Tag Archives: let’s

Cleopatra had a big, beautiful nose. So let’s see it onscreen | Radhika Sanghani

Cleopatra is having a remake. The Egyptian queen, so memorably immortalised by Liz Taylor in Joseph Mankiewicz’s 1963 film, is coming back to our screens. And this time it’s going to be “dirty, bloody, with lots of sex”.

The new film, directed by Denis Villeneuve, aims to tell the story from Cleopatra’s perspective. “There have been so many narratives of Cleopatra that have all been framed through the eyes of men,” Scarpa told film website Collider. “The entire history of that period is framed through the eyes of men, specifically Roman men. We’re going to approach it through her point of view.”

Their goal is admirable (and long overdue) – but in order to be faithful to Cleopatra, as a strong, badass Egyptian queen, they’re going to need the right actor.

Cleopatra’s beauty is well-known. “She was a woman of surpassing beauty, and at that time, when she was in the prime of her youth, she was most striking,” wrote the Roman statesman Dio Cassius, while Plutarch spoke of “a woman who was haughty and astonishingly proud in the matter of beauty”. The two most powerful men of Rome, Julius Caesar and Marc Antony, both fell in love with her “wit as well as her good looks”, according to historian Appian.

But unlike Taylor’s Cleopatra, the real one had a big nose. The 17th-century philosopher Pascal famously wrote: “Cleopatra’s nose, had it been shorter, the whole face of the world would have been changed.” In coins and busts bearing her image, she has a strong profile. Her nose is hooked and eagle-like, her chin juts out and her forehead is short. Joyce Tyldesley, lecturer and author of Cleopatra: Last Queen of Egypt, has told the BBC: “People tend to think that her coins are more lifelike and if you look at them, she’s not particularly beautiful, as she has a big nose and chin.”

A coin with a depiction of Cleopatra

‘On coins, Cleopatra’s nose is hooked and aquiline, her chin juts out and her forehead is short.’ Photograph: Derek Hawes/AP

As always with history, there is debate among experts as to how big her nose was, how dark her skin was (she was Egyptian but was believed to have Macedonian descent), and whether she really was “beautiful”. But even if the nose-deniers are right and she actually had a Kate Middleton ski-jump, Cleopatra wanted people to see her as a woman with a strong, long profile. “She may not have wanted to look delicate and beautiful, she may have wanted to show power above anything else,” suggested Tyldesley on her coin images.

It is telling – and sad – that historians like Tyldesley assume that if Cleopatra did have a big nose, she would not have been beautiful. There are countless research papers asking whether she had a small nose – and was thus the Taylor-esque queen we think of today – or whether she was just a manipulative big-nosed seductress.

Unlike 17th- and 19th-century aesthetics, which decreed that big noses on women were strong and beautiful, society today cannot seem to move away from Hollywood’s white beauty standards. Big noses are seen as unsightly, unattractive, and – judging by the thousands who opt for rhinoplasty each year – something to be removed as soon as possible.

As a larger-nosed lady myself, I am desperate to see a 21st-century Cleopatra onscreen who looks like me. A Cleopatra who doesn’t have a “sweet little snub” or an “adorable button”, but the kind of nose that society has deemed appropriate only for witch costumes on Halloween.

There is a big move now in the media to try and improve diversity, so that the next generation will grow up seeing people onscreen who look like them, be it in terms of their race, disability or body shape. But one thing that it’s near-impossible to spot among celebrities is a big nose. Bar the handful of aquiline A-listers like Anjelica Huston, Lady Gaga, Maya Rudolph and Lea Michele, few have large noses, and many are plagued with rumours of nose jobs. No wonder, when it seems that a petite proboscis is the key requirement to succeeding Hollywood.

It’s something that has to change – and Cleopatra is the perfect opportunity to do it. The film industry has a chance to spread an important message: that big noses can be beautiful. It’s all very well seeing men like Adrien Brody and Owen Wilson as romantic leads on our screens, but the pattern is never reversed. Even Barbra Streisand’s famous Funny Girl is seen as “normal-looking” and not aesthetically worthy of the handsome leading man.

Cleopatra could finally show society that a woman with a big nose can win not just one but two handsome men’s hearts. And judging from everything we know about the queen – who possibly commissioned coin portraits of her side profile to make it look even bigger than it was (something no modern-day woman would ever do) – it’s exactly what she’d want from a film on her life.

Radhika Sanghani is a freelance journalist and novelist

The Guardian view on 50 years of legal abortion: let’s finish the work | Editorial

It is 50 years on Friday since David Steel’s abortion act became law. It did not come into force until the following April. In those six months, it is likely that around 70 women died from sepsis or some other cause resulting from illegal abortion: in the previous decade, it claimed at least 150 lives a year, the biggest single cause of maternal mortality. Activists in a campaign that began in the 1930s toasted victory with champagne. But one veteran, who had had an illegal abortion herself, dampened the celebrations. They should be drinking half-glasses, she said, for the job was only half done.

Nonetheless, in the past 50 years millions of women have benefited from access to safe abortion. It has transformed the future for many girls and women – young women in particular, for the peak age for abortion is 19; it is also disproportionately in demand in poorer parts of England and Wales. There are now around 200,000 abortions recorded each year, but almost all of them – 92% – take place in the first trimester of pregnancy. No one likes carrying out an abortion, says the Royal College of Obstetricians and Gynaecologists, but the alternative – illegal, unsafe abortion – is worse.

Yet reforming the law does remain a job half done. The Abortion Act 1967 did not decriminalise termination; it merely introduced a very narrow set of exemptions from the criminal law, a tiny window where abortion was legal, restricted by the requirement that two doctors agree that carrying a pregnancy to term would be a greater risk than termination, or that the unborn child had such physical or mental abnormalities that it would be seriously handicapped.

Over time, these rules have been interpreted much less restrictively. But even if practice has changed, they are still in force, and abortion remains a criminal offence both for the woman and for medical practitioners. Every doctor is aware that they remain open to prosecution. Nor is it only in Northern Ireland that women who buy abortion pills online are open to prosecution. An adult woman still does not have the autonomy to make one of the most fundamental decisions about her body and her life. And for all those involved – women and health practitioners – the climate around abortion remains punitive.

Yet despite the strength of argument for reform, this is perilous territory. In the past half century, for every tentative attempt to complete the process of liberalising the law, there have been a score or more efforts to restrict it further. Only one has succeeded, a cut in the maximum term from 28 to 24 weeks – but in an age of culture wars, this is a field aggressively patrolled by anti-abortion activists, many of whom are part of a revivalist right that sanctifies motherhood and sees every liberal advance as a cautionary tale about modernity.

And yet, in March this year, Diana Johnson, the Kingston upon Hull MP, successfully won a vote on a backbench bill to decriminalise abortion. Although the general election intervened, MPs believe there is still a pro-change majority in the Commons and in the Lords. Nor is it only campaigners in parliament who think that the time has come for further reform. One reason for the new optimism is that for the first time, the British Medical Association, the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists all now support decriminalisation. The professionals who are most closely involved in reproductive health, trained and qualified people devoted to securing and protecting healthy lives for women and babies, believe that it is necessary to change the law to reflect the way the world has changed since 1967.

Changes in practice mean most abortions are now medical rather than surgical; a steady rise in early terminations has accompanied the widespread introduction of drugs that trigger abortion. Experience in Canada and parts of Australia where decriminalisation has been introduced shows it has not led to a surge in abortion. Above all, decriminalisation does not mean deregulation. The Johnson bill would have made no change at all to the existing restrictions on, for example, the 24-week limit or the ban on sex-selection abortion. It continued to recognise that there are deeply held conscientious objections. It could have introduced new criminal sanctions on those who coerce or deceive women into abortion. Abortion has always been polarising. But this is a job half done, and it’s time to complete it.

Let’s put our NHS worries in perspective – and celebrate what we have | Ann Robinson

The latest GP story to scare us witless says that a “record number of GP practices closed last year, forcing thousands of patients to find a new surgery”. Pulse, the GP website, highlighted NHS England data that shows nearly 100 practices closed in 2016 – a 114% increase on 2014 – and that more than a quarter of a million people have had to change practice. Cue claims that GPs aren’t coping with increased demand, the NHS needs more cash and staff – and that the whole system is teetering on the brink of collapse.

But what’s the true picture? Are you likely to find yourself without a GP any time soon? Is the service contracting? And is the closure of a GP practice always a bad thing?

People get understandably upset when a much loved, familiar, local service shuts down. It doesn’t matter if it’s a GP surgery, library, community centre or takeaway. I’ve been registered at the same GP practice for 30 years; I never go, but I was quite discombobulated when I got a letter saying that one of the long-serving doctors was retiring. If I had memory impairment and long-term health problems, I’d be upset and anxious if the whole practice closed down and I had to move somewhere unfamiliar.

But let’s keep this story in perspective; there are 7,674 GP practices in England, so the closure of 92 practices means that 98.8% remain open. Primary healthcare services are not necessarily contracting; in 2014 there were 5,729 more GPs and 1,688 more practice nurses employed by GPs than 10 years earlier. Admittedly, a lot of those GPs and nurses work part time, and there’s also more work done in primary care now. So no one’s saying that there’s not a case for more money, training and efficiencies. It’s just that it’s not fair to paint an apocalyptic vision of sick people roaming the streets of England, looking in vain for a doctor to treat them.

Every person with an NHS number has the right to be registered with a GP and get primary care services, and access to hospital-based services if needed. If you assault your GP and are removed from the practice, the local clinical commissioning group (CCG) will refer you to a specialist GP who takes on the role of caring for the violent, abusive or just unmanageable. If you kill someone and go to prison, you have access to a doctor. There is literally nothing you can do in the UK that means you forfeit the right to see a GP. If all your local GP practices are full, the CCG has an obligation to find you one. Asylum seekers and refugees are also entitled to NHS care while waiting for their application to be processed and are encouraged to register with a local GP surgery.

The overwhelming majority of us who live in the UK will be registered with a GP from the day we’re born to the day we die. And in an era where Obamacare is under attack in the US, it’s worth celebrating what we’ve got in this country. Sure, the system’s not perfect, but there’s no evidence that any one system works better across all parameters; and no one can argue with the fact that our system is equitable.

GP treating an elderly patient

‘GPs are more inspected, regulated and scrutinised than ever before – and quite right too.’ Photograph: Alamy

There is a problem with the huge variation in quality between different GP practices. But inspections by the Care Quality Commission and the publication of its findings are helping to enforce high standards across the board. The CQC can demand an action plan when practices are found to be inadequate and shut down surgeries on the spot if they’re found to be unsafe. Every British GP has to undergo an annual appraisal, providing evidence that they meet professional standards. Any GP that fails to play ball can be denied the right to continue working. This is a completely different landscape to when I started working as a GP nearly 30 years ago. We are more inspected, regulated and scrutinised than ever – and quite right too.

But some GPs can’t hack it. There’s more work, more scrutiny and higher expectations now. Practices have to adapt, and many single-handed GPs find that hard. The climate nowadays favours larger group practices; there are economies of scale, a mix of skills among a range of GPs, less risk of professional isolation, and more chance of resisting the creeping penetration by large global healthcare organisations. Virgin Care already runs more then 400 NHS and social care services. Single-handed practices can’t fight the Goliaths who are sniffing round primary care.

So some GPs are taking early retirement, and fewer young medics are opting for general practice. And 1.2% of GP practices closed last year. Some of those practices will be a loss, some won’t. Many patients will be upset that they’ve had to move but no one will be left without a GP. And that’s the real story.

Let’s applaud Simon Stevens: the NHS boss with a plan | Deborah Orr

One trouble with dropping targets is that such a decision tends to create a target. The head of NHS England, Simon Stevens, has outlined many sensible goals in his proposals for the future of the health service. But attention has focused on one thing. In order to take the strain off A&E departments and improve cancer treatment, Stevens has decided to drop the target whereby 92% of routine surgery is carried out within 18 weeks of a GP referral. The moment that some ghastly failure can be personalised in the form of an iconic victim of this change, Stevens will be held personally responsible. He is the target now.

Why is Stevens taking this risk? Largely because the government has made it clear that the extra funding Stevens needs will not be forthcoming. But it’s also another attempt at a nudge, to GPs and to patients. People can be aggressively passive about their health. They want doctors to fix it for them. GPs are wary of berating patients into losing weight and exercising more, especially now, when patients have read on the internet all about the operation they can get. The promise of elective surgery within 18 weeks, I’m afraid, only encourages both GP and patient to kick the can down the road. The hope is that the removal of the target will encourage GPs and patients to opt first for physiotherapy, which is what all sensible people should be doing anyway.

Some of the problem is with us, and our demands. We trail off to the GP with our colds and beg for antibiotics

Around 150 urgent treatment centres are being planned, to take the strain off A&E, which NHS chiefs say still attracts about 3 million people each year with minor ailments. Stevens is hoping to persuade all GP practices to offer evening and weekend appointments, so that A&E departments don’t become one-stop-shops over the weekend. Astoundingly, Stevens is also demanding that all A&E departments should introduce “comprehensive front-door clinical streaming”. Here in my metropolitan elite bubble, I’d imagined that all A&E departments had been assessing all walk-ins by medical need for decades. It’s easy to forget just how much sheer inertia is inevitable when dealing with a beast as large and complex as the NHS.

Stevens also addresses the system’s two most glaring failures – the lack of integration with social care and the relatively slender access to mental health services. On the first, Stevens aims, through closer coordination between hospitals and councils, to free up potentially 3,000 hospital beds. On the second, the aim is to provide talking therapies to 200,000 more people. These are ambitious goals. Considering the lack of investment, they are valiantly optimistic. Sometimes, people doing tough work need a bit of encouragement and applause. Stevens is one of them.

An ambulance

‘Some of the problem is with us, the users, and our demands. We trail off to the GP with our colds and beg for antibiotics; we call ambulances because our friend is very drunk.’ Photograph: Yui Mok/PA

There is a great deal of cognitive dissonance to Britain’s relationship with the NHS. Yes, we love it. No surprises there. It’s worth loving and not only for sentimental or socialist reasons. All but the most cock-eyed of diehard free-marketeers are obliged to bow to the evidence and admit that the NHS is the most cost-efficient health service in the world. Many politicians have struggled to come up with alternative funding models and had to admit that nothing is really worth the hassle it would cause. Insurance-based schemes around the world have been scrutinised and the conclusion is pretty much always that these simply drive up the cost of healthcare generally, with the US a particularly abject example.

Yet at the same time, our love for the NHS is sometimes skin-deep. When things go wrong or are disappointing, this is seen as proof that the service is falling apart, hardly ever that medical problems can be complex and baffling, or that people are not always the most reliable witnesses to their own problems. There’s still a great deal of suspicion about change.

Stevens has come up with a solid plan, and everyone’s up in arms because operations that might not work are being sidelined in favour of restorative exercises that probably will, if only people commit to carrying them out. Why is this supposedly awful thing being done? Just so that people who have been knocked down by cars or people with cancer can have their actual lives saved. Just so that hospitals don’t have to farm operations out to private providers simply to hit their targets on not always terribly necessary operations.

Some of the problem is us, the users; our own expectations and demands. We have this precious, amazing resource. We stand with it and see the government as its enemy. Yet we trail off to the GP with our colds and beg for antibiotics; we call ambulances when our friend is drunk; we’re astounded when our neighbour reveals himself as proficient in first aid.

Right now, there’s a hullabaloo because elderly people with some money behind them are expected to pay for people to help them with things they can no longer do for themselves. This, apparently, punishes “the thrifty”. How can having the wherewithal to pay for things you need be “a punishment”? Sometimes, the basic problem is that we want the best but we don’t want to pay for it. Full stop.

Good social workers are invaluable. So let’s give them proper support | David Brindle

About three in every 10 people in Britain think social workers help with household chores like cooking and cleaning, with personal care like washing and dressing, and with childcare. Two in 10 reckon they will nip to the shops for you. Asked to choose from a given list of professionals they consider important providers of mental health support, 69% of people identify psychiatrists and 65% GPs – but only 41% pick social workers.

These findings come from a ComRes survey commissioned by Think Ahead, the fast-track training graduate scheme for mental health social workers, to mark this week’s World Social Work Day. As Lyn Romeo, England’s chief social worker for adults, comments with a certain understatement, “there is still more to do to communicate the crucial role of social workers”.

That was to have been the role of the short-lived College of Social Work, set up by ministers in 2010 with plans for it to grow to become a royal college on a par with those for the most esteemed professions, but shut down in chaos five years later. News that the College of Occupational Therapists is to become royal – richly deserved, by the way – has rubbed a good deal of salt into that wound.

There is a fresh plan, however. From 2018, part of the brief of a proposed new regulator for social workers in England will be “to promote and maintain public confidence” in the profession. The mandate for the organisation, provisionally titled Social Work England (SWE), is contained in the children and social work bill currently before parliament. After a rocky start, it enjoys broad support.

One reason SWE is being welcomed is that it will give social work its own regulator again after six years under the generic Health and Care Professions Council. A second is that ministers accept it cannot be self-financing, at least in the short term, and are underwriting it by £16m in its first two years. And the most significant reason is that an initial idea for it to be run direct by Whitehall has been ditched.

Just how independent it will be remains moot: a quango accountable to government, not parliament, it will need ministerial approval of the professional standards it polices. But the social work world sees the lifting of the spectre of regulation by a government department as a clear win.

Another success being celebrated is the withdrawal of clauses from the bill that would have allowed councils to seek exemptions from children’s social care law to test innovative ways of working. Critics saw the idea as erosion of vital safeguards and mounted a strong, successful campaign against it – but the issue was almost certainly settled when Eileen Munro, the leading social work academic often cited by ministers in support of professional reform, opposed it.

However, real tensions remain between the government’s social work reform vanguard led by Isabelle Trowler, chief social worker for children, and the bulk of the sector establishment, with plans for accreditation tests for children’s social workers looming as a new flashpoint. But there is a sense of a thawing in relations.

Herbert Laming, sector elder statesman and crossbench peer who led both the seminal inquiry into the death of Victoria Climbié, which published its report in 2003, and a review of child protection six years later following the Baby P affair, hopes the thaw continues. He tells me: “What social work needs above all at this time is a bit of tender loving care.”

In a lecture on Wednesday at the University of Suffolk, Lord Laming will spell out the enormously high expectations that society has of frontline workers’ skills and judgment when dealing with vulnerable children and adults. The task, he will say, has been made infinitely more difficult by austerity, which is why he joined the call for withdrawal of the exemption clauses at this point even though he understood and backed the case for innovation.

Social workers are crying out for support and encouragement, Laming says. He is surely right. There has been too much stick and not enough carrot in the mix of late.

Let’s talk about cancer: the Manchester project that aims to save lives

Security guard Gilbert Morris will stop at nothing to talk to other black men like himself about cancer screening. He once defused a late-night fight in a Manchester club by asking five scuffling men whether they had had their prostate tested.

“It was like I had a magic wand that lowered their aggression,” laughs Morris. “They stopped in their tracks and put their fists down. Two of them said their fathers had prostate cancer and another’s uncle had it. We ended up sitting round the table talking about their fears of having their privates looked at.”

The success of this 51-year-old six footer in communicating the risk of cancer is being harnessed by health chiefs in Greater Manchester as part of the launch of a social movement to sign up 20,000 people as cancer champions.

The idea, led by Greater Manchester Cancer Vanguard Innovation, (part of Greater Manchester Cancer – the cancer programme of Greater Manchester’s devolved health and social care partnership), is to use people power to create a cultural shift in one of the UK’s cancer hot spots, and make it normal to talk about screening, healthier lifestyle options and catching symptoms early.

Working with the voluntary sector, the aim is to sign up 5,000 cancer champions by autumn 2017, and to reach 20,000 by 2019. Mobilising this cancer army is one of a series of measures to cut premature cancer deaths in the area by 1,300 by 2021.

Gilbert Morris

Gilbert Morris developed prostate cancer in his 40s and couldn’t find anyone to talk to about it. Photograph: Karen Wright

The cancer death rate in Greater Manchester is 10% higher than the national average, according to Cancer Research UK figures. Manchester comes bottom out of 150 local authorities for premature deaths (under 75 years). Cancer experts reckon that around 40% of cancer deaths could have been prevented by screening or lifestyle changes, the potential for saving lives in Greater Manchester is great, since 6,700 people died of the disease in 2013.

Cancer champions programme director, Jenny Scott, explains: “By creating champions we will create support for active lifestyle changes. We need to engender people’s interest and then it will spread like a wave. I hope that people will soon be chatting about what they can do – whether it be at the bus stop or a football match.”

This radical approach is the result of a realisation that health systems are not having an impact in many sectors of society.

Morris’s story underlines this. He developed prostate cancer in his 40s and could not find anyone to talk to about it. He volunteered with the Manchester-based Black Health Agency to highlight the heightened risk of the disease in the African-Caribbean community. As his experience shows, the mention of prostate cancer can stop people in their tracks.

Morris says: “Doctor does not always know best, because some men never go to the doctor. I will speak to men anywhere – at a street corner or a bus stop. I am not embarrassed about talking about it, because if I can save one life I have done my job.”

He joins 1,000 plus existing volunteers willing to become cancer champions. More will be recruited through formal links between local authorities, Action Together and Voluntary Sector North West. Interested individuals will be put in touch with voluntary organisations across the 10 local authority areas, and receive advice and training. Workshops and publicity campaigns are planned. A web platform is also being built where people can become a champion and share their experience.

The rewards of volunteering are rich according to cancer champion Zoe Ashworth, a 29-year-old single parent from Stockport. She spends around three hours a fortnight at a nearby GP surgery in a deprived area calling people who have not returned their bowel cancer screening kits.

“Volunteering gives me real personal satisfaction,” says Ashworth. “Of all the people I have called, every single one has agreed to receive a screening kit. My friends will not listen to anybody else, but they can’t get away from me!”

Findings from the cancer champions project, will be combined with other data and public health information, to create a national dashboard to help prevent avoidable deaths across the rest of the UK. It will also be shared with cancer alliances being set up all round the country.

Leading Greater Manchester’s social movement projects, Ben Gilchrist, sees the cancer champion work in the context of a step change in society, in which many people no longer take their health messages from a health system.

He is clear that volunteering is not a replacement for NHS and public services, or a cost-cutting measure but the “right thing to do” to empower communities.

Join the Healthcare Professionals Network to read more about issues like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

We are rightly proud that our NHS is free. Let’s keep it that way | Ann Robinson

Imagine you have a big, greasy, warty growth on your back. It’s embarrassing, catches on your clothes and means you avoid swimming or exposing your back on holiday. Your GP confirms that it’s not cancer and says it’s a seborrhoeic wart. That’s great, but you’d like it removed. Your GP says you can’t be referred for removal on the NHS because it’s a cosmetic problem.

So what should you do next? Live with it? Pay a private skin specialist to remove it (likely to be over £120 to have it scraped or frozen off)? Or have a stand-up fight with your GP?

There’s another option being proposed by a group of GPs; let your GP do it, and pay a fee. At the moment, NHS GPs aren’t allowed to charge their registered patients for standard NHS care. But charging for non-NHS extras, like sick certificates for insurance companies, reports for health clubs that you’re fit to exercise, diving certificates and other optional extras, is allowed.

The British Medical Association (BMA) explains that GPs sometimes charge fees because “they are self-employed and they have to cover their costs – staff, buildings, heating, lighting, etc – in the same way as any small business. The NHS covers these costs for NHS work, but for non-NHS work, the fees charged by GPs contribute towards their costs.”

But until now, the permission to charge for non-NHS work has been limited to certificates and administrative tasks. The idea of allowing GPs to charge for clinical work that isn’t available on the NHS is much more challenging. After all, we are rightly proud of the fact that we don’t need to take a credit card or cheque book when we go to the GP. It’s anathema to many that this situation may change.

The controversial proposal has been spelled out by Dr Prit Buttar, chair of Oxfordshire’s local medical committee (LMC), who told Pulse magazine there had been discussions about rolling out the system nationally by the end of 2017. Under the proposed plans, GPs would be able to provide private services to their own patients by working through a third party company, which would take payment from patients and pay GPs for their time.

The plan is to extend the scope of non-NHS services that GPs can offer to patients for a fee. So if you want to see your GP outside of NHS-contracted hours (generally 8am-8pm), you could pay to see him/her privately instead of relying on the out-of-hours services that GPs employ to provide cover from 8pm-8am. At the moment, that wouldn’t be allowed. If you want to see a GP for a routine appointment at 9pm, you can’t. If it’s urgent, there are walk-in centres and NHS 111. If you’re mortally ill or wounded, there’s A&E.

As a GP who starts seeing patients at 7.30am, I can’t imagine why a GP would want to see private patients at 9pm. Or have the strength to work a 12-hour day and then keep going into the night. But, more importantly, I think it will taint the precious patient-doctor relationship that relies on trust that the GP is acting in your best interests, free at the point of delivery and unsullied by any profit motive.

You can see where Dr Buttar and co are coming from; people want choice and convenience in all areas, including healthcare. That includes the freedom to have an ugly wart removed or to see your own doctor late in the evening by mutual consent. GPs want to respond to people’s needs and wishes but are only contracted and paid by the NHS to provide a limited range of services. The NHS can’t fund a limitless range of interventions, because taxpayers don’t want to pay huge taxes so that you can get your wart removed.

So where does this leave us? The NHS restrictions are not sacrosanct and can be challenged; for instance, it’s hard to get varicose veins treated on the NHS – but guidelines from the National Institute for Health and Care Excellence (Nice) state that if you have symptoms like pain and aching, you should be referred for assessment and treatment. Your GP is your advocate within the system; helping you to navigate referral pathways and fighting your corner when needed.

What faith can you have that your GP is doing their best for you if they stand to personally gain by offering you a private alternative? It’s a slippery slope all right; the wrong solution to a pressing problem.

Let’s be honest about socialism’s paradoxes | Letters

The question arising from Owen Jones’s article (How the Tories are victimising young people, 12 January) has to be: is socialism choking itself to death on its own inherent contradictions? Has the past 50 years been a good period in history, or has it not? If it could be repeated, should it be repeated? If the parental generation has spent its children’s future, how does the next generation suppose it can avoid doing the same to its children?

Jones reports that rates of depression and anxiety among the young have increased by 70%; a third feel they will have a worse standard of living than their parents; 42% feel owning a home is an unrealistic prospect. If we compare the last 50 years with preceding periods of history, it is apparent that the last 50 years has been the aberration. The parental generation enjoyed a higher standard of living, not because it worked for it, but because it mortgaged (borrowed) from subsequent generations.

When socialists argue that a socialist government could renew the country with a different tax regime, they implicitly argue that the Tories haven’t done such a bad job of running the country. The evidence in the rest of Jones’s article suggests that failure is endemic in that class. Britain is poor because it has been running a trade deficit for 40-odd years. Austerity was the hangover from decades of overindulgence. Brexit is the tantrum that comes from the loss of self-worth. Unfortunately, youthful optimism is no substitute for gainful employment. We need to be more honest about the excreta we are sitting in.
Martin London
Henllan, Denbighshire

John Harris’s recommendation of universal basic income as a key Labour policy is sensible (Opinion, 13 January). It is, as he says “a given that work will define a declining share of most of our lives”. In their thought-provoking 2015 book, Inventing the Future, Postcapitalism and a World Without Work, Nick Srnicek and Alex Williams argue that we should welcome that fact, even demand full automation, and, among other things, introduce UBI. Then, as Harris also says, tax avoidance is naturally an obvious target for Labour, though awkwardly a moving target: it is transnational and the avoiders move. Therefore one other policy Labour must promote more strongly is a land value tax. Land cannot be secreted away in treasure islands.
John Airs

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ADHD Medication Can Cause Psychosis or Worse – Let’s Encourage Health Instead

Eleven percent of children (20% of all boys) are diagnosed with ADHD. Most are on ADHD medication. Parents are told that ADHD is chronic and lifelong. And, they are told that drugs are the “best chance” to get kids on track. Did you know that side effects include psychosis and death?

When a child receives a diagnosis of ADHD, it’s hard for parents to deal with the emotional repercussions. In addition, it is hard to sort out the mass of information. However, there is one message that will be coming through loud and clear from doctors, teachers, psychiatrists, and practitioners — and that’s:

“You should get him on ADHD medication immediately!”

To use ADHD medication or not, that’s the big question

An ADHD diagnosis is particularly prone to this knee-jerk response from professionals who are so convinced these children have a genetic disorder that they have called off the search for a better understanding of the underlying conditions. Sadly, our society has become conditioned to trust the physicians and jump to a pill for the ‘quick fix.’

Of course, conventional medicine is a powerful tool, and certainly the best place to start if you have a broken leg or a heart attack. However, it falls short against a more nuanced disorder like ADHD. Parents will be told that ADHD is complex in nature, possibly a result of genetic, psychological, and other unknown factors. In general, however, allopathic doctors do not address the wide range of physical symptoms often shared by kids with this disorder, such as:

As a psychotherapist who has worked for over a decade in mainstream medicine, I empathize with parents seeking a quick fix with ADHD medication. However, I feel it is important for parents to look deeper to search for underlying causes. In addition, to consider the results that parents are seeing with holistic approaches and dietary changes.

What you won’t hear from a conventional doctor

Your child is probably suffering from genetic mutations and a nutritional deficiency combined with a food sensitivity.

Genetically modified foods, food dyes and preservatives, and chemicals are having an adverse reaction on your child’s attention, focus, and sleep.

For every medication, there is a natural plant or remedy that can achieve the same result without side effects.

Our emotions are largely governed by our intestinal system. There is more serotonin in our bowels than in our brains.

Bear in mind

Every child is unique. A well thought out integrative treatment plan needs to be tailored to each child’s specific immunologic, digestive, and metabolic conditions. So, find physicians and practitioners who will listen to you and conduct a thorough investigation. You will most likely need a team or different practitioners.

Changes can take time. Move slowly but steadily with dietary changes and protocols.

Treatment can be expensive. You are not letting your child down if you can’t afford the most expensive therapies. Check with special needs associations about the Department of Education services, government subsidies, financial aid, and therapists who provide sliding scales. You may also have to make lifestyle changes.

Focus on love, patience, and hard work. Know that the most important therapy takes place at home.

Trust your gut! You know your child best. Your intuition is the best guide.

Important first steps

  1. Look for a qualified naturopath or integrative MD in your area who specializes in ADHD and related disorders. Google Naturopathic (ND), Defeat Autism Now (DAN), Medical Academy of Pediatric Special Needs (MAPS) physician, Functional Medicine, or Integrative Medical Doctor (MD) practitioners in your area.
  2. Do your research. Have a list of questions for your selected doctor. Ask for a complete metabolic workup including blood, urine and fecal testing. Also request a food sensitivity test (IgG) or ALCAT, Organic Acids Test to determine nutritional deficiencies.
  3. Read the books and scientific journal articles most of your doctors aren’t reading.
  4. Continue with mainstream therapies like OT and PT, behavioral plans, and psychotherapy. Also investigate other modalities such as acupuncture, craniosacral, brain balance therapies, and so on. Biomedical treatment enhances the effects of other therapies.

Our children deserve a healing-oriented approach. One that, considers the whole person — body, mind, and spirit. In fact, the best results come from tailor-made therapies, both conventional and alternative. Good medicine should be based on good science, be inquiry-driven, and be open to new paradigms. Therefore, we need a system that promotes prevention of illness as well as a healthier treatment of disease.  So, I urge parents to consider natural, effective interventions whenever possible.

To learn more about how to treat our children without mind altering chemicals, read my award winning book Healing without Hurting. Investigate the 101 ways to treat ADHD, Apraxia and Autism Spectrum Disorders Naturally and Effectively Without Harmful Medications.

Happiness study ‘lets austerity off the hook’, psychologists claim

Clinical psychologists have raised the alarm over a controversial piece of research led by a Labour peer, with one saying it “lets austerity off the hook” as a cause of mental health problems.

The London School of Economics study led by Lord Richard Layard, published in early December, found that failed relationships and physical and mental illness were bigger causes of misery than poverty.

The study, headlined the “Origins of happiness”, made the claim that eliminating depression and anxiety would reduce misery by 20%, while eliminating poverty would only reduce it by 5%.

But psychologists who spoke to the Guardian said that the findings ran in the face of decades of evidence showing that an individual’s social circumstances had a big impact on mental health.

“It lets politicians off the hook, it lets austerity off the hook, it says that all that doesn’t matter, making a better society doesn’t matter, just offering technical treatments,” said Dr Anne Cook, director of clinical psychology at Canterbury Christ Church University.

“I am one of the people that offers technical treatments and I think they can be extremely helpful to some people but that argument is being stretched beyond the point at which it applies.”

Dr Peter Kinderman, president of the British Psychological Society, said he welcomed Layard’s call for a focus on national wellbeing through investment in mental health services. But he had misgivings about how the study had treated mental illness as a distinct variable from human misery.

“I’m not sure that is quite the same as saying that our wellbeing … would be better off if we were to tackle mental illness, because it suggests that the one variable is the cause of the other where I would see them as the same,” Kinderman said.

It is understood that the LSE study has caused widespread unease among clinical psychologists, particularly as Layard is highly influential with policymakers.

Layard’s work has previously led to David Cameron’s adoption of national wellbeing statistics, and he was also a driving force behind the adoption of the Improving Access to Psychological Therapies to increase access to “talking therapies” on the NHS.

That latter policy was particularly controversial because it established finding work as an outcome of psychological treatment, which critics said may not be a suitable outcome for some and encouraged a policy of forcing people into work which may not be appropriate for them.

Now Layard, an economist by training, is calling for a “new role for the state” that swaps wealth creation for wellbeing creation through targeted mental health interventions. Dr Jay Watts, a clinical psychologist, said his call “negates decades worth of data linking mental health to poverty”.

“It’s ripe for misuse … in the current political climate,” she added.

Sarah Carr, vice-chair of the National Survivor User Network, said that Layard’s findings failed to reflect the realities of people who have experienced mental health problems.

“We’ve got people who are now known as the precariat,” Carr said. “We have in-work poverty, we have people who need to rely on welfare benefits, we have people who are in debt, and these have massive effects on people’s mental health anyway.

“Even if they didn’t have a pre-existing condition they can exacerbate pre-existing conditions, and they affect people’s relationships. It’s a problematic piece of research to use to make such a high-level, universal policy proposal.”

Cook said that rather than focusing on mental health interventions, as Layard suggested, a better way to improve people’s wellbeing on a societal level would be to take a public health approach. “Cholera wasn’t eradicated by developing new treatments, it was eradicated by improving drains back in pre-Victorian times,” she said.

“What [Layard] neglects is the people at the bottom of the pile who are really, really struggling, and in current circumstances there are a lot of them. People who you see at food banks for example, who are in incredible distress and certainly would – most of them or a lot of them – meet the criteria for an anxiety disorder or depression.

“But it’s largely a response to their circumstances. If we do something about that, rates of mental illness in the population are going to come down a lot more effectively than providing a lot more therapy.”