’s wanted, is pretty good,” Linden points out. “Even petting your dog. Even petting a dog that’s not yours.” For the truly solitary, daily power walking stimulates pressure points. It’s what Tiffany Field does. She also advocates yoga: “It’s moving your limbs against each other.”

Of course, nobody thinks that a cure for loneliness will happen at a stroke, but maybe careful touch could bring it closer.