Category Archives: Rheumatoid Arthritis

We need to clean up our act on roadside pollution | Letters

We must cut through the smog of rhetoric if we are to have clean air. Through deft political sleight of hand, the environment secretary Michael Gove’s defence of what the government is doing to address air pollution (Letters, 24 May) diverts attention from the cause of dirty air in most of our cities: diesel-fuelled vehicles. This risks slowing down the action required to tackle air pollution at a moment when more and more people are becoming aware that it is a serious risk to health in places beyond London.

As city leaders, we are keen to work with ministers to tackle the wider challenges of air pollution, but this requires a government strategy that has cleaner transport at its heart. We need a national framework so that residents and businesses can make the shift as quickly as possible to less polluting ways of moving around.

We know many measures need to be tailored to local conditions, but a consistent, national approach that acknowledges the seriousness and urgency of the situation is essential. That is why we continue to ask for a number of measures, including a diesel scrappage scheme and clean air legislation.

It is not that roadside emissions matter above all else, but that we have only just begun to focus our activity on tackling this urgent threat to public health – and we recognise we have a long way to go. Freight, taxis and buses all need cleaning up if our cities are to thrive, and business opportunities for Britain for leading the shift could be missed if we take our eye off the ball. We urge an honest approach to what is working and what is not, together with the focus necessary for us all to tackle this public health crisis and secure the future of generations to come. 
Cllr Judith Blake, Leader Leeds city council, Cllr John Holdich, Leader Peterborough council

Michael Gove’s letter is a blatant attempt to divert attention away from diesel towards other sources of particulate pollution. Areas in breach of the EU air quality for small particulates are all urban, and if the more stringent WHO annual limit is applied, 85% of the urban population across the EU is exposed to levels above 10 microgrammes per cubic metre of air – and 100% in central London.

It is disingenuous to pretend that the situation is improving. Levels of Benzo(a)pyrene, a carcinogenic subset of particulate pollution, have risen by 52% since 2000 due to the unprecedented rise in diesel usage. Instead of protecting old fashioned polluting technologies, Gove should be looking towards a greener future that benefits all members of society, and not just the car manufacturers.
Dr Robin Russell-Jones
Former chair, Campaign for Lead Free Air

The government’s clean air strategy is yet another example of its focus on meeting targets for air pollution, rather than truly improving our health. What is needed is greater understanding of overall exposure to air pollution – outdoors, indoors, across transport networks and in the workplace so solutions can be targeted. Legislation should also protect workers from exposure where businesses can take action to provide cleaner air.

We welcome the strategy’s reference to WHO limits for PM2.5 rather than the higher EU limits, as well as a broader focus on pollutants, but the government’s plans to delegate responsibility locally are flawed. More centralised science-based research as to the cost-effectiveness of different solutions to reduce exposure is required – this cannot be resourced locally. 
Sophie Power
CEO and co-founder, Airlabs

Motor traffic is the main source of air pollution in towns and cities, but so far the government has fallen woefully short in detailing how it plans to reduce car use and support more people to walk, cycle and use public transport (Wood burners could feel the heat in pollution crackdown, 22 May). More than 2,000 schools and nurseries in England and Wales are located within 150m of a road with illegal levels of air pollution, and research from Living Streets shows that one in three parents are now taking air pollution levels into consideration when choosing their child’s school.

One in four cars in morning peak traffic are on the school run. Making it possible for more families to walk to school is an effective and practical way to reduce air pollution. This stands to have a much bigger impact on the air quality in our towns and cities – and around our children’s schools – than targeting the minority of people who use wood burners.
Tompion Platt
Head of policy, Living Streets

Your editorial highlighting the continued problems of nitrogen dioxide (NO2) at the roadside significantly underplays the impact other pollution sources have on the health of the UK population (23 May). While excessive NOx from Euro 4 and 5 vehicles truly has been a Europe-wide scandal, the impacts of poor air quality on public health and the environment arise from overall exposure, not just from one pollutant and time spent at the roadside. The new Department for Environment, Food and Rural Affairs (Defra) clean air strategy proposes that the largest overall national benefits can be realised through simultaneously reducing emissions from a wide range of sectors, and that is supported by the latest scientific evidence on atmospheric chemistry, health and ecosystem effects. 
Prof Alastair Lewis 
National Centre for Atmospheric Science, University of York

You really got Gove rattled in your editorial of 23 May, which said that road transport contributes hugely to air pollution. Methinks he doth protest too much! He should be spending time sorting it out instead of trying vainly to defend the government’s woeful record. I have huge concerns for schools on busy roads with playgrounds a few metres from toxic fumes.
Catherine Roome
Staplehurst, Kent

Reading your article on particle pollution in London classrooms (Report, 25 May) provided me with the information I have been looking for – particle size. I first raised concerns about this in the spring of 2014 when all my spiders suddenly died. The response from various environmental departments was pure complacency, despite my pointing out that the most probable explanation was particle size, the same size that lodges in the human lung.

The particle size that reaches the alveoli and lodges permanently is between 5 and 0.5 microns. Larger particles don’t get there, smaller ones are exhaled. Over time they build up, leading to various forms of pneumonoconiosis. There is no effective treatment and no one is immune.

Government policy, as usual, is if we do not know what to do about it, pretend it is not happening. I am not being melodramatic when stating that in time it will kill us all. There is going to be massive healthcare demand far beyond what the health services can cope with. It will probably take 25 years plus to begin to show, but it is probable that the increase in respiratory diseases is largely due to the present levels of particulate matter in the air we all breathe.
Terry Milton
Guildford, Surrey

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Ireland’s abortion decision: a photo essay

On Friday Ireland will vote in a referendum that could in effect end the ban on abortion. Voters will be asked if they want to repeal the eighth amendment of the constitution, which recognises the equal right to life of mother and unborn child.

Every year, 3,000 Irish women travel overseas, usually to the UK, to end pregnancies, including those caused by rape or incest. Expectant mothers diagnosed with fatal foetal abnormalities – meaning the baby may die before full term or is not expected to live for long – must also travel to the UK for terminations.

Graffitti artist Shirani Bolle paints an image of Savita Halappanavar, who died after doctors refused her an abortion in 2012

  • Graffitti artist Shirani Bolle paints a mural of Savita Halappanavar, who died after doctors refused her an abortion in 2012.

In 2012, Savita Halappanavar died from sepsis after miscarrying her daughter, after doctors refused her an abortion. Her death shocked Ireland and brought new awareness and energy to the campaign to repeal the eighth amendment.

Some of the amendment’s consequences have been unexpected: women lose autonomy over their bodies as soon as they become pregnant, and because doctors have an equal responsibility to foetus and mother, many discourage home births. Ireland has the lowest rate of home births in Europe.

For Caitriona Kenny, from Dublin, whose mother was forced to adopt her son, a home birth was a rebellious act against the state’s control of her body.

Catriona Kenny gives birth to her son, Tom

  • A rebellious act: Catriona Kenny gives birth at home to her son, Tom, while her two-year-old daughter, Nora and husband, Derek, look on, in Dublin. Right: Catriona feeding Tom after the birth.
Catriona Kenny breastfeeds her newborn son after giving birth at home in Dublin

For many voters in favour of retaining the current laws, opposition to abortion is not a question of women’s rights but rather of equating termination of pregnancies with murder. They believe a repeal of the eighth amendment as a retrograde step for human rights.


My grandmother was bound to the Catholic church by guilt learned in childhood and the thrill of forgiveness

Olivia Harris
Megan Scott, a repeal campaigner, dressed as Saint Brigid, patron of Ireland, in Dublin

  • Megan Scott, a repeal campaigner, is dressed as Saint Brigid, patron of Ireland, on Dublin’s main shopping street.

Ireland, once described by Pope Paul VI as “the most Catholic country on earth”, has undergone a massive change in the past 30 years. Its moral authority has been damaged by a series of scandals, including the compulsory servitude of young unmarried mothers by nuns and the forced adoption of their babies. The discovery of the remains of babies in sewers at Tuam monastery in 2017 as well as clerical child abuse scandals have made headlines around the world.

Students buoyed by the international women’s movement call for greater autonomy over their bodies at a protest in Dublin

  • Students buoyed by the #MeToo international women’s movement stage a rally calling for the state to grant them greater autonomy over their bodies.
Giant figures called Cassandras wait to parade through Limerick in a silent appeal to residents to repeal the eighth amendment

  • Artist Alice Maher uses reflective discs on the heads of figures called Cassandras to represent what she sees as society’s hypocrisy.

Despite the recent scandals engulfing the Catholic church, Irish identity is bound up with the religion. First Holy Communion remains a rite of passage for girls in Ireland, despite the falling attendance of weekly mass from 63% in 2002 to 48% in 2010.

New mothers, aged 18, share a joke after learning how to put on condoms

  • New mothers, aged 18, share a joke after learning how to put on condoms at a sex education class run by the Brook sexual health clinic.

Although the church’s influence has waned, it retains control over sex education in almost all Irish schools.

A man shows off tattoos of his children on a hot day in Dublin

  • A man shows off tattoos of his children on a hot day in Dublin.
Catholic students carry a statue of Mary, mother of Jesus

  • Catholic students carry a statue of Mary as part of a co-ordinated nationwide prayer on Ireland’s beaches to keep abortion out of Ireland.

Ireland legalised contra­ception in 1985 but some people believe it is an offence against God and nature.

The Irish Catholic church has asked followers to work actively to reject any change to abortion laws. Devotees have held prayer vigils at “mass rocks”, historic sites at which priests held services in secret when Catholicism was suppressed by the British.

A woman kisses a statue of Mary

  • A woman in Carlingford kisses a statue of Mary, mother of Jesus, after a nationwide prayer to save the eighth amendment, in March.
An anti-abortion campaigner recites the Eucharist with a priest at the summit of Croagh Patrick, a holy mountain in County Mayo, on 26 August 2017.

  • An anti-abortion campaigner recites the Eucharist with a priest at the summit of Croagh Patrick, a holy mountain in County Mayo, on 26 August 2017.

In 2017, two crisis pregnancy centres with links to anti-abortion groups were investigated after reportedly telling women that abortion causes breast cancer and infertil­ity, contraception was dangerous and that women could die from having sex.

And yet Irish public opinion is moving away from its past. In 1992, homosexuality was still illegal in Ireland; in 2015 it became the first country to legalise same-sex marriage by referendum. The country now has an openly gay prime minister, Leo Varadkar, a former GP.

The rosary of the unborn, designed by the Ohio-based organisation Holy Love

A prop used by pro-life campaigners to show pregnant women considering abortion the size of a foetus in the womb

  • The Rosary of the Unborn, designed by the Ohio-based organisation Holy Love, for sale in Knock. Right: A prop used by anti-abortion campaigners to show pregnant women considering abortion the size of a foetus in the womb.
Andrea Horan, who owns a nail bar, wears a Repeal the Eighth badge

  • Andrea Horan, who owns a nail bar, wears a Repeal the Eighth badge. She encourages her technicians to wear repeal T-shirts.

During the 1983 referendum a bucket of pig’s blood was poured over a pro-choice campaigner and verbal abuse was exchanged on the streets. This time campaigners have been more restrained. The repeal jumper, now symbolic of the campaign, was the first quiet call for a change to the law. A flurry of performance art, embroidered banners and T-shirts followed in an attempt to encourage discussion on the subject.

Women dance in repeal jumpers

  • Women dance in repeal jumpers, now symbolic of the campaign.

All photographs by Olivia Harris, supported by the International Women’s Media Fund.

I had to travel abroad to end my doomed pregnancy. Ireland must change its abortion law | Siobhan Donohue

I’ve never been involved in politics or campaigned for anything. If you’d told me 10 years ago that I would one day be stepping up and speaking in public about liberalising abortion law in Ireland, I would have called you crazy. But all that changed on a warm autumn day in 2011.

I was 20 weeks into my third pregnancy, and a little bit chuffed with myself. As an older mum (I was 35 when my first child was born), I was delighted to be on track to complete my three-child family shortly after turning 40, and that day I was looking forward to getting a first proper glimpse of my baby at the anomaly scan. But shortly after the sonographer started the scan, she went very quiet. Then she said: “I’m a little concerned – I can’t see the top of the baby’s head.”

I’m a GP, so my medical brain took over as I tried to work out what she meant. It took a second but then the penny dropped. “Do you mean like anencephaly?” I heard myself say. “Oh, you’ve heard of it,” she said, with obvious relief. Relief that she didn’t need to explain that the top half of my baby’s head had never formed, that there was nothing above his eye level – no brain, no scalp, no skull, and that my baby would not survive outside the womb for long, if at all. In that moment my world was turned upside down. The future as I had planned it was gone. Wiped out in an instant. My husband hadn’t been able to attend the scan with me that day, so the consultant suggested we return to see him together to discuss what would happen next. Our options were to continue with the pregnancy and carry the baby to term, or travel abroad for a termination. I made my way across Dublin with my sister, who had been with me for the scan. The news was starting to sink in, and I realised I would have to let people know. My mother was texting to know how it had gone but I couldn’t answer her. I needed to let my husband know, but I couldn’t speak on the phone to him. I’d fill him in later, face to face.

We stumbled through that weekend trying to get used to our new reality. But I very quickly realised how difficult daily life was going to be, carrying this news around with me. I could foresee the same conversations happening everywhere I went, the questions that every pregnant person has about due dates and whether or not you know what you’re having.

Quick guide

The Irish abortion referendum

The Irish abortion referendum

Ireland is set to vote on abortion law reform on Friday 25 May. In a the referendum, voters will decide if they want to repeal an article in the republic’s constitution known as the eighth amendment. 

The amendment, or article 40.3.3 of the constitution, gives unborn foetuses and pregnant mothers an equal right to life – and is, in effect, a ban on abortion. Currently, terminations are allowed only when the life of the mother is at risk, with a penalty of up to 14 years in prison for breaking the law. 

The government in Dublin has promised to introduce legislation allowing for abortions during the first 12 weeks of pregnancy if the vote goes in favour of repeal.

Photograph: Clodagh Kilcoyne/X03756

What would I tell people? Would I play along and pretend everything was normal, or would I tell them we’d be having a funeral instead of a christening? How would I continue to work as a doctor after a conversation like that with every patient who noticed I was pregnant? The distress, the torture of retelling the awful truth or denying it completely: I’d be in bits. Day-to-day living would be intolerable. Faced with this reality, we decided to travel out of Ireland. We booked flights and accommodation, arranged childcare and took the lonely early-morning departure to Liverpool surrounded by businessmen and hen parties. It was surreal to be going through the greatest tragedy of our lives hidden in plain sight, hoping no one would ask us where we were going or why.

Liverpool was a place I’d never been to. I had a picture in my head of a grey, industrial city, but Liverpool was the beacon of light in this story – a warm and vibrant place that took care of us. We went straight from the airport to Liverpool Women’s Hospital, where we were wrapped in a blanket of care and compassion. Everyone we met said they were so sorry we had to be there. They confirmed the diagnosis, talked us through what would happen over the following days, and then sat with us to discuss what we would like to do with our baby’s remains afterwards.

I was given the first dose of medication and we then had 48 hours before we had to return to the hospital. We checked into our hotel and wandered around the old docks, dining out and shopping. I’d read it was a good idea to bring a hat for a baby with anencephaly so we bought one to cover my baby’s head. To the outside world, we must have looked like tourists enjoying the Indian summer weather, but we carried our dark secret in our hearts.

We returned to the hospital on the Saturday, where I was admitted for a compassionate induction of labour, and late that night our little mite was delivered silent and still. We held him and named him TJ and, though we mourned the death of our son, there was a moment of peace as we sat there holding him. The cause of his death was clearly visible: we could see remnants of brain tissue and we knew we had made the right decision.

And then we had to leave him behind and return home to our family; to pick up the pieces of our lives and move on. About three weeks later, a courier arrived at my front door with a Jiffy bag containing the cremated remains of my child. That’s how my baby came home to me.

Time moved on and we began to heal. Good things happened in our lives again – we went on to have another baby. We are a happy family and we talk openly with our children about their brother TJ.

But I feel scarred by a constitutional amendment that says I should be punished because I could not continue with my crisis pregnancy. It doesn’t need to be this hard for people. Travelling abroad for a termination doesn’t make you think any harder about your decision, it just traumatises you and diverts your energies away from what you should be focusing on: the death of your baby.

On Friday 25 May, the people of Ireland will decide whether or not to remove from our constitution the amendment that means there is a near-total ban on abortion in the country. Introduced in 1983, the eighth amendment gives the unborn foetus the same protection as the life of the mother and makes legislating for abortion in cases like mine impossible.

I know that for many voters this is a deeply difficult topic to think about, and something that they have not wanted to discuss openly. For many others, it is personal because they have been directly affected by its consequences, and I am one of the latter.

I wish TJ could have been delivered in Ireland. I wish his brother and sister and grandparents had met him. I wish my mum had been there to give me a hug. But mostly I wish that no other family has to endure what we went through.

We can help achieve that wish by voting yes to the repeal of the eighth amendment to the constitution. It is time we in Ireland brought compassion home.

Siobhan Donohue is a GP based in Dublin

Hospitals struggling to afford new equipment after NHS budget cuts

Hospitals can no longer afford the most modern scanners and surgical equipment to treat patients who have cancer and other diseases because of multibillion-pound cuts to the NHS’s capital budget, research reveals.

Staff are having to continue using vital diagnostic and treatment technology beyond its natural life because there are insufficient funds to replace it.

For example, radiographers are using out-of-date scanners that produce images so unclear they impede correct diagnosis. In one case, 200 patients had to be rescanned because the images of their lumps, tumours and broken bones were of such poor quality.

Ambulances are breaking down because they have been kept in service for too long, and hospitals are having to continue using archaic IT systems in the wake of repeated government raids on NHS capital funding, the researchers heard. One trust had to scrap plans to bring in electronic scheduling of operations because it could not afford the technology.

Others are unable to expand their A&E units to help them cope with rising patient numbers, while some lack the money to repair rotten windows and leaking roofs in hospital buildings because of the cash squeeze.

The problems are outlined in research conducted at 30 trusts by the health services management centre at Birmingham University and funded by the Health Foundation, a thinktank.

Trust bosses told the academics the lack of money for new equipment and repairs had started to affect the quality and safety of patient care.

“The surroundings that they [patients] are actually being cared for in are appalling and we all know … that those surroundings do impact the recovery rate. So in that respect it is impacting their recovery as well,” one NHS trust finance director said.

Since 2014 Jeremy Hunt, the health and social care secretary, has taken £4.3bn from the NHS in England’s capital budget and used it to help pay for day-to-day running costs, in response to its deepening financial crisis. In 2016-17 alone he removed £1.2bn, a fifth of the entire capital budget.

“This has left the NHS between a rock and a hard place, postponing and cutting vital capital investment to fund day-to-day running costs,” said Anita Charlesworth, the Health Foundation’s director of research and economics. “It’s clear that shortfalls in NHS capital spending are starting to hurt: spending on new equipment such as medical scanners has more than halved over the last four years.”

NHS Providers, which represents NHS trusts, said the shortage of capital funding was so acute that hospitals could not afford to replace outmoded machines that deliver radiotherapy to cancer patients.

“Just in the last few days one trust leader told us of frustrating delays in funding needed to improve an emergency department. Another spoke of her worries about being able to replace linear accelerators. But as we see in this report, this is also a major problem for mental health, community and ambulance services as well,” said Phillippa Hentsch, the organisation’s head of analysis.

A separate analysis of NHS finances by the Health Foundation found that capital spending for healthcare, such as for hospitals and equipment, in the UK was low compared with other OECD countries, at 0.3% of GDP compared with an average of 0.5%.

Increasing the percentage spent in the UK to the OECD average would mean the NHS had another £3bn a year for such projects, it said.

Charlesworth said: “The maintenance backlog for hospitals is now over £5bn. Most worryingly, £2.8bn of this backlog is high or significant risk, related to clinical services and safety.” She said cutting capital spending was “a false economy” that made hospitals inefficient and prevented them from improving patient care.

One trust boss said £40m of “priority one high-risk” urgent repairs were needed in one year, but only £11m was available for them.

On Wednesday Labour will use parliamentary procedure to try to force ministers to disclose documents that reveal what elements of the Health and Social Care Act 2012 they want to scrap.

There have been reports that Theresa May is keen to repeal some sections of the legislation to help pave the way for an overhaul of how the service works, tied to a big increase in NHS funding planned to mark its 70th birthday on 5 July.

Ex-footballer Terry Butcher accuses British army of failing his son

The former England football captain Terry Butcher has accused the British army of failing his son, who died after developing post-traumatic stress disorder (PTSD).

Butcher told an inquest on Monday that Christopher, 35, had turned to alcohol and drugs after being discharged from the armed forces in April 2015, due to the mental health condition.

“Christopher passed away several months ago. But, in reality, the Chris that we all knew and loved had ceased to exist years before,” Butcher told Ipswich coroner’s court.

“Diagnosed with severe post-traumatic stress disorder, his life spiralled downwards as the demons took control of his mind. In truth after intense tours of Iraq and Afghanistan he became a victim of war.

“These circumstances are all too familiar. Our country has a number of veterans suffering from the same condition, released from the armed forces too early and having to rely on an overloaded NHS that is ill-equipped and underfunded to cope.”

Butcher, who struggled to hold back tears during the hearing, said the armed forces’ duty of care towards personnel had been “discarded too easily, which has resulted in a growing number of our veterans turning to anything that might help including alcohol, drugs and suicide as a means of alleviating the flashbacks and nightmares”.

The inquest heard how Christopher, a former captain in the Royal Artillery, had been haunted by nightmares and flashbacks about the deaths of comrades and civilians in Afghanistan.

Butcher found his son’s body wedged between his bed and a wall when he went to check on him on the morning of 16 October last year at his home in Suffolk.

A postmortem failed to identify Christopher’s cause of death, but found he had an enlarged heart, which could have been caused by drug use. Toxicology tests revealed he had non-lethal levels of cocaine and heroin in his body, as well as prescription drugs he had been taking for several years. A makeshift crack pipe in a sunglasses case was also found in his room.

Suffolk’s assistant coroner, Dr Dan Sharpstone, concluded that Christopher died from an enlarged heart due to uncertain causes with a background of drug use and PTSD.

Butcher remembered his son as a man who had a “glittering career in the army ahead of him, a loving wife and dreams of having children of his own. His unnecessary death has deprived us of a wonderful son, husband, brother and grandson, friend and comrade”.

Sharpstone said: “When people serve in the armed forces, they give everything in the defence of our country and this may result in death or serious injury. However, it can also result in PTSD.”

  • In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

Ex-footballer Terry Butcher accuses British army of failing his son

The former England football captain Terry Butcher has accused the British army of failing his son, who died after developing post-traumatic stress disorder (PTSD).

Butcher told an inquest on Monday that Christopher, 35, had turned to alcohol and drugs after being discharged from the armed forces in April 2015, due to the mental health condition.

“Christopher passed away several months ago. But, in reality, the Chris that we all knew and loved had ceased to exist years before,” Butcher told Ipswich coroner’s court.

“Diagnosed with severe post-traumatic stress disorder, his life spiralled downwards as the demons took control of his mind. In truth after intense tours of Iraq and Afghanistan he became a victim of war.

“These circumstances are all too familiar. Our country has a number of veterans suffering from the same condition, released from the armed forces too early and having to rely on an overloaded NHS that is ill-equipped and underfunded to cope.”

Butcher, who struggled to hold back tears during the hearing, said the armed forces’ duty of care towards personnel had been “discarded too easily, which has resulted in a growing number of our veterans turning to anything that might help including alcohol, drugs and suicide as a means of alleviating the flashbacks and nightmares”.

The inquest heard how Christopher, a former captain in the Royal Artillery, had been haunted by nightmares and flashbacks about the deaths of comrades and civilians in Afghanistan.

Butcher found his son’s body wedged between his bed and a wall when he went to check on him on the morning of 16 October last year at his home in Suffolk.

A postmortem failed to identify Christopher’s cause of death, but found he had an enlarged heart, which could have been caused by drug use. Toxicology tests revealed he had non-lethal levels of cocaine and heroin in his body, as well as prescription drugs he had been taking for several years. A makeshift crack pipe in a sunglasses case was also found in his room.

Suffolk’s assistant coroner, Dr Dan Sharpstone, concluded that Christopher died from an enlarged heart due to uncertain causes with a background of drug use and PTSD.

Butcher remembered his son as a man who had a “glittering career in the army ahead of him, a loving wife and dreams of having children of his own. His unnecessary death has deprived us of a wonderful son, husband, brother and grandson, friend and comrade”.

Sharpstone said: “When people serve in the armed forces, they give everything in the defence of our country and this may result in death or serious injury. However, it can also result in PTSD.”

  • In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

Secret Teacher: I hated teaching – until I realised my school was the problem

Not so long ago, I was ready to quit teaching. Now, I’ve got my sights on leadership. The difference is my headteacher.

Under my previous head, I got the point where I couldn’t go on. I was signed off work with anxiety and stress. At school, we’d been under intense pressure to get more children to expected levels to show the school was improving – and were always on edge thanks to drop-in observations. As a member of the school leadership team, the headteacher expected me to remain distant from the rest of the staff, meaning I was isolated from my colleagues.

To make matters worse, a child who had special educational needs was subjecting me to frequent physical assaults. One day, I ended up in hospital with concussion and a suspected broken nose.

I expected my headteacher to support me. But when I returned to work the following day, I discovered there had been no consequence for the student. I explained that staff needed to be protected, only to be told that I was overreacting. Nothing changed.

Across the school, issues with violent and disruptive behaviour had become the norm. Teachers often missed their PPA (planning, preparation and assessment) time because they were dealing with pupils’ behaviour. When staff sought support, they were made to feel it was their fault, and their responsibility alone to deal with it. Morale was low – everyone had given up any hope of getting help. People were often found silently crying in various rooms around the school. I felt completely inadequate.


When staff sought support, they were made to feel it was their fault – and their responsibility alone to deal with it

But then I moved schools – and I saw that it wasn’t the profession that was the problem, but the leadership. My new head puts students at the heart of every decision they make. Learning is thought of as something that should be fun, and children are encouraged to explore their full range of abilities, not just English and maths. The school focuses on progress, while also recognising that it’s not about endless Sats drills. We don’t have target cards, because how does that really help pupils to learn?

The head puts just as much emphasis on the wellbeing of staff. We’re often treated to staff breakfasts, dinners on parents’ evenings, and simple messages and demonstrations of thanks. We’re encouraged to aspire to reach our professional goals, and the head recognises our strengths and encourages us to use them.

I even have my life back. Marking is done with students in lessons, so I haven’t needed to take any books home since I started, and the school is closed over the holidays so there’s no expectation to work on our classrooms. Instead, the expectation is that we rest and feel refreshed for the next term.

I’m still in disbelief that I’ve got to this point, considering where I was before. I have fallen in love with teaching again, and I now know that this can be the best job in the world – you just need to find the right school.

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Guernsey parliament votes against assisted dying

An attempt to legalise assisted dying in Guernsey has been defeated in the island’s parliament after a three-day debate.

Members of the legislature voted against a requete – similar to a private member’s bill – proposed by Guernsey’s chief minister, Gavin St Pier. A series of votes on different clauses were lost decisively.

If the requete had passed, Guernsey would have become the first place in the British Isles to offer euthanasia for people with terminal illnesses.

Supporters of the requete said they were disappointed by the outcome, but believed change was inevitable.

“Naturally we are disappointed with this result, although it was not entirely unexpected. We believe that a majority of the population do support a change in the law. However, we live in a representative democracy and our parliamentary assembly, the States of Deliberation, has by majority, made a democratic decision which settles the matter in Guernsey.”

“We, of course, accept that decision. We remain of the view that this is an inevitable change which in the fullness of time Guernsey will one day adopt.”

The proposal sought to adopt the Oregon model, meaning that euthanasia would be restricted to people with a diagnosis of terminal illness with less than six months to live and full mental capacity. People from other areas of the British Isles would not be able to travel to Guernsey to take advantage of its law.

It was opposed by Christian leaders on the island, the British Medical Association and the Guernsey Disabilities Alliance. A key government committee refused to back the proposal, saying it was not a priority and investigations would be a drain on resources.

The Oregon model has been adopted in six US states as well as Oregon, Canada and the Australian state of Victoria. New Zealand is considering the legislation.

The Netherlands, Belgium and Luxembourg have more permissive laws, based on applicants’ suffering, but not requiring a terminal diagnosis. Switzerland allows assisted dying on compassionate grounds to residents and non-residents.

The requete needed a simple majority of the 40 deputies who sit in Guernsey’s States of Deliberation.

Suffer hay fever? Don’t blow your nose | Brief letters

It’s not just trees (We can’t chop down all these trees and not harm ourselves, 15 May). The railway ecosystem includes many other types of plant. On my trips from Winchester to Waterloo in the 1960s, I saw everlasting peas (Lathyrus latifolius) in full flower, cascading down the banks. There are still pockets of plant diversity on the route between Cambridge and King’s Cross, thanks to Margaret Fuller, wife of the crossing keeper at Shepreth, as recorded in The Illustrated Virago Book of Women Gardeners (ed Deborah Kellaway; 1995).
Margaret Waddy
Cambridge

David Cox offers some good advice (Seven ways to deal with hay fever, G2, 14 May) but misses out the real game-changer. Hay fever sufferers must not blow their noses. Everyone seems to know not to rub an irritated eye, but not that blowing has much the same effect on the nasal passages – congestion, irritation, and more discharge.
Dr Stuart Handysides
(Retired GP), Ware, Hertfordshire

Woody Guthrie’s words of long ago apply: Some rob you with a six-gun and some with a fountain pen (Carillion fall blamed on hubris and greed, 16 May). Why no prosecutions?
Huw Kyffin
Canterbury

Is it my imagination or is the royal romance, and lead-up to the wedding, beginning to sound a little like the plot of Notting Hill Part II (Markle’s father ‘may miss her wedding after surgery’, 16 May)?
Tony Hart
Formby, Merseyside

Who is giving Prince Harry away?
Marion McNaughton
Warburton, Cheshire

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Introduce mental health checks for new mothers, ministers told

New mothers should receive a mental health checkup six weeks after giving birth to help tackle possible postnatal depression and other problems related to having a baby, ministers have been told.

A cross-party group of 60 MPs and peers have written to Steve Brine, the minister for public health and primary care, demanding that all mothers in England have an assessment of their emotional and mental health carried out by a GP, practice nurse or health visitor.

They say that making such checkups mandatory would reduce the damage experienced by women, children and families caused by mothers suffering psychological problems associated with pregnancy and birth, which often go undetected.

About half of mothers in the UK develop a mental health problem of some sort during that time, such as postnatal depression, anxiety, post-traumatic stress disorder and postpartum psychosis, according to the parenting charity NCT.

The MPs and peers are lobbying for checks to become automatic as members of the all-party parliamentary group for prevention of adverse childhood experiences. It is jointly chaired by the Labour MP Dr Paul Williams, who is a GP, and Dr Alex Burghart, a Conservative MP who is a former teacher and former adviser to Theresa May in Downing Street.

In their letter they tell Brine that there is “significant harm caused to mothers and children by low rates of diagnosis of maternal mental health problems. These unseen and untreated mental health conditions create great suffering for mothers. But, crucially, they also erode parents’ ability to create healthy bonding with and support for their children.”


The maternal check is often either not done at all or is done in a hurry at the end of the baby check appointment

Letter to Steve Brine

Babies and mothers are both meant to have their health assessed by a GP at the six-week postnatal check. The National Institute for Health and Care Excellence (Nice) recommends that both should happen. However, research last year by NCT found 42% of mothers said that their perinatal mental health problems were not picked up at those appointments.

Many mothers miss out because while checking the baby’s health is a stipulation under the GP contract, doing the same for the woman is not, according to the MPs and peers.

“As a result, mothers report that while baby checks are routinely carried out, the maternal check, including a discussion about the mother’s emotional and mental wellbeing, is often either not done at all or is done in a hurry at the end of the baby-check appointment,” the letter says.

They are urging Brine to ensure that all mothers start to receive a checkup of their own health, at a separate appointment to their baby’s, also six weeks after the birth. Such checkups should include “open questioning about her mental health”. The scheme would cost about £20m a year to operate but would more than pay for itself because perinatal mental health problems cost an estimated £8bn, they say.

“It’s profoundly unfair that some women get excellent care while others aren’t even asked about how they are feeling by health workers. I hope to persuade the government to commit to come fully around to our view that a universal six-week perinatal mental health check for all women needs to be written into all GPs’ contracts,” said Williams.

The NCT backed the move. “It’s crucial that new mums’ mental health problems are picked up early and the six-week postnatal checkup is the ideal opportunity to do so. At the moment many mothers are suffering in silence and this can have a huge emotional impact on women, as well as devastating consequences for families,” said Abi Wood, the charity’s head of campaigns.

Jackie Doyle-Price, the mental health minister, last week hinted in parliament that ministers were considering obliging GPs to conducts six-week checks on mothers’ mental health.

Replying to a question by the Labour MP Jenny Chapman, she said: “Nice recommends postnatal checks for mothers and NHS England expects commissioners to undertake that those guidelines are being met. As for any further support by GPs, she will be aware that there is a renegotiation of the GP contract [starting in July] and it will be covered there.”