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The NHS is standing up for itself about underfunding. About time too | Rachel Clarke

When the NHS excels, the government is only too keen to grab a slice of the glory. Manchester, Westminster, London Bridge, Grenfell. This year has been punctuated by acts of terror and disaster to which the NHS has stepped up magnificently – and ministers have flocked for their photo ops, like flies to nectar, full of gushing tributes and praise.

Only a fortnight ago, the prime minister described her “humbling gratitude” for the “incredible people” who staff the NHS when she visited the hospitals who cared for the victims of each of these atrocities. “In every instance,” she wrote in the Daily Mail, “what struck me was not only the medical expertise of the staff, but the compassion with which people were treated and the way the NHS, in an emergency, clicks into action.”

The moment things go wrong, however, the government sings to a different tune. Then it becomes a blame game. When waiting lists balloon, or patients die on trolleys in hospital corridors, we hear a depressingly familiar refrain. Out come the Department of Health spin doctors, claiming – erroneously – that the NHS has been given the funds it has asked for, so the buck stops with them alone.


No more is Stevens colluding with Hunt in the fiction that the NHS is performing safely

This month, the prime minister went one step further. In a pre-emptive strike to deflect the political repercussions of this year’s NHS winter crisis, Theresa May told Simon Stevens, the head of NHS England, that he was “personally responsible” for how the NHS performs this winter. Her straitjacket of social care underfunding and NHS understaffing on A&E departments’ ability to perform was conveniently ignored.

Until now, the government has deployed with impunity this strategy of revelling in opportunistic glory, while deflecting all blame on to the NHS for its own, “self-inflicted” shortcomings. But not any more. The gloves are off. Stevens – tired, one presumes, of being Jeremy Hunt’s whipping boy – has delivered a speech in which he demanded from the government the £350m a week promised by the Brexiteers. Next, with unprecedented bluntness, Stevens stated that unless another £4bn was found for 2018, the government risked a visibly deteriorating service in which waiting lists would soar, plans to improve cancer and mental health care may have to be shelved, and – as we celebrated the NHS’s 70th birthday – patients would see their health service “retrenching and retreating” around them.

So the battlelines have been drawn. Having put his head on the block, Stevens no longer has anything to lose, and that makes him politically dangerous. No more is he colluding with Hunt in the fiction that the NHS is performing safely. How could he, with any credibility, when the number of patients on long waiting lists has topped 4 million for the first time in a decade?

Crucially, for an NHS England granted by the chancellor only a fraction of what it asked for in last week’s budget, key NHS targets – such as 92% of patients being treated within 18 weeks of referral by their GP – are enshrined in law. The NHS constitution, drafted to mark the NHS’s 60th birthday, is no mere pledge by politicians – we all know how flimsy those can be – but a legal guarantee, passed by a previous parliament, about the minimum standards of care to which NHS patients are entitled in England.

Persistent flouting of these standards will entail, says Stevens, the government having to legally abolish patients’ national guarantee on waiting times. Otherwise, it may find itself vulnerable to legal challenge from patients who have been harmed by long waits.

For as long as NHS England colluded with the Department of Health in maintaining a queasy silence over the NHS’s failure to meet its constitutional requirements, this unlawfulness could be glossed over. But now that Stevens has spoken out unequivocally about the catastrophic impact of underfunding, the government is in the firing line. For the first time, frontline staff, trust CEOs, health unions, health thinktanks and the top brass at NHS England are all aligned and speaking the same, potent truth: that we simply cannot, any longer, provide patients with acceptable care on current funding.

This makes this Thursday’s NHS England board meeting – to which, unusually, all the press have been invited – crunch time for May and her health secretary. If Stevens reiterates before the assembled press that the NHS has been doomed by underfunding to fall short of standards of care that are enshrined in law, Hunt will be boxed into an awkward corner. How could he respond? Tearing up the NHS constitution isn’t quite the PR he’ll be after on the NHS’s 70th birthday. Worse still is the prospect of a crowd-funded, patient-led judicial review taking him to court for violation of patients’ constitutional rights to timely treatment.

The chancellor might dearly hope that he’s ended further discussion of the NHS budget. But – as winter bites down in A&Es across the country – make no mistake, the public conversation has only just begun.

Rachel Clarke is a palliative care doctor in Oxford and author of Your Life in my Hands, a book about life on the NHS frontline

‘It tears every part of your life away’: the truth about male infertility

James and Davina D’Souza met and fell in love in their early 20s. They got married five years later, and three years afterwards had saved enough to buy a family home in a quiet cul-de-sac in London. Then, when Davina was 29 and James 33, they started trying for a baby.

“I knew that the moment we bought a home, we’d start a family,” Davina tells me in their living room, beside shelves crammed with framed photos of nieces, nephews, cousins and siblings. “My parents live down the road, and if I needed help to raise a child, my mum would be here.”

“We thought about all of that stuff,” James adds. “The job, the future, the house, the home: we make things happen.”

But after a year of trying, nothing had happened. Davina went to their GP, who referred her for the kind of invasive tests that have become the norm for women who experience problems conceiving: she had an internal, transvaginal scan to check her womb for fibroids, and an HSG test, where dye was pushed into her fallopian tubes to see if they were blocked. Everything looked normal.

It was only then that anyone suggested testing James. He had his semen analysed, and was told that only 1% of his sperm were formed normally. Still, it only takes one, the consultant said. She told them not to worry and to carry on trying. Two years after Davina came off the pill, James was tested again. This time, he had no normally formed sperm at all.


Male sperm counts in the western world have declined by almost 60% in 40 years

“My first thought was, ‘Oh, it’s my fault,’” James says, quietly. He stares at the coffee table through his thick-framed glasses. “I felt helpless. No one was talking about this stuff. You’d go online and there was no male conversation. I’d Google ‘problems having a baby’ or ‘fertility issues’, and the websites that came up were all pink. I’d post in a forum and women would respond on behalf of their husbands. There was nothing for men.”

Though he may have felt it, James is not alone. Across the western world, men are facing a fertility crisis. A landmark study by the Hebrew University of Jerusalem, published in July, showed that among men from Europe, North America and Australia, sperm counts have declined by almost 60% in less than 40 years. Fertility specialists have described it as the most robust study of its kind (the researchers came to their conclusions after reviewing 185 previous studies involving 43,000 men from across the globe) and the findings are stark. Such a significant decline in male reproductive health over a relatively short period in such a specific population suggests there’s something in the way we live now that means it’s much harder for men to become fathers than a generation ago.

***

Until recently, the focus of both fertility experts and research scientists has been overwhelmingly on women’s bodies, while male reproductive health has been almost ignored. For decades, the average age of both fathers and mothers has been increasing, but it’s women who have felt the pressure of balancing the need to invest in their careers with the so-called “timebomb” of their own declining fertility. They have been encouraged to put family first and to change their lifestyles if they want to become mothers, at the same time as male fertility appears to have fallen off a cliff.

Davina says the consultant gynaecologist who was treating her and James had no hesitation about next steps. “She said, ‘James’s sperm results are in, and we think you should go for IVF.’ That was it. The NHS didn’t have any other options for us.” Indeed, the NHS couldn’t even fund any IVF in their area at that time, so they had to scrape the money together to go private. They spent more than £12,000 on two rounds of IVF, and were finally offered a third round on the NHS this year. But after nearly seven years of trying for a baby, they are still childless.

“IVF takes a huge physical, hormonal and emotional toll – on a woman,” James tells me. “Sometimes I felt totally powerless, ineffective. I questioned my masculinity, my sense of myself as a man, through those rounds of IVF.” During consultations, James felt the conversations were always directed at Davina. “I felt like I had to say, ‘I’m here.’ I’d deliberately ask a question to make my presence felt.”

On their first round of IVF, someone at the clinic recommended James take a vitamin supplement. It was the first time lifestyle factors had been mentioned. “That was when I realised, maybe there is something I can do,” he says between slurps of his own blend of bulletproof coffee (made with grass-fed butter, coconut oil and egg yolk). James, head of sixth form at a local school, is a fan of self-help books. He’s been on a high-fat, low-carbohydrate ketogenic diet for months and says it’s done him good: he’s slim and spry, but says he wasn’t always this way. He’s wearing a digital fitness tracker. But as someone who rarely drinks, has never smoked and doesn’t ride a bike, there were few lifestyle changes he could make, beyond taking colder showers and wearing looser underwear. Still, his sperm quality has improved.

At the moment, the couple’s fertility problems are unexplained. They decided against adoption when social workers said they’d have to use contraception during the process, because it wouldn’t be fair on an adopted child to move into a home with a new baby, and they aren’t prepared to stop trying just yet.

“We’ve talked about when we’re going to call it a day,” James says.

Davina glances at him with wet eyes. “It makes me sad to think we’ll be putting a cap on it.”

“But it regularly comes up,” he says. “We did actually say at the end of this year we’ll stop. I’ve been asking, ‘Why do we want to have children?’ We’ve decided it isn’t going to define us.”


I was horrified by the lack of investigation and appropriate management of male infertility, so I started my own clinic

“There is treatment for male infertility, but it’s certainly not in the fertility clinic,” says Sheryl Homa, scientific director of Andrology Solutions, the only clinic licensed by the Human Fertilisation & Embryology Authority to focus purely on male reproductive health in the UK. “Men are channelled from their GP with a semen analysis and sent straight to a gynaecologist in an IVF clinic. But gynaecologists are interested in the female reproductive tract.”

A former clinical embryologist, Homa once led IVF laboratories in both the private and public sectors. “I was quite horrified by the lack of investigation and appropriate management of male infertility,” she says, “so I decided to start my own clinic specifically to focus on male fertility diagnosis and investigation.” Male reproductive health is being assessed through semen analysis, which she argues has “a very poor correlation” with fertility. Instead of having their detailed medical history taken and a full physical examination, men are being given a cup and asked to produce a sample.

Homa says the leading cause of male infertility (around 40%) is varicocele (a clump of varicose veins in the testes). “It can be determined from a physical exam, and can certainly be ruled out by an ultrasound scan. All women get ultrasound scans; why aren’t men getting them?”

Varicoceles can be repaired by fairly simple surgery under local or general anaesthetic, leading to a significant improvement in a couple’s chances of successful natural or assisted conception. But many are going undiagnosed. “The NHS is carrying out far too many IVF treatments when they could be saving money by doing proper investigations in men.”

Homa says there is also some evidence linking “silent infections” – those with no symptoms, such as chlamydia in men – with delayed conception and an increased risk of miscarriage. But if a man is judged by his semen sample alone, there would be no way of addressing these hidden concerns.

Apart from saving the NHS money, there are important medical reasons why men should be thoroughly examined, Homa argues. “Semen parameters are a marker of underlying systemic illness: they might have diabetes, they might have kidney disease, they might have cardiac problems. It could be something much more serious that’s contributing to the problem.”

As for the possible reasons for falling sperm counts across the west, Homa mentions “all the chemicals and pesticides that we are exposed to in our environment”, as well as smoking, rising levels of obesity and increasingly sedentary lifestyles. But at the moment, ideas such as these – including hormones in the water and BPA in plastics that might mimic the effect of oestrogen inside the body – are just theories that make intuitive sense. In the absence of widespread research over time, no one can pinpoint exactly which factor or combination of factors is making the difference.

In the 10 years her clinic has been operating, Homa has seen demand for her services steadily rise. She says she gets “the fallout” from men who’ve been sent by their GP for multiple rounds of fertility treatments that fail, when IVF should be the last resort. But at the moment, National Institute for Health and Care Excellence (Nice) guidelines give GPs no option but to refer men with fertility problems to IVF clinics. “If there’s a female problem, the GP will refer them to a gynaecology clinic. If there’s a male problem, they need to be referring to a consultant urologist who deals with male infertility. But it’s just not happening.”

Gareth Down with his son, Reece


Gareth Down and his wife, Natalie, went through 10 rounds of IVF before their son, Reece, was born. Photograph: Harry Borden for the Guardian

In some ways, Gareth Down and his wife, Natalie, were lucky: they knew from the start that their problems conceiving were probably down to Gareth, because he had had surgery to remove benign lumps on his testes as a teenager, and always feared they might interfere with his chances of becoming a father. But after 10 cycles of IVF that cost them tens of thousands of pounds, and several miscarriages, “lucky” doesn’t feel like the right word.

“I always wanted kids,” says Gareth, 31. “My mum was a childminder, and I was brought up looking after kids, so from as young as I can remember, we’ve had a house full of them.” He and Natalie started trying for a baby six months before their wedding in 2010, and went to the GP a year later, when nothing had happened. Gareth was referred to a urologist, who confirmed that the surgery he’d had as a teen had affected his sperm production, and that he had azoospermia: a zero sperm count.

The Downs were determined to have children, but trying almost broke them. “It invades every part of your life,” Gareth says. “On a personal level, you have to confront the fact that you might not have a family. It affects you financially, as you try and save to fund the treatment. We had family fallouts because we couldn’t see newborn nieces and nephews – we just couldn’t be around babies. We changed jobs because time off with certain employers was difficult. I had quite a customer-facing job at one point, and when they were telling me about their problems, I was thinking, ‘You ain’t got problems.’” He pauses. “I don’t think there was any part of who we were that we held on to by the end. It tears just about every part of your life away.”

Gareth has just put his 16-month-old son, Reece, to bed while Natalie is still at work. Reece was conceived with donor sperm, on their 10th round of IVF, when Natalie had had enough of the heartache of fertility treatment and was convinced they should give up. After going through so much to have him, their first feeling when Reece was finally born was not joy, but disbelief. “It was surreal,” says Gareth. “I don’t think either of us could accept it was real and going to last. We’d had so many ups and downs that we couldn’t believe nothing bad was going to happen. We kept checking the cot to see if he was still there. It was weeks before we realised he was not going to be taken away from us.”


If any other part of your body wasn’t working properly, you’d seek advice. Slowly, those barriers are coming down

It was during their final attempt to have a baby that Gareth set up his closed, men-only Facebook group, Men’s Fertility Support. Over the years, Natalie had found a lot of comfort online, from forums and support pages to Facebook groups, and was surrounded by an international community of women going through the same experience. Gareth had tried to contribute in the same places, but never stuck around long. “There were no other men there to relate to what you were saying, or make you feel you could say what you meant – and that it wouldn’t be taken the wrong way by an audience that vastly outnumbered you.”

The 300 or so members of his group are a diverse mix of men, mostly from the UK. Some are just beginning to have problems with conception, others went through it decades ago; some never had a happy ending and are there to share their experiences that a life beyond trying to have a family is possible. Many members say it’s the only place they can be totally honest: the belief that the ability to father children is a marker of masculinity has left many unwilling to talk about their issues anywhere else.

“We do get women wanting to join,” Gareth tells me with a smile, “but we want a degree of privacy. It’s about having freedom to talk, to say, yes, those [IVF] hormones really do screw her up and it’s really tough. You need to be able to vent somewhere without causing offence to anyone you know.”

Everyone Gareth and Natalie told about their problems conceiving assumed the issue must be hers. “Every step of the way it was, ‘Poor Nat – what’s going on with her?’” But he hopes that men are starting to seek help. “If it was any other part of your body that wasn’t working properly, you’d seek advice. Slowly, those barriers are beginning to come down a bit.”

He wonders whether the new figures on declining sperm counts could have been coloured by this growth in awareness: fertility treatments are more in demand than ever, so more men are having their fertility investigated. “Are we just testing more, looking into things more?” he asks. “If you had fertility problems 40 years ago, you wouldn’t have wanted to confront it or had anywhere to go with it.”

Dr Xiao-Ping Zhai, the fertility specialist behind the Zhai Clinic, agrees. “We never really tested men in the past, and if you use the word ‘decline’, you have to have something to compare it to. In the past, people probably had problems, didn’t want to say they had problems, and didn’t have children.” Even though the Hebrew University of Jerusalem study is the best piece of research we’ve had so far, she points out, the data from 40 years ago is still very thin.

Trained both in western and traditional Chinese medicine, Zhai has a unique perspective on fertility treatment and, since she opened her Harley Street clinic more than 20 years ago, claims she’s had a great deal of success in helping couples conceive – even though many patients come to her out of desperation rather than faith in traditional medicine. It’s mainly women who call to make the appointments. “Eighty per cent of the time, the partner doesn’t even want to come along. They don’t think they have a problem.”

Rather than look at sperm counts, Zhai takes a full health MOT of all her patients, using diagnostics from Chinese medicine to find out which part of the body needs to be addressed: “You find that a lot of people have something that can’t be discovered on a scan or through mechanical investigation – what we’d call a functional problem.” Zhai offers a range of treatments according to the patient’s specific constitution, including acupuncture, herbal supplements and advice on lifestyle changes and diet. None of this is cheap: an initial consultation costs £250, and a four-week course of bespoke herbal supplements can cost up to £350.

But IVF treatment on Harley Street costs even more, and Zhai says many of her patients arrive in the consulting room having already spent “lots of money. It’s to do with the culture here: in the UK, if a man has a problem, then the woman needs IVF.” IVF clinics can offer only what they specialise in.

In 2014, Zhai launched a national campaign to end the stigma attached to male infertility and improve the treatment choices offered to men. She called for a full parliamentary debate on male fertility issues, and on health secretary Jeremy Hunt to work with doctors to improve practice and treatment pathways for men within the NHS. But there has been no debate and no change in NHS strategy. “There are too few options for infertile patients,” Zhai says. “It will take a long, long time to overcome this culture.”

Gary Parsons


The doctor who rang with Gary Parsons’ sperm count results simply said it was ‘game over’. Photograph: Harry Borden for the Guardian

Gary and Kim Parsons went to their GP two years after Kim stopped taking the pill, when there was still no sign of pregnancy. “She went through all the regular tests – blood tests and then more invasive examinations – and everything came back A-OK,” says Gary, 36, from his home in Burnham-on-Sea. “Then it was my turn.” Like James, Gary had no physical examination and was asked only to produce a sample to check his sperm count. “That came back as a big fat zero. There was nothing to count.”

When the doctor rang to deliver the results, he said it was “game over”. Gary blinks in disbelief when he tells me this. “I really didn’t need any encouragement to feel more down about things, so that was an unfortunate turn of phrase.” Gary thinks this may have been because it was a conversation between men. “That extreme, direct way of communicating might have been the only way he thought he could get me to understand that this is not something where I could drink a kale smoothie and everything would be OK.”

Still, that’s what Gary tried, at first. Or, rather, he turned to vitamin supplements and a high-protein diet in the hope they could help. “I’m a vegetarian, so for a second I thought, ‘Oh no, I’m one of these anaemic, lentil-based stereotypes.’” But, ultimately, he knew this probably wouldn’t help because his count wasn’t low – it was zero. “There was nothing to improve. That’s the thing I’ve found hardest. Most problems I’ve had in my life I’ve overcome with either bloody-mindedness or effort, and that’s not this,” he says, shaking his head. “That’s not this.”

Gary’s infertility remains unexplained. The next step is for him to have a testicular sperm extraction procedure, to find out if he’s producing sperm that are being blocked, which could potentially be extracted for use in assisted conception. Three years after they started trying for a baby, this will be the first time he will be examined beyond blood tests and semen samples.

Without Gareth Down’s Facebook group, it would have been hard to find someone to talk to. Gary is a counsellor, and when he looked at who was registered with the British Infertility Counselling Association, the professional body for fertility counsellors in the UK, he found that the 46 registered practitioners were all women. Emotional support provision for men is “glaring in its absence”, he says. “It’s just a case of, ‘On your bike, son. Get on with it.’”

The way that men are treated as the secondary partner in infertility treatment could have worrying consequences, he says. “All the paperwork goes through the female. Everything is done through my wife. In meetings, it’s been very rare that I’ve even been able to get any eye contact from a consultant so far. It occurred to me that, should my wife leave me, I would have no mechanism for resolving this, or getting any questions answered, and that would have an impact in terms of maybe meeting someone new, or even knowing if I’m able to be a parent one day.”


Sperm production is a more complex process to understand than the menstrual cycle, and we haven’t done enough research

Edinburgh University professor Richard Sharpe, an expert in sperm count and male fertility, believes the University of Jerusalem study’s findings should be taken very seriously. “If something is having that big an effect – something in our environment, diet, lifestyle, and we don’t know what it is – what else might it be doing to us? We think of sperm counts as a fairly crude barometer of overall male health. It’s a warning shot across our bows.”

Sharpe has been specialising in male infertility for 25 years, but even he can offer only general hypotheses about what could have made sperm counts fall by 60% in little over a generation. He thinks diet and lifestyle are much more likely to be contributory factors than environmental chemicals such as pesticides, plastics and hormones in the water, because the evidence that they could induce such striking effects at low levels of exposure is unconvincing. But our understanding of the normal process of sperm production is “very poor, completely superficial”, he says. “It’s a much more complex process to understand than the menstrual cycle, and we haven’t done enough research.”

There is a chance that women might ultimately be behind the sudden drop in sperm count, Sharpe believes. His work has looked at the link between rates of maternal smoking and the use of painkillers during pregnancy, and the reduced sperm counts of sons in adulthood. A baby boy’s testes are formed during the first trimester, when many women don’t know they’re pregnant, and the period immediately after their formation is critical for the production of testosterone. What we are seeing now could be the expression of a generational problem: the fact that, since the 1970s, women are more likely than ever to smoke and take over-the-counter painkillers.

But, again, the evidence isn’t strong enough. “There are four studies that all show a significant association between maternal smoking and reduction in sperm counts in male offspring, so it’s plausible,” he says, “but it can’t explain the 60% fall, because not so many women smoke and smoke heavily.” A longitudinal study, over 20 years, would be needed to demonstrate the effects of maternal lifestyle on male fertility, but long-term research projects are inherently difficult to get funding for, unless public bodies think the issue is critically important. “Male fertility is not considered a high-priority issue, partly because there’s this perception that it’s a problem solved by assisted reproduction. That’s not treatment of the underlying issue behind male infertility. It’s simply ignoring it.”

We may be sleepwalking into a future where we become increasingly dependent on assisted reproduction, Sharpe argues, without fully understanding the long-term consequences of the technologies we’re relying upon. Researchers have already demonstrated in animals that it’s possible to make sperm out of other kinds of cell. “People are going to do this in humans – not in the UK, initially, but they will somewhere in the world. Those techniques are going to be applied in the fertility clinic, but we don’t have the knowledge to do it in a truly informed way, to know that it’s all safe, that there are no consequences.”

Whatever the reasons for our underinvestment in male fertility – lack of funding and research, male pride or the overemphasis on women in fertility treatment – it has huge implications for both men and women. “We’re flying blind to a large extent, and so far we’ve been ridiculously lucky,” Sharpe says. “It’s a perfect storm, at every level.”

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Behind Belle Gibson’s cancer con: ‘Everything about this story is extreme’

More than two years after her very public exposure and disgrace, the spectre of Belle Gibson still strikes fear into her former associates, even those who once called her their friend.

Or so found the writers Beau Donelly and Nick Toscano when researching their new book about the wellness entrepreneur’s astonishing downfall, The Woman Who Fooled the World. The two journalists had done some of the earliest investigative reporting on Gibson, revealing in 2015 that the young Instagram star, who claimed to have healed her own brain cancer solely through diet, had raised substantial funds for charity with the help of her hundreds of thousands of followers – and then had not donated the money. The revelation led to increased scrutiny on the health claims that formed the foundation of Gibson’s wellness business, which included a cookbook and app named The Whole Pantry – claims that quickly began to fall apart.

Beau Donelly


Beau Donelly: ‘People thought she was lying. It only was believed when she was sending her story out online.’ Photograph: Chris Hopkins

But when Donelly and Toscano went hunting for the full facts from Gibson’s colleagues and friends, including those at Apple and Penguin who had lent Gibson their organisations’ huge commercial clout, they found the process was like pulling teeth.

“Her name was poison,” Toscano tells Guardian Australia. “I can’t think of another story I’ve covered that’s been so difficult to get people to speak to me.”

“We were shut down by dozens and dozens of people,” Donelly says. “We were threatened with lawsuits by others. It was incredibly difficult.”

Gibson herself declined to be interviewed and, though the authors secured some key on-the-record interviews – including talks with Gibson’s grandmother and estranged mother – many sources only agreed to speak to the authors anonymously and only after extensive negotiation, even those whose association with Gibson seemed innocuous.

The phenomenon that emerges in The Woman Who Fooled the World is deliriously complex and multifaceted: a combination of faults both individual and institutional, and of social trends both centuries old and very, very new. “There’s nothing new in cancer scamming,” Toscano points out. “There have always been snake-oil salespeople. There have always been people like [Gibson]. But where this story differs is her explosion to success, and her incredible reach was made possible by a number of intensely modern forces.”

Nick Toscano:


Nick Toscano: ‘It’s hard not to think that the shaming of Belle Gibson crossed a line.’ Photograph: Justin McManus

These forces include the rise of a wellness industry that, in its worst manifestations, has become dangerously untethered from best medical practice. This is coupled with the emergence of social media and online “influencers”, and seismic shifts in the media industry that have radically changed how the public consumes news.

“The way information flows has changed a lot,” Toscano says. “The Gibson story is a really good example, I think, in the sense that she flourished and developed 200,000 followers without ever having gone through the checks and balances that are provided by traditional media.”

At the time of The Whole Pantry’s public collapse, “fake news” was not yet the meme-ified concept it became in the wake of the 2016 US election, but it was evidently on Toscano and Donelly’s minds as they wrote their book. Gibson’s story does seem to reflect some essential quirk in online media that facilitates, if not encourages, the spread of misinformation and untruth.

“Pretty much everything Belle had said about her varying illnesses in the years before she took to Instagram to post about having terminal brain cancer wasn’t really believed,” Donelly says, and the authors draw on testimony from old friends and classmates that paint Gibson as a habitual fibber. “People called her out on it, people thought she was lying. It only was believed when she was sending her story out online. And her whole business grew online.”

Just as Gibson’s rise exemplified some of the worst habits of online media, so did her downfall. Donelly and Toscano draw on the British journalist Jon Ronson’s 2015 book So You’ve Been Publicly Shamed to explore the violent outcry – including death threats and the circulation of her personal information – that accompanied Gibson’s fall from grace.


You don’t want someone googling your name and having it come up against Belle Gibson’s

Nick Toscano

“Her scam was so against the norms of society that it does deserve condemnation,” Toscano says. “But when you delve into the social media damnation that she bore the brunt of, it’s hard not to think that the shaming of Belle Gibson crossed a line.”

Donelly says: “Ten years ago her public shaming would not have happened to this extent. Everything about this story is extreme.”

The book captures the spread of the Gibson phenomenon but there’s still a sense that there are depths yet to be plumbed. The specifics of her personal pathology will probably never be publicly revealed, along with certain elements of her biography, and the involvement and culpability of her various friends and associates as The Whole Pantry scam took flight.

“Like any story, all the facts aren’t available,” Donelly says, “and we can really only run with what we can substantiate. I think there are so many unanswered questions.”

If parts of Gibson’s story are still murky, it’s because the same people who refused to ask questions of her as she rose to prominence now refuse to respond to questions about her in the aftermath of her disgrace.

Cover image for The Woman Who Fooled the World

“People don’t want their names anywhere near hers,” Toscano says. “Young people who are among Belle Gibson’s age bracket – her group of friends and business partners – are more aware of their online footprint now. You don’t want someone googling your name and having it come up against Belle Gibson’s. That digital footprint is very hard to erase.”

Many of her associates are still operating in social media and wellness industry circles today, a fact that lends a self-interested air to their refusal to account for Gibson’s meteoric rise. “There’s a hesitation from some of those people because any scrutiny on the industry that they belong to is bad for business, and bad for them personally,” Donelly says.

“I think a lot of these people have some things to answer for. A lot of them took her story hook, line and sinker, and they endorsed her, and they partnered with her, and they used her – and she used them.”

The Woman Who Fooled the World is out on 13 November through Scribe

Jacqui Dyer: Talking about race and mental health is everyone’s business | Hélène Mulholland

For Jacqui Dyer, trying to talk about the issue of race and inequality in mental health services is sometimes like “pulling teeth”. Yet the over-representation of black people in inpatient mental health services is part of the country’s “dirty secret” that needs to be addressed once and for all.

“Wherever there is exclusion or detention in this society, that’s where you find over-representation of black people,” says Dyer, who argues that the notion of the black person as “big, black and dangerous” still prevails within institutional service settings.

Dyer, 51, has just been appointed to the advisory panel for the government’s Mental Health Act, which aims to investigate, among other things, why a disproportionate number of black, Asian and minority ethnic people are detained under the act. It is too early to say what the review will achieve, but Dyer is clear that detention cannot be seen in isolation from the systemic inequalities in mental health.


Even when black adults do manage to access talking therapies, we don’t have the same outcomes

Last month’s race disparity audit showed that common mental disorders such as anxiety and depression were most prevalent among black women, while black men were more than 10 times as likely to have experienced a psychotic disorder within the past year as white men. Yet the audit also showed that black adults in the general population were the least likely to report being in receipt of any treatment – medication, counselling or therapy, and the most likely to have been detained under the Mental Health Act.

Dyer suggests the rate of detentions is linked to not enough people having access to early intervention services. The audit has made it that bit easier to press home the need to do more. “It’s what we’ve always known, but having that data has helped us to have those conversations a bit more easily when people have traditionally tried to avoid that.”

Dyer was also vice-chair of the independent Mental Health Taskforce, set up in 2015 to produce the Department of Health’s Five Year Forward View for Mental Health for the NHS in England. Published last year, it laid out a series of recommendations to transform mental health services, including 24/7 support for people in crisis and “tackling unwarranted variations in care”.

But the race disparity audit suggests little has changed. Dyer says that black voices are rarely heard at the decision-making table, where more are needed, locally as well as nationally. It is why she is passionate about the Black Thrive scheme in Lambeth, south London. It is a community-led initiative to create a more positive story around mental health in the African-Caribbean community and ensure services are more responsive and culturally sensitive to its needs. Black Thrive came out of the 2014 Black Health and Wellbeing Commission she co-chaired as a local Labour councillor in response to the death of local resident Sean Rigg, who died after being restrained by police officers during a schizophrenic episode.

The commission found that 70% of the borough’s residents in secure psychiatric settings were of African or Caribbean descent, despite making up just 26% of Lambeth’s population

The commission made 40 recommendations to improve services, health and wellbeing for the borough’s black population, and Dyer decided to drum up some funding to carry the work forward. Discussions with the community on the “dirty stuff that nobody wants to talk about,” ensued, such as the way the impact of racism on people’s mental health is often overlooked.

“Even when we do access talking therapies, the data shows we’re not having the same outcomes,” says Dyer. “How can we have the same outcomes when we’re not having the same experiences?” Dyer knows all too well how hard it can be to get the right services, having had bouts of depression and severe anxiety since childhood and caring for her three siblings with severe mental illness for the past three decades, one of whom died a few years ago.

Black Thrive seeks to empower the African Caribbean community in Lambeth to understand their own mental health needs and what early intervention services are available, as well as the way the mental health system works. People are also supported to use their voices to shape and influence the commissioning of local services. Dyer, a trained counsellor whose previous jobs included commissioning mental health services and outreach work, says: “You have to be systematic about it. What I’m looking for is the voice of the lived expert experience of our community, because the black voice is rarely at the decision-making table. And that’s what Black Thrive does. It ensures the black voice is heard.”

Dyer knows firsthand how tough it can be to speak up, not least as a black woman whose “animated” personality can be misconstrued in the context of “an inbuilt fear of blackness”. But she does it anyway, time and again. “The number of times people have not wanted to include me in decision-making because they find it uncomfortable to have a black voice with a different experience … When there’s a bit of grit there, people feel uncomfortable,” she says. ”

Austerity makes her worry about the prospect of success. Part of her NHS England role is to ensure equality issues are considered in the implementation of the recommendations of the Five Year Forward View. A tall order, surely, at a time of mental health budget pressures? Dyer is concerned about whether the funding is there, but points out that the over-representation of black people in mental health services has been ignored for far too long. “Isn’t this precisely the time to dig seriously deep for money, because the impact of austerity is creating even more mental illness as people struggle to survive?”

Ultimately, Dyer says, addressing mental health inequalities is “everyone’s business”. How will we know it’s been achieved? “When people access services much earlier, services give the black community a better deal, and we don’t have deaths in custody,” she says. Curriculum vitae

Age: 51.

Family: Single

Lives: Lambeth, London

Education: Deighton High School, Huddersfield; Huddersfield Technical College – University Access Course; Goldsmiths University (BA Hons social policy and public administration); NHSE Institute for Innovation & Improvement – Aspiring Directors Programme; Brunel University (MA social work); Preparing to Teach in the Lifelong Learning Sector (PTTLS), Level 4.

Career: 2016-present: independent health and social care consultant, NHS England; 2015–2016: vice chair, NHS England mental health taskforce; 2014-present: Elected as a Lambeth Labour councillor and vice chair, overview and scrutiny committee, London Borough of Lambeth; 2012-present: member, lived expert by experience, Time To Change Senior Management Group; 2012-2015: member, DH Ministerial Mental Health Advisory Group; 2011–2012: volunteer family support worker, HomeStart Lambeth; 2003-2007: senior mental health manager, Enfield primary care trust; 2000-2003: assertive outreach worker, Lewisham Family Health Isis; 1994 -2000: Team leader, Addaction Maya Residential Rehabilitation.

Public life: Chair, Black Thrive; Mental Health Foundation Trustee; advisory panel member, Mental Health Act Review2016-present: co-chair, Thrive London steering group; March 2013-May 2014: Chair, Myatts Field North Residents Association & PFI Monitoring Board.

Interests: Reading, travelling, films, weight training, aerobics, most music genres, community empowerment.

When do the clocks go back? Key facts about the switch to GMT

Britons will be able to enjoy an extra hour under the duvet – and reap health and cognitive bonuses – on Sunday when the clocks go back at 2am, according to sleep experts.

As daylight saving time ends, the UK will switch from British summer time (BST) to Greenwich mean time (GMT), heralding the start of lighter mornings but darker evenings.

But – according to Prof Matthew Walker, director of the Center for Human Sleep Science at Berkeley, California – a small boost to our nightly slumber can also improve memory and increase learning capacity.

Walker, who recently published Why We Sleep, a book drawing on 20 years of research and findings from his laboratory, said: “Just 60 to 90 minutes of additional sleep boosts the learning capacity of the brain, significantly increasing memory retention of facts and preventing forgetting.”

In a study published six years ago in Current Biology, Walker and a team of researchers demonstrated that during a demanding memorising task, test subjects who were allowed extra nap time performed better than those who did not.

They found the brain’s ability to learn was linked to sleep spindles: fast pulses of electricity generated during REM (rapid eye movement) sleep, which accounts for 25% of total sleep time in adult humans.

Spindle-rich sleep, which is said to occur in the second half of the night, helps with the brain’s ability to create new memories by “clearing a path to learning”.

But it is not just about improved brain power. Experiments conducted in 2013 by the Surrey Sleep Centre and the BBC showed a link between an extra hour in bed and genetic expression that helps protect against illnesses such as cancer, diabetes and stress.

Scientists at the centre in Guildford divided the participants into two groups. During the first week, one group slept for six-and-a-half hours nightly while the other had seven-and-a-half hours of sleep. The volunteers then switched their sleep patterns in the second week.

The researchers found that those who had less sleep struggled with mental agility tasks. Blood tests revealed that genes associated with processes such as inflammation, immune response and response to stress became more active for those who had less sleep.

The activity of genes associated with heart disease, diabetes and risk of cancer also increased. They found the reverse happened when the volunteers slept for an extra hour.

Meanwhile, other studies have linked extra sleep time to a lower risk of heart disease. A 2008 study published in the Journal of the American Medical Association showed that adults who slept for seven hours a night had a lower chance of having calcium deposits in their arteries than adults who had only six hours of sleep.

According to scientists from the University of Chicago, who conducted the five-year research, “the benefit of one hour of additional sleep was comparable to the gains from lowering systolic blood pressure by 17mmHg”.

Another study, published in 2012 in the Journal of Sleep Research, found that getting an extra hour of sleep significantly improved blood pressure levels among people with hypertension or pre-hypertension.

Daylight saving time has also been linked to heart attacks. In a study published in the British Medical Journal in 2014, Amneet Sandhu of the University of Colorado reported a 24% increase in heart attack admissions at hospitals in Michigan from 2010 to 2013 on the Monday after the clocks went forward in spring, when compared with other Mondays throughout the year.

In contrast, he noted a 21% decrease in heart attacks on the Tuesday in the same hospitals after the clocks moved an hour back in autumn.

Last year a poll by the Royal Society for Public Health revealed people in the UK slept an average of 6.8 hours, under-sleeping by about an hour a night.

Modern daylight saving time (DST) is a little over 100 years old. It was first proposed by a New Zealander named George Hudson in 1895 and first introduced in the city of Orillia in Ontario in 1911-12.

The idea’s big breakthrough came during the first world war when Germany introduced DST on 30 April 1916 to alleviate hardships from wartime coal shortages and air raid blackouts.

Britain, most of its allies and many European neutrals soon followed suit. Russia and a few other countries waited until the next year, and the US adopted it in 1918.

When do the clocks go back? Key facts about the switch to GMT

Britons will be able to enjoy an extra hour under the duvet – and reap health and cognitive bonuses – on Sunday when the clocks go back at 2am, according to sleep experts.

As daylight saving time ends, the UK will switch from British summer time (BST) to Greenwich mean time (GMT), heralding the start of lighter mornings but darker evenings.

But – according to Prof Matthew Walker, director of the Center for Human Sleep Science at Berkeley, California – a small boost to our nightly slumber can also improve memory and increase learning capacity.

Walker, who recently published Why We Sleep, a book drawing on 20 years of research and findings from his laboratory, said: “Just 60 to 90 minutes of additional sleep boosts the learning capacity of the brain, significantly increasing memory retention of facts and preventing forgetting.”

In a study published six years ago in Current Biology, Walker and a team of researchers demonstrated that during a demanding memorising task, test subjects who were allowed extra nap time performed better than those who did not.

They found the brain’s ability to learn was linked to sleep spindles: fast pulses of electricity generated during REM (rapid eye movement) sleep, which accounts for 25% of total sleep time in adult humans.

Spindle-rich sleep, which is said to occur in the second half of the night, helps with the brain’s ability to create new memories by “clearing a path to learning”.

But it is not just about improved brain power. Experiments conducted in 2013 by the Surrey Sleep Centre and the BBC showed a link between an extra hour in bed and genetic expression that helps protect against illnesses such as cancer, diabetes and stress.

Scientists at the centre in Guildford divided the participants into two groups. During the first week, one group slept for six-and-a-half hours nightly while the other had seven-and-a-half hours of sleep. The volunteers then switched their sleep patterns in the second week.

The researchers found that those who had less sleep struggled with mental agility tasks. Blood tests revealed that genes associated with processes such as inflammation, immune response and response to stress became more active for those who had less sleep.

The activity of genes associated with heart disease, diabetes and risk of cancer also increased. They found the reverse happened when the volunteers slept for an extra hour.

Meanwhile, other studies have linked extra sleep time to a lower risk of heart disease. A 2008 study published in the Journal of the American Medical Association showed that adults who slept for seven hours a night had a lower chance of having calcium deposits in their arteries than adults who had only six hours of sleep.

According to scientists from the University of Chicago, who conducted the five-year research, “the benefit of one hour of additional sleep was comparable to the gains from lowering systolic blood pressure by 17mmHg”.

Another study, published in 2012 in the Journal of Sleep Research, found that getting an extra hour of sleep significantly improved blood pressure levels among people with hypertension or pre-hypertension.

Daylight saving time has also been linked to heart attacks. In a study published in the British Medical Journal in 2014, Amneet Sandhu of the University of Colorado reported a 24% increase in heart attack admissions at hospitals in Michigan from 2010 to 2013 on the Monday after the clocks went forward in spring, when compared with other Mondays throughout the year.

In contrast, he noted a 21% decrease in heart attacks on the Tuesday in the same hospitals after the clocks moved an hour back in autumn.

Last year a poll by the Royal Society for Public Health revealed people in the UK slept an average of 6.8 hours, under-sleeping by about an hour a night.

Modern daylight saving time (DST) is a little over 100 years old. It was first proposed by a New Zealander named George Hudson in 1895 and first introduced in the city of Orillia in Ontario in 1911-12.

The idea’s big breakthrough came during the first world war when Germany introduced DST on 30 April 1916 to alleviate hardships from wartime coal shortages and air raid blackouts.

Britain, most of its allies and many European neutrals soon followed suit. Russia and a few other countries waited until the next year, and the US adopted it in 1918.

When do the clocks go back? Key facts about the switch to GMT

Britons will be able to enjoy an extra hour under the duvet – and reap health and cognitive bonuses – on Sunday when the clocks go back at 2am, according to sleep experts.

As daylight saving time ends, the UK will switch from British summer time (BST) to Greenwich mean time (GMT), heralding the start of lighter mornings but darker evenings.

But – according to Prof Matthew Walker, director of the Center for Human Sleep Science at Berkeley, California – a small boost to our nightly slumber can also improve memory and increase learning capacity.

Walker, who recently published Why We Sleep, a book drawing on 20 years of research and findings from his laboratory, said: “Just 60 to 90 minutes of additional sleep boosts the learning capacity of the brain, significantly increasing memory retention of facts and preventing forgetting.”

In a study published six years ago in Current Biology, Walker and a team of researchers demonstrated that during a demanding memorising task, test subjects who were allowed extra nap time performed better than those who did not.

They found the brain’s ability to learn was linked to sleep spindles: fast pulses of electricity generated during REM (rapid eye movement) sleep, which accounts for 25% of total sleep time in adult humans.

Spindle-rich sleep, which is said to occur in the second half of the night, helps with the brain’s ability to create new memories by “clearing a path to learning”.

But it is not just about improved brain power. Experiments conducted in 2013 by the Surrey Sleep Centre and the BBC showed a link between an extra hour in bed and genetic expression that helps protect against illnesses such as cancer, diabetes and stress.

Scientists at the centre in Guildford divided the participants into two groups. During the first week, one group slept for six-and-a-half hours nightly while the other had seven-and-a-half hours of sleep. The volunteers then switched their sleep patterns in the second week.

The researchers found that those who had less sleep struggled with mental agility tasks. Blood tests revealed that genes associated with processes such as inflammation, immune response and response to stress became more active for those who had less sleep.

The activity of genes associated with heart disease, diabetes and risk of cancer also increased. They found the reverse happened when the volunteers slept for an extra hour.

Meanwhile, other studies have linked extra sleep time to a lower risk of heart disease. A 2008 study published in the Journal of the American Medical Association showed that adults who slept for seven hours a night had a lower chance of having calcium deposits in their arteries than adults who had only six hours of sleep.

According to scientists from the University of Chicago, who conducted the five-year research, “the benefit of one hour of additional sleep was comparable to the gains from lowering systolic blood pressure by 17mmHg”.

Another study, published in 2012 in the Journal of Sleep Research, found that getting an extra hour of sleep significantly improved blood pressure levels among people with hypertension or pre-hypertension.

Daylight saving time has also been linked to heart attacks. In a study published in the British Medical Journal in 2014, Amneet Sandhu of the University of Colorado reported a 24% increase in heart attack admissions at hospitals in Michigan from 2010 to 2013 on the Monday after the clocks went forward in spring, when compared with other Mondays throughout the year.

In contrast, he noted a 21% decrease in heart attacks on the Tuesday in the same hospitals after the clocks moved an hour back in autumn.

Last year a poll by the Royal Society for Public Health revealed people in the UK slept an average of 6.8 hours, under-sleeping by about an hour a night.

Modern daylight saving time (DST) is a little over 100 years old. It was first proposed by a New Zealander named George Hudson in 1895 and first introduced in the city of Orillia in Ontario in 1911-12.

The idea’s big breakthrough came during the first world war when Germany introduced DST on 30 April 1916 to alleviate hardships from wartime coal shortages and air raid blackouts.

Britain, most of its allies and many European neutrals soon followed suit. Russia and a few other countries waited until the next year, and the US adopted it in 1918.

When do the clocks go back? Key facts about the switch to GMT

Britons will be able to enjoy an extra hour under the duvet – and reap health and cognitive bonuses – on Sunday when the clocks go back at 2am, according to sleep experts.

As daylight saving time ends, the UK will switch from British summer time (BST) to Greenwich mean time (GMT), heralding the start of lighter mornings but darker evenings.

But – according to Prof Matthew Walker, director of the Center for Human Sleep Science at Berkeley, California – a small boost to our nightly slumber can also improve memory and increase learning capacity.

Walker, who recently published Why We Sleep, a book drawing on 20 years of research and findings from his laboratory, said: “Just 60 to 90 minutes of additional sleep boosts the learning capacity of the brain, significantly increasing memory retention of facts and preventing forgetting.”

In a study published six years ago in Current Biology, Walker and a team of researchers demonstrated that during a demanding memorising task, test subjects who were allowed extra nap time performed better than those who did not.

They found the brain’s ability to learn was linked to sleep spindles: fast pulses of electricity generated during REM (rapid eye movement) sleep, which accounts for 25% of total sleep time in adult humans.

Spindle-rich sleep, which is said to occur in the second half of the night, helps with the brain’s ability to create new memories by “clearing a path to learning”.

But it is not just about improved brain power. Experiments conducted in 2013 by the Surrey Sleep Centre and the BBC showed a link between an extra hour in bed and genetic expression that helps protect against illnesses such as cancer, diabetes and stress.

Scientists at the centre in Guildford divided the participants into two groups. During the first week, one group slept for six-and-a-half hours nightly while the other had seven-and-a-half hours of sleep. The volunteers then switched their sleep patterns in the second week.

The researchers found that those who had less sleep struggled with mental agility tasks. Blood tests revealed that genes associated with processes such as inflammation, immune response and response to stress became more active for those who had less sleep.

The activity of genes associated with heart disease, diabetes and risk of cancer also increased. They found the reverse happened when the volunteers slept for an extra hour.

Meanwhile, other studies have linked extra sleep time to a lower risk of heart disease. A 2008 study published in the Journal of the American Medical Association showed that adults who slept for seven hours a night had a lower chance of having calcium deposits in their arteries than adults who had only six hours of sleep.

According to scientists from the University of Chicago, who conducted the five-year research, “the benefit of one hour of additional sleep was comparable to the gains from lowering systolic blood pressure by 17mmHg”.

Another study, published in 2012 in the Journal of Sleep Research, found that getting an extra hour of sleep significantly improved blood pressure levels among people with hypertension or pre-hypertension.

Daylight saving time has also been linked to heart attacks. In a study published in the British Medical Journal in 2014, Amneet Sandhu of the University of Colorado reported a 24% increase in heart attack admissions at hospitals in Michigan from 2010 to 2013 on the Monday after the clocks went forward in spring, when compared with other Mondays throughout the year.

In contrast, he noted a 21% decrease in heart attacks on the Tuesday in the same hospitals after the clocks moved an hour back in autumn.

Last year a poll by the Royal Society for Public Health revealed people in the UK slept an average of 6.8 hours, under-sleeping by about an hour a night.

Modern daylight saving time (DST) is a little over 100 years old. It was first proposed by a New Zealander named George Hudson in 1895 and first introduced in the city of Orillia in Ontario in 1911-12.

The idea’s big breakthrough came during the first world war when Germany introduced DST on 30 April 1916 to alleviate hardships from wartime coal shortages and air raid blackouts.

Britain, most of its allies and many European neutrals soon followed suit. Russia and a few other countries waited until the next year, and the US adopted it in 1918.

When do the clocks go back? Key facts about the switch to GMT

Britons will be able to enjoy an extra hour under the duvet – and reap health and cognitive bonuses – on Sunday when the clocks go back at 2am, according to sleep experts.

As daylight saving time ends, the UK will switch from British summer time (BST) to Greenwich mean time (GMT), heralding the start of lighter mornings but darker evenings.

But – according to Prof Matthew Walker, director of the Center for Human Sleep Science at Berkeley, California – a small boost to our nightly slumber can also improve memory and increase learning capacity.

Walker, who recently published Why We Sleep, a book drawing on 20 years of research and findings from his laboratory, said: “Just 60 to 90 minutes of additional sleep boosts the learning capacity of the brain, significantly increasing memory retention of facts and preventing forgetting.”

In a study published six years ago in Current Biology, Walker and a team of researchers demonstrated that during a demanding memorising task, test subjects who were allowed extra nap time performed better than those who did not.

They found the brain’s ability to learn was linked to sleep spindles: fast pulses of electricity generated during REM (rapid eye movement) sleep, which accounts for 25% of total sleep time in adult humans.

Spindle-rich sleep, which is said to occur in the second half of the night, helps with the brain’s ability to create new memories by “clearing a path to learning”.

But it is not just about improved brain power. Experiments conducted in 2013 by the Surrey Sleep Centre and the BBC showed a link between an extra hour in bed and genetic expression that helps protect against illnesses such as cancer, diabetes and stress.

Scientists at the centre in Guildford divided the participants into two groups. During the first week, one group slept for six-and-a-half hours nightly while the other had seven-and-a-half hours of sleep. The volunteers then switched their sleep patterns in the second week.

The researchers found that those who had less sleep struggled with mental agility tasks. Blood tests revealed that genes associated with processes such as inflammation, immune response and response to stress became more active for those who had less sleep.

The activity of genes associated with heart disease, diabetes and risk of cancer also increased. They found the reverse happened when the volunteers slept for an extra hour.

Meanwhile, other studies have linked extra sleep time to a lower risk of heart disease. A 2008 study published in the Journal of the American Medical Association showed that adults who slept for seven hours a night had a lower chance of having calcium deposits in their arteries than adults who had only six hours of sleep.

According to scientists from the University of Chicago, who conducted the five-year research, “the benefit of one hour of additional sleep was comparable to the gains from lowering systolic blood pressure by 17mmHg”.

Another study, published in 2012 in the Journal of Sleep Research, found that getting an extra hour of sleep significantly improved blood pressure levels among people with hypertension or pre-hypertension.

Daylight saving time has also been linked to heart attacks. In a study published in the British Medical Journal in 2014, Amneet Sandhu of the University of Colorado reported a 24% increase in heart attack admissions at hospitals in Michigan from 2010 to 2013 on the Monday after the clocks went forward in spring, when compared with other Mondays throughout the year.

In contrast, he noted a 21% decrease in heart attacks on the Tuesday in the same hospitals after the clocks moved an hour back in autumn.

Last year a poll by the Royal Society for Public Health revealed people in the UK slept an average of 6.8 hours, under-sleeping by about an hour a night.

Modern daylight saving time (DST) is a little over 100 years old. It was first proposed by a New Zealander named George Hudson in 1895 and first introduced in the city of Orillia in Ontario in 1911-12.

The idea’s big breakthrough came during the first world war when Germany introduced DST on 30 April 1916 to alleviate hardships from wartime coal shortages and air raid blackouts.

Britain, most of its allies and many European neutrals soon followed suit. Russia and a few other countries waited until the next year, and the US adopted it in 1918.

When do the clocks go back? Key facts about the switch to GMT

Britons will be able to enjoy an extra hour under the duvet – and reap health and cognitive bonuses – on Sunday when the clocks go back at 2am, according to sleep experts.

As daylight saving time ends, the UK will switch from British summer time (BST) to Greenwich mean time (GMT), heralding the start of lighter mornings but darker evenings.

But – according to Prof Matthew Walker, director of the Center for Human Sleep Science at Berkeley, California – a small boost to our nightly slumber can also improve memory and increase learning capacity.

Walker, who recently published Why We Sleep, a book drawing on 20 years of research and findings from his laboratory, said: “Just 60 to 90 minutes of additional sleep boosts the learning capacity of the brain, significantly increasing memory retention of facts and preventing forgetting.”

In a study published six years ago in Current Biology, Walker and a team of researchers demonstrated that during a demanding memorising task, test subjects who were allowed extra nap time performed better than those who did not.

They found the brain’s ability to learn was linked to sleep spindles: fast pulses of electricity generated during REM (rapid eye movement) sleep, which accounts for 25% of total sleep time in adult humans.

Spindle-rich sleep, which is said to occur in the second half of the night, helps with the brain’s ability to create new memories by “clearing a path to learning”.

But it is not just about improved brain power. Experiments conducted in 2013 by the Surrey Sleep Centre and the BBC showed a link between an extra hour in bed and genetic expression that helps protect against illnesses such as cancer, diabetes and stress.

Scientists at the centre in Guildford divided the participants into two groups. During the first week, one group slept for six-and-a-half hours nightly while the other had seven-and-a-half hours of sleep. The volunteers then switched their sleep patterns in the second week.

The researchers found that those who had less sleep struggled with mental agility tasks. Blood tests revealed that genes associated with processes such as inflammation, immune response and response to stress became more active for those who had less sleep.

The activity of genes associated with heart disease, diabetes and risk of cancer also increased. They found the reverse happened when the volunteers slept for an extra hour.

Meanwhile, other studies have linked extra sleep time to a lower risk of heart disease. A 2008 study published in the Journal of the American Medical Association showed that adults who slept for seven hours a night had a lower chance of having calcium deposits in their arteries than adults who had only six hours of sleep.

According to scientists from the University of Chicago, who conducted the five-year research, “the benefit of one hour of additional sleep was comparable to the gains from lowering systolic blood pressure by 17mmHg”.

Another study, published in 2012 in the Journal of Sleep Research, found that getting an extra hour of sleep significantly improved blood pressure levels among people with hypertension or pre-hypertension.

Daylight saving time has also been linked to heart attacks. In a study published in the British Medical Journal in 2014, Amneet Sandhu of the University of Colorado reported a 24% increase in heart attack admissions at hospitals in Michigan from 2010 to 2013 on the Monday after the clocks went forward in spring, when compared with other Mondays throughout the year.

In contrast, he noted a 21% decrease in heart attacks on the Tuesday in the same hospitals after the clocks moved an hour back in autumn.

Last year a poll by the Royal Society for Public Health revealed people in the UK slept an average of 6.8 hours, under-sleeping by about an hour a night.

Modern daylight saving time (DST) is a little over 100 years old. It was first proposed by a New Zealander named George Hudson in 1895 and first introduced in the city of Orillia in Ontario in 1911-12.

The idea’s big breakthrough came during the first world war when Germany introduced DST on 30 April 1916 to alleviate hardships from wartime coal shortages and air raid blackouts.

Britain, most of its allies and many European neutrals soon followed suit. Russia and a few other countries waited until the next year, and the US adopted it in 1918.