Just keep swimming – through the pee, plasters and human hair | Sally Goble

Look. If you are of a delicate disposition, best not take up swimming. Don’t venture down to your local pool, strip off your clothes, wade through a slightly wet and dirty changing room and immerse yourself into what is, effectively, a communal bath full of the hoi polloi and all their bodily fluids. Just don’t do it.

If you are of a delicate disposition, you won’t end up feeling relaxed, with a sense of wellbeing and a healthy glow. You’ll be too concerned about verrucas, or cross and suffering from “lane rage”. You’ll complain about everything from people peeing in the water – which scientists have found is a frequent occurrence – to the quantity of the pool chemicals needed to counteract the peeing, to the water being too cold (or too hot).

You’ll be unhappy about the plasters and miscellaneous hairs that have sunk to the bottom of the pool. You’ll be irritated by the kids screaming and about swimmers splashing arrogantly; or women slowly breaststroking in twos and chatting while still in full makeup. You’ll feel as if your swim has been ruined.

I’ve swum in many pools – probably more than 100 – and I can tell you that every one has its fair share of annoyances. And they all, undoubtedly, have users who pee in the water. Every pool in the UK (where, for some reason, we don’t require swimmers to wear bathing caps) has great billowing clouds of hair floating around waiting to get caught repulsively between your fingers.

Many pools aren’t as clean as we’d like, but public pools are often underfunded. The staff who work at these places are often poorly paid and on casual shifts. The lifeguards who keep order, and whom we trust to save our lives, if necessary, are often required to do most of the cleaning, and to regulate the chemicals and temperatures of the water. Cut them some slack.

In most pools, just as there are cleanliness issues, there are people issues too. Every leisure centre has a weirdo who spends too much time in the shower. Every swim features a strange encounter with a near-naked stranger.

If you are of a delicate disposition you won’t end up feeling relaxed. You’ll be too concerned about verrucas

Last weekend, as I was doing lengths at my local pool, I noticed a woman standing at the end of the pool, at the deep end. She stood for about five minutes on the pool deck, with her arms folded, staring at the swimmers already in the water. It was disconcerting. Every time I swam up to the deep end, I wondered if she would jump on top of me as I reached the wall to turn.

Instead, after a while, she got into the lane next to me and swam breaststroke – badly – clad in swimwear that left little to the imagination, splendidly displaying much of her bottom as she glided along.

The weekend before, there was a strange man practising “free diving”. This moustachioed fellow would periodically swoop down to the bottom of the pool where he would stay for minutes at a time, staring in a trance at the tiles, barely moving. If you didn’t know what he was doing, you’d think he had drowned. It slightly unnerved me as I swam over the top of him, metres above.

And every week, no matter where I swim, there is always some beefy guy in beach shorts who gets in the same lane as me. This bloke will assume that he can swim faster than me because he’s a bloke and I am a middle-aged woman. So he will wait until I am about to turn at the end of the lane and push off in front of me and then hold me up by swimming more slowly than me. I take great pleasure in overtaking while simultaneously, very deliberately, eyeballing him.

But I don’t get exercised. I don’t complain to the lifeguards. It’s not my pool, I think. It’s there for us all to share. Live and let live. Your swim is just as valid as my swim. I embrace your chattering, your free-diving, your breaststroke screw-kick and your bikinis. I embrace the floating plasters and the overwhelming smell of chlorine. And if your kid (or you) have peed in the water, I don’t really care about that either.

But if the thought of urine, sweat and snot (and worse) appals you, and if you don’t want to swim too close to someone who is almost naked and cooperate with them, then do yourself – and me – a favour. Walk up a deserted mountain instead.

Just keep swimming – through the pee, plasters and human hair | Sally Goble

Sorry, Sally Phillips, but a woman should be able to know if her unborn baby has Down’s syndrome | Hadley Freeman

I’ve always been a fan of Sally Phillips. I loved her as the chain-smoking feminist Shazza in Bridget Jones, of course, as well as the nightmare girlfriend from the past in Green Wing. But mainly I loved her for the 90s feminist sketch show Smack the Pony. Some women experience their feminist awakening when they read The Female Eunuch or Andrea Dworkin. For me, it came from Nora Ephron and Smack the Pony, in which Phillips, along with Fiona Allen and Doon Mackichan, gloriously satirised the rigid expectations placed on women, often by other women.

Which brings me to Phillips’ documentary, A World Without Down’s Syndrome?, which screened on Wednesday night on BBC2. There has been an enormous amount of publicity for this documentary, with praise for Phillips’ clearly heartfelt intentions. The actor has an adorable young son, Olly, who has Down’s syndrome, and one of her aims is to provide a counterbalance to the almost entirely negative depiction of Down’s syndrome in both society and the media. For this, she should be loudly applauded. True, her wholly positive depiction of her life with a child with Down’s syndrome is as partial as the wholly negative ones, not least because her son is relatively high-functioning and Phillips and her husband are able to afford help. Still, as I said, it’s a much-needed corrective, and hats off to her.

But that is not all Phillips and her film are arguing for. Rather, the documentary was pegged to the imminent availability of non-invasive prenatal testing on the NHS, which is a safe and more accurate method of screening for Down’s syndrome than the form currently available, and with no risk of miscarriage. This, according to Phillips, is “sad, it’s just horrible, really”. Later, she describes herself as “really quite angry” about it.

To argue for screening is not to argue, as Phillips suggests, that people with Down’s don’t have a right to life

Phillips makes no bones that she is coming at this subject from a deeply personal perspective, one that is occasionally blurred with tears during her film. This perhaps explains why such a bright woman repeatedly and determinedly conflated equipping pregnant women with knowledge about their unborn baby – that is, being screened – and the advice they are then given about it. No doubt some medical professionals have advised women to have terminations after receiving a positive test; there absolutely should be campaigning about how this kind of information is imparted to expectant women and mothers who have just given birth.

This, however, does not mean that women should be denied available information about their unborn baby’s health, and instead be unnecessarily surprised at birth with a situation for which they may be entirely unprepared. Phillips is right: rates of Down’s syndrome probably will decrease with the rise of easier, more accurate screening. But she is wrong to then draw the conclusion that women should therefore not be informed about the health of their in utero baby.

Phillips did not know Olly had Down’s syndrome until he was born. But this, she says, was a good thing, because by having no choice she was compelled to see how much Olly benefits her family. “That made me wonder whether choice is always the wonderful thing it’s cracked up to be,” she says, a statement which casts something of a shadow on her description of herself as “pro-choice”. But while not having a choice has worked out wonderfully for her family, no consideration is given to women who do not have Phillips’ aforementioned privileges. A single mother with two jobs and three kids, for example, might not find similar benefits from a lack of choice. It is very difficult to see how compelling women who genuinely feel they cannot care for a child with special needs to give birth helps anyone, least of all people with Down’s syndrome.

To argue for screening – and for women to have the freedom to make their own choice with the information – is not to argue, as Phillips suggests, that people with Down’s syndrome don’t have a right to life, or should never have been born. The point is it’s the woman’s choice about what’s best for her and her family, whatever the situation. Early in the film Phillips meets Prof Sue Buckley, who works at Down’s Syndrome Education. “We don’t believe that a diagnosis of Down’s syndrome should be a reason for termination,” Buckley says to a solemn Phillips.

And therein lies the rub: the idea that women should only have terminations for reasons someone else finds acceptable. How about if a woman feels too young to have a baby, or too poor, or doesn’t want to be tied to the man she conceived with for the rest of her life, or she doesn’t want a third baby, or any baby at all – are these permissible reasons for a termination? They are all pretty common ones. Or is it just a Down’s syndrome diagnosis that is deemed an unacceptable cause for an abortion? In more controversial areas, such as sex-selection abortion, the correct approach is to tackle the attitudes behind it, not ban abortion per se. Similarly, with Down’s syndrome screening what needs examining is the image around the syndrome and the way doctors discuss it, not the screening itself. It’s the attitudes, not the science, that’s the problem. Science is what gives women the choice. Which brings me to the nub of Phillips’ documentary.

Phillips, a committed Christian (which was not mentioned in the documentary), and her many online supporters insist that they’re not anti-choice – they just want women to make “informed” choices. The lie of this was revealed when Phillips met Kate, a woman who terminated her pregnancy after she was told her baby would have Down’s syndrome. Kate talked about how she read blogs, positive (“loads”) and negative, by parents of children with Down’s syndrome. She felt “informed”, and she then opted for a termination. Phillips says afterwards to the camera that she felt Kate was wrong: “Kate didn’t want a child like mine. That was difficult to hear.”

So it’s not choices that are “uninformed” that are the problem, it’s choices Phillips and others of her mindset don’t agree with. It is human for Phillips to relate these stories so closely to herself, but it is also astonishingly solipsistic and, given that she is doing so on such a public platform, potentially destructive. I am not generally given to making hand-wringing proclamations about what the BBC should and should not show, but it is genuinely shocking that BBC2 decided to screen a documentary with such a blatantly anti-choice message.

Phillips opened her documentary with the following questions: “What kind of society do we want to live in and who should be allowed to live in it?” The answer to the latter is, of course, everyone, which is the status quo – and more screening would not change that.

Phillips’ inference that screening will lead to babies with Down’s syndrome not “being allowed” to live in this society is dishonest. Anything that gives women more objective scientific information about their pregnancy is good.

The question of what kind of society we want to live in is, to my mind, even more simple: one in which women are not dismissed as “uninformed” or “wrong” on national TV – or anywhere – for making a choice about their pregnancy, and that goes equally for women who decide to carry their Down’s syndrome baby to term, or women who opt for a termination. Feeling is not fact, and being pro-choice means supporting all women’s choices, not just the ones you agree with. I’m pretty sure Smack the Pony once taught me that.

Sorry, Sally Phillips, but a woman should be able to know if her unborn baby has Down’s syndrome | Hadley Freeman

Sally Phillips’s film on Down’s is ‘unhelpful’ for families, warns antenatal specialist

One of Britain’s leading antenatal experts has strongly criticised a BBC film about children with Down’s syndrome, before its broadcast this week.

The documentary, A World Without Down’s Syndrome?, will be shown on Wednesday and is presented by the actress Sally Phillips, who has a child with Down’s herself. In the programme Phillips, known for her role as Tilly in Miranda, makes the case against the introduction of a new NHS pregnancy screening test that would detect with 99% accuracy the foetal abnormalities indicating Down’s syndrome.

Jane Fisher, director of Antenatal Results and Choices, an organisation set up to support parents affected by foetal screening and its consequences, said she thought the programme – in which she is interviewed – was “not at all helpful” to people facing difficult decisions around a prenatal diagnosis of disability.

“Sally is a very compelling presenter,” Fisher told the Observer, “and – absolutely – it’s great to have the positive images of people [with Down’s] who are already here. But it’s very personal, and it’s an extra layer of difficulty for couples and families who might be making the decision now about whether to end their pregnancy. It risks offering the suggestion to those who have [decided to end a pregnancy] that they have made the wrong decision.

“It’s too problematic to have one individual representing that choice – one who is an advocate for not screening, who has a high-functioning, much-loved child. A woman who admits she has the resources for extra help with her absolutely lovely little boy.” She added: “No one is casting aspersions on Sally’s son. Or trying to invalidate his right to be here.”

People with Down’s have an extra copy of a chromosome and have learning and developmental difficulties ranging from mild to severe. Some are more prone to serious health conditions, especially heart and thyroid problems.

Jane Fisher, director of Antenatal Results and Choices.

Current testing for the condition takes place after 12 weeks, at which point women are told if they are at high or low risk. They can also be invited to have a more accurate – but invasive – amniocentesis test, which carries a one-in-100 risk of miscarriage.

The new test, non-invasive prenatal (NIPT), is a blood test that boasts a detection rate of 99%. Currently 90% of people informed that their child has Down’s choose to terminate the pregnancy. Anti-screening campaigners fear that rate will rise if the more accurate, non-invasive NIPT is made available on the NHS, something ministers are currently considering. When NIPT was introduced in Iceland, the termination rate rose to 100%. The test is already available in private clinics, costing around £400.

About 750 babies are born each year with Down’s syndrome in the UK, and there are an estimated 40,000 people living with the condition.

In a joint statement with the BBC, the programme’s makers, Dragonfly, said the film was intended to “bring difficult questions into the public arena. This film follows Sally Phillips as she explores what effect the test could have on our society, drawing not only from her first-hand experience but also by meeting several families who give an insight into their experiences of having a child with Down’s syndrome, as well as people with Down’s syndrome themselves. She also talks to health professionals and experts with a wide variety of views.”

Phillips, who is a Christian, is pro-choice, but says women are pressurised into having abortions by medics, and that the positives and rewards in parenting a disabled child are ignored. “Nobody knows what Down’s syndrome children can achieve,” she says.

There will always be people who choose not to screen, who choose to have the child. The point is choice

Jane Fisher

Anti-abortion groups are involved in the Don’t Screen Us Out (DSUO) campaign, calling on MPs not to introduce NIPT. Lynn Murray of DSUO has called the test the “new eugenics”.

But, according to Fisher, the programme’s warning of a potential “world without Down’s”, if NIPT screenings are introduced, is an over-simplification.

“Full respect for Sally,” said Fisher. “You can see her empathy and her love for her son, and wish for people to have a more positive attitude towards the condition. But it’s important we don’t get too simplistic about this. There will always be people who choose not to screen, who choose to have the child. The point is choice.

“We want to make sure that women who take the decision to end the pregnancy are not perceived somehow as saying they do not value people who are here – they are saying this is not something they can do, that it is not right for them or for their families.

“Not only does no one know how their child would be affected by Down’s, but the big conflict for women is the adult the child will be 20 or 30 years down the line. For most women, that is the bit that tips them to end the pregnancy. An adult who will be, at best, vulnerable,” she said.

Sally Phillips in a scene from A World Without Down’s Syndrome? Photograph: Brian Ritchie/BBC/Dragonfly

The Down’s Syndrome Association has not taken a position either for or against the proposed new screening regime, focusing instead on its own Tell It Right, Start It Right educational campaign, which calls for better training and information provided for health professionals.

Carol Boys, chief executive of the charity and mother of a young man with Down’s, said: “For a long time, we’d been receiving calls from families who are going through the screening process and want more information. Quite a number complain about the way they have been treated.

“Our organisation wasn’t set up to make judgments, but you cannot make an informed decision if you don’t have all the facts. The problem with testing is that people go along and don’t really know what they are being tested for or the implications of the result.

“They find themselves in a high-risk category and don’t know what it means. The screening committee have asked us to help them with training, and we are happy to do that.

“We are essentially here for people with Down’s and their families. As far as life for people with Down’s goes, things have come a long, long way in the past 30 years. Life is always going to be more challenging. They have a learning disability, and they are always going to need extra help and support – but then so do a lot of other people in our communities.”

A World Without Down’s Syndrome? is on BBC2 at 9pm on Wednesday

Sally Phillips’s film on Down’s is ‘unhelpful’ for families, warns antenatal specialist

Sally Phillips: Do we really want a world without Down’s syndrome?

Sally Phillips and her husband, Andrew, didn’t find out that their first child, Olly, 12, had Down’s syndrome until he was 10 days old. Nobody noticed on the day he was born. “I had a caesarean because he was breech,” says Phillips. “I reacted badly to the anaesthetic so everyone was focused on me. Olly scored highly on all the tests and no one noticed there was anything different about him. I noticed. And I asked them to look at him. There was something about his eyes that was troubling me. It was as if his cheeks were really big and not allowing his eyes to open. I said, ‘Does he look like that because I ate a lot of cake when I was pregnant?’ They said, ‘Yes, probably.’”

Best-known for her roles in the Bridget Jones films (as Bridget’s best friend, Shazza) and Miranda (where she plays Miranda’s old school friend, Tilly), she has a knack of making comedy out of life, including her own. And she is not afraid of making fun of herself or her family. Indeed, showing that you can have a normal family life (because what is that anyway?) with a child with Down’s syndrome is one of the main points of a documentary Phillips has made for BBC2, A World Without Down’s Syndrome?

Her first documentary, it examines whether the new, non-invasive screening tests that are available will eventually eradicate Down’s syndrome. Phillips finds the prospect chilling.

She didn’t know that Olly would have Down’s syndrome. “Babies with Down’s syndrome quite often have poor muscle tone and find it hard to feed. We would stay up all night trying to feed him and by 10 days after his birth, he had gone down from 8lb to 3lb. Everyone was still saying, ‘You’re a first-time mum and you’re worrying. Babies always lose weight.’”

She had all the usual prenatal tests but they all came out as indicating an average risk. She admits she felt strange during the pregnancy but put it down to being a first-time mother. “I’m not one of these people who thinks they are psychic. But I just didn’t feel good during the pregnancy. I was all swollen up. It was like I’d been stung by a giant hornet. But everyone kept saying, ‘You’re a first-time mum, it’s all fine.’ Now, being politically correct, I wouldn’t say that I felt that something was ‘wrong’ but I knew that it was different.”

Phillips’ instinct was right. But she is evidently resilient and resolved to be open-minded about parenting a child with Down’s syndrome.

She has been pleasantly surprised. “There were lots of moments during Olly’s babyhood where I would think to myself, ‘Wait a minute, I am not experiencing this as a disaster.’ But you are so bought into the narrative. All the pregnancy books refer to Down’s syndrome as a ‘defect’. All you get is this information that says ‘High incidence of leukaemia, high incidence of deafness’ … It’s totally overwhelming and unhelpful.”

Her family life, as seen on the documentary, is the counter-narrative: water fights, paint fights, an obsession with Barcelona football club and a lot of dancing. Olly, it turned out, was completely different to the “tragedy” she was reading about. “Olly smiled his first smile at four weeks, like any baby, and it was this massive great big smile. I remember I had this one moment when I was going into town on the bus and there were these two mums with their ‘perfect’ babies and they were complaining and whingeing about everything. I thought, oh. I’m supposed to be having a dreadful time? I’m really not.

Sally Phillips in a scene from the documentary, A World Without Down’s Syndrome? Photograph: Brian J Ritchie

“At that point I was swinging Olly around the house in a towel, trying to teach him to crawl. That is something you would not have to teach a ‘normal’ child. But we were learning to crawl together and our bond was incredibly strong. We would laugh like lunatics for large portions of the day.”

We are talking in a large room overlooking the garden at her house in south-west London. Every two seconds we are interrupted by her two younger sons, Tom, four, and Luke, nine, showing off and being random. Their father, Andrew, a shipping industry executive, hovers nearby. She chases the boys out but they keep coming back. Eventually Olly wanders in with his iPad, looking for peace and quiet.

“Turn the sound off if you’re coming in here, Olly,” says Phillips.

“It is off,” he looks at us, witheringly, suddenly deciding against sharing space with two boring old people, “But bye bye.” It’s standard 12-year-old behaviour.

Olly attends a mainstream school and has disproved a lot of theories Phillips was told about when he was born. “I was told he would never ride a bike. He goes for a bike ride every day. I was told he would never be able to climb anything. Then we started having this problem where he would scale the back fence of the garden because he wanted to make friends with the neighbour’s children. None of the rest of us could scale that fence. The thing is, nobody knows what Down’s syndrome children can achieve.”

Do we really want to eliminate this community of people – 40,000 strong – in the UK?

It took years for her to decide that she was willing to front a documentary about Down’s syndrome. For a long time she had been hoping that someone else would make one and show the truth about how living with a child with Down’s syndrome is not depressing and life-ruining – in fact, the opposite. Eventually she realised that this wouldn’t happen and she would have to make it herself.

The tipping point? The new prenatal testing that should soon be available on the NHS – NIPT (non-invasive prenatal testing). This is a blood test that is done from week 10 of pregnancy and detects Down’s syndrome with 99% accuracy. In countries such as Iceland (which Phillips visits in the film), the introduction of the test has meant that 100% of Down’s syndrome pregnancies are terminated.

Phillips wants to pose the question: Do we really want to eliminate this community of people – 40,000 strong – in the UK?

“We have the most expensive state-of-the-art Down’s syndrome detection test and the ability to terminate right up until birth. But no allowance is made for the point of view of the other side. The families of people with Down’s syndrome are not consulted. People with Down’s syndrome are not consulted. There has never been an ethical debate about it.”

Phillips didn’t particularly want to be the one to start this debate, but that’s how it has worked out. Her status as an apologetic and reluctant activist is what makes the film appealing, funny and easy to watch. Although she has made no secret of the fact that she is a Christian and a lot of her fascination with ethics is clearly informed by her faith, she is keen to emphasise that she is pro-choice. Plus, she has a fierce curiosity about the views of those she disagrees with.

The film shows her struggling with her emotions as she interviews a woman who decided to abort a Down’s syndrome child. Phillips shows the woman a video of a Down’s syndrome woman competing at a gymnastics competition. The woman is unmoved and unimpressed. As the mother of a Down’s syndrome child, Phillips is clearly angry. But you can also see that she is empathetic, trying to understand. She’s a good person to put across two sides of the story.

There are, of course, two sides to her own story in this context: life before and after Down’s syndrome. “I didn’t know anything about Down’s syndrome at all,” she says. “I didn’t even know anyone with a disabled child. In fact, I don’t think I knew anyone who was disabled.”

Her point is that we are sleepwalking into a world where we could eliminate Down’s syndrome. Is that what we really want? There is a question she has faced all her life as a parent that has always bothered her. “I get asked, ‘Did you know?’ But what I hate is that I also get asked, ‘Didn’t you know?’” The implication being that if she had known, surely she would have terminated the pregnancy.

“And that’s what worries me.”

She would not have terminated the pregnancy. And with what she knows now, she wants to make more people aware of the fact that a Down’s syndrome child does not need to be in the “defect” category. Quite the opposite, she would argue.

She adds: “In a system where everybody screens and where you know at 10 or 12 weeks with 99% certainty whether your unborn baby has Down’s syndrome, it becomes ‘your fault’ if you choose to have the baby. We have imperceptibly flipped into a situation where the woman is under societal pressure to have that termination. Where does it lead? If you choose to have that child, should the government help you? After all, it was your choice. Why should anyone else help you?

“We are really close to that attitude already. There is already a new kind of pernicious discrimination towards disabled people, the idea that they are scroungers. ‘Why should you steal my taxes?’ Who, then, would want to have that child?”

• A World Without Down’s Syndrome? will be shown on BBC2 on 5 October

Sally Phillips: Do we really want a world without Down’s syndrome?

In the 19th century it was clean consuming water, now its healthy behaviour | Sally Davies

Local government could act to restrict the results of alcohol, tobacco and quick foods by incorporating a overall health effect evaluation into the approval processes for preparing applications. Photograph: Matt Cardy/Getty Pictures

The first wave of public wellness action occurred in the wake of the industrial revolution. It was mainly aimed at bettering environmental problems: the provision of clean consuming water, enhanced sewage disposal and safer foods. There was also legislation to improve functioning problems and protect children.

It was throughout this period that John Snow identified the supply of the 1854 Soho cholera epidemic as the public water pump on Broad Street, following conversations with regional residents and clever linking of information. It was later identified that the public properly had been dug only 3 feet from an outdated cesspit. Snow’s review is regarded by a lot of as the founding event of the science of epidemiology and is an early demonstration of the value of very good public well being practice.

Defending people from these types of threats stays at the heart of our public health method. We continuously face new infectious disease threats, such as antimicrobial resistance. But public well being practice is evolutionary, driven by waves of well being challenges and continuous improvement in our understanding and information. Every new wave reflects major shifts in pondering about the nature of society and wellness.

The most latest wave – roughly from the 1960s to existing – has encompassed identifying effective interventions that prolong healthful existence, higher comprehending of the leads to of disease, action close to risk factors and life-style, and addressing social inequalities in overall health.

The greatest problems dealing with societies in the 21st century are the altering burden of disease and development of resistance of microbes to remedy. This indicates that men and women and society alike need to take more obligation for well being.

Three items will support to attain this: incentives for wholesome behaviour promotion of a healthier option as the default choice and tackling environments that advertise unhealthy behaviour.

Various groups in society are probably to contribute in diverse methods. Governments need to have to make certain that public wellness policy is informed by evidence, is rigorously assessed and coordinated successfully across Whitehall. My part as chief health-related officer is unique, as I am a civil servant but have a statutory duty to give independent advice to government. It is my job to make certain that public overall health and antimicrobial resistance is at the forefront of politicians’ minds.

Meanwhile, the wide remit of nearby government – which contains infrastructure organizing, waste and recycling, leisure and tourism, and social care – gives a number of possibilities to promote healthier environments. Action could consist of reduction of the density and spot of alcohol, tobacco and quickly-foods shops. This could be done by incorporating a wellness influence evaluation into approval processes for planning.

The private sector can also play a element as employers, as building- and land-owners, and by way of its affect on customers. In particular, market has a part in promoting the wellness of its workforce, along with a broader duty to society as a complete.

Attaining all this will imply a huge adjust in social norms. There is expanding evidence of the power that social networks exert on behaviour. For healthy behaviour to come as common, institutional, social and physical environments all want to help this shift in the collective mindset. It can only function as a holistic, collaborative hard work.

Several of these ideas are not new and there is sturdy evidence for their significance, emanating for illustration from the Ottawa Charter and the Planet Overall health Organisation’s Commission on the Social Determinants of Overall health. But we need to have a new wave of leaders, in households, social networks, organisations and wider society – collectively driving a adjust towards more healthy behaviour.

•The Guardian Society Professionals web site for people doing work in the public servies is revisiting Beveridge’s five giant evils of the welfare state. Lengthy-term and continual overall health situations are a modern social evil. Find out how social professionals are helping to increase care at theguardian.com/societyprofessionals

In the 19th century it was clean consuming water, now its healthy behaviour | Sally Davies

Lord Archer"s former lover Sally Farmiloe says "They contact me Lazarus - I"ve risen from the dead"

Miraculously, Farmiloe started to improve, and following a few weeks she started to sift by way of her stack of health care notes. Buried there was a psychological detonator: a report describing her as “clinically deteriorating” and noting that in see of her sophisticated illness it would not be acceptable to resuscitate her in the event of a cardiac arrest. The words and their implication made her truly feel dizzy.

“Whaaat?” she says huskily. “I had by no means mentioned it with them never authorised it. Even in my weakened state, I would have desired to battle with every fibre of my currently being. But a group of effectively-that means medics had made the decision that, need to my heart fail, I would be too weak to undergo remedy to revive me.”

What incensed her was that the situation had been raised only with one of her in-laws. “I feel strongly that if a patient is not well enough to be in charge of their own lifestyle and death, something as critical as this ought to be mentioned with a blood relation. It should have been Jade [her 22-yr-old daughter, Jade Farmiloe-Neville, a style and elegance model]. She is my rock, my explanation for residing she knew I would battle to the bitter end.”

Farmiloe is campaigning for far more stringent principles governing do-not-resuscitate orders and for folks to make residing wills so that their intentions are clear. “I am fortunate in that no 1 in my family has a vested curiosity in hastening my end. Other people may be much more vulnerable. As a patient who has been traumatised by this, I want to include my very own little voice so that other folks have a opportunity to make their wishes identified.”

Cancer has a way of realigning values and priorities, as Farmiloe has found. Righting wrongs is one facet, exorcising old feuds another. In this “spirit of forgiveness”, she approached her former lover, Lord Archer, at a City awards ceremony not too long ago and, resplendent in red, had her photograph taken with him. Despite her energetic round of solution endorsements, fund-raising for great brings about, creating and modelling, it is a penalty of the celebrity circus she enjoys so much that she is remembered for being Lord Archer’s mistress and all-round very good-time lady far better than almost something else. (She had many acting roles, such as the Bafta-winning Dear Rosie (1991) and as a standard in the common but cheesy Eighties tv drama Howards’ Way.)

_{Sally Farmiloe and her former lover Lord Archer}

Although he has disappointed her in the past, she says, specially by not keeping an undertaking to shell out her legal bill when she sued a newspaper at the height of her alleged kiss-and-inform scandal, a current report claiming that he spoke disparagingly of her wellness crisis infuriated her significantly more. (In an article in The Instances in March, Andrew Billen said he was shocked by a callous comment the peer created about his ex-mistress. Lord Archer had asked him not to print it and, despite currently being harried by other journalists, Billen has not disclosed what it was.)

“I was shocked since Jeffrey has in no way slagged me off in the past,” she says. “He presumably mentioned it because he thought I was dying and would not see it.”

She intended to confront Archer, but says her anger melted away when they met. “I realised it did not matter. He was very sweet and charming and chivalrous. We just talked about his new guide [Be Careful What You Want For, which, by a good irony, Farmiloe is reviewing for her column on a website, Hot Gossip]. I was pleased I bumped into him. I’m glad I’ve had the likelihood to clear the air, type of thing. I really don’t want to have any bad emotions for anybody. It’s not very good for you as a cancer patient to harbour anger inside you.”

_{Lord Archer and his wife Dame Mary}

Farmiloe’s three-and-a-half 12 months affair with Archer was exposed in 1999, just before he was identified guilty of perjury and perverting the course of justice and sent to prison. The affair defined her life, but she does not regret it: “only that I was caught”. He was, she says, a wonderful boyfriend, generous and witty. As the confidante of “lots of richer and a lot more famous” men, she had been the soul of discretion. Then came a trumped-up “true confessions” story in a nationwide newspaper, which was taken up by other publications. “That ruined me, actually, since I looked like a kiss-and-tell lady. I looked like a undesirable man or woman. I had to sue the newspaper. If I had had Jeffrey’s funds behind me, I would have sued them all. It was pretty tough operate and rather nasty. It was out there – and it wasn’t correct.”

Did she have any misgivings although the affair was going on? “Not actually. I knew about the marriage. I’m not a particular person who goes around nicking married women’s husbands. It wasn’t like it was a really strong marriage and I was going to break it up. I did not come to feel poor because I knew she had her very own existence, you know.”

Farmiloe is now securely married to Jeremy Neville, 60, who runs a property management company in west London. She has not only brought up Jade and Alistair, her stepson, but also Kat, the daughter of her ideal friend Marilyn, who died of cancer 18 years ago. Neville has not featured significantly in this narrative so far. “He is a quite stoical kind of man or woman, as Englishmen usually are,” she explains. “He has had really a whole lot of cancer in his daily life already. He had a new enterprise, which was like holding a tiger by the tail. He’s there if he’s essential.”

Severe sickness can undermine a marriage as effectively as strengthen it, I say. “I consider a great deal of females with cancer are concerned they are going to lose their partners. And a good deal of males do run for the hills when they find out their partner is going to shed their hair, have to take steroids, place on fat, produce marks on their skin.” (There are bruises on her arms where the skin has thinned, and a sweat-band sized bandage the place it has broken. “There’s a bit of a bleed going on here,” she says matter-of-factly.) “And there are numerous unpleasant side‑effects. I can kind of comprehend it. Jeremy puts up with it, bless him. But Jade is my primary cancer buddy, the most treasured particular person in my whole lifestyle. She sees me by means of.”

At the finish of her breast cancer therapy last 12 months – a lumpectomy followed by eight sessions of chemotherapy – Farmiloe wrote My Left Boob: A Cancer Diary, an idiosyncratic, informative book about how the adore of friends and family members, the skill of doctors and faith in a wide selection of therapeutic interventions, from hypnotherapy to hairdressing, saved her daily life and her sanity.

A glass of champagne meets most emergencies. Fake lashes are her best close friends. She can be amusingly frank and useful. The dent in her breast from surgery does not bother her “because it is on the outside of the boob, which does not display in dresses, and I will nonetheless have my cleavage, which is the bit of the bustline I require for my work”. Her ash‑blonde acrylic NHS wig, “Crystal”, is a life‑support. You cannot but respond to her quite human muddle of courage and fear, as nicely as the generosity of spirit with which she shares the entire humiliating organization.

Sadly, she is now working on a sequel. She has a new battle on her hands: a lot more chemotherapy, a diverse variety of cancer. Of program, no person dies of cancer any a lot more. The modern language of health-related positivism dictates that they “live with” it. I really don’t feel I have met anyone who embodies that principle very as totally as Sally Farmiloe.

At Sally Farmiloe’s request, the Telegraph has made a donation to Professor Ian Smith’s cancer investigation fund. ‘My Left Boob’, RRP £9.99, is available to buy from Telegraph Books at £9.99 + £1.ten p&ampp. Phone 0844 871 1514 or pay a visit to books.telegraph.co.uk

Lord Archer"s former lover Sally Farmiloe says "They contact me Lazarus - I"ve risen from the dead"

Where Recollections Go: Why Dementia Alterations Almost everything by Sally Magnusson – assessment

Alan Bennett launched himself to me at a get together. “I read your book about your mam,” he explained. “She went mad far more interestingly than my mam.” In the madness of dementia, people can seem beatific, getting to be quieter and quieter, lowered to a faint smile. They can sit slackly, eyes unfocused in the direction of the green blur of the nursing home garden, or they can rave and be unreasonable. Dementia can be a disease of cruelty, insults, bodily violence – the patient attacking the carer. My mom had vascular dementia, and invested the last four many years in a residence in which she was described as the most challenging situation they had ever had.

Sally Magnusson, broadcaster daughter of Magnus, who presented Mastermind, had a mom she adored, Mamie Baird Magnusson, a newspaper journalist. When dementia took hold, it started with sweetness, humour and an component of insight. Her loved ones had been adamant that they would care for her at house, setting up complex rotas by Dropbox folder. By the finish, Mamie was aggressive and alienated from her personal twin sister. “I am aghast at how swiftly my temper frays when practically nothing I say or do seems to aid,” Sally writes.

Mamie was previously exhibiting the signs of Alzheimer’s illness when her husband died of cancer. It was not protected for her to administer his medication. A working-class woman who entered journalism in the 1940s, in her heyday she had been a pioneer who became the star author of the Scottish Day-to-day Express. The photographs in In which Memories Go demonstrate that all through her existence she possessed elegance, vivacity and a smile that could eclipse lighthouses. She was a woman who loved language, and the 1st realisation that one thing was incorrect comes when she reads an tackle at a friend’s funeral, then starts once more on the first page and has to be led away.

A trip on a paving stone and a proposed hip operation turns into a hospital remain of unmitigated horror: delirium in the evening, cancelled operations and subhuman nursing leaving her terrified and alone, with out foods or drink. The household decides that she will by no means yet again face institutional care. By now, Mamie’s memory is becoming bulldozed. Sally’s brother, her parents’ 1st-born, died aged 11, run more than by a lorry. Mamie would sit howling on the bedroom floor with 1 leg flung against the door in situation a youngster need to see her. In her dementia come phrases that Sally hears “with a thud of horror”. After a long browsing look, Mamie asks: “Now remind me. Who is Siggy?”

And on and on the condition relentlessly runs with the sickening bumps of new revelations of its advance and the occasional surprises of comedy: the calm declaration that Mamie and Magnus had found America, a last holiday to a Spanish city that she likens to Aberdeen and the gnomic observation that the then president of the Czech Republic, Václav Klaus, was the person who forced Sally’s inlaws to depart their property and come to Scotland (a feasible confusion with Hitler). But Magnusson understands that these startling inventions are a “straining to get element in a conversation by appropriating whatever has presented itself” to her mother’s imagination “by way of a story after heard or a snippet of info absorbed”.

Dementia is a ailment that proceeds in minor spirals – there are a handful of mirages of a return to cogency – but, as opposed to psychological illness, it is, at present, incurable. It ends only in death. The narrative construction of The place Memories Go alternates amongst the story of Mamie’s advancing sickness and Sally’s very own journalistic excursions – like other carers just before her, Magnusson trudges round from skilled to professional making an attempt to understand. I did considerably the same myself a decade earlier. The professionals throw some light on the nature of Alzheimer’s condition, but it is challenging to see how any of it helps, and these are the least interesting chapters.

She has selected, unusually, to publish the guide in the second person singular, and is speaking to her mother (“you”) during. This effect is rather suffocating: it the two excludes the reader from the dialogue and raises the query of how a lot is not getting mentioned. Is Magnusson saying what she would have liked to have told her mother if she could have understood her, or what she would never ever have dared to have communicated? How trustworthy are really like letters, specially people written as a posthumous eulogy?

We hear minor about Magnusson’s romantic relationship with her mother ahead of she was sick, apart from a lengthy letter Mamie wrote to her a couple of weeks before her wedding in 1984. It displays what a lively and thoughtful author she was. The breakdown, the eclipse of these skills, should have been heartbreaking to watch, but we get little sense of who Mamie genuinely was prior to the condition. Admiration smooths out comprehending.

The ultimate pages detailing the final couple of weeks of Mamie’s existence had been agonizing for me to read through. Mamie’s death and my personal mother’s death had been of a piece: the breakdown of language into fragments of syllables, the hands clutching the air, the hallucinations, the skeletal figure in the bed. This isn’t the first guide-length account of dementia, nor will it be the final. But as dementia goes on repeating itself, the story bears repeating, in excess of and over once more since the loss of memory is a single of the biggest mysteries of our age. Without memory we are practically nothing and no one.

• Remind Me Who I Am, Yet again by Linda Grant is published by Granta.

Where Recollections Go: Why Dementia Alterations Almost everything by Sally Magnusson – assessment

Let mothers breastfeed their babies in workplace meetings, says Dame Sally Davies

Mothers need to be allowed to breastfeed their children at work and even in office meetings, the country’s chief healthcare officer Professor Sally Davies has explained.

Professor Davies mentioned ladies ought to be allowed to feed their babies in the workplace as component of daily lifestyle.

Dame Sally, who earns far more than £225,000 a year as the Government’s prime healthcare advisor, described the time that she shocked male colleagues when she attempted to breastfeed her daughter in the course of a meeting, the Mail reported.

Speaking of the want to make breastfeeding far more ‘acceptable’, she said: ‘I was there in this giant shirt with a child hiding below it and a comment was produced and my response was quite sharp.

Addressing an occasion organised by the Wellbeing of Women charity in London yesterday, Dame Sally, 64, mentioned that one particular way of boosting women’s prospective customers in the workplace would be encouraging them to breastfeed at operate.

Prof Davies claimed that women physicians have been underestimated and poorly paid as properly as far significantly less most likely to be in positions of energy.

She used her speech to try and motivate the NHS to do more to ensure females can ‘make it up the ladder’.

Let mothers breastfeed their babies in workplace meetings, says Dame Sally Davies