Tag Archives: great

‘He is the great survivor’: Jeremy Hunt’s ascendancy

In January this year, Jeremy Hunt’s days as health secretary appeared to be numbered. He walked into Number 10, his regular NHS pin badge missing from his lapel, as rumours swirled that he was facing demotion to the business department. Two hours later, he emerged from his meeting with Theresa May not only still in post, but with a beefed-up brief to cover social care.

Now Hunt has secured a funding boost for the NHS well beyond expectations, and has become the longest serving health secretary in history. His longevity is so remarkable that even May has taken to teasing him about it. At a journalists’ dinner earlier this year, she joked that if Jeremy Corbyn became prime minister she would be “breaking rocks in John McDonnell’s re-education camp … But of course, Jeremy Hunt would still be health secretary.”

Q&A

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

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

Read a full Q&A on the NHS winter crisis

Hunt’s renaissance has been a triumph in its own right. But it has also led many observers to ask if the MP for South West Surrey has an even bigger job in his sights. With the funding battle behind him, few Conservatives would be surprised if Hunt’s ambitions turned from the health service’s future to his own – in No 10.

“He’s on manoeuvres, there’s no doubt,” one senior backbench MP said. “The question is how far he is really prepared to push it.”

Even those outside of his party acknowledge his ascendancy. “Jeremy Hunt is in a very powerful position now, the only question is how much he chooses to deploy that power,” his former Lib Dem junior minister Norman Lamb said. “He is the great survivor. He has a skill for seeing off political disasters.”

Lamb said Hunt now felt far more confident to make spending demands public. “We all know it’s pretty much impossible to get sacked these days so he can choose to be much more vocal about it,” he said. “Ultimately, it doesn’t go far enough, there’s no certainty about where the money is coming from and it does all feel quite fragile, but it is a significant shift.”

NHS bosses who until recently viewed Hunt with disdain are now full of praise for his dogged, and ultimately successful, campaign to be the first public service to be taken out of the austerity straitjacket. David Nicholson, the former NHS chief executive in England, tweeted some personal praise – “Longevity has its benefits.”

“I’m not usually Hunt’s biggest fan but he’s played a bit of a blinder, you have to say,” a senior NHS official said. “When May came into No10 in 2016, she was very hostile to the NHS, so for Hunt to win her round was remarkable.”

His friends say Hunt, whose NHS lapel pin is firmly back on, is “genuinely passionate” about getting the right resources for the NHS.

Q&A

Does the UK have enough doctors and nurses?

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

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

Read a full Q&A on the NHS winter crisis

An ally of Hunt, who saw the negotiations with Hammond up close, said: “For Hunt, this was not about helping the NHS but also about his moment in history. If it had been only 1.5%, he would have walked. Now he’s going to be the health secretary at the NHS’s birthday and is the one who has taken the NHS out of austerity.”

One of the health policy experts Hunt used to help him build his case was struck by how some of those around him saw him winning £20bn more for the NHS as, in part at least, also his pitch as a potential future Tory leader.

“Brexit’s paralysis of most normal government business means few ministers are actually able to get anything major achieved in their areas. In a future leadership contest, Hunt will be able to say ‘I saved the NHS’, which is no small thing,” he said.

Hunt seriously considered a bid for the leadership in 2016 after David Cameron stood down but did not have the support to mount a realistic bid, having taken a daily battering for his handling of the junior doctors strikes. He was a vocal supporter of remain during the referendum but two years of EU negotiations later, Hunt told LBC he was now a Brexit convert, because of the “arrogance” of the EU Commission’s approach.

A number of Conservative backbenchers said they had begun to see him as a more plausible “unity candidate” than many of his main cabinet rivals.

Tory MPs said they understood Hunt would be highly unlikely to challenge May and would only consider a run should a vacancy arise. One source said Hunt was effusively supportive of May in front of colleagues at cabinet. “He spends a lot of his time saying how great the PM is,” one cabinet minister said.

Several MPs have floated the theory that Hunt is now one of the two most plausible “born-again Brexiter” candidates, alongside new home secretary Sajid Javid.

“Jeremy’s stock is undervalued and Sajid’s is overvalued,” another Tory MP said. “Sometimes colleagues look confused when you mention his name, but that could be because they’ve never really thought about it, not that they are against it.

“You need to have someone who can expand their appeal. Jeremy has a lot of people you could potentially add to his tally, you can’t really say that about Sajid and you definitely can’t say that about Michael Gove.”

Embracing Brexit at this late stage is not a universally popular tactic, however. “To be honest, that actually makes me think less of him, not more,” one minister said.

Another move that has piqued colleagues’ interest is his emerging role as “minister for the Today programme”, a role once held by Michael Fallon, as the government’s most trusted attack dog. With Fallon gone, Hunt was the man sent out on the airwaves after the messy departure of Damian Green.

His main obstacle to Number 10, at least at an election, is his public image which he will hope the funding boost can repair.

As culture secretary, he only narrowly survived a Leveson inquiry examination into his relationship with James Murdoch. He is a multi-millionaire, made from the sale of the website he co-founded, Hotcourses, before making the leap into politics, and his finances have come under fire, most recently for failing to declare the purchase of seven luxury flats. His tenure in the health department saw the first strikes by NHS doctors in 40 years. .

There are tough battles to come for Hunt, especially on social care reform which may prove even more difficult given the Tories’ toxic “dementia tax” policy from the election. One Whitehall source said Hunt probably felt less personally attached to social care reform than NHS funding, but knew he needed to confront it.

Lamb said Hunt needed to prove he could be just as bullish on social care reform and funding. “He absolutely has to turn his attention to social care now. He has said it will need more money. But now they need to deliver.”

“He is a very, very ambitious man, but he does really care too about a properly funded NHS and he doesn’t mind if he has to carry quite a lot of shit to see it through,” the Whitehall source said.

“He has fought really hard for this victory and he now has that stable relationship with the health service. When you have that, it gives you space to start thinking longer-term.”

Mental health: awareness is great, but action is essential | Dean Burnett

It’s mental health awareness week, 2018. And that’s good. It’s important to be aware of something that affects literally everyone, and that a quarter of the population regularly struggle with. It’s weird that anyone wouldn’t be when you put it in those terms, but that does seem to the case.

Perhaps the term is a bit misleading, or not specific enough. It’s not exactly mental health that people need to be made aware of, so much as the fact that mental health can, and regularly does, go wrong. And when someone’s mental health does falter or fail, they should receive the same concern and help that someone with a more obvious “physical” ailment should get, not scorn and stigma, as often happens.

This is where awareness helps. If you end up with depression, anxiety, OCD or any other condition, it can be hugely debilitating, often consuming your daily existence. Having someone, be they a family member or total stranger, dismiss it outright or accuse you of “faking it” or similar can only make it worse, compounding the problem.

This is how campaigns to raise awareness of the issues can be beneficial. Just like how increased exposure to people of different ethnicities or backgrounds has been shown to reduced feelings of prejudice and suspicion, so increased exposure to, or discussions about, mental health problems and what they mean for those who deal with them can enhance the understanding, or even just the patience, of those who don’t have to.

The human brain, powerful as it is, can still be overwhelmed by the complex world we inhabit, so when it comes to creating mental models of how the world works, it operates a general “stick to what you know” policy. As such, things that are different or unfamiliar, especially if they’re confusing and uncertain or introduce an element of perceived threat or danger, are met with suspicion, doubt, dismissal and so on. All are defence mechanisms, in a way; it’s the brain saying “this is NOT how the world is meant to work, so I must dismiss this challenging new information”.

But the brain is not that inflexible. Our idea of how the world (and those in it) works is adaptable and ever-updating, based on what we experience in our day-to-day lives. And if those experiences involve people discussing mental health and the issues around it, that’s more likely to become part of how we see the world and so has less chance of unsettling us overall.

Woman with her head in her hands as levels of anxiety among British people are rising, a mental health charity has warned. PRESS ASSOCIATION Photo. Issue date: Monday May 12, 2014. Almost one in five people from around the UK feels anxious a lot or all the time, the Mental Health Foundation said. A survey conducted by the charity found that almost half of Britons feel more anxious than they used to. Around three-fifths of the 2,300 British adults polled said that they experience anxiety on a daily basis.


There have been many years of progress, but still the most common image in any mental health search is the classic ‘headclutcher’. Photograph: David Cheskin/PA

This is especially important for mental health, as opposed to more physical ailments, because mental health problems often affect people’s minds and understanding rather than their bodies (although there’s copious overlap). Basically, someone experiencing a mental health problem or crisis may not realise this. Many need help and assistance to even accept they have an issue that requires dealing with. And the more there are people around them who are “aware” of mental health problems and how they manifest, the more likely this assistance is.

So, yes. Mental health awareness is good.

But it’s not an answer in and of itself. And it can actually be detrimental in some circumstances.

The main problem is, the human brain is very good at becoming aware of things, but it’s a lot harder for this awareness to lead to changes in behaviour. Abstract concepts and understanding can be useful, but things that cause strong sensory or emotional reactions carry more “weight” as far as our grey matter is concerned. For instance, dieting is hard because although we know the risks of high-calorie foods etc, we like pizza and cake. The sensory pleasure you get from the latter often outweighs the intangible understanding of the former when it comes to deciding what to do and what decisions to make. Cigarette packaging has been emblazoned with images of the ghastly consequences smoking can have for years, and yet smoking is still pretty common.

Similarly, having an abstract awareness of mental health issues does not automatically translate to a willingness or ability to do anything about them. Someone may be newly aware of what’s happening when a friend is in the grips of depression, but they could also be aware that helping them is likely to be demanding, stressful and largely unrewarding. The latter could well be what sways their behaviour, compelling them to keep their distance rather than intervene.

The point is, raising awareness of mental health is all well and good, but it doesn’t automatically follow that the problems and concerns around mental health will be affected in any appreciable way. Many people are “aware” that their clothes are probably made in sweatshops, or that their elected leaders are corrupt, or that their car is harming the environment, but do little or nothing about these things.

Prozac capsules


Often the discussion around mental health turns into one about the pros and cons of medication, but many people struggle to get to the point where that’s even an option. Photograph: Alamy Stock Photo

The danger essentially lies in people thinking “raising awareness” is sufficient to deal with the issue, whatever it may be. In most cases, it isn’t. And this isn’t ideal. It’s a common complaint, about the people who, following a tragedy, change their profile pic on Facebook, or tweet “thoughts and prayers”, or sign a petition, or what have you. While an action like that may be 100% well intended, all it really achieves is making the individual feel better because they’ve “done something”. A sense of control in the face of unpleasant events in the world is restored: a sense of achievement at getting something “out there”. But in real-world terms, it changes nothing. And people feeling like they’ve done something when they haven’t is counterproductive when it comes to dealing with big, complex problems like mental health, because they’re less likely to feel motivated to do something else. Something that may be genuinely useful.

Essentially, mental health awareness is fine, but action is what’s actually needed. Awareness is great for prompting those with issues to seek help, but effectively meaningless if there’s no help available. And with ongoing cuts and shocking provisions to mental health services, that’s where the real problems lie.

If mental health awareness can be channelled in to actually dealing with the issues around it, then that would be great. But raising awareness is just the start of the process, not the end. There’s a lot of work that needs doing here. And that’s something we should all be aware of.

Dean Burnett discusses these issues further in his new book The Happy Brain and his previous book The Idiot Brain, both available now.

Mental health: awareness is great, but action is essential | Dean Burnett

It’s mental health awareness week, 2018. And that’s good. It’s important to be aware of something that affects literally everyone, and that a quarter of the population regularly struggle with. It’s weird that anyone wouldn’t be when you put it in those terms, but that does seem to the case.

Perhaps the term is a bit misleading, or not specific enough. It’s not exactly mental health that people need to be made aware of, so much as the fact that mental health can, and regularly does, go wrong. And when someone’s mental health does falter or fail, they should receive the same concern and help that someone with a more obvious “physical” ailment should get, not scorn and stigma, as often happens.

This is where awareness helps. If you end up with depression, anxiety, OCD or any other condition, it can be hugely debilitating, often consuming your daily existence. Having someone, be they a family member or total stranger, dismiss it outright or accuse you of “faking it” or similar can only make it worse, compounding the problem.

This is how campaigns to raise awareness of the issues can be beneficial. Just like how increased exposure to people of different ethnicities or backgrounds has been shown to reduced feelings of prejudice and suspicion, so increased exposure to, or discussions about, mental health problems and what they mean for those who deal with them can enhance the understanding, or even just the patience, of those who don’t have to.

The human brain, powerful as it is, can still be overwhelmed by the complex world we inhabit, so when it comes to creating mental models of how the world works, it operates a general “stick to what you know” policy. As such, things that are different or unfamiliar, especially if they’re confusing and uncertain or introduce an element of perceived threat or danger, are met with suspicion, doubt, dismissal and so on. All are defence mechanisms, in a way; it’s the brain saying “this is NOT how the world is meant to work, so I must dismiss this challenging new information”.

But the brain is not that inflexible. Our idea of how the world (and those in it) works is adaptable and ever-updating, based on what we experience in our day-to-day lives. And if those experiences involve people discussing mental health and the issues around it, that’s more likely to become part of how we see the world and so has less chance of unsettling us overall.

Woman with her head in her hands as levels of anxiety among British people are rising, a mental health charity has warned. PRESS ASSOCIATION Photo. Issue date: Monday May 12, 2014. Almost one in five people from around the UK feels anxious a lot or all the time, the Mental Health Foundation said. A survey conducted by the charity found that almost half of Britons feel more anxious than they used to. Around three-fifths of the 2,300 British adults polled said that they experience anxiety on a daily basis.


There have been many years of progress, but still the most common image in any mental health search is the classic ‘headclutcher’. Photograph: David Cheskin/PA

This is especially important for mental health, as opposed to more physical ailments, because mental health problems often affect people’s minds and understanding rather than their bodies (although there’s copious overlap). Basically, someone experiencing a mental health problem or crisis may not realise this. Many need help and assistance to even accept they have an issue that requires dealing with. And the more there are people around them who are “aware” of mental health problems and how they manifest, the more likely this assistance is.

So, yes. Mental health awareness is good.

But it’s not an answer in and of itself. And it can actually be detrimental in some circumstances.

The main problem is, the human brain is very good at becoming aware of things, but it’s a lot harder for this awareness to lead to changes in behaviour. Abstract concepts and understanding can be useful, but things that cause strong sensory or emotional reactions carry more “weight” as far as our grey matter is concerned. For instance, dieting is hard because although we know the risks of high-calorie foods etc, we like pizza and cake. The sensory pleasure you get from the latter often outweighs the intangible understanding of the former when it comes to deciding what to do and what decisions to make. Cigarette packaging has been emblazoned with images of the ghastly consequences smoking can have for years, and yet smoking is still pretty common.

Similarly, having an abstract awareness of mental health issues does not automatically translate to a willingness or ability to do anything about them. Someone may be newly aware of what’s happening when a friend is in the grips of depression, but they could also be aware that helping them is likely to be demanding, stressful and largely unrewarding. The latter could well be what sways their behaviour, compelling them to keep their distance rather than intervene.

The point is, raising awareness of mental health is all well and good, but it doesn’t automatically follow that the problems and concerns around mental health will be affected in any appreciable way. Many people are “aware” that their clothes are probably made in sweatshops, or that their elected leaders are corrupt, or that their car is harming the environment, but do little or nothing about these things.

Prozac capsules


Often the discussion around mental health turns into one about the pros and cons of medication, but many people struggle to get to the point where that’s even an option. Photograph: Alamy Stock Photo

The danger essentially lies in people thinking “raising awareness” is sufficient to deal with the issue, whatever it may be. In most cases, it isn’t. And this isn’t ideal. It’s a common complaint, about the people who, following a tragedy, change their profile pic on Facebook, or tweet “thoughts and prayers”, or sign a petition, or what have you. While an action like that may be 100% well intended, all it really achieves is making the individual feel better because they’ve “done something”. A sense of control in the face of unpleasant events in the world is restored: a sense of achievement at getting something “out there”. But in real-world terms, it changes nothing. And people feeling like they’ve done something when they haven’t is counterproductive when it comes to dealing with big, complex problems like mental health, because they’re less likely to feel motivated to do something else. Something that may be genuinely useful.

Essentially, mental health awareness is fine, but action is what’s actually needed. Awareness is great for prompting those with issues to seek help, but effectively meaningless if there’s no help available. And with ongoing cuts and shocking provisions to mental health services, that’s where the real problems lie.

If mental health awareness can be channelled in to actually dealing with the issues around it, then that would be great. But raising awareness is just the start of the process, not the end. There’s a lot of work that needs doing here. And that’s something we should all be aware of.

Dean Burnett discusses these issues further in his new book The Happy Brain and his previous book The Idiot Brain, both available now.

Mental health: awareness is great, but action is essential | Dean Burnett

It’s mental health awareness week, 2018. And that’s good. It’s important to be aware of something that affects literally everyone, and that a quarter of the population regularly struggle with. It’s weird that anyone wouldn’t be when you put it in those terms, but that does seem to the case.

Perhaps the term is a bit misleading, or not specific enough. It’s not exactly mental health that people need to be made aware of, so much as the fact that mental health can, and regularly does, go wrong. And when someone’s mental health does falter or fail, they should receive the same concern and help that someone with a more obvious “physical” ailment should get, not scorn and stigma, as often happens.

This is where awareness helps. If you end up with depression, anxiety, OCD or any other condition, it can be hugely debilitating, often consuming your daily existence. Having someone, be they a family member or total stranger, dismiss it outright or accuse you of “faking it” or similar can only make it worse, compounding the problem.

This is how campaigns to raise awareness of the issues can be beneficial. Just like how increased exposure to people of different ethnicities or backgrounds has been shown to reduced feelings of prejudice and suspicion, so increased exposure to, or discussions about, mental health problems and what they mean for those who deal with them can enhance the understanding, or even just the patience, of those who don’t have to.

The human brain, powerful as it is, can still be overwhelmed by the complex world we inhabit, so when it comes to creating mental models of how the world works, it operates a general “stick to what you know” policy. As such, things that are different or unfamiliar, especially if they’re confusing and uncertain or introduce an element of perceived threat or danger, are met with suspicion, doubt, dismissal and so on. All are defence mechanisms, in a way; it’s the brain saying “this is NOT how the world is meant to work, so I must dismiss this challenging new information”.

But the brain is not that inflexible. Our idea of how the world (and those in it) works is adaptable and ever-updating, based on what we experience in our day-to-day lives. And if those experiences involve people discussing mental health and the issues around it, that’s more likely to become part of how we see the world and so has less chance of unsettling us overall.

Woman with her head in her hands as levels of anxiety among British people are rising, a mental health charity has warned. PRESS ASSOCIATION Photo. Issue date: Monday May 12, 2014. Almost one in five people from around the UK feels anxious a lot or all the time, the Mental Health Foundation said. A survey conducted by the charity found that almost half of Britons feel more anxious than they used to. Around three-fifths of the 2,300 British adults polled said that they experience anxiety on a daily basis.


There have been many years of progress, but still the most common image in any mental health search is the classic ‘headclutcher’. Photograph: David Cheskin/PA

This is especially important for mental health, as opposed to more physical ailments, because mental health problems often affect people’s minds and understanding rather than their bodies (although there’s copious overlap). Basically, someone experiencing a mental health problem or crisis may not realise this. Many need help and assistance to even accept they have an issue that requires dealing with. And the more there are people around them who are “aware” of mental health problems and how they manifest, the more likely this assistance is.

So, yes. Mental health awareness is good.

But it’s not an answer in and of itself. And it can actually be detrimental in some circumstances.

The main problem is, the human brain is very good at becoming aware of things, but it’s a lot harder for this awareness to lead to changes in behaviour. Abstract concepts and understanding can be useful, but things that cause strong sensory or emotional reactions carry more “weight” as far as our grey matter is concerned. For instance, dieting is hard because although we know the risks of high-calorie foods etc, we like pizza and cake. The sensory pleasure you get from the latter often outweighs the intangible understanding of the former when it comes to deciding what to do and what decisions to make. Cigarette packaging has been emblazoned with images of the ghastly consequences smoking can have for years, and yet smoking is still pretty common.

Similarly, having an abstract awareness of mental health issues does not automatically translate to a willingness or ability to do anything about them. Someone may be newly aware of what’s happening when a friend is in the grips of depression, but they could also be aware that helping them is likely to be demanding, stressful and largely unrewarding. The latter could well be what sways their behaviour, compelling them to keep their distance rather than intervene.

The point is, raising awareness of mental health is all well and good, but it doesn’t automatically follow that the problems and concerns around mental health will be affected in any appreciable way. Many people are “aware” that their clothes are probably made in sweatshops, or that their elected leaders are corrupt, or that their car is harming the environment, but do little or nothing about these things.

Prozac capsules


Often the discussion around mental health turns into one about the pros and cons of medication, but many people struggle to get to the point where that’s even an option. Photograph: Alamy Stock Photo

The danger essentially lies in people thinking “raising awareness” is sufficient to deal with the issue, whatever it may be. In most cases, it isn’t. And this isn’t ideal. It’s a common complaint, about the people who, following a tragedy, change their profile pic on Facebook, or tweet “thoughts and prayers”, or sign a petition, or what have you. While an action like that may be 100% well intended, all it really achieves is making the individual feel better because they’ve “done something”. A sense of control in the face of unpleasant events in the world is restored: a sense of achievement at getting something “out there”. But in real-world terms, it changes nothing. And people feeling like they’ve done something when they haven’t is counterproductive when it comes to dealing with big, complex problems like mental health, because they’re less likely to feel motivated to do something else. Something that may be genuinely useful.

Essentially, mental health awareness is fine, but action is what’s actually needed. Awareness is great for prompting those with issues to seek help, but effectively meaningless if there’s no help available. And with ongoing cuts and shocking provisions to mental health services, that’s where the real problems lie.

If mental health awareness can be channelled in to actually dealing with the issues around it, then that would be great. But raising awareness is just the start of the process, not the end. There’s a lot of work that needs doing here. And that’s something we should all be aware of.

Dean Burnett discusses these issues further in his new book The Happy Brain and his previous book The Idiot Brain, both available now.

Mental health: awareness is great, but action is essential | Dean Burnett

It’s mental health awareness week, 2018. And that’s good. It’s important to be aware of something that affects literally everyone, and that a quarter of the population regularly struggle with. It’s weird that anyone wouldn’t be when you put it in those terms, but that does seem to the case.

Perhaps the term is a bit misleading, or not specific enough. It’s not exactly mental health that people need to be made aware of, so much as the fact that mental health can, and regularly does, go wrong. And when someone’s mental health does falter or fail, they should receive the same concern and help that someone with a more obvious “physical” ailment should get, not scorn and stigma, as often happens.

This is where awareness helps. If you end up with depression, anxiety, OCD or any other condition, it can be hugely debilitating, often consuming your daily existence. Having someone, be they a family member or total stranger, dismiss it outright or accuse you of “faking it” or similar can only make it worse, compounding the problem.

This is how campaigns to raise awareness of the issues can be beneficial. Just like how increased exposure to people of different ethnicities or backgrounds has been shown to reduced feelings of prejudice and suspicion, so increased exposure to, or discussions about, mental health problems and what they mean for those who deal with them can enhance the understanding, or even just the patience, of those who don’t have to.

The human brain, powerful as it is, can still be overwhelmed by the complex world we inhabit, so when it comes to creating mental models of how the world works, it operates a general “stick to what you know” policy. As such, things that are different or unfamiliar, especially if they’re confusing and uncertain or introduce an element of perceived threat or danger, are met with suspicion, doubt, dismissal and so on. All are defence mechanisms, in a way; it’s the brain saying “this is NOT how the world is meant to work, so I must dismiss this challenging new information”.

But the brain is not that inflexible. Our idea of how the world (and those in it) works is adaptable and ever-updating, based on what we experience in our day-to-day lives. And if those experiences involve people discussing mental health and the issues around it, that’s more likely to become part of how we see the world and so has less chance of unsettling us overall.

Woman with her head in her hands as levels of anxiety among British people are rising, a mental health charity has warned. PRESS ASSOCIATION Photo. Issue date: Monday May 12, 2014. Almost one in five people from around the UK feels anxious a lot or all the time, the Mental Health Foundation said. A survey conducted by the charity found that almost half of Britons feel more anxious than they used to. Around three-fifths of the 2,300 British adults polled said that they experience anxiety on a daily basis.


There have been many years of progress, but still the most common image in any mental health search is the classic ‘headclutcher’. Photograph: David Cheskin/PA

This is especially important for mental health, as opposed to more physical ailments, because mental health problems often affect people’s minds and understanding rather than their bodies (although there’s copious overlap). Basically, someone experiencing a mental health problem or crisis may not realise this. Many need help and assistance to even accept they have an issue that requires dealing with. And the more there are people around them who are “aware” of mental health problems and how they manifest, the more likely this assistance is.

So, yes. Mental health awareness is good.

But it’s not an answer in and of itself. And it can actually be detrimental in some circumstances.

The main problem is, the human brain is very good at becoming aware of things, but it’s a lot harder for this awareness to lead to changes in behaviour. Abstract concepts and understanding can be useful, but things that cause strong sensory or emotional reactions carry more “weight” as far as our grey matter is concerned. For instance, dieting is hard because although we know the risks of high-calorie foods etc, we like pizza and cake. The sensory pleasure you get from the latter often outweighs the intangible understanding of the former when it comes to deciding what to do and what decisions to make. Cigarette packaging has been emblazoned with images of the ghastly consequences smoking can have for years, and yet smoking is still pretty common.

Similarly, having an abstract awareness of mental health issues does not automatically translate to a willingness or ability to do anything about them. Someone may be newly aware of what’s happening when a friend is in the grips of depression, but they could also be aware that helping them is likely to be demanding, stressful and largely unrewarding. The latter could well be what sways their behaviour, compelling them to keep their distance rather than intervene.

The point is, raising awareness of mental health is all well and good, but it doesn’t automatically follow that the problems and concerns around mental health will be affected in any appreciable way. Many people are “aware” that their clothes are probably made in sweatshops, or that their elected leaders are corrupt, or that their car is harming the environment, but do little or nothing about these things.

Prozac capsules


Often the discussion around mental health turns into one about the pros and cons of medication, but many people struggle to get to the point where that’s even an option. Photograph: Alamy Stock Photo

The danger essentially lies in people thinking “raising awareness” is sufficient to deal with the issue, whatever it may be. In most cases, it isn’t. And this isn’t ideal. It’s a common complaint, about the people who, following a tragedy, change their profile pic on Facebook, or tweet “thoughts and prayers”, or sign a petition, or what have you. While an action like that may be 100% well intended, all it really achieves is making the individual feel better because they’ve “done something”. A sense of control in the face of unpleasant events in the world is restored: a sense of achievement at getting something “out there”. But in real-world terms, it changes nothing. And people feeling like they’ve done something when they haven’t is counterproductive when it comes to dealing with big, complex problems like mental health, because they’re less likely to feel motivated to do something else. Something that may be genuinely useful.

Essentially, mental health awareness is fine, but action is what’s actually needed. Awareness is great for prompting those with issues to seek help, but effectively meaningless if there’s no help available. And with ongoing cuts and shocking provisions to mental health services, that’s where the real problems lie.

If mental health awareness can be channelled in to actually dealing with the issues around it, then that would be great. But raising awareness is just the start of the process, not the end. There’s a lot of work that needs doing here. And that’s something we should all be aware of.

Dean Burnett discusses these issues further in his new book The Happy Brain and his previous book The Idiot Brain, both available now.

Mental health: awareness is great, but action is essential | Dean Burnett

It’s mental health awareness week, 2018. And that’s good. It’s important to be aware of something that affects literally everyone, and that a quarter of the population regularly struggle with. It’s weird that anyone wouldn’t be when you put it in those terms, but that does seem to the case.

Perhaps the term is a bit misleading, or not specific enough. It’s not exactly mental health that people need to be made aware of, so much as the fact that mental health can, and regularly does, go wrong. And when someone’s mental health does falter or fail, they should receive the same concern and help that someone with a more obvious “physical” ailment should get, not scorn and stigma, as often happens.

This is where awareness helps. If you end up with depression, anxiety, OCD or any other condition, it can be hugely debilitating, often consuming your daily existence. Having someone, be they a family member or total stranger, dismiss it outright or accuse you of “faking it” or similar can only make it worse, compounding the problem.

This is how campaigns to raise awareness of the issues can be beneficial. Just like how increased exposure to people of different ethnicities or backgrounds has been shown to reduced feelings of prejudice and suspicion, so increased exposure to, or discussions about, mental health problems and what they mean for those who deal with them can enhance the understanding, or even just the patience, of those who don’t have to.

The human brain, powerful as it is, can still be overwhelmed by the complex world we inhabit, so when it comes to creating mental models of how the world works, it operates a general “stick to what you know” policy. As such, things that are different or unfamiliar, especially if they’re confusing and uncertain or introduce an element of perceived threat or danger, are met with suspicion, doubt, dismissal and so on. All are defence mechanisms, in a way; it’s the brain saying “this is NOT how the world is meant to work, so I must dismiss this challenging new information”.

But the brain is not that inflexible. Our idea of how the world (and those in it) works is adaptable and ever-updating, based on what we experience in our day-to-day lives. And if those experiences involve people discussing mental health and the issues around it, that’s more likely to become part of how we see the world and so has less chance of unsettling us overall.

Woman with her head in her hands as levels of anxiety among British people are rising, a mental health charity has warned. PRESS ASSOCIATION Photo. Issue date: Monday May 12, 2014. Almost one in five people from around the UK feels anxious a lot or all the time, the Mental Health Foundation said. A survey conducted by the charity found that almost half of Britons feel more anxious than they used to. Around three-fifths of the 2,300 British adults polled said that they experience anxiety on a daily basis.


There have been many years of progress, but still the most common image in any mental health search is the classic ‘headclutcher’. Photograph: David Cheskin/PA

This is especially important for mental health, as opposed to more physical ailments, because mental health problems often affect people’s minds and understanding rather than their bodies (although there’s copious overlap). Basically, someone experiencing a mental health problem or crisis may not realise this. Many need help and assistance to even accept they have an issue that requires dealing with. And the more there are people around them who are “aware” of mental health problems and how they manifest, the more likely this assistance is.

So, yes. Mental health awareness is good.

But it’s not an answer in and of itself. And it can actually be detrimental in some circumstances.

The main problem is, the human brain is very good at becoming aware of things, but it’s a lot harder for this awareness to lead to changes in behaviour. Abstract concepts and understanding can be useful, but things that cause strong sensory or emotional reactions carry more “weight” as far as our grey matter is concerned. For instance, dieting is hard because although we know the risks of high-calorie foods etc, we like pizza and cake. The sensory pleasure you get from the latter often outweighs the intangible understanding of the former when it comes to deciding what to do and what decisions to make. Cigarette packaging has been emblazoned with images of the ghastly consequences smoking can have for years, and yet smoking is still pretty common.

Similarly, having an abstract awareness of mental health issues does not automatically translate to a willingness or ability to do anything about them. Someone may be newly aware of what’s happening when a friend is in the grips of depression, but they could also be aware that helping them is likely to be demanding, stressful and largely unrewarding. The latter could well be what sways their behaviour, compelling them to keep their distance rather than intervene.

The point is, raising awareness of mental health is all well and good, but it doesn’t automatically follow that the problems and concerns around mental health will be affected in any appreciable way. Many people are “aware” that their clothes are probably made in sweatshops, or that their elected leaders are corrupt, or that their car is harming the environment, but do little or nothing about these things.

Prozac capsules


Often the discussion around mental health turns into one about the pros and cons of medication, but many people struggle to get to the point where that’s even an option. Photograph: Alamy Stock Photo

The danger essentially lies in people thinking “raising awareness” is sufficient to deal with the issue, whatever it may be. In most cases, it isn’t. And this isn’t ideal. It’s a common complaint, about the people who, following a tragedy, change their profile pic on Facebook, or tweet “thoughts and prayers”, or sign a petition, or what have you. While an action like that may be 100% well intended, all it really achieves is making the individual feel better because they’ve “done something”. A sense of control in the face of unpleasant events in the world is restored: a sense of achievement at getting something “out there”. But in real-world terms, it changes nothing. And people feeling like they’ve done something when they haven’t is counterproductive when it comes to dealing with big, complex problems like mental health, because they’re less likely to feel motivated to do something else. Something that may be genuinely useful.

Essentially, mental health awareness is fine, but action is what’s actually needed. Awareness is great for prompting those with issues to seek help, but effectively meaningless if there’s no help available. And with ongoing cuts and shocking provisions to mental health services, that’s where the real problems lie.

If mental health awareness can be channelled in to actually dealing with the issues around it, then that would be great. But raising awareness is just the start of the process, not the end. There’s a lot of work that needs doing here. And that’s something we should all be aware of.

Dean Burnett discusses these issues further in his new book The Happy Brain and his previous book The Idiot Brain, both available now.

Mental health: awareness is great, but action is essential | Dean Burnett

It’s mental health awareness week, 2018. And that’s good. It’s important to be aware of something that affects literally everyone, and that a quarter of the population regularly struggle with. It’s weird that anyone wouldn’t be when you put it in those terms, but that does seem to the case.

Perhaps the term is a bit misleading, or not specific enough. It’s not exactly mental health that people need to be made aware of, so much as the fact that mental health can, and regularly does, go wrong. And when someone’s mental health does falter or fail, they should receive the same concern and help that someone with a more obvious “physical” ailment should get, not scorn and stigma, as often happens.

This is where awareness helps. If you end up with depression, anxiety, OCD or any other condition, it can be hugely debilitating, often consuming your daily existence. Having someone, be they a family member or total stranger, dismiss it outright or accuse you of “faking it” or similar can only make it worse, compounding the problem.

This is how campaigns to raise awareness of the issues can be beneficial. Just like how increased exposure to people of different ethnicities or backgrounds has been shown to reduced feelings of prejudice and suspicion, so increased exposure to, or discussions about, mental health problems and what they mean for those who deal with them can enhance the understanding, or even just the patience, of those who don’t have to.

The human brain, powerful as it is, can still be overwhelmed by the complex world we inhabit, so when it comes to creating mental models of how the world works, it operates a general “stick to what you know” policy. As such, things that are different or unfamiliar, especially if they’re confusing and uncertain or introduce an element of perceived threat or danger, are met with suspicion, doubt, dismissal and so on. All are defence mechanisms, in a way; it’s the brain saying “this is NOT how the world is meant to work, so I must dismiss this challenging new information”.

But the brain is not that inflexible. Our idea of how the world (and those in it) works is adaptable and ever-updating, based on what we experience in our day-to-day lives. And if those experiences involve people discussing mental health and the issues around it, that’s more likely to become part of how we see the world and so has less chance of unsettling us overall.

Woman with her head in her hands as levels of anxiety among British people are rising, a mental health charity has warned. PRESS ASSOCIATION Photo. Issue date: Monday May 12, 2014. Almost one in five people from around the UK feels anxious a lot or all the time, the Mental Health Foundation said. A survey conducted by the charity found that almost half of Britons feel more anxious than they used to. Around three-fifths of the 2,300 British adults polled said that they experience anxiety on a daily basis.


There have been many years of progress, but still the most common image in any mental health search is the classic ‘headclutcher’. Photograph: David Cheskin/PA

This is especially important for mental health, as opposed to more physical ailments, because mental health problems often affect people’s minds and understanding rather than their bodies (although there’s copious overlap). Basically, someone experiencing a mental health problem or crisis may not realise this. Many need help and assistance to even accept they have an issue that requires dealing with. And the more there are people around them who are “aware” of mental health problems and how they manifest, the more likely this assistance is.

So, yes. Mental health awareness is good.

But it’s not an answer in and of itself. And it can actually be detrimental in some circumstances.

The main problem is, the human brain is very good at becoming aware of things, but it’s a lot harder for this awareness to lead to changes in behaviour. Abstract concepts and understanding can be useful, but things that cause strong sensory or emotional reactions carry more “weight” as far as our grey matter is concerned. For instance, dieting is hard because although we know the risks of high-calorie foods etc, we like pizza and cake. The sensory pleasure you get from the latter often outweighs the intangible understanding of the former when it comes to deciding what to do and what decisions to make. Cigarette packaging has been emblazoned with images of the ghastly consequences smoking can have for years, and yet smoking is still pretty common.

Similarly, having an abstract awareness of mental health issues does not automatically translate to a willingness or ability to do anything about them. Someone may be newly aware of what’s happening when a friend is in the grips of depression, but they could also be aware that helping them is likely to be demanding, stressful and largely unrewarding. The latter could well be what sways their behaviour, compelling them to keep their distance rather than intervene.

The point is, raising awareness of mental health is all well and good, but it doesn’t automatically follow that the problems and concerns around mental health will be affected in any appreciable way. Many people are “aware” that their clothes are probably made in sweatshops, or that their elected leaders are corrupt, or that their car is harming the environment, but do little or nothing about these things.

Prozac capsules


Often the discussion around mental health turns into one about the pros and cons of medication, but many people struggle to get to the point where that’s even an option. Photograph: Alamy Stock Photo

The danger essentially lies in people thinking “raising awareness” is sufficient to deal with the issue, whatever it may be. In most cases, it isn’t. And this isn’t ideal. It’s a common complaint, about the people who, following a tragedy, change their profile pic on Facebook, or tweet “thoughts and prayers”, or sign a petition, or what have you. While an action like that may be 100% well intended, all it really achieves is making the individual feel better because they’ve “done something”. A sense of control in the face of unpleasant events in the world is restored: a sense of achievement at getting something “out there”. But in real-world terms, it changes nothing. And people feeling like they’ve done something when they haven’t is counterproductive when it comes to dealing with big, complex problems like mental health, because they’re less likely to feel motivated to do something else. Something that may be genuinely useful.

Essentially, mental health awareness is fine, but action is what’s actually needed. Awareness is great for prompting those with issues to seek help, but effectively meaningless if there’s no help available. And with ongoing cuts and shocking provisions to mental health services, that’s where the real problems lie.

If mental health awareness can be channelled in to actually dealing with the issues around it, then that would be great. But raising awareness is just the start of the process, not the end. There’s a lot of work that needs doing here. And that’s something we should all be aware of.

Dean Burnett discusses these issues further in his new book The Happy Brain and his previous book The Idiot Brain, both available now.

Patients put at risk by ‘aggressive’ treatment at Great Ormond Street

Great Ormond Street children’s hospital unnecessarily gave patients potentially dangerous drugs, subjected them to invasive tests and wrongly diagnosed them with a rare allergy, it can be revealed.

An inquiry into the world-renowned London hospital’s care of children with gut conditions found it was putting patients’ physical and mental health at risk, previously unpublished documents show. Misdiagnosis and over-treatment also saw patients put on very strict “exclusion diets” which brought no benefit.

The hospital’s own top doctor said that its gastroenterology department was managing eosinophilic gastrointestinal disorders (EGID) in a clinically “aggressive” and risky way that was at odds with usual medical practice.

EGID is an inflammation of the gut which can cause vomiting, diarrhoea and stomach pain, sometimes described as a complex food allergy as children cannot eat some foods.

Patients’ families, hospital staff and senior doctors in other hospitals began raising concerns about the gastroenterology department as far back as 2011. However, they have still not been completely resolved, despite several inquiries and major improvements having been made.

The controversy has been uncovered in a year-long investigation by the Bureau of Investigative Journalism and Amazing Productions, whose documentary airs on ITV on Wednesday. Secret hospital documents obtained by the BIJ show it called in outside experts in 2011, 2012 and 2015 to inquire into practices within the department after receiving unusually high numbers of complaints from families and after doctors both internally and externally expressed alarm. It is unclear how many patients were wrongly treated, although one document from 2015 saysGOSH’s gastroenterology team was treating “around 400 children” who had been diagnosed with the disorder. The full findings of the last of those three probes, an “invited review” by the Royal College of Paediatrics and Child Health, have never been disclosed – until today.

The Royal College panel of four leading experts wrote to the hospital before starting the inquiry, saying they had “specific patient safety concerns … which leads us to believe the way the service is currently delivered may be causing avoidable harm to children”. Hospital staff and other NHS medics believed “the gastroenterology team ‘over-investigates’ and ‘over-diagnoses’. This, they felt, results in children undergoing invasive procedures and treatments which could unnecessarily compromise their physical or psychological wellbeing”, the letter added.

The hospital has admitted failings and apologised to patients affected. It has identified an unspecifiednumber of patients to the Care Quality Commission, the NHS watchdog, who, it admitted, had come to harm.

The Royal College also highlighted how some patients being treated for EGID had undergone “initial or multiple … gastroscopies and other invasive or lengthy procedures” before their symptoms had been properly considered, referring to a potentially unpleasant procedure in which a tiny camera is put down the throat to let doctors assess someone’s gullet and stomach.

GOSH staff had also diagnosed gastrointestinal conditions, including EGID, “excessively”, the panel found. In an extraordinary move, doctors in other hospitals were so concerned that they had stopped sending patients to Great Ormond Street .


In a 2016 briefing, Great Ormond Street had admitted that some approaches had been ‘at the aggressive end of the spectrum’

“Several clinical leads in secondary and tertiary trusts told us that they will no longer send patients to [GOSH] for second opinions because they are worried that they will return with an unexpected rare condition diagnosis and consequent treatment plan”, the experts wrote in July 2015 to Dr Vinod Diwakar, GOSH’s then medical director.

Great Ormond Street then brought in more external doctors to review the care given to more than 300 patients.

In a briefing to NHS England and the Care Quality Commission in December 2016, the hospital admitted that some approaches had been “at the aggressive end of the spectrum” and “some patients were exposed to the risks of unnecessary invasive investigations, difficult food-exclusion diets and drugs with potentially serious side effects”.

It also said some children had in fact been suffering from reflux or constipation, reviewers believed some endoscopies were unnecessary and some children should have been observed before being put on strong anti-inflammatory drugs.

Anxiety about the gastroenterology service forced the hospital to stop accepting most new referrals in 2015. The restriction is still in place. A recent follow-up report from the RCPCH found that that suspension had created “utter chaos” for other hospitals, which then had to look after an influx of medically complex patients who would normally have gone to GOSH.

The Royal College report found that the hospital was making “good progress” towards changes experts recommended in 2015, but some children still had diagnostic tests after too few checks and some of the gastroenterology consultants had not accepted the need to change their practices.

In a statement, the hospital said: “This is an incredibly complex area of medicine where there are no agreed clinical guidelines. Within this context while we always strive to provide the best possible care, we have acknowledged that we haven’t always got this right. For that we are very sorry.”

It added that experts believe the vast majority of care was good and there was no evidence of long-term consequences for any patients.

Patients put at risk by ‘aggressive’ treatment at Great Ormond Street

Great Ormond Street children’s hospital unnecessarily gave patients potentially dangerous drugs, subjected them to invasive tests and wrongly diagnosed them with a rare allergy, it can be revealed.

An inquiry into the world-renowned London hospital’s care of children with gut conditions found it was putting patients’ physical and mental health at risk, previously unpublished documents show. Misdiagnosis and over-treatment also saw patients put on very strict “exclusion diets” which brought no benefit.

The hospital’s own top doctor said that its gastroenterology department was managing eosinophilic gastrointestinal disorders (EGID) in a clinically “aggressive” and risky way that was at odds with usual medical practice.

EGID is an inflammation of the gut which can cause vomiting, diarrhoea and stomach pain, sometimes described as a complex food allergy as children cannot eat some foods.

Patients’ families, hospital staff and senior doctors in other hospitals began raising concerns about the gastroenterology department as far back as 2011. However, they have still not been completely resolved, despite several inquiries and major improvements having been made.

The controversy has been uncovered in a year-long investigation by the Bureau of Investigative Journalism and Amazing Productions, whose documentary airs on ITV on Wednesday. Secret hospital documents obtained by the BIJ show it called in outside experts in 2011, 2012 and 2015 to inquire into practices within the department after receiving unusually high numbers of complaints from families and after doctors both internally and externally expressed alarm. It is unclear how many patients were wrongly treated, although one document from 2015 saysGOSH’s gastroenterology team was treating “around 400 children” who had been diagnosed with the disorder. The full findings of the last of those three probes, an “invited review” by the Royal College of Paediatrics and Child Health, have never been disclosed – until today.

The Royal College panel of four leading experts wrote to the hospital before starting the inquiry, saying they had “specific patient safety concerns … which leads us to believe the way the service is currently delivered may be causing avoidable harm to children”. Hospital staff and other NHS medics believed “the gastroenterology team ‘over-investigates’ and ‘over-diagnoses’. This, they felt, results in children undergoing invasive procedures and treatments which could unnecessarily compromise their physical or psychological wellbeing”, the letter added.

The hospital has admitted failings and apologised to patients affected. It has identified an unspecifiednumber of patients to the Care Quality Commission, the NHS watchdog, who, it admitted, had come to harm.

The Royal College also highlighted how some patients being treated for EGID had undergone “initial or multiple … gastroscopies and other invasive or lengthy procedures” before their symptoms had been properly considered, referring to a potentially unpleasant procedure in which a tiny camera is put down the throat to let doctors assess someone’s gullet and stomach.

GOSH staff had also diagnosed gastrointestinal conditions, including EGID, “excessively”, the panel found. In an extraordinary move, doctors in other hospitals were so concerned that they had stopped sending patients to Great Ormond Street .


In a 2016 briefing, Great Ormond Street had admitted that some approaches had been ‘at the aggressive end of the spectrum’

“Several clinical leads in secondary and tertiary trusts told us that they will no longer send patients to [GOSH] for second opinions because they are worried that they will return with an unexpected rare condition diagnosis and consequent treatment plan”, the experts wrote in July 2015 to Dr Vinod Diwakar, GOSH’s then medical director.

Great Ormond Street then brought in more external doctors to review the care given to more than 300 patients.

In a briefing to NHS England and the Care Quality Commission in December 2016, the hospital admitted that some approaches had been “at the aggressive end of the spectrum” and “some patients were exposed to the risks of unnecessary invasive investigations, difficult food-exclusion diets and drugs with potentially serious side effects”.

It also said some children had in fact been suffering from reflux or constipation, reviewers believed some endoscopies were unnecessary and some children should have been observed before being put on strong anti-inflammatory drugs.

Anxiety about the gastroenterology service forced the hospital to stop accepting most new referrals in 2015. The restriction is still in place. A recent follow-up report from the RCPCH found that that suspension had created “utter chaos” for other hospitals, which then had to look after an influx of medically complex patients who would normally have gone to GOSH.

The Royal College report found that the hospital was making “good progress” towards changes experts recommended in 2015, but some children still had diagnostic tests after too few checks and some of the gastroenterology consultants had not accepted the need to change their practices.

In a statement, the hospital said: “This is an incredibly complex area of medicine where there are no agreed clinical guidelines. Within this context while we always strive to provide the best possible care, we have acknowledged that we haven’t always got this right. For that we are very sorry.”

It added that experts believe the vast majority of care was good and there was no evidence of long-term consequences for any patients.

Patients put at risk by ‘aggressive’ treatment at Great Ormond Street

Great Ormond Street children’s hospital unnecessarily gave patients potentially dangerous drugs, subjected them to invasive tests and wrongly diagnosed them with a rare allergy, it can be revealed.

An inquiry into the world-renowned London hospital’s care of children with gut conditions found it was putting patients’ physical and mental health at risk, previously unpublished documents show. Misdiagnosis and over-treatment also saw patients put on very strict “exclusion diets” which brought no benefit.

The hospital’s own top doctor said that its gastroenterology department was managing eosinophilic gastrointestinal disorders (EGID) in a clinically “aggressive” and risky way that was at odds with usual medical practice.

EGID is an inflammation of the gut which can cause vomiting, diarrhoea and stomach pain, sometimes described as a complex food allergy as children cannot eat some foods.

Patients’ families, hospital staff and senior doctors in other hospitals began raising concerns about the gastroenterology department as far back as 2011. However, they have still not been completely resolved, despite several inquiries and major improvements having been made.

The controversy has been uncovered in a year-long investigation by the Bureau of Investigative Journalism and Amazing Productions, whose documentary airs on ITV on Wednesday. Secret hospital documents obtained by the BIJ show it called in outside experts in 2011, 2012 and 2015 to inquire into practices within the department after receiving unusually high numbers of complaints from families and after doctors both internally and externally expressed alarm. It is unclear how many patients were wrongly treated, although one document from 2015 saysGOSH’s gastroenterology team was treating “around 400 children” who had been diagnosed with the disorder. The full findings of the last of those three probes, an “invited review” by the Royal College of Paediatrics and Child Health, have never been disclosed – until today.

The Royal College panel of four leading experts wrote to the hospital before starting the inquiry, saying they had “specific patient safety concerns … which leads us to believe the way the service is currently delivered may be causing avoidable harm to children”. Hospital staff and other NHS medics believed “the gastroenterology team ‘over-investigates’ and ‘over-diagnoses’. This, they felt, results in children undergoing invasive procedures and treatments which could unnecessarily compromise their physical or psychological wellbeing”, the letter added.

The hospital has admitted failings and apologised to patients affected. It has identified an unspecifiednumber of patients to the Care Quality Commission, the NHS watchdog, who, it admitted, had come to harm.

The Royal College also highlighted how some patients being treated for EGID had undergone “initial or multiple … gastroscopies and other invasive or lengthy procedures” before their symptoms had been properly considered, referring to a potentially unpleasant procedure in which a tiny camera is put down the throat to let doctors assess someone’s gullet and stomach.

GOSH staff had also diagnosed gastrointestinal conditions, including EGID, “excessively”, the panel found. In an extraordinary move, doctors in other hospitals were so concerned that they had stopped sending patients to Great Ormond Street .


In a 2016 briefing, Great Ormond Street had admitted that some approaches had been ‘at the aggressive end of the spectrum’

“Several clinical leads in secondary and tertiary trusts told us that they will no longer send patients to [GOSH] for second opinions because they are worried that they will return with an unexpected rare condition diagnosis and consequent treatment plan”, the experts wrote in July 2015 to Dr Vinod Diwakar, GOSH’s then medical director.

Great Ormond Street then brought in more external doctors to review the care given to more than 300 patients.

In a briefing to NHS England and the Care Quality Commission in December 2016, the hospital admitted that some approaches had been “at the aggressive end of the spectrum” and “some patients were exposed to the risks of unnecessary invasive investigations, difficult food-exclusion diets and drugs with potentially serious side effects”.

It also said some children had in fact been suffering from reflux or constipation, reviewers believed some endoscopies were unnecessary and some children should have been observed before being put on strong anti-inflammatory drugs.

Anxiety about the gastroenterology service forced the hospital to stop accepting most new referrals in 2015. The restriction is still in place. A recent follow-up report from the RCPCH found that that suspension had created “utter chaos” for other hospitals, which then had to look after an influx of medically complex patients who would normally have gone to GOSH.

The Royal College report found that the hospital was making “good progress” towards changes experts recommended in 2015, but some children still had diagnostic tests after too few checks and some of the gastroenterology consultants had not accepted the need to change their practices.

In a statement, the hospital said: “This is an incredibly complex area of medicine where there are no agreed clinical guidelines. Within this context while we always strive to provide the best possible care, we have acknowledged that we haven’t always got this right. For that we are very sorry.”

It added that experts believe the vast majority of care was good and there was no evidence of long-term consequences for any patients.