The government has made a last-minute application to the high court to delay the publication of its plan to tackle the air pollution crisis.
Ministers were under a court direction to produce tougher draft measures to tackle illegal levels of nitrogen dioxide pollution, which is largely caused by diesel traffic, by 4pm on Monday. The government’s original plans had been dismissed by judges as so poor as to be unlawful.
But following the announcement by Theresa May of a general election on 8 June, ministers lodged a lengthy application to the court late on Friday. It is understood they are asking judges to allow them to breach Monday’s deadline and submit a draft in June – after the general election.
It is understood that a full policy will not be produced until September this year.
The government has had months to come up with its air quality plans and Whitehall sources indicated to the Guardian this week they would be published in time.
The late application to delay publication was condemned by the environmental lawyers group ClientEarth, which successfully took the government to court over its air quality plans. MPs have said air pollution in the UK is a public health emergency that causes 40,000 premature deaths a year.
James Thornton, CEO of ClientEarth, said: “We are urgently considering the government’s application to delay the publication of the draft air quality plan which was received on Friday evening, less than one working day before the plans are due.
“It is far from acceptable that ministers have left this to the very last minute. The government proposes to delay the publication of the air quality plan despite the clear public health risk caused by illegal air quality. These plans are essential to safeguard public health and they should be put in place without delay.”
The application is likely to be considered by judges on Monday. Judges have already told ministers that their plans were taking too long and imposed the deadline to force the government to come up with new measures more quickly.
The government lodged a lengthy application shortly before 7pm on Friday to the court, which was too late for the court to accept. It will now be considered early next week.
Thornton said the general election was not an acceptable reason to delay taking action against air pollution.
“This is not a political issue but a public health issue. Whichever party is in power, the British public need to see an air quality plan which relies on good scientific evidence and which ensures that people no longer have to breathe toxic air and suffer the grave consequences to their health as a result,” he said.
Greenpeace also condemned the delaying tactics. Anna Jones, from Greenpeace UK said: “Ministers have had months to come up with a robust plan to tackle illegal air pollution. They have no excuses to delay its publication any further.
“The Cabinet Office guidance makes it clear that essential consultations can still be launched during purdah, and even mentions safeguarding public health as a ground for exceptions.
“Air pollution is a full-blown public health emergency, linked to thousands of premature deaths and a host of health problems. If the government intends to use the election as a pretext to buy more time, that would only be a sign that they just don’t get the gravity of the situation.”
A joint Guardian/Greenpeace investigation revealed this month that hundreds of thousands of children were being educated within 150 metres of a road where levels of nitrogen dioxide from diesel traffic breached legal limits.
A spokesman for the Department for Environment, Food & Rural Affairs said: “We are firmly committed to improving the UK’s air quality and cutting harmful emissions. We are seeking an extension to comply with pre-election propriety rules.”
The findings in your article (Hundreds of thousands of children being exposed to illegal levels of damaging air pollution from diesel vehicles, 4 April) are scandalous. We are storing up huge unknowns in terms of the future of our children’s lung health. We need urgent action. The government must bring in a fair and ambitious Clean Air Act with targets to ensure pollution levels are monitored around every school and nursery located close to busy roads, arming parents and teachers with the information they need to take action to protect children’s health. Traffic emissions are the main culprit, but we know people bought their old diesel cars in good faith. A targeted scrappage incentive scheme would be a positive step, which could persuade drivers to switch quickly to cleaner vehicles. The Guardian and Greenpeace’s investigation shows our children’s lung health demands action now. Dr Penny Woods Chief executive, British Lung Foundation
• Your article highlights diesel fumes in London.In Hampstead, north-west London, pleas to Camden council to take account of the EU air quality directive and limit developments with massive lorry movements have not been heard. The council accepts that if it complied with the directive it will have to stop developments, and it is just not going to do that. Some 12,500 children go to schools in Hampstead every day, many under the age of seven. Development after development is approved by Camden and government planning inspectors right next to schools where children are exposed to lorry diesel fumes. One such development will see 2,000 lorry movements.
Cycle superhighway 11 will shut five out of 10 lanes on the main north-south corridor used by 40,000 vehicles a day. Transport for London confirmed that traffic will fan out into our narrow residential streets causing congestion and pollution, with up to an extra 475 vehicles an hour on one of our roads which has two primary schools with kids aged from two. Parliament passed laws to enable HS2 to pollute our area with 800 lorry movements a day. The continuing assault on air quality by local councils and government authorities shows that they pay only lip service to improving our air quality. Jessica Learmond-Criqui London
• Schools should be especially concerned as air pollution has been shown to cause a range of adverse effects including obesity, asthma, infant mortality, low birthweight babies, and depressed IQ.
All schools keep a record of asthma inhalers brought to school and over two decades ago, the late Dr Dick van Steenis proposed that “every county conduct a survey of primary schools to ascertain the proportion of children taking inhalers to school, and that any area with high proportions be investigated locally. This would be quick, cheap and effective.” (Airborne pollutants and acute health effects, The Lancet, 8 April 1995).
As far as I know, no council bothered to do so. Perhaps this will change now that Sadiq Khan is mayor of London and an asthma sufferer who’s determined to tackle air pollution, but who seems to have overlooked the impact of incinerator emissions. Will Khan publish the percentages of children in Years 3 to 6 in each London school who bring in asthma inhalers? Michael Ryan Shrewsbury, Shropshire
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An EU review has revealed multiple failings by the UK in applying environmental law, on the same day that the commission escalated its action against Britain for breaching air pollution limits.
Britain has been in breach of EU nitrogen dioxide (NO2) limits since 2010, with London overshooting its annual air pollution limit for the whole of 2017 in just the first five days.
The Guardian understands that a “reasoned opinion” will now be sent on 15 February to the UK and four other countries: Germany, France, Italy and Spain. If a satisfactory response is not received within two months, a case at the European court could follow.
“In principle it could start later this year, but first we have to decide on a referral to court,” an EU source said. “Your goal is always to get them [infringing countries] to comply without taking them to court.”
An estimated 50,000 Britons die prematurely each year from diseases caused by air pollutants such as fine particulate matter, nitrogen dioxide and ozone, according to the review.
Six million working days are lost from pollution-related illnesses annually, at a cost of €28bn per year, it says.
News of the court move was welcomed by Seb Dance, the Labour MEP who was photographed behind Nigel Farage in parliament with a sign saying “he’s lying to you” last week. “It is great that the EU is doing this,” he said. “It shows the value of being in the union and having recourse to action when standards are breached.”
A high-profile environmental case against the UK at the European court of justice could inflame eurosceptic passions, as fears grow on the continent about the potential shock waves from Brexit.
Britain is already failing in its application of laws on air quality, water standards, and the conservation of several species, particularly marine porpoises, according to the latest review.
If Theresa May makes good on her threat to turn the UK into a low tax zone off the shores of Europe because a Brexit deal cannot be reached, environmentalists fear a further deterioration.
Pieter de Pous, the deputy director of the European environment bureau, said: “This review is the latest sobering reminder of the UK government’s shameful lack of ambition when it comes to environmental protection.
“Given Theresa May’s extremely worrying threats to turn the UK into a tax and deregulation haven post-Brexit, any future deal granting the UK access to the single market must come with strict conditions – and rock-solid guarantees from the UK – to ensure that it complies with existing and future EU environmental law.”
Commission sources said that Brexit would have “economic implications” for EU environmental policy, but that it was too early to speculate what they might be.
The Green MEP Molly Scott Cato said that May’s failure to include environmental protections among the 12-points of her Brexit white paper was “a clear indication that to be charitable, the environment is not at the top of her list and, to be more cynical, that Brexit is partly being driven by a desire to reduce environmental standards as part of a bonfire of the regulations”.
She said: “Using attempts to destroy our own standards as a bargaining chip is something I find extraordinary. It’s absurd. Who would go into a negotiation like that? Our weaknesses in leaving the EU throw us into the hands of the US when it is being run by a president and cabal who are deeply anti-environment and climate action. It leaves our environment very vulnerable.”
In an interview with Michael Gove last month, Trump railed against “environmental tricks” by the EU, which he claimed had prevented him from building a sea wall to protect a golf course in Ireland.
The construction works would have destroyed the natural habitat of the 2mm long narrow-mouthed whorl snail.
Conservatives hoping to lure the US into a rapid free-trade deal may be frustrated to discover that the UK is still obliged to draw up a strategy for protecting bats and the great-crested newt under EU birds and habitat laws, which will continue to apply until Britain has finally departed the union.
Full compliance with the EU’s waste recycling laws by 2020 could net €42bn of savings across Europe and create 400,000 new jobs, according to the EU study.
Charities are calling for improved mental health provision in schools as new figures reveal more than 50,000 children and young people contacted Childline last year seeking help for serious mental health problems.
The helpline has seen a 36% rise over four years in youngsters needing help for depression and other disorders, while there was also a rise in the number of youngsters feeling suicidal.
Figures from the National Society for the Prevention of Cruelty to Children (NSPCC) reveal 50,819 children and young people in 2015/16 received counselling for a serious mental health issue – a rise of 8% over four years.
Those aged 12 to 15 made up a third of the sessions, with girls almost seven times more likely to seek help than boys.
Peter Wanless, chief executive of the NSPCC, said the figures, released at the start of Children’s Mental Health Week, were deeply concerning.
He said: “To ensure the next generation aren’t left to deal with a mental health epidemic, there has to be a much more comprehensive network of professional support and treatment in place that is easily accessible for young people who are desperate for help to get their lives back on track.”
Sam Royston, director of policy and research at the Children’s Society, said it was desperately worrying that so many young people were experiencing problems.
She said: “Whilst such issues may affect any child, in our own research, we have found there is a widening gap between the wellbeing of adolescent girls and boys.
“Many factors may contribute to this – for example we have found that adolescent girls are particularly likely to experience emotional bullying such as name-calling.”
She added: “Failing to address mental health problems early on can severely damage the lives of young people. As a first step all children should be able to access mental health and wellbeing support such as counselling in schools so they get support early to prevent a problem becoming a crisis.”
Childline said early signs of a serious mental health problem in children and young people include becoming withdrawn from friends and family, being tearful or irritable, sudden outbursts, and problems eating or sleeping.
One 16-year-old girl told Childline: “I want to know what’s wrong with me. I have been seeing a counsellor about my mental health issues recently but they just told me to eat and sleep better and forget about the past, which didn’t help me at all.
She added: “I wish I could speak to someone who actually cared about me and I felt comfortable talking to.”
Another young person said: “I’m struggling to cope with bipolar. One minute, I feel so low, like I’m trapped, and all I want to do is disappear. Then suddenly, I feel the complete opposite, and I’m really happy and I start thinking about everything in a really positive light. I feel like I push away everyone that tries to help, I tell them I hate them and blame them for everything. I just feel like I’ve turned into a monster.”
Childline founder Dame Esther Rantzen said: “It’s striking how many more children seem to be suffering serious mental health problems today than when we launched Childline 30 years ago.
“So many desperately unhappy children seem to be suffering suicidal thoughts, self-harming, becoming anxious and depressed, with many of them turning to Childline because no other support is available.”
Rantzen said children’s mental health services are already “terribly overstretched” with young people unable to access the professional help they need.
She said: “We believe there needs to be far more emphasis on providing help for these children as they struggle to deal with what are very serious illnesses.”
Sarah Brennan, chief executive at the charity YoungMinds, agreed more support for young people was vital, especially from schools.
She said: “Young people face a huge range of pressures including stress at school, college, university, body image issues, bullying on and offline, around-the-clock social media and uncertain job prospects.
“Difficult experiences in childhood including bereavement, domestic violence or neglect can also have a serious impact on mental health.”
Brennan added: “As a society we need to do far more to prevent mental health problems from developing in the first place. To start with, we urgently need to rebalance our education system, so that schools are encouraged to prioritise well-being and not just exam results.”
Childhood memories of growing up with an alcoholic father have prompted the shadow health secretary to call for greater recognition of the damage done by excessive drinking.
Jonathan Ashworth said there was a need for urgent action because the cost of alcohol-related harm was not just the £3.5bn NHS price-tag, but up to £7bn in lost productivity for the British economy.
During an interview with the Guardian, the Labour MP said he also wanted there to be much more focus on the needs of families affected by alcoholism, claiming the issue would be a priority for him and Labour in 2017.
Ashworth said he was surprised to find himself disclosing, for the first time to a national newspaper, the reason he felt so passionately about the issue.
“It’s quite personal for me, because my dad was an alcoholic,” he said, suddenly spilling out early memories of his father falling over drunkenly at the school gates and of returning home to a fridge stacked with cheap booze and no food.
Ashworth said he had never really considered his experience as something relevant in policy terms. “You didn’t think there was a problem, you just thought ‘that is the life I’ve got’,” he said.
Then he came across the work being carried out by his Labour colleague, Liam Byrne, whose childhood was affected in a similar way.
The MP’s all-party parliamentary group dedicated to the children of alcoholics has revealed that local authorities across the country tend to have no specific strategies to help young people affected in this way.
The group, which is publishing research on the issue in the new year, said that millions of children were “suffering in silence”.
Inspired by Byrne’s work, Ashworth felt he wanted to make the issue a priority in 2017. “I wanted to do something on alcoholism so that if nothing else I’ll have done something on that,” he said, before adding: “I know it’s cliched.”
As well as backing Byrne’s ideas he wants to support a phoneline run by the National Association for Children of Alcoholics to help make it a nationwide service. He also wants more specialised training for professionals to support children and for councils to be properly funded to be able to reach out to families affected by alcoholism through schools, via community nurses and in Sure Start children’s centres.
Ashworth was inspired by Labour MP Liam Byrne who has set up an all-party parliamentary group dedicated to the children of alcoholics. Photograph: Peter Macdiarmid/Getty Images
Ashworth talked about his own experience as an only child in a working-class part of north Manchester after his mother, who worked as a barmaid, and his father, a croupier in a Salford casino, divorced.
He spoke vividly about the days that he stayed with his father – whom he said he loved dearly.
“I remember him falling over when he picked me up at the school gates and we’d get home and there would be nothing in the fridge other than bottles of wine – he drank cheap horrible bottles of white wine … and cans of lager and Stone’s bitter,” said Ashworth.
“When I got to 11 or 12 then I was effectively looking after him on the weekends because he was drunk all weekend,” he said, pausing before adding: “And eventually he died.”
Ashworth recalled trying to persuade his father not to move to Thailand one Christmas. The MP said he knew in his heart it would end badly, but his father replied: “No, I’m going,” and he went.
“I never saw him again,” said the MP.
About a year later he received a call telling him to travel to the small apartment where his father had been staying. When he got there he found his bed surrounded by empty whisky bottles. “He was in Thailand for that last year drinking a bottle of whisky a day … I had to clear it up. That was my life. He was 60.”
Ashworth said his father, also called Jon, had not been offered formal help, although he himself had tried to raise the issue of his drinking as an adult. He said his dad thought he was OK because he didn’t touch alcohol during his working hours. “But as a child I didn’t see him at work,” he said.
Ashworth, who was politically active for the Labour party from the age of 15, through college and on into a job advising Gordon Brown, said the experience with his dad left him feeling “not damaged but determined”.
The MP for LeicesterSouth – who was promoted to shadow health secretary by Jeremy Corbyn after his second victory in a leadership contest – now feels he has an opportunity to take action.
As well as the work he outlined with charities and councils, he believes that part of the solution must also be a cultural drive to have alcoholism taken more seriously. Ashworth recalled how “people used to think it was funny – a right laugh” that his dad was a drinker.
He remembered his father in goal in the work football team and people pointing off the pitch and shouting: “Oh Jon Ash is in goal – just throw a crate of Stella in that direction and he’ll go after that.”
“And I was like ‘oh yeah that’s funny’, but actually that was my dad and for my teenage years I was looking after him. It just became a norm. I had to grow up very fast.”
But he is not just concerned about alcohol. “Public health has been cut back by the Tories but they are storing up huge problems,” he said. “Obesity is a huge problem that costs the NHS billions. The debate on obesity and diabetes hasn’t punched through.”
Ashworth said there were lessons to be learned from the bold action to ban smoking in public places, which had a massive impact. He called for much more direct action on poor diet.
“I think we have to be bold about what we say to the advertising industry – not just with kids programmes but families sitting down watching The X Factor. Think of the hundreds of thousands of calories being advertised this winter in the run-up to Christmas,” said Ashworth, arguing that fast food and supermarkets selling “tasty treats” were all over family viewing times.
“The government watered this down. There were going to be stricter restrictions on the industry, [David] Cameron was going to go for it and the story is that Theresa May got her red pen out and cut it out. I think we have got to be bold.”
Childhood memories of growing up with an alcoholic father have prompted the shadow health secretary to call for greater recognition of the damage done by excessive drinking.
Jonathan Ashworth said there was a need for urgent action because the cost of alcohol-related harm was not just the £3.5bn NHS price-tag, but up to £7bn in lost productivity for the British economy.
During an interview with the Guardian, the Labour MP said he also wanted there to be much more focus on the needs of families affected by alcoholism, claiming the issue would be a priority for him and Labour in 2017.
Ashworth said he was surprised to find himself disclosing, for the first time to a national newspaper, the reason he felt so passionately about the issue.
“It’s quite personal for me, because my dad was an alcoholic,” he said, suddenly spilling out early memories of his father falling over drunkenly at the school gates and of returning home to a fridge stacked with cheap booze and no food.
Ashworth said he had never really considered his experience as something relevant in policy terms. “You didn’t think there was a problem, you just thought ‘that is the life I’ve got’,” he said.
Then he came across the work being carried out by his Labour colleague, Liam Byrne, whose childhood was affected in a similar way.
The MP’s all-party parliamentary group dedicated to the children of alcoholics has revealed that local authorities across the country tend to have no specific strategies to help young people affected in this way.
The group, which is publishing research on the issue in the new year, said that millions of children were “suffering in silence”.
Inspired by Byrne’s work, Ashworth felt he wanted to make the issue a priority in 2017. “I wanted to do something on alcoholism so that if nothing else I’ll have done something on that,” he said, before adding: “I know it’s cliched.”
As well as backing Byrne’s ideas he wants to support a phoneline run by the National Association for Children of Alcoholics to help make it a nationwide service. He also wants more specialised training for professionals to support children and for councils to be properly funded to be able to reach out to families affected by alcoholism through schools, via community nurses and in Sure Start children’s centres.
Ashworth was inspired by Labour MP Liam Byrne who has set up an all-party parliamentary group dedicated to the children of alcoholics. Photograph: Peter Macdiarmid/Getty Images
Ashworth talked about his own experience as an only child in a working-class part of north Manchester after his mother, who worked as a barmaid, and his father, a croupier in a Salford casino, divorced.
He spoke vividly about the days that he stayed with his father – whom he said he loved dearly.
“I remember him falling over when he picked me up at the school gates and we’d get home and there would be nothing in the fridge other than bottles of wine – he drank cheap horrible bottles of white wine … and cans of lager and Stone’s bitter,” said Ashworth.
“When I got to 11 or 12 then I was effectively looking after him on the weekends because he was drunk all weekend,” he said, pausing before adding: “And eventually he died.”
Ashworth recalled trying to persuade his father not to move to Thailand one Christmas. The MP said he knew in his heart it would end badly, but his father replied: “No, I’m going,” and he went.
“I never saw him again,” said the MP.
About a year later he received a call telling him to travel to the small apartment where his father had been staying. When he got there he found his bed surrounded by empty whisky bottles. “He was in Thailand for that last year drinking a bottle of whisky a day … I had to clear it up. That was my life. He was 60.”
Ashworth said his father, also called Jon, had not been offered formal help, although he himself had tried to raise the issue of his drinking as an adult. He said his dad thought he was OK because he didn’t touch alcohol during his working hours. “But as a child I didn’t see him at work,” he said.
Ashworth, who was politically active for the Labour party from the age of 15, through college and on into a job advising Gordon Brown, said the experience with his dad left him feeling “not damaged but determined”.
The MP for LeicesterSouth – who was promoted to shadow health secretary by Jeremy Corbyn after his second victory in a leadership contest – now feels he has an opportunity to take action.
As well as the work he outlined with charities and councils, he believes that part of the solution must also be a cultural drive to have alcoholism taken more seriously. Ashworth recalled how “people used to think it was funny – a right laugh” that his dad was a drinker.
He remembered his father in goal in the work football team and people pointing off the pitch and shouting: “Oh Jon Ash is in goal – just throw a crate of Stella in that direction and he’ll go after that.”
“And I was like ‘oh yeah that’s funny’, but actually that was my dad and for my teenage years I was looking after him. It just became a norm. I had to grow up very fast.”
But he is not just concerned about alcohol. “Public health has been cut back by the Tories but they are storing up huge problems,” he said. “Obesity is a huge problem that costs the NHS billions. The debate on obesity and diabetes hasn’t punched through.”
Ashworth said there were lessons to be learned from the bold action to ban smoking in public places, which had a massive impact. He called for much more direct action on poor diet.
“I think we have to be bold about what we say to the advertising industry – not just with kids programmes but families sitting down watching The X Factor. Think of the hundreds of thousands of calories being advertised this winter in the run-up to Christmas,” said Ashworth, arguing that fast food and supermarkets selling “tasty treats” were all over family viewing times.
“The government watered this down. There were going to be stricter restrictions on the industry, [David] Cameron was going to go for it and the story is that Theresa May got her red pen out and cut it out. I think we have got to be bold.”
Self-harm among young people, particularly girls, has rocketed in the last decade. The number of girls admitted to hospital after cutting themselves has quadrupled, incidents of poisoning have risen by more than 40%, and demand for university counselling services has mushroomed. Behind these figures are young people and families struggling to cope with toxic levels of mental distress.
In part these numbers reflect a greater awareness of mental health and willingness to seek help but more is going on than that. These figures are also evidence that the today’s generation of young people are facing unprecedented levels of social pressure leading to serious psychological distress. Our response, as a society, has not, as yet, been anywhere near sufficient to answer this cry for help.
At the Tavistock and Portman specialist mental health trust, we have been engaged for nearly 100 years in understanding the causes of psychological distress among young people and, in particular, the impact of childhood experience, relationships and trauma, on mental health. It is why we feel strongly that it was the right thing to do to let the cameras in and help tell the story of young people, their families and clinicians working with them.
Channel 4’s documentary Kids on the Edge, screened over the last month, is the result. For us it has captured, with great sensitivity, the challenges faced by young people and their families, and which our services are working through on a daily basis. Some of what is shown is shocking but not in a sensationalist way. Only by better understanding, both intellectually and emotionally, the level of distress that can drive a young person to self-harm or to think of taking their own life can we begin to move forward.
Ash, featured in Channel 4’s documentary Kids on the Edge. Photograph: Jude Edginton/Channel 4
There is a growing crisis in children and young people’s mental health. It demands a response, it requires urgent action. We would highlight three priorities.
First, demand for help is outstripping supply. A target has been set that 30,000 more young people are able to access help by 2020. That is welcome. However, the treatment gap is enormous. It is estimated that only 25-35% of young people who need help for mental health difficulties receive it. If this was true for cancer there would be a public outrage. Furthermore many services are seeing year-on-year increases in demand of more than 10%, often combined with a rise in case complexity. If the goal is to get good quality and timely help to the young people who need it, the new money promised by the government for children’s mental health must reach the frontline. So far the story on this has been mixed.
Second, dealing with emotional and mental distress is part of the day-to-day business of teachers, social workers and other professionals. This workforce need the right skills, recognition and support to help build resilience in children and keep them engaged with education.
This is more than just mindfulness, helpful though that might be. Some of these challenges were brought into focus by the programme in our school, Gloucester House, which supports some of the most troubled children who have been excluded from other parts of the educational system.
As a society we must acknowledge the negative impact growing social pressures and targets are having on our children and young people, and the part our education system plays in turning up that pressure. A child’s wellbeing should never be sacrificed in the pursuit of educational achievement.
The third issue, graphically illustrated in the final programme, is the difficulty of supporting a young person in transition between adolescent and adult services. An arbitrary age cut-off can do untold harm. Mental healthcare relies on strong therapeutic relationships between service users and clinicians. Care should be organised around an individual’s circumstances not the arbitrary diktats of service boundaries and funding.
There is, in our view, no area of work in the NHS more valuable and rewarding than investing in the health and wellbeing of young people. They are our future and when we get things right there is a lifetime of benefit to be gained for individuals and society.
We have opened our doors at the Tavistock and Portman because we wanted to create a platform for the young people and families using the services and the clinicians who work with them. There is a growing public demand for children and young people’s mental health to be awarded the priority and the investment it needs. This government has made important commitments, but for kids on the edge turning sympathy into action cannot come too quickly.
Paul Jenkins is chief executive of the Tavistock and Portman NHS trust. Paul Burstow chairs the Tavistock and Portman NHS trust and previously served as minister for mental health.
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Urgent action is needed to help and protect girls and young women from Aids in sub-Saharan Africa, thousands of whom are still being infected with HIV every week, the UN says.
Many adolescent girls do not know they have the virus and do not seek help or get treatment because they cannot tell their families they have had a sexual relationship with an older man. The death rates among adolescents are high.
In 2015, 7,500 girls and young women aged 15 to 24 were infected with HIV every week. More than 90% of the adolescents infected in sub-Saharan Africa are girls. Between 2010 and 2015, the total annual number of new infections among 15- to 24-year-old women fell just 6%, from 420,000 to 390,000. The UN target to reduce that number to fewer than 100,000 a year by 2020 is way off track, says the latest report from UNAids.
Too little has been done to help girls protect themselves and stay well, according to Michel Sidibé, the executive director of UNAids. “Young women are facing a triple threat,” he said. “They are at high risk of HIV infection, have low rates of HIV testing, and have poor adherence to treatment. The world is failing young women and we urgently need to do more.”
A woman looks at posters displaying information about HIV and Aids at a hospital in Liberia. Photograph: Ahmed Jallanzo/EPA
Girls are particularly vulnerable in southern Africa because of their low status in a strongly patriarchal society. “Women’s and girls’ heightened vulnerability to HIV goes far beyond physiology: it is intricately linked to entrenched gender inequalities, harmful gender norms, and structures of patriarchy that limit women and girls from reaching their full potential and leave them vulnerable to HIV,” says the report.
Helping girls avoid HIV is hard because efforts must address the issues of gender imbalance and violence in societies, as well as poverty, which causes some girls to have relationships with men for money, says the report. Education is also important. Studies have shown that girls who stay in school longer are less likely to become infected.
The report says that a cycle of infection is taking place, which must be broken. Girls and young women are infected with HIV by older men. Men tend to acquire HIV later in life, from women who were infected when they were younger.
The good news from the report is that the numbers of people with HIV being put on drug treatment to keep them well has now reached 18.2 million, which is 3 million more than two years ago. UNAids says it is on track to meet the treatment target of 30 million people by 2020.
But preventing infection is proving more difficult. There were 2.1m new infections in 2015 – the same number as in each of the last three years and only slightly down from 2.2m in 2010.
Global HIV numbers
It was hoped that widespread drug treatment would make a difference to the numbers becoming infected. People who are on the drugs have a low level of the virus in their blood and are unlikely to transmit it to their sexual partners.
But many men are reluctant to go to health clinics and do not get tested, or if they do, they will not go on drug treatment until they actually fall ill, which could be months or years later. “Studies are showing that almost 61% of infections are caused by people who know they are HIV positive but they are not on treatment,” said Sidibé. While that is happening, he said, “how do we control the epidemic?”
Drug resistance is another issue highlighted in the report, which is published ahead of World Aids Day on 1 December. The basic drug combination – “first line” treatment – has become cheap, but the virus is adept at mutating. When people develop or pick up resistant strains of HIV, they need second- or third-line drugs, which are much more expensive. If resistance spreads, said Sidibé, the cost of treating millions of people with newer drugs will be prohibitive and make it impossible to end Aids.
“We need really to protect the drugs that we have. If not, we will have failed,” he said.
The science fiction author William Gibson famously quipped the future is here, it’s just not evenly distributed. There is arguably no greater manifestation of our uneven world than that of healthcare. In the wealthiest countries, thousands of people in their 60s and 70s are kept alive with cardiac pacemakers that are remotely monitored over the internet, and adjusted by algorithms with no human intervention. In poorer states, three-quarters of a million children under five are dying each year because of shit in their water.
What can explain such unevenness, and what might be done about it? A scan of the proceedings at the World Health Summit in Berlin, which starts on Sunday, and where technological innovation is one of the major themes, is revealing. “Despite the exponential growth of scientific and technological development, low- and middle-income countries are still largely excluded from access to appropriate and affordable health technologies. Therefore novel technological devices need to be developed that can address health problems and improve quality of life,” reads the blurb for Monday’s keynote session.
Is this “must try harder” assessment correct? Is the solution to stark inequities in global health outcomes, and the enduring exclusion of developing countries from the benefits of innovation, to do more and better innovation?
Certainly, innovation for improved global health is arguably needed more than ever with the need to combat new and emerging diseases from Ebola to Zika and to find better ways of tackling non-communicable diseases such as cancer. But when we look at the innovations made in response to Ebola, we should pause for thought.
One stark example: in November 2014, when the Ebola outbreak was raging through west Africa, the US Food and Drug Administration went through an expedited approval process for a one-hour Ebola test, reducing the time for results by five hours from the previous fastest machines. The problem was that few west African countries had the resources to acquire the $ 40,000 machines or the skills to run them. They were, however, to be found in many US hospitals.
Or another example: Medécins Sans Frontières (MSF) helped to trial and demonstrate the effectiveness of new tests for TB in low income and humanitarian settings in 2011-12. But the price of the test made it prohibitive for many countries until a large public-private initiative emerged to subsidise the cost of the tests for 145 developing countries that were most affected by TB. Only then could this innovation benefit those who needed it most.
These are far from the only stories of how the poorest are excluded from the innovations that they need most. Once the stories start to accumulate, they turn from a trickle to a river to a flood. And one has to start wondering whether the old adage about famines is not relevant here: famines rarely result from a lack of food, rather it is lack of access to food. Similarly, the inequalities in tackling health problems are not because of a lack of innovation, but because of a lack of access to innovation. The binding constraints, I would argue, are seldom technical but instead related to the political and economic choices, which determine how innovations get funded, resourced and supported, by whom and for whom.
What to do in the face of such a system? The answer is to fight the innovation and political battles at the same time. We have to identify the gaps, and to test and trial the best new ideas that can address longstanding challenges faced by the world’s most vulnerable people, and build the evidence base that these ideas really can make a difference. Political leaders need to ensure that the scaling of new solutions includes those people who need innovation most, and who are most likely to be excluded from its benefits.
In doing so, it is worth looking to the work of organisations such as MSF, which do an admirable job of balancing the scientific and political aspects of advocacy in their Access to Medicines campaign. But we should also remember the work of pioneers, from Florence Nightingale to John Snow, who worked tirelessly to ensure their ideas benefited those in society who needed them the most.
The speakers and delegates at the World Health Summit should remember this pioneering spirit, which fused the spirit of medical discovery with political advocacy. And they should ensure that any statement calling for more and better medical technologies is quickly followed by a statement recognising that technology should at best be seen as a complement to, but never a substitute for, political action.
Junior doctors have been told by the General Medical Council (GMC) that they should call off their planned five-day strike for later this month and that putting patients at risk of significant harm could lead to them being struck off.
The GMC issued the unusually severe warning on Monday in advice issued to doctors contemplating taking part in the strike, starting on 12 September, and to other doctors who may be affected by the industrial action.
It expressed reservations before previous walkouts by junior doctors this year, but today’s statement is its bluntest yet, prompted by fears that the length of the strike, the relatively short notice given about it to management and the fact that emergency care is included mean that the risk of patients suffering is greater than before.
The GMC does not have the power to prevent doctors from going on strike, but it exercises considerable power as a regulator and its statement contains an implicit threat that doctors who withdraw care could be putting themselves at risk of being sanctioned, including possibly struck off, for unprofessional conduct.
In a statement urging doctors to call off at least the strike planned for September Prof Terence Stephenson, chair of the GMC, said: “We know that doctors will again want to do their utmost to reduce the risk of harm and suffering to patients. However … it is hard to see how this can be avoided this time around.
“We therefore do not believe that the scale of action planned at such short notice can be justified and we are now calling on every doctor in training to pause and consider the implications for patients.”
Junior doctors have already staged six walkouts this year as part of their campaign against the proposed new contract being imposed on them by the government, but Stephenson said the BMA was now planning “a substantial escalation” of the dispute.
From 12 September junior doctors will go on strike for five days in a row, from 8am until 5pm each day, with emergency care as well as elective care affected. Further five-day strikes are planned starting on 5 October, 14 November and 5 December.
In its advice to doctors contemplating strike action the GMC said they must take “reasonable steps” to satisfy themselves about the arrangements being made to protect patients while they are not working.
“Given the scale and repeated nature of what is proposed, we believe that, despite everyone’s best efforts, patients will suffer. In light of this, the right option may be not to take action that results in the withdrawal of services for patients.”
Senior doctors and managers had to be given enough time to put in place alternative arrangements, the GMC said. “Action without warning or with inadequate warning is not acceptable.”
The GMC also said in its advice that, if it became clear in a particular area that patients were at risk because of inadequate medical cover and that if doctors were asked “in good faith” to return to work, the GMC would expect them to do so.
In a statement issued alongside the advice, Niall Dickson, the GMC’s chief executive, said it was being issued to doctors under the authority of the 1983 Medical Act and that doctors could face sanctions if they acted unprofessionally.
He said that doctors had a right to take strike action, but that they also had a duty to make the care of patients their first concern and that “the question each doctor must ask … before taking action is whether what they are proposing to do is likely to cause significant harm to patients under his or her care or who otherwise would have come under his or her care.”
He went on: “The GMC has powers under the [Medical] Act to investigate and apply sanctions to any doctor whose behaviour has fallen consistently or seriously below the standards required. Where we are presented with evidence that a doctor’s actions may have directly led to a patient or patients coming to significant harm, we would be obliged to investigate and if necessary take appropriate action.”
In its press notice setting out the advice, the GMC said that its job was to protect the public, not doctors.
Every time it rains in San Juan, Dr Brenda Rivera-Garcia walks around her home emptying containers of standing water, likely wearing long sleeves, and almost certainly wearing mosquito repellant. Rivera-Garcia is the state epidemiologist in Puerto Rico, a woman tasked with tracking every single Zika-infected pregnant woman in the US territory.
Less than two weeks after the US health and human services administration declared the spread of Zika on the island an epidemic, Rivera-Garcia said it’s not frustration or anger that overtakes her when she adds a new woman’s name to a list of roughly 700 confirmed to be infected with the disease.
It’s sadness.
“Every time I have to add a pregnant woman to that list, I just think of what’s going to be of this pregnancy,” she said, her eyes visibly wet. “What’s going to be of this child later on, and, it’s, it’s – it breaks my heart.”
As much as 25% of the island’s population could have the disease by the end of mosquito season, the Centers for Disease Control and Prevention estimates, and up to 50 pregnant women each day are infected on the island.
A recent study projected as many as 270 babies could be born with the debilitating birth defect microcephaly, between now and mid-2017. In a normal year, doctors expect 16.
The defect causes infants of mothers infected with the virus to be born with abnormally small heads, and suffer life-long developmental disorders. Some will have trouble walking. Others may have hearing or vision loss, trouble swallowing or seizures. Many are likely to have shortened life expectancy.
But health officials have had difficulty translating those projections into urgency among many Puerto Rico residents, who have been dogged in the past by tropical diseases with more apparent symptoms, such as Dengue and Chikungunya. Indeed, the government’s efforts to control the virus seem hampered at every turn, thwarted by apathy, lack of trust, misinformation, insecticide resistance and even architecture.
“The system doesn’t work so of course people are going to be skeptical,” said Joe Torra, 40, a professional driver in San Juan.
Referencing colonialism, Torra said: “The best way to control minds is to control bodies.”
A health worker prepares insecticide before fumigating a neighborhood in San Juan on 27 January 2016. Photograph: Alvin Baez / Reuters/Reuters
‘False alarms’
Denisse Velazquez, 36, stood under the shade of a tree in Old San Juan, one of the hardest hit municipalities, as she said that the government “created false alarms”.
Juan Martinez, 43, said that with “all these diseases we have seen, it’s something normal”, referring to periodic outbreaks of Dengue the island has struggled with since the 1980s, and the recent Chikungunya outbreak. “In the Caribbean there has always been mosquitoes.”
Even tourism officials have reinforced the view that Zika risk has been overblown.
“From the very beginning the numbers that were given were based on projections. The reality is that as of today, less than half of 1% of the population has the virus,” Clarisa Jimenez, CEO of the Puerto Rico Hotel and Tourism Association, told CNBC’s Squakbox. “The only issue here is if you’re pregnant.”
Jimenez focused on the roughly 10,600 Puerto Ricans who had, at the time, been diagnosed with Zika by the CDC. The figure is an underestimate, because four out five infected people have no symptoms and likely do not know they are ill.
Now, near the end of August, the health department of Puerto Rico and the CDC have diagnosed 12,800 Zika infections, including more than 670 in pregnant women, believed to represent only a fraction of actual infections.
So far, only one child has been born with microcephaly. But experts expect that number to increase dramatically in coming months, particularly from September to December.
Health professionals believe the most dangerous time for a pregnant woman to be infected is in her first trimester, though more research is needed. Those pregnancies are expected to begin coming to term this fall.
“Right now, most of the births we have seen are among second and third trimester infections,” said Rivera-Garcia. “For us, it’s not just a number. There’s a family behind that number.” Doctors suspect that even these cases, which are less dramatic in appearance, could result in problems that won’t manifest until much later.
The island’s timetable of epidemic infection is about one year behind Brazil’s. In December 2015, as cases of microcephaly began to surge in Brazil, cases of locally acquired infections were just beginning to show up in Puerto Rico.
“When you’re involved in major epidemics, and particularly this one for some reason, I’ve been unable to disconnect,” said Dr Francisco Alvarado-Ramy, a senior CDC official and native Puerto Rican who helps lead the federal government’s response to the epidemic. He is stationed at the Dengue Branch, an outpost in San Juan established to combat another virus spread by the same mosquito as Zika, the aggressive Aedes aegypti.
“The moment that I go to the sleep to the moment that I wake up, my mind seems to be around Zika all the time, trying to think if there’s any other thing we can do,” he said.
“When something goes wrong, it’s also a very fast way down, downstairs in terms of your emotional well-being. We’re trying to prepare our staff, as well, if we start seeing a lot of people with bad outcomes how to handle that emotionally.”
Employees with the municipal government collect used tires on 7 August 2016 in the Rio Piedras section of San Juan, Puerto Rico. Photograph: Angel Valentin/Getty Images
Cat, Dog, Mosquito
“We have in Puerto Rico a dog, a cat and a mosquito,” said Carmen Deseda, the former state epidemiologist who battled several epidemics of Dengue, a hemorrhagic fever that can incapacitate a person for weeks. “The problem is not the mosquito, it’s the virus.”
Deseda expressed a view common among Puerto Ricans: the mosquito is here to stay, fumigating won’t work, so the government better find some other way to deal with this.
She was among many prominent opponents of fumigating the island with an insecticide called Naled, a solution proposed by the CDC and used on about 6m acres of land each year in Florida. Many residents were outraged that the federal government would, in their view without permission, spray chemicals over the island.
“When they said that I was very upset,” said Miguel Pellot, 48, the owner of a smoothie stand called Fruta Fruit in San Juan. “¿Como se dice, una falta de respeta?” he said, asking how to express lack of respect in English.
“For people here, this is nothing new. We’ve had mosquitoes here since we were born,” Deseda said. “They don’t feel threatened by the mosquito, because it’s been always with them.”
Deseda said government fumigation encourages apathy among the population. “The government is doing something so they don’t have to anything.”
Ceda Velez, a 36-year-old woman working a juice stand near San Juan’s cruise ship ports said she was in favor of government fumigation.
“We use repellant, but at least it would help with where the mosquitoes breed, to kill the mosquitoes,” she said in Spanish. “I worry.”
Puerto Rico won’t fumigate with Naled from planes, as Florida does. And even if Puerto Rican authorities decided to fumigate street-side from trucks, only about 12 on the island are outfitted to spray for mosquitoes. Regional resistance to insecticides has also confounded eradication efforts.
Some residents believe the island was a guinea pig for past federal government experiments, that Zika was mild and posed no risk, that they weren’t going to stop “living”, or were simply misinformed about how to prevent exposure.
“I had, yes, but I drink Tylenol, y ya,” said Naara Nieves, 39, who stood outside at noon in San Juan proselytizing, a gregarious evangelist of Jehovah’s Witness. “I think the women who are pregnant, is bad, but for me, no.”
Marylin Vigo, who was visiting her sister on the island from Brooklyn, New York, said her relatives called her “paranoid” for even slathering on mosquito repellent.
“She goes, ‘Ugh! That doesn’t mean you’re going to get Zika, because of mosquito bites,’” Vigo said, describing her sister’s reaction. This is despite her sister’s belief that Vigo’s 29-year-old nephew just contracted the virus.
A cultural gulf
One of the most cited differences between Puerto Rico and the mainland is the lack of screened windows and air conditioning, which hamper mosquito-borne diseases spread in places like Texas.
Tropical breezes course uninhibited through flung open doors, patios and unscreened louvre window shades. The open roofs of Spanish-influenced architecture let in rain drained away by a floor grate.
“If you go to the communities, people love to sit out on their patio, play dominoes, play music, have a barbecue, and that’s difficult to do in a screened in porch, or take advantage of the Caribbean leeward breezes,” said Rivera-Garcia. “It certainly changes your way of life.”
So the Puerto Rico Department of Health is focused on behavioral and cultural change.
River-Garcia said past epidemics of diseases with severe symptoms like Chikungunya have not driven people to engage in practices like wearing repellant and investing in screened windows.
“That’s why we – from the get-go in January – we said, ‘OK, we need behavioral science studies. We need to understand what will be that one driver, or the drivers, to effect behavior change.”
Even for those who might want screens, it could be a real burden.
Nearly half the population, 46%, lives in poverty. The average per capita income is just $ 19,600, making an air conditioned bedroom unattainable.
A raft of other science conducted on the island is looking at other solutions. Children of Zika-infected mothers will be followed until they are three years old. Alvarado and his team collect blood and placenta samples from Zika-infected women who give birth and miscarry.
Traps are being reengineered at the Dengue branch, including the promising, pesticide-free innovation of a bucket that uses fermenting hay and water to trap mosquitoes.
“It drives me to keep trying and see where can we improve, what else can we do,” said Rivera-Garcia. “I think for all the responders both local and stateside with many Puerto Ricans in various areas of expertise – they’re coming back, donating their time, or asking for deployments in Puerto Rico.”
Promises, platitudes and plans are piling up for mental health, but how much is going to be delivered?
Mental health accounts for roughly £12bn of the NHS budget. In parliamentary terms the current support for mental health is unprecedented – parity of esteem with physical health services is enshrined in the Health and Social Care Act 2012, plus last year’s spending review made explicit reference to improving quality, choice and outcomes in mental health.
But a recent report by the health select committee on the impact of the spending review on health and social care was sceptical about whether the rhetoric is being matched by actions. The committee called for verifiable evidence that the additional cash promised to mental health was reaching the front line, and that the cultural change necessary to deliver parity of esteem was happening.
Related: ‘This isn’t acceptable’: outcry at state of NHS mental health care funding
The NHS planning guidance for 2016-21 instructs clinical commissioning groups to increase investment in mental health at least at the level which matches their overall spending increase, but whether this being done is disputed. NHS clinical commissioners insisted to MPs that this is happening while NHS Providers maintained the money is not coming through. It even accused commissioners of using “weird and wonderful calculation methodology” to justify their claims.
The government has made specific promises: more cash for young people with eating disorders, a “system-wide transformation” of children and young people’s mental health and perinatal mental health, and improved access to psychological therapies. But it is far from clear how the money for this will avoid being dragged into the black hole of the acute sector’s deficit.
Even if these promises are delivered, they are still largely focused on crisis management. The big win will come when services routinely support people who are at risk of mental illness before they reach crisis. This is a long way off.
NHS England has just published its implementation plan for the mental health Five Year Forward View. It sets some impressive targets, such as treating at least 70,000 additional children and young people each year from 2020-21.
The scale of the task is becoming clearer, but it is daunting.
This target illustrates the enormity of the change being envisaged. For example, inappropriate use of inpatient facilities needs to be eliminated and a drastic increase in community-based support for eating disorders is needed to reach it. At least 1,700 more therapists and supervisors will be required. Local plans to deliver this are supposed to be in place by October.
But delivering national goals on mental health requires transformation well beyond the borders of the NHS. As the Mental Health Foundation points out in its guidance on population-based mental health care, many of the people most at risk of self-harm or suicide are in contact with the police or in prison.
Police forces across the country feel they are routinely left to deal with dangerous mental health crises because of failures in NHS care. Suicides in prison are now their highest for at least 25 years – 100 in 12 months – that’s one death every three to four days. Much closer working with police and prison services is just one of the changes in culture that ‘“parity of esteem” for mental health requires, alongside massive investment in prison services and facilities.
Related: Joined up health and care needs a giant leap forward | David Behan
In the West Midlands, local government is providing leadership on mental health with a commission set up by the region’s combined authority, chaired by the MP and former Liberal Democrat health minister Norman Lamb. It is assessing the scale of mental health problems and identifying good practice nationally and internationally in areas such as suicide prevention, with the aim of driving through reforms to the way public services are delivered based on sound evidence of the costs of mental illness and the benefits of tackling it.
It is a huge objective, but the ambition is there and Lamb is clearly determined to make things happen. The scale of the task of improving mental health is at least becoming clearer, but it is daunting. It means getting into every school, prison, workplace and custody suite. The commitment is growing, but the capacity and the investment are still a long way short.
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Optimistic considering is a valuable device that can assist you overcome obstacles, deal with soreness, and reach new objectives. The advantages of seeking on the brilliant have been plainly documented. Investigation scientific studies have found that optimistic folks have a tendency to appreciate increased marital fulfillment, greater physical health, and larger incomes.
All the buzz about the benefits of positivity, has led to some misunderstandings about the idea of positive pondering. However, .
Good Pondering Isn’t About Establishing Unrealistic Expectations
Often individuals confuse positive thinking with fantasizing. They picture reaching their objectives will lead to limitless happiness. By saying items like, “I’m going to target on all the optimistic issues that will come about when I shed weight – I’ll have more close friends, earn far more income, and be able to meet the individual of my dreams,” they romanticize the long term.
But “focusing on the positive” turns into self-destructive when people set up unrealistic expectations. Just like it’s not wholesome to think overly negative ideas (see my previous post on the 10 Contemplating Mistakes That Will Hold You Back In Life), exaggeratedly optimistic ideas can be equally detrimental. If you overestimate how considerably of a good affect a particular modify will have on your daily life, you might end up feeling disappointed when reality does not live up to your fantasy.
There is even study that suggests to accomplish your ambitions. A review published in the Journal of Experimental Social Psychology identified that the most constructive fantasies about the future predicted poor achievement. When individuals imagined an idealized future, they truly had significantly less power and motivation to turn that fantasy into a actuality.
Positive Considering Does not Possess Magical Powers
Someplace along the line positive pondering looks to have been puzzled with magical thinking. There’s a notion that if you consider positively adequate, you can make anything take place by utilizing the power of your thoughts. All the constructive thinking in the world will not supply you great fortune or avoid tragedy from striking.
When an individual says his work interview did not go properly, his household may say, “Think great ideas,” as if considering he’ll get the work will somehow influence the interviewer’s choice. Although positive contemplating surely serves several purposes – like helping us cope with tough circumstances – optimism doesn’t adjust the actuality of a situation.
That does not suggest you shouldn’t hold out hope or appear on the brilliant side. But deluding your self into believing, “If I think positively sufficient, almost everything will perform out,” isn’t practical. Idealism does not avoid issues.
Good Thinking Cannot Change Good Action
Hopefully you wouldn’t get into a auto and say, “I’m not going to put on my seatbelt these days. Instead, I’m just going to believe positively about arriving at my location safely.” But, that’s exactly what many individuals do in the business globe. Occasionally individuals seem to believe that constructive considering is the single driving force that leads to good change.
A business owner may possibly say, “I’m just going to think positively about our income for the second half of the yr,” or a salesperson may well say, “I’ve just got to inform myself it’s going to get greater.” If they end quick of combining their positive pondering with constructive action, they will not see any constructive outcomes.
Overconfidence is not the exact same as healthier optimistic considering. Overestimating your potential to attain your goals could avoid you from taking the required steps to set your self up for accomplishment. As a consequence, your “positive thinking” could backfire and leave you feeling unprepared for the actuality of the situation.
Establish a Positive Yet Practical View of the Planet
The government’s refusal to let a 1% spend rise demonstrates a contempt for NHS workers, stated Unison. Photograph: Christopher Furlong/Getty Images
Hundreds of 1000′s of NHS staff will be balloted more than strike action in a row over pay out, it has been announced.
The union Unison mentioned it would ask 300,000 of its members to back walkouts following the government’s decision not to accept a advisable across-the-board 1% wage rise for NHS staff.
If accredited the industrial action will take area in early October, followed by additional waves of strike action.
Hospitals across the nation could encounter disruption if nurses, therapists, porters, paramedics, healthcare secretaries, cooks, cleaners and healthcare assistants make a decision to join picket lines.
The union stated the government’s choice not to apply the one% pay out rise advised by the NHS spend evaluation body would deny 60% of NHS employees and 70% of nurses a shell out rise for the next two many years.
Christina McAnea, head of overall health at Unison, explained: “Balloting for strike action is not an straightforward decision – especially in the NHS. But this government is showing total contempt for NHS staff.
“It has swept aside the spend assessment body’s recommendations and ignored the union’s contact for a honest deal. Our members are angry at the way they are currently being treated and we are left with tiny choice but to ballot for action.
“We hope to work closely with the other overall health unions to strategy and coordinate action. It is not too late nonetheless for [the well being secretary] Jeremy Hunt to agree to additional talks, without preconditions, to settle the dispute.”
The ballot will commence on 28 August and run right up until 18 September.
The Royal University of Midwives (RCM) mentioned it would also ballot its members on no matter whether or not to take industrial action.
It is the very first time in the union’s background that members will be balloted, a spokesman mentioned.
About 26,000 midwives and maternity support workers doing work in the NHS in England will be balloted in September with likely industrial action expected to consider spot in October.
The RCM spokesman explained the action was anticipated to be a quick stoppage followed by action short of a strike.
Members will be asked if they are prepared to get strike action and if they are ready to get industrial action quick of a strike.
“Hard-working midwives are deeply concerned that the independent pay out assessment entire body is getting ignored and the NHS spend framework threatened,” said the RCM chief executive, Cathy Warwick.
“Midwives are at the end of their tether. They have previously accepted lengthy-term shell out restraint and modifications to their pension and terms and problems. Meanwhile they are functioning more difficult and tougher to supply high-high quality care with continuing shortages of midwives and daily pressures on providers.
“In the history of the RCM there has by no means been a ballot for industrial action. Of course it goes without having saying that if it is required to get action RCM members will not put the security and care of women and infants at threat.
“NHS workers have to be valued and relatively rewarded for the work they do. Personnel that are demoralised cannot deliver the high quality of care that NHS end users, including mothers and infants, deserve. Investing in employees is an investment in better care. I hope the government joins the RCM and other unions at the negotiating table, reconsiders their place and seeks a resolution.”
Positive Considering Does not Possess Magical Powers