The government is on course to impose steep cuts in public spending from April and increase taxes by the end of the decade to their highest level as a share of national income since 1986–87 to combat the UK’s persistent budget deficit.
But slower economic growth following the Brexit vote will still leave the UK with one of the largest black holes in public spending in the developed world, meaning the next government must find £40bn to eliminate the budget deficit in the next parliament, according to the Institute for Fiscal Studies.
“For all the focus on Brexit the public finances in the next few years look set to be defined by the spending cuts announced by George Osborne,” said IFS director Paul Johnson.
“Cuts to day-to-day public service spending are due to accelerate while the tax burden continues to rise. Even so the new chancellor may not find it all that easy to meet his target of eliminating the budget deficit in the next parliament.
“Even on central forecasts that is going to require extending austerity towards the mid-2020s. If the economy does less well than hoped then we may see yet another set of fiscal rules consigned to the dustbin.”
The leading tax and spending thinktank said downgrades in GDP growth over the next four years will strain the public finances, which are already on course to be £13bn worse off in this financial year than forecast, after weak growth in tax receipts.
Highlighting the pressure on the chancellor, Philip Hammond, the IFS’s annual assessment of the public finances found that Britain’s ageing population and increasing demands on the NHS will blow a large hole in the government budget over the next two parliaments.
It said: “Demographic and non-demographic pressures are projected to put upward pressure of 1% of national income on health, social care and pension spending by 2025.
“Taking into account possible negative effects from lower growth, the government may need to enact further measures worth £40bn (in 2016–17 terms) in order to eliminate the deficit in the next parliament,” the report said.
Deep cuts in welfare benefits are due to take effect from April alongside cost cutting in Whitehall department budgets. Yet the government still plans to pay for large giveaways in the form of a higher income tax personal allowance at the basic and higher rate and was expected to maintain freezes on fuel duty that totalled £4.5bn a year.
The IFS said the promised spending and slower growth would force the government to implement tougher austerity, even though the chancellor has abandoned his predecessor’s pledge for a budget surplus by 2020.
It said: “Real levels of day-to-day public service spending have actually fallen very little overall in the last three years. The rate of reduction is set to speed up after this year, with cuts of nearly 4% due between 2016–17 and 2019– 20.
“In addition, tax is rising as a share of national income and by 2019–20 is due to reach its highest level since 1986–87.”
It said a deficit in 2016-17 of 3.5% of GDP, or £68.2bn, was £12.7bn higher than the Office for Budget Responsibility, the Treasury’s independent forecaster, had predicted in March 2016.
“This increase was not a result of a downgrade to the forecast for economic growth, but arose as a result of weak growth in tax receipts – in particular, income tax, National Insurance contributions (NICs) and stamp duty land tax – and faster growth in local authority spending,” it said.
Hammond said in the autumn statement last year that he plans to boost public investment spending beyond pre-crisis levels as a proportion of overall public spending, with much of the extra cash to be spent on transport infrastructure.
However, many departments will need to make further savings on day-to-day spending by the end of the parliament.
The IFS said: “Public spending, especially on health, pensions and overseas aid will be higher as a share of national income than in 2007–08, while spending on schools, defence and (in particular) public order and safety will be lower.”
The NHS is facing a “humanitarian crisis” as hospitals and ambulance services struggle to keep up with rising demand, the British Red Cross has warned, following the deaths of two patients after long waits on trolleys in hospital corridors.
Worcestershire Royal hospital launched an investigation on Friday into the deaths and did not deny reports that they had occurred after long waits on trolleys in corridors over the new year period.
On Friday, doctors’ leaders warned that more patients could die because of the chaos engulfing the NHS.
The deaths prompted claims that the health service was “broken”, and long waits for care, chronic bed shortages and staff shortages were leading towards what the head of Britain’s A&E doctors called “untold patient misery”.
It is believed that one woman died of a heart attack after waiting for 35 hours on a trolley in a corridor, and another man suffered an aneurysm while on a trolley, and could not be saved.
It is also believed that another patient was found hanged on a ward at the same hospital, which admitted that it was under serious pressure, partly as a result of the extra strain hospitals face during winter. The deaths are said to have happened between New Year’s Day and Tuesday 3 January.
Many other patients who visited Worcestershire Royal hospital this week told the Guardian of long waits in A&E, corridors lined with patients, and overstretched staff doing their best to cope.
Dr Mark Holland, the president of the Society for Acute Medicine, said: “For a long time we have been saying that the NHS is on the edge. But people dying after long spells in hospital corridors shows that the NHS is now broken.
“We have got to the point where the efforts of staff to prop up the system are no longer enough to keep the system afloat. We are asking NHS staff to provide a world-class service, but with third world levels of staffing and third world levels of beds.
“That so many other hospitals in England are facing the same pressures as the one in Worcester means that other fatalities could occur. I would suggest that the same thing could happen in other hospitals, because lots of hospitals are under the same pressures.”
It is also possible that mainly frail elderly patients admitted to hospital over the festive period may have died because they received inadequate care on wards where staff were ill-equipped to deal with their conditions, Holland added.
“At the moment, we have lots of patients in the wrong beds in hospitals. That is, patients admitted as an emergency, but who do not need an operation, being looked after on wards that usually look after patients with surgical care needs,” he said.
“They may not have nurses with the right skill mix or the same level of dedicated medical cover [as general medical wards], so we know that these patients often don’t get the same level of care. Therefore I fear that during the Christmas and new year period, people in non-specialist beds may have come to harm.” Holland added that he could not estimate how many may have died as a result.
Fifty of England’s 152 NHS acute hospital trusts were forced to declare an alert last month, and sometimes temporarily scale back the level of care they offered to patients, because they could not cope with the number of people seeking medical attention, according to analysis by the Nuffield Trust health thinktank. Every hospital in Essex has had to go on “black alert” – the NHS’s highest level – in recent weeks.
In December, seven trusts had to declare the highest level of emergency 15 times, meaning they were unable to give patients comprehensive care. Paramedics have told the Guardian they have had to wait for up to eight hours at a time outside A&E units to discharge a patient into the care of hospital staff, because emergency departments cannot accept any more admissions, thereby lengthening 999 response times.
Dr Taj Hassan, the president of the Royal College of Emergency Medicine, said figures it obtained from hospitals across the UK showed some were treating as little as 50%-60% of A&E patients within four hours, far below the 95% target.
“Figures cannot account for untold patient misery,” he said. “Overcrowded departments, overflowing with patients, can result in avoidable deaths.” Hassan and Holland blamed the government’s underfunding of the NHS and social care systems for contributing to hospitals becoming worryingly full.
“The emergency care system is on its knees, despite the huge efforts of staff who are struggling to cope with the intense demands being put upon them. The situation is intolerable for both staff and patients, who are all too often left in the undignified position of waiting on a trolley in a corridor for a bed to become free,” said Hassan, who is an A&E consultant at two hospitals in Leeds.
Separately, the London Ambulance Service is looking into the possibility that problems when its IT system crashed on New Year’s Day contributed to the death of at least one patient. Staff had to make paper records of 999 calls in what one ambulance crew member described as “a shambles”.
The latest official NHS performance figures, released on Friday, showed that A&E units across England were forced to divert patients to nearby hospitals 57 times over the Christmas period. In addition, 34 hospitals said they had experienced major problems coping with demand.
Paramedics are set for pay rises worth at least £4,400 from the Department of Health and NHS Employers amid trade unions’ concerns that their members were not being paid properly for their life-saving work.
About 12,000 of the health workers – who are trained in emergency medical care and first aid, but not to the level of a qualified doctor – will be affected by the agreement, which will increase starting salaries from £21,909 to £26,302.
Under the terms of the deal, most paramedics, including ambulance crews, will move up the pay scale. However, union leaders have warned that the change may not be enough to staunch a steady drain of workers leaving the ambulance service.
While Christina McAnea, the Unison union’s head of health, backed the new pay deal, she added: “The banding issue alone may not solve the drain of paramedics from the ambulance service, but it will certainly make it a little easier for trusts to hold on to experienced staff.”
The pay rise comes as the UK faces a critical shortage of paramedics, which has left at least one trust paying £30 an hour for agency staff – almost double the rate given to staff workers – and another seeking permission from immigration officials to poach 250 workers from Australia and New Zealand.
Paramedics have reported working under tremendous pressure as a result of increasing demand and a healthcare system battered by cuts. Many say they continue working well past the end of their 12-hour shifts, and rarely get meal breaks. At the end of 2015, a survey of 3,200 paramedics, commissioned by the GMB, Unison and Unite unions, found that three-quarters said they were planning to quit the NHS.
The DoH said the deal had been the result of several years’ negotiation between government officials and unions to thrash out how best to recruit and retain ambulance staff. It goes hand in hand with plans to modernise the role of paramedics, including expectations that they will carry out more treatment at the scene of emergencies, and take patients to medical centres other than hospitals, a spokesman said.
He added that 2,200 more paramedics had been recruited since 2010, and the number of training contracts had been increased by 60%.
Jeremy Hunt, the health secretary, said: “In recognition of their increased responsibilities, we have agreed to look at rebanding around 12,000 paramedics where their job description matches the requirements of the new band six profile, moving them up the pay scale and making sure we are able to better recruit and retain paramedics in the future to ensure patients will continue to get the very best care.”
Sharon Holder, national officer of the GMB general trade union, said: “GMB has campaigned for many years to ensure all ambulance staff receive fair pay. This agreement is a step in the right direction.
“The GMB is pleased the Department of Health has finally realised paramedics need to be paid properly.”
This article was amended on 9 December 2016 to correct the assertion that the government accepted paramedics were not being paid enough. The Department of Health says this is not the case.
Nearly 19,000 children and young people were treated in hospital in England and Wales after self-harming in the last year, a figure that has risen steeply in recent years, according to a leading children’s charity.
The National Society for the Prevention of Cruelty to Children (NSPCC), which collected the data from hospitals using freedom of information requests, says the rise of 14% over the last three years – an extra 2,400 cases – is worrying. A growing number of hospital beds are being filled by children who have taken violent and drastic steps to alleviate their emotional pain and suffering, says the charity.
The children most likely to harm themselves are aged 13 to 17 and tend to be struggling to cope with the pressures of modern life, the charity warned.
Childline, run by the NSPCC, also delivered 50 counselling sessions a day in the last year to children and young people about self-harm. The charity is appealing for funds, saying it can deal with only three out of every four young people who call the free hotline.
One 14-year-old boy who contacted Childline said: “Sometimes I get flashbacks from what happened when I was younger and I cope with the horrible memories by cutting myself. School helped take my mind off things but now that the holidays are here I’m struggling. My parents always seem to be too busy for me and I don’t want to tell my friends what happened. I feel so miserable and lonely – can you please help?”
A 14-year-old girl told counsellors: “Recently I’ve lost some people that were really close to me. When I started to self-harm it seemed to mask the emotional pain I was feeling, even if it only helped for a little while. When I get the urge, I can’t seem to stop it until it’s done; otherwise I get really upset and angry. A couple of times I’ve gone too far and ended up in hospital.”
Peter Wanless, chief executive of the NSPCC, said: “A frightening number of children and teenagers are being driven to self-harm as a way of dealing with unresolved feelings, tensions and distress in their lives.
“Knowing hospital beds are full of young people crying out for help should be a real wake-up call to all those [who] care for the wellbeing of the younger generation. It is vital we confront the fact that an increasing number are struggling to deal with the pressures and demands of modern-day life, to such an extent they are inflicting terrible damage upon themselves.”
Childline’s president, Dame Esther Rantzen, said it was deeply disturbing that children were ending up in hospital. “Self-harming is at epidemic level among young people: at Childline we hear from them every day.
“It has become one of the most common problems young people bring to us, and I know from our counsellors that these are some of the most painful stories we hear. Often the young people feel too ashamed and fearful to seek help from those around them, until they harm themselves so badly they have to be rushed to hospital.”
Dr Max Davie of the Royal College of Paediatrics and Child Health said the rise in the numbers was of real concern. “Whilst we don’t know what it was that brought all 19,000 children to self-harm, what we do know is that support was not offered early enough to prevent it from getting this serious. Early intervention is essential if we are to reduce the number of children self-harming and needing specialist mental health or emergency services.”
He called for comprehensive personal, health, social and economic (PHSE) teaching in all schools, which addresses a range of issues including eating disorders, self-harm and suicide, as well as positive relationships, sex education and the dangers of drugs and alcohol abuse.
“There are a lot of pressures on children. It is not easy being a child these days,” said Dr Jon Goldin, a consultant child and adolescent psychiatrist and spokesman for the Royal College of Psychiatrists. “In some ways children are encouraged to grow up too fast.”
He cited the sexualisation of children in the media and the pressure of social media on children and adolescents to look good and as if they are having a good time, when the reality might be different. Cyberbullying is a problem and schools are focusing intensely on academic work and examinations. Children need also to learn about relationships and emotional wellbeing. “I think schools need permission from government to see that as part of their remit,” he said.
Economic and social factors affecting families are also part of it. “Young people are a kind of canary in the mine, drawing attention to other social problems,” he said. Sadly, he felt young people were not always optimistic about the future of themselves or their world and he said that they need their often-very-busy parents and others to find time to listen to them and help them understand their own distress.
Sarah Brennan, chief executive of YoungMinds, said the rise in self-harm was extremely worrying and called for early intervention. “We know from our research that young people face a huge range of pressures, including stress at school, college or 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, often several years down the line.
“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 wellbeing and not just exam results.”
Use of some of the strongest antibiotics available to treat life-threatening infections has risen to record levels on European farms, new data shows.
The report reinforces concerns about the overuse of antibiotics on farms, following revelations from the Guardian of the presence of the superbug MRSA in UK-produced meat, in imported meat for sale in UK supermarkets, and on British farms.
According to the data from the European Medicines Agency, medicines classified as “critically important in human medicine” by the World Health Organisation appear to be in frequent use on farm animals across the major countries of the EU, including the UK. This comes in spite of WHO advice that, because of their importance, these drugs should be used only in the most extreme cases, if at all, in treating animals.
The latest report from the EMA collates data from member states on the sales of antibiotics for veterinary purposes in 2014, and shows that antibiotic use on farms fell by about 2% on the previous year overall, and by as much as 12% in many countries. But this disguises the rise in the use of the strongest medicines, such as colistin, which is a last resort for life-threatening human illness.
The percentage of antibiotics sales made up by the most potent antibiotics remained steady or in some cases increased slightly, indicating an increase in the amount of so-called critically important antibiotics used.
For instance, sales of fluoroquinolones – the newest versions of which are used to treat life-threatening illnesses including pneumonia and Legionnaire’s disease – stood at 141 tonnes across the countries surveyed in 2013, and rose to 172 tonnes in 2014. Sales of macrolides, also classed as critically important to human health, rose from 59 to 67 tonnes in the same period. This shows that efforts to prevent the drugs most crucial for human health from being used in farming are failing.
Experts are increasingly concerned by growing evidence that the overuse of antibiotics on farms – which in the EU account for three times the quantity of antibiotics dispensed to the human population – is endangering human health by fostering the development of bacteria resistant to even the strongest medicines.
Cóilín Nunan, of the Alliance to Save Our Antibiotics, which comprises several NGOs concerned with animal and human health, said: “The shocking overuse of farm antibiotics shown [in the report] is a result of the continued failure by most countries to ban routine preventative mass medication in intensive farming.
“Spain now uses 100 times more antibiotics per unit of livestock than Norway, 80 times more than Iceland and 35 times more than Sweden. The main reason for the difference is that Spain, like most of Europe, allows routine mass medication, whereas the Nordic countries do not. The increased use of last-resort and critically important antibiotics is particularly alarming and confirms that reliance on voluntary and softly-softly approaches is not working.”
The Guardian has exposed new evidence of the superbug MRSA present in meat produced in the UK and on sale in UK supermarkets. When present in food, the bug can be killed by cooking, but lapses in hygiene can result in human infection. It can be contracted from infected farm animals, so the finding that UK farms are becoming a reservoir for the disease shows there is a danger of it spreading more widely in Britain.
Antibiotic resistance has been called a threatened “apocalypse” by the UK’s chief medical officer, Dame Sally Davies. She has warned that in less than two decades operations now regarded as simple, such as hip replacements, could become dangerous to patients because of the risk they could contract untreatable infections. The overuse of antibiotics has been a key factor in the rise of resistant bacteria.
The government’s review of the situation, conducted by Lord O’Neill and published last year, found that farms were a potential source of increasing resistance. Germs that acquire immunity to strong antibiotics in animals can spread to humans.
Routine use of antibiotics on animals – which is frequently practised across the world as a method of promoting their growth – is supposed to be banned within the EU.
However, the new data from EMA showed that farmers and vets are over-using strong antibiotics, campaigners told the Guardian. The O’Neill review advised that the UK and other countries should aim to use no more than 50mg of antibiotic per kilogramme of livestock, but the data shows that the average use across the EU is three times higher at 152mg per kg, according to the Alliance to Save Our Antibiotics.
A third of hospital trusts in England have increased their car parking charges in the last year, figures show.
Some are now charging as much as £4 for a one-hour stay, with a third increasing their average charge over a three-hour period.
The analysis, by the Press Association, includes figures obtained directly from NHS trusts and data submitted to NHS Digital.
The NHS Digital data suggests a 15% average rise in parking charges across trusts in England between 2014/15 and 2015/16.
Some trusts allow patients and visitors to park for free for the first 30 minutes before charges kick in but others have scrapped a one- or two-hour charge, meaning people have to pay a flat fee for three hours even if they stay for less than that.
The most expensive trust in the country for a one-hour stay is the Royal Surrey county hospital in Guildford, where patients pay £4 for any stay up to two hours. It does have a few bays where people can park for 20 minutes before being charged.
Hereford county hospital lets people park for free for 10 minutes, but then charges £3.50 for an hour and £5 for two hours.
Meanwhile, London’s Royal Free hospital charges a flat rate of £3 an hour.
Of the 209 hospital trusts that reported figures to NHS Digital for both 2014/15 and 2015/16, a third (69 trusts) showed an increase in their average hourly charge when calculated across three hours.
126 (60%) showed no change over the year while 14 (7%) showed a decrease.
Among those trusts that have hiked up parking charges in 2016 are the Royal Surrey, where the cost of an hour has doubled from £2 in 2013 to £4.
Stockport NHS foundation trust increased its prices by about 40% over the summer.
The cost of a four-hour stay at the town’s Stepping Hill hospital rose from £6 to £8, with a short stay rising from £2.50 to £3.50.
England is the only part of the UK where hospitals routinely charge patients and visitors for parking. Almost four out of 10 (38%) NHS trusts said they also charged for disabled parking.
Laura Keely, campaigns manager at Macmillan Cancer Support, said: “Cancer patients often need to make frequent trips to hospital. They should not be left out of pocket in order to receive life-saving treatment.
“Public transport is not always an option as cancer patients can have an increased risk of infection because treatment has compromised their immune system. Treatments can also leave patients feeling tired, sick and weak, so they have little choice but to travel by car.
“Car parking is free at most hospitals in Scotland, Northern Ireland and Wales but not across all hospitals in England. Those in charge of hospital car parking have a responsibility to ensure that their schemes work for vulnerable people, such as those living with cancer.”
At the other end of the scale, car parking at Trafford general hospital in Greater Manchester is free for up to three hours.
Alder Hey children’s NHS foundation trust charges £2 a day and the Christie cancer hospital in Manchester charges £1.50 a day. The Clatterbridge Cancer Centre on the Wirral offers free parking.
Some NHS trusts offer concessions to people visiting someone who is terminally ill, and also discounts or weekly tickets for lengthy courses of treatment.
Last December, figures obtained under the Freedom of Information Act by the Press Association revealed that some NHS trusts are making more than £3m a year from car parking fees.
Of more than 90 trusts that responded to the FoI request, half are making at least £1m a year.
Seven NHS trusts earned more than £3m in 2014/15 from charges, a further eight made more than £2m a year while a further 33 earned more than £1m a year.
Royal Surrey had a deficit of more than £11m at the end of March, against a forecast of £2m. It has blamed several factors including increasingly expensive agency staff. It said it was expanding its car park capacity by 100 spaces due to increased demand. A £10m multi-storey is planned to create a long-term solution, it said.
Deputy chief executive Alf Turner said: “I do not like having to charge people for car parking and in an ideal world we would not have to, however both my colleagues on the board and I know that it is an unfortunate necessity to cover our car parking improvement and running costs.
“We have listened carefully to the views of our patients, visitors and staff and they have been telling us that our current car parking provisions are inadequate and urgent changes need to be made. The trust’s challenging financial position means that it does not have the additional funds to invest in the future of its car parking facilities without making the incredibly difficult decision to charge people for using the car parks.”
Shadow health secretary Jonathan Ashworth said: “These figures show a worrying increase in the cost of car parking charges in our hospitals.
“Racking up charges on people who have no choice isn’t fair and will only cause more distress for patients and their families.
“Hospitals across the country are hard-pressed because of this Government’s underfunding of the NHS, but money should not be made up through charging patients and their families more and more for an essential service. These increases cannot be justified.”
Most expensive trusts in England for a one-hour visits:
Life expectancy has increased by 10 years across the globe in the past 35 years, thanks in part to efforts to treat infectious diseases such as Aids and malaria, but diet, obesity and drug use are now major causes of death and disability while too many women still die in childbirth, data reveals.
The Global Burden of Disease study, which regularly reviews the causes of illness, disability and death in every country in the world, shows health is improving but not to the same extent or in the same ways in every country. And as people live longer, they are suffering from more ill health and disability in their old age.
“Development drives, but does not determine health,” said Dr Christopher Murray, director of the Institute. “We see countries that have improved far faster than can be explained by income, education or fertility. And we also continue to see countries – including the United States – that are far less healthy than they should be given their resources.”
Life expectancy from 1980 to 2015 has risen globally by more than a decade to 69 years in men and 74.8 years in women. The cause of 70% of deaths is non-infectious diseases that often have lifestyle origins, such as heart disease, stroke and diabetes, but also include dementia. HIV/Aids, which was a major killer, accounted for 1.2 million deaths in 2015, which is a reduction of a third from 2005.
People are spending more years with chronic illness and disability, caused by drug use – particularly of opioids and cocaine – loss of sight and hearing and osteoarthritis, according to the series of papers published by the Lancet medical journal.
Low back and neck pain, sight and hearing loss, depression and anaemia caused by a lack of iron were the main reasons why people were living in poor health. Huge numbers of people suffer for more than three months from cavities in their teeth – 2.3 billion – while 1.5 billion suffer long-term from tension-style headaches. There have been drops in the numbers with chronic obstructive pulmonary disease (COPD), asthma, cervical cancer and ischemic heart disease.
High blood pressure, smoking, high blood sugar, high body mass index, and childhood undernutrition were the leading risk factors for premature death and ill health in 2015.
Environmental factors undermine people’s health worldwide. Obesity caused by bad diets – those high in salt and low in fruit, vegetables, wholegrains, nuts, seeds and seafoods – drug use and pollutants such as diesel exhaust and benzene encountered in people’s working lives as well as ozone pollution, have an impact on diabetes, heart disease and cancers, says the study coordinated by the Institute for Health Metrics and Evaluation at the University of Washington in Seattle.
Progress has been made in reducing the threat to health from smoking, unsafe sanitation and water, and household air pollution, although they remain major causes of poor health. Exposure to smoking fell by over a quarter worldwide, but it is still ranked among the top five risks associated with health loss in 140 countries, claiming 289,000 more lives in 2015 (total deaths: 6.4 million) than 2005, and is the leading risk factor for poor health in the UK and the US.
Investment in the Millennium Development Goals brought down the numbers of childhood and maternal deaths, and yet in 2015 more than 275,000 women died in pregnancy or childbirth in 2015, mostly from preventable causes. In 24 countries, deaths have actually risen. Many, such as Afghanistan and Palestine, have been affected by conflict, but some are high-income countries such as the US, Greece and Luxembourg. In the poorest countries, with most of the deaths in childbirth, women most often die from haemorrhage, but in rich countries they die from complications, such as heart problems which may be obesity-related.
Prof John Newton of Public Health England, who is involved in the study as chair of the European Burden of Disease Network, said: “The global picture is similar to that in England – people are living longer, but spending more time living with illness and disability. While we’ve made great strides to reduce deaths and illness from infections like HIV, malaria and measles, it’s the chronic, non-communicable conditions like diabetes, drug use disorders and hearing and sight loss that create the bigger burden of illness. The treatment and resource implications for health systems are huge.
“This presents a great opportunity for prevention both in England and worldwide. Consequences of a poor diet now account for 10% of all ill-health worldwide and levels of alcohol consumption and air pollution have hardly changed. We can tackle all of this and more through committed individual, national and global action.”
The number of students seeking counselling at university has rocketed by 50% in the last five years, according to figures obtained by the Guardian.
As tens of thousands of teenagers leave their family homes this week and begin to arrive on campuses for freshers’ week, research shows that university counselling services are under increasing pressure as demand grows.
Heads of university counselling services say they are seeing more students arrive with existing psychological or mental health conditions. Some counselling services are under-resourced, and students are seeking help against a backdrop of mounting pressure to get the best possible degree, in order to secure a good job to pay off their debts from student loans.
“What used to happen was that in the first year people played hard,” said one head of counselling. “But now they are coming in already worried that they need to do well. They are far more vulnerable.”
The increasing number of international students is also a factor, with many under even greater pressure to succeed, coming from families who may have saved up for years to send one of their children to a UK university.
But though the overall trend is up, experts in the sector say part of the increase in demand is down to a new willingness among young people to ask for help. Many universities have also become far more proactive in reaching out to students.
The figures, obtained through a series of freedom of information requests to higher education (HE) institutions across the UK, indicate that at some universities young men, who are traditionally hard to reach, are increasingly using services as some of the taboo surrounding mental health dissipates.
For instance, at the University of Edinburgh, the number of male students approaching support services – including chaplaincy, disability and mental health services – between 2010-11 and 2014-15, more than doubled, with numbers up from 274 a year to 623.
Numbers of men approaching services also almost doubled at Glasgow University over the same period, thanks in part to male staff working on the counselling team, and a peer-to-peer support network which attracted a significant number of male students.
University counselling
University College London was the only institution in the sample to include figures for transgender students seeking counselling. The figures were collected for the last three years and have increased slowly to 12 in 2015-16.
Catherine McAteer, the head of UCL’s student psychological services, said: “We have 39,000 students, soon to go up to over 40,000. There are 13 clinicians in my team. The reality is 13 people cannot meet that kind of demand.”
McAteer said her team had looked after 3,022 students in 2015-16, some of whom had lengthy waits before being seen, the longest being 15 weeks. “The problem is the longer they have to wait, the more likely it is that the problem will escalate,” she said.
When McAteer took over as head of the department in 2002, just 9% of students who accessed the service had existing psychological or mental health conditions. Last year it was 53%, who had previously been seen by therapists for a variety of issues including depression, anxiety and eating disorders.
The 50% increase in the number of students accessing counselling is based on figures comparing uptake of services in 2010-11 and 2014-15 provided to the Guardian by 37 higher education institutions, including many leading Russell Group universities such as Oxford, Durham, Liverpool and Sheffield.
In numerical terms, the number of students accessing counselling services in the Guardian sample rose from just under 25,000 five years ago to more than 37,000 in the 2014-15 academic year, a 50% rise.
This trend persists even when an overall increase in student enrolment is taken into account. Among those institutions which provided comparable enrolment and counselling figures, the proportion of students accessing these services rose by 47% in the same period.
“What’s happening is that students are now coming to university when previously they would not have come,” said McAteer. “When they come to a university like UCL or Oxford or Cambridge – one of the top 10 universities – the pressure is enormous.”
Swansea University, which recorded just 80 students seeking counselling in 2010-11, saw figures shoot up to more than 1,000 five years later, largely as a result of the university’s efforts to raise awareness among students and to destigmatise mental health issues.
Swansea University Photograph: Swansea University
Kevin Child, the head of student services at Swansea University, said: “The significant increase in demand for mental health support is a national trend, with all HE providers identifying the issue as a significant challenge.
“We have attracted students to our services who may traditionally have attempted to manage mental health issues for longer periods without coming forward, especially males. This has enabled us to make earlier interventions and provide more specific and effective support at an earlier stage.”
Ruth Caleb, the head of counselling services at Brunel University London (which was not part of the Guardian sample), and chair of the mental wellbeing in higher education working group, said there had been a 22% increase in demand for counselling at her university last year alone, with young men coming forward in greater numbers – 42.5% of Brunel students seeking counselling were male in 2015-16.
“Now that students are paying higher fees and are coming away with quite a lot of debt, there’s a lot more concern about getting a job and paying that debt off. They come in with the anxiety that they need to get a good degree,” said Caleb. “If the first few assignments don’t go brilliantly, it’s far more of a concern to them than it used to be.
“The other issue is the enormous growth in international students and widening participation students. It’s much harder to be a student if you are the first in your family or community to go to university.”
International students are often reluctant to join in social activities because they feel they should work all the time. Caleb cited “students who are coming from sometimes unstable societies – Syrian students Skyping their families and hearing the guns going off behind the Skype picture”.
Caleb said it was good that more young people felt able to come forward and ask for help, but resources for counselling services had not always grown sufficiently and in some cases had gone down in spite of the growth in demand. A report on Thursday by the Higher Education Policy Institute said that a number of universities needed to triple their spending on mental health to meet demand.
Some universities are prioritising mental health care. The University of York announced on Thursday it was investing £500,000 in mental healthcare provision across its campus after a six-month review, prompted by an increasing demand for services from students and disruptions to mental health provision in the city.
The university is planning to expand its in-house counselling service, with two new members of staff to ensure that those who need urgent appointments can be seen quickly. Its vice-chancellor, Prof Koen Lamberts, said: “As the number of students considering higher education grows, we must work hard to encourage openness between staff and students to talk about these issues in a supportive environment.”
The Nightline Association, which offers counselling services to roughly 18,000 students a year through its 39 branches, said in the last year alone calls to Nightline rose by 78% in Leicester, 46% in Sheffield, 40% in Durham and 35% in Leeds.
Katie Nicoll Baines, a volunteer at Nightline, said: “The rise is perhaps because people are becoming willing to use our services, and perhaps they just need them more because university is becoming such a competitive and trying environment for a lot of young people.”
Alan Percy, who is head of counselling at Oxford University and on the executive of the Heads of University Counselling Services, warned against “catastrophising” student mental health.
“A lot of these things are normal emotional responses to life challenges,” he said. “A lot of students are feeling overwhelmed by life and the pressures of life in terms of having to be perfect. A lot of them feel they’ve got to get everything right.”
But he added: “It’s not universities that are causing this. It’s a wider social problem.”
‘You know that you’re going to come out with around £50,000 of debt. I stress about that all the time’
Struggling to be heard over the din of excited freshers, a small group of students has gathered in Sheffield University’s students’ union to talk about mental health. The committee of the Mental Health Matters Society are not in the least surprised by new statistics showing university counselling services around the country to be under huge pressure.
They all say they love their university, describe it as “welcoming” and are sure it’s better than most at providing services but have joined the society, set up a decade ago, to be part of a student support network, and to campaign for more awareness and funding for mental health.
Joseph Bonnett, a final-year geography student and the society’s men’s health representative says he found help with his friends by talking about his problems and also with the society.
Joseph Bonnett Photograph: David Sillitoe for the Guardian
He says that though such societies cannot provide treatment or counselling, offer a support network outside the official structures for those suffering from mental health problems.
With £9,000-a-year tuition fees and a tough graduate jobs market, the group agree that modern student life involves more pressure. When the society’s president, Reena Staves, was managing the society’s various online accounts last year she was inundated by people needing help, with depression, anxiety and eating disorders being among the most common problems.
Reena Staves Photograph: David Sillitoe for the Guardian
“I just really wanted to say to them: ‘I’ve been in a similar place,’ but I couldn’t because that would have been unprofessional, so I just had to point them in the direction of the various services available,” she says.
Gracie Marlow, a second-year English and philosophy student, says she is constantly stressed about her job prospects when she graduates. “You know that you’re going to come out with around £50,000 of debt. I stress about that all the time,” she says. “And you’re probably going to end up with a job that doesn’t pay much more than it would if you didn’t have a degree.”
Gracie Marlow Photograph: David Sillitoe for the Guardian
A common issue raised is the pressure to have the stereotypical student experience, with all the heavy drinking and late nights that that entails. “I remember during the first week of uni there was a kind of intro tour and they told us this was going to be the best three years of our lives and that we were going to have the most amazing time,” says Lucy Baldwin, the society’s vice-president, who is in the final year of a zoology degree.
“My uni experience has not been the same as a lot of people’s and you think: ‘Have I wasted this? Should I have tried harder?’ And a lot of people can get in a rut thinking that their experience hasn’t been what it was supposed to be and feeling like everybody else around them is having the best time ever. I don’t think social media helps with that.”
The group acknowledges that the growing burden put on university mental health services is also partly the result of a greater willingness to talk about the issue. “[Society] is becoming more open, but if we can’t provide support for the people who now feel that they can speak up about [mental ill health], that’s a really difficult position to be in,” says Megan Myer, who is doing a master’s in English literature.
Myer argues that universities should be prioritising funding for mental health services above all else. “It’s great to have the infrastructure and the resources, but if you as a person don’t have the resources to get through university then there’s no point having the big expensive buildings,” she says. “People should be the priority.”
Louise Knowles, the head of the University Counselling Service, says the wellbeing of students and staff is paramount and that the service works hard to ensure its “free, confidential service is one our students have confidence in”.
“It is our work in this area that helped us become the first university counselling service – and one of only seven organisations nationally – to be awarded a new quality assurance accreditation badge through the Accreditation Programme for Psychological Therapy Services last year,” she says.
“Our accreditation recognises both the extremely short wait times – which have almost halved since 2011-12 – as well as our talented and clinically robust team who offer a varied range of treatments and interventions in a challenging environment.
“We are committed to continually improving the quality and standard of the service we deliver, balancing this against increasing numbers accessing our service and looking at new and innovative ways of working with students.”
Additional reporting by Pamela Duncan and Sophia Schirmer.
Dr Potter who runs the HRC clinic in Newport Beach in California, said 80 per cent of couples from Britain are choosing to have a girl.
It had been feared that allowing sex selection would lead to an imbalance between the genders with fewer girls born for cultural reasons.
However Dr Potter said the women he sees are desperate for a girl having grown up playing with dolls and always imagined they would have daughter.
He told the Telegraph: “Some have only one child but most have two or three of the same gender. The process is driven by the mother who has identified with little girls since her own childhood and has always had a place for a daughter. When they do not have one, it is like a death and they grieve for their little girl.”
Dr Potter’s patients often do not need fertility treatment in order to conceive but go through the process so that the resulting embryos can be screened and the chosen sex transferred to the womb.
The whole process costs around US$ 15,000 and requires a 12 day stay near the clinic.
Dr Potter said: “I think that pregnancy termination as a method of gender selection is not acceptable but I also believe that is it not for me to impose my values on other people.
“I believe women should have reproductive freedom and that should include selecting the gender of their child if they wish. But in countries like the UK where the government pays for some IVF, taxpayers’ money should not be used to people can have a boy or a girl because that is what they want. That is inappropriate.
“I have had patients come to me from the other side of the world who have never been on a plane before and have saved up for a long time, it is really very important to them.”
He said the arguments against sex selection using IVF were mostly ‘absurd’ and focus on it ‘interfering with God’s will’ or somehow sexually discriminating against the embryo.
One in ten of Dr Potter’s patients are now seen for gender selection with the largest numbers of couples from outside America coming from Australia, the UK and Canada. In these countries, most couples want a girl, he said.
Some patients travel from China wanting to have a boy but many also want twins, with one of each sex.
One British patient who asked to be known only as Hayley said: “I’d always wanted a little girl but logistically, we didn’t want lots of children, we only wanted three, so we though we’d go down this route.
“My husband said “you can have one more baby” at which point I said, if I’m having one more I’ll make sure it’s a girl.
“I just think I’ve always wanted a mother daughter relationship. Not to take away from what I have with my sons which is lovely.”
Hayley and her husband Greg already had two boys, Bobby, six and Christopher, four. After searching the Internet, Hayley found lots of couples were looking for the same, and had coined the phrase, ‘gender dreaming’.
She said: “It took a lot of soul searching to go to the US to be honest – it took us a long time and we had to do lots of talking before we decided.
“Dr Potter was fantastic right from the care you receive in the UK. He was reassuring, really professional and everything you could want.”
“Of the eggs we created, we had 6 healthy embryos, 3 girls, 3 boys.”
Hayley chose to have one female implanted, which led to a successful pregnancy.
“I still can’t quite believe it, I’ll believe it when she’s here.
“The remaining embryos are frozen, they’ll probably remain frozen for a while. At some point we’ll make a decision, and I’m not sure what they decision will be.”
“We spent £22,000 on treatment but we never think about the cost, it was worth every penny.”
The Human Fertilisation and Embryology Authority which regulates fertility treatment in Britain carried out a review of sex selection in 1993 and again in 2002. Sex selection for social or family balancing reasons is illegal under the amended HFE Act which came into force in 2009.
Dr Potter who runs the HRC clinic in Newport Beach in California, said 80 per cent of couples from Britain are choosing to have a girl.
It had been feared that allowing sex selection would lead to an imbalance between the genders with fewer girls born for cultural reasons.
However Dr Potter said the women he sees are desperate for a girl having grown up playing with dolls and always imagined they would have daughter.
He told the Telegraph: “Some have only one child but most have two or three of the same gender. The process is driven by the mother who has identified with little girls since her own childhood and has always had a place for a daughter. When they do not have one, it is like a death and they grieve for their little girl.”
Dr Potter’s patients often do not need fertility treatment in order to conceive but go through the process so that the resulting embryos can be screened and the chosen sex transferred to the womb.
The whole process costs around US$ 15,000 and requires a 12 day stay near the clinic.
Dr Potter said: “I think that pregnancy termination as a method of gender selection is not acceptable but I also believe that is it not for me to impose my values on other people.
“I believe women should have reproductive freedom and that should include selecting the gender of their child if they wish. But in countries like the UK where the government pays for some IVF, taxpayers’ money should not be used to people can have a boy or a girl because that is what they want. That is inappropriate.
“I have had patients come to me from the other side of the world who have never been on a plane before and have saved up for a long time, it is really very important to them.”
He said the arguments against sex selection using IVF were mostly ‘absurd’ and focus on it ‘interfering with God’s will’ or somehow sexually discriminating against the embryo.
One in ten of Dr Potter’s patients are now seen for gender selection with the largest numbers of couples from outside America coming from Australia, the UK and Canada. In these countries, most couples want a girl, he said.
Some patients travel from China wanting to have a boy but many also want twins, with one of each sex.
One British patient who asked to be known only as Hayley said: “I’d always wanted a little girl but logistically, we didn’t want lots of children, we only wanted three, so we though we’d go down this route.
“My husband said “you can have one more baby” at which point I said, if I’m having one more I’ll make sure it’s a girl.
“I just think I’ve always wanted a mother daughter relationship. Not to take away from what I have with my sons which is lovely.”
Hayley and her husband Greg already had two boys, Bobby, six and Christopher, four. After searching the Internet, Hayley found lots of couples were looking for the same, and had coined the phrase, ‘gender dreaming’.
She said: “It took a lot of soul searching to go to the US to be honest – it took us a long time and we had to do lots of talking before we decided.
“Dr Potter was fantastic right from the care you receive in the UK. He was reassuring, really professional and everything you could want.”
“Of the eggs we created, we had 6 healthy embryos, 3 girls, 3 boys.”
Hayley chose to have one female implanted, which led to a successful pregnancy.
“I still can’t quite believe it, I’ll believe it when she’s here.
“The remaining embryos are frozen, they’ll probably remain frozen for a while. At some point we’ll make a decision, and I’m not sure what they decision will be.”
“We spent £22,000 on treatment but we never think about the cost, it was worth every penny.”
The Human Fertilisation and Embryology Authority which regulates fertility treatment in Britain carried out a review of sex selection in 1993 and again in 2002. Sex selection for social or family balancing reasons is illegal under the amended HFE Act which came into force in 2009.
The Royal University of Nursing, which carried out the analysis, stated the figures highlighted the increasing disparities on pay for NHS personnel. Photograph: Christopher Furlong/Getty Photos
Hospital bosses’ pay has been growing far faster than that of frontline NHS workers for the duration of the service’s unprecedented monetary squeeze, prompting angry claims by nurses’ leaders of double requirements.
Senior NHS managers’ salaries have risen by an average of six.one% in excess of the last two years – virtually four occasions the regular charge of 1.6% for nurses, midwives and wellness site visitors, in accordance to new figures.
Some hospital trust chief executives and other senior figures have obtained bonuses of at least £40,000 – much more than a ward sister’s yearly salary – pay rises of up to £30,000 and benefits in type, this kind of as a leased vehicle, worth £10,000, freedom of details requests show.
The disclosures have led the Royal University of Nursing (RCN), which conducted the research, to condemn what it says are unfair and increasing disparities on shell out in England at a time when most NHS workers who seem after sufferers have had pay freezes or small pay out rises.
They come as anger is expanding amongst unions representing the NHS’s one.35 million-sturdy workforce at the selection by the health secretary, Jeremy Hunt, to reject the NHS pay out-overview body’s recommendation that all NHS staff need to get a 1% pay out rise this year. Several of the unions are contemplating undertaking a coordinated programme of industrial action in the autumn, ranging from an overtime ban to likely strike action, in protest.
The RCN mentioned: “People currently on the highest salaries in the overall health service are seeing their rewards accelerating ahead of the earnings of the staff they lead.” Its general secretary, Dr Peter Carter, described the findings as “yet another kick in the teeth for hardworking and loyal nursing staff”.
NHS hospital trusts are in a position to determine with out ministerial interference how much their senior employees must be paid but are anticipated to do so “with obligation and sensitivity to the place of personnel who are subject to national contracts and restraint over their pay out”.
Dan Poulter, the wellness minister, not too long ago insisted that most were carrying out that. But he said that the specifics supplied by hospitals, contained in a new RCN report, “fly in the face of this assertion”.
For instance, the chief executive of Oxford University Hospital NHS Believe in, which runs the city’s John Radcliffe hospital, acquired a bonus of among £40,000 and £45,000, even though one executive received one of £5,000-£10,000 and six other individuals of amongst £10,000 and £15,000.
Similarly, the chief executive of West Hertfordshire Hospitals NHS Trust, which runs Watford standard hospital and other hospitals, also got a £40,000-£45,000 bonus, while 3 executives acquired bonuses of £15,000-£20,000 and a single of £20,000-£25,000.
The chief executive at 10 other hospital trusts and deputy chief executive at a single other each enjoyed pay out hikes of among £15,000 and at least £30,000 throughout 2011-twelve and 2012-13. For instance, the salary of the chief executive of York Teaching Hospitals NHS Foundation Believe in rose from £160,000-£165,000 to £190,000-£195,000.
“It is incredibly worrying that the government believes that trusts are acting responsibly when it truly is clear several are failing to display the leadership they ought to on senior management pay out,” said Carter.
“The government has maintained an iron grip on the pay out and advantages of frontline staff whilst the senior managers’ shell out bill has gone seemingly unchecked. This is the worst kind of double regular and can make a mockery of their insistence that fairness has been at the heart of their selection-making on public-sector pay out.”
Jamie Reed, the shadow health minister, stated: “Difficult-operating nurses and midwives will locate this galling. David Cameron need to have honoured his promise to give frontline workers a spend rise.”
Bosses have been awarded enhanced packages at a time when the support has been acquiring the smallest spending budget increases in its historical past and struggling to provide £20bn in efficiency financial savings in between 2011 and 2015 – the so-referred to as Nicholson Challenge.
The NHS Confederation, which represents senior managers, declined to comment.
The Division of Wellness (DH) said the RCN’s findings were not dependable simply because they had integrated exit packages awarded to some of the 7,250 NHS managers who had misplaced their jobs because 2010 but not carried out the identical with nurses. There are now 16,300 much more clinical employees and 7,250 fewer managers in the NHS than when the coalition took energy in Might 2010, a DH spokesman explained. He claimed that the government’s radical overhaul of the NHS was conserving £5bn, which was far a lot more than the fees of the 7,250 redundancies.
In a separate matter, Carter stated that the NHS would be forced to rely on rising numbers of company and foreign nurses to bridge the gap brought on by cuts to the quantity of pupil-nurse instruction locations.
Speaking from the RCN yearly congress in Liverpool, Carter said: “The NHS, possessing cut the number of places for pupil nurses, is now not receiving the by way of-put, they’re now having to go off to all points of the compass.
“As an illustration, three many years ago, the NHS in London minimize instruction locations by 24%. Now the result of that is beginning to come through.”
Warming by 4C (seven.2F) from pre-industrial ranges will lead to a “fundamentally different” globe from today – whereas limiting warming to 2C (three.6F) by cutting emissions will outcome in a world “not dramatically different” from right now, Chris Area, co-chair of the IPCC functioning group that authored the report.
“With large levels of warming that result from continued development in greenhouse fuel emissions, dangers will be demanding to handle, and even significant, sustained investments in adaptation will encounter limits,” he explained.
Ed Davey, Britain’s vitality and climate adjust secretary, said the report showed that “left unchecked, climate modify will have far reaching consequences for our society” and vindicated the government’s drive to go green.
“This evidence builds the case for early action in the United kingdom and close to the globe to reduce the dangers posed by climate modify,” he said. “We can not afford to wait.”
The IPCC’s report into “Impact, Adaptation and Vulnerability” brings together the work of hundreds of climate scientists around the world.
It concludes the impacts of climate adjust are currently evident nevertheless several parts of the world are “ill-prepared for the risks” it brings.
“Investments in far better planning can pay dividends for the two the current and the potential,” Vicente Barros, co-chair of the functioning group, said.
Britain is reasonably properly-positioned to be in a position to adapt to climate modify but requirements to consider action to do so, authors of the report mentioned ahead of its formal launch in Japan.
“The sea level is increasing, so we know that the risk of flooding on the coastal zone is going to boost,” Nigel Arnell of the University of Reading through Walker Institute, stated.
“We know temperatures are rising, so we know the danger of heatwaves and prolonged hot spells are going to improve, and we know the implications of individuals in our cities and for crop production.
“We strongly suspect climate alter will influence on the reliability of our water supply methods. And we really strongly suspect that climate change will make flooding along our rivers and in our modest catchments a lot more frequent.”
Climate alter is also probably to hit crop production globally, resulting in “instability and volatility of worldwide food prices”, Neil Adger of the University of Exeter’s School of Life and Surroundings Sciences explained.
“Britain is not immune from the global trends in the way worldwide agricultural markets are set up.”
Cities are most likely to be particularly badly impacted by climate change simply because the dense population exacerbates other risks, and elderly folks are most likely to be specifically affected by heatwaves.
“In Britain we not very very good at adapting to heatwaves. Individuals who are vulnerable to heatwaves are physiologically vulnerable to them. They frequently influence the elderly,” he mentioned, describing present strategies to support elderly cope with extreme heat as “not very effective”.
Climate controversy
The IPCC’s report into the impacts of climate alter threatens to be overshadowed by a row in between its authors above its findings.
Richard Tol, a scientist who was a lead writer on a section of the report dealing with the economic results of international warming, last week claimed the report’s conclusions were “also alarmist”.
But Chris Field, the co-chair of the report, hit back yesterday saying that Tol’s very own analysis was “outdated-fashioned” and had contained “mistakes”.
A leaked draft of the suggestions to policymakers explained that “global indicate temperature increases of 2.5C above preindustrial amounts may lead to worldwide aggregate financial losses among .2 and 2 per cent of income”, in line with Tol’s views.
But critics argued the prediction underplayed the very likely affect. In the ultimate version, the section has been substantially rewritten. It now says that “global financial impacts from climate modify are tough to estimate” and heavily caveats the .2 to 2pc forecast.
Discipline explained: “There had been a couple of meaningful mistakes in the way Richard had completed his evaluation and as a consequence of mindful work in the final couple of week we have come up with a much better way of considering about them, a more accurate way.”
“Richard Tol is a fantastic scientist but.. he is sort of out on the fringe. When you truly seem at in which we are with modern day science I feel individuals .2-2pc numbers are truly previous-fashioned.”
Tol advised the Telegraph: “The Technical Assistance Unit mentioned one error correcting it did not considerably modify the conclusions.”
Free of charge-market place thinktank the Institute of Financial Affairs says the nation faces a option between spending cuts of far more than 25% and substantial tax hikes. Photograph: Image Source/REX
United kingdom taxpayers were being kept in the dark about the big scale of investing cuts or tax rises essential to fund potential pension and social obligations for an ageing population, the Institute of Economic Affairs explained.
The country faced a stark decision in between complete investing cuts of much more than a quarter, wellness and social safety spending cuts of 50%, or “important” tax hikes if prolonged-phrase obligations have been to be met, the free of charge-market place champions explained.
In its report, the Government Debt Iceberg, the IEA said the measure of indebtedness amongst western governments including the Uk need to include the extent to which all future spending plans could not be financed by the current tax system.
Taking into account commitments that have been produced beneath social protection and healthcare programmes, the United kingdom fiscal imbalance – or the gap amongst tax and paying – was 13.6% of the estimated existing worth of United kingdom GDP, the IEA mentioned.
On that basis, the Uk had the decision of raising the equivalent of 13.six% of GDP with further tax revenues, more than and above existing taxes, which would be levied each year to make certain that government investing commitments could be met from taxation.
Or it has the decision of cutting spending by a lot more than a quarter – or halving paying on overall health and advantages.
The IEA stated the government’s planned measures – which includes a proposed rise in the state pension age to 68 by 2046 – have been not enough to deal with the scale of the challenge.
Professor Philip Booth, editorial and programme director at the IEA, mentioned: “Without having reform, today’s young folks are probably to be disappointed, either in terms of increased tax prices or in terms of diminished long term advantages offered by government. The quicker the government changes policy, the more painlessly the circumstance will be resolved. For as well lengthy people have voted themselves advantages to be paid for by the following generation of taxpayers, not by sacrifices that they will make themselves.”
The IEA argues in the report that Europe and the US “will quickly commence to encounter fiscal constraints the like of which we have never ever seen just before” since governments have produced unfunded social insurance coverage programmes where retiree rewards are paid for from the taxes of the working-age population.
“Politicians have known about population ageing for all around 50 years but ignored the problems it will produce for public finances,” the report mentioned.
Bottles of wine in a supermarket. Photograph: Sean Spencer/Alamy
Medical professionals and alcohol campaigners have written to the chancellor, George Osborne, urging him not to give in to industry stress to scrap yearly tax increases on alcohol in the up coming price range.
Sir Ian Gilmore, chair of the Alcohol Health Alliance and the Royal University of Physicians’ particular adviser on alcohol, stated he was concerned that Osborne had frozen the duty escalator on beer – “showing indicators that he is weakening on this resolve” – – and that the industry was campaigning to scrap it altogether.
“The government’s record has not been good on alcohol,” he mentioned. “The minimal unit pricing U-turn was a choice instance of failing to comply with in which the evidence lies. We know that value is the most important determinant of how significantly society drinks. In the absence of setting a sensible floor price, duty is the traditional way of doing it.”
The alliance lobbied for minimum unit pricing since it would boost the price of the strongest drinks above weaker drinks. “The way that cider is preferentially taken care of indicates that you can nevertheless buy a litre of white cider with 7.5% tax for next to nothing – virtually pocket money charges,” he mentioned.
David Cameron 1st backed minimum unit pricing and then transformed his thoughts. The alliance fears the government may cave in to business stress in excess of the duty escalator too.
The letter is signed by 24 members of the alliance, urging the chancellor to stand firm in the encounter of a campaign from the Wine and Spirit Trade Association, the Scotch Whisky Association and the TaxPayers’ Alliance.
Katherine Brown, director of the Institute of Alcohol Scientific studies, mentioned it would be madness for the government to give in to stress. “Scrapping the duty escalator would be going towards nevertheless another government dedication to tackle the low-cost alcohol that is creating mayhem on our streets and bringing our well being support to its knees.
“Moreover, creating alcohol more cost-effective poses a genuine danger to vulnerable groups such as young women. With nearly a third of female drinkers aged sixteen-24 consuming the equivalent of nine shots of vodka in a session each week, we want to be doing almost everything in our powers to curb excessive alcohol consumption, not encouraging it by decreasing the cost.”
The alliance says alcohol harm in the United kingdom expenses much more than £21bn every single yr, which is far more than double the total income collected from alcohol duties (£10bn). Alcohol bought in supermarkets and off-licences is 61% a lot more cost-effective than it was in 1980, it says.
Miles Beale, chief executive of the Wine and Spirit Trade Association, explained: “Most responsible customers would be outraged to find out that because the alcohol duty escalator was launched in 2008, tax on wine has improved by 50% and on spirits by 44%. Independent investigation from Ernst and Youthful has located that if the chancellor scraps the escalator in his approaching price range, this would improve public finances by £230m in 2014 alone and generate much more than 6,000 jobs.”
Examination by Labour demonstrates 300,370 individuals over the age of 90 have been taken to A&E by ambulance in the final yr. Photograph: Bethany Clarke/Getty Images
The amount of extremely elderly individuals needing to go to hospital by ambulance has risen 81% given that 2009-ten, in accordance to new figures.
Analysis by Labour showed that 300,370 men and women more than the age of 90 were taken to A&E by ambulance in the last 12 months, a considerable rise on prior years. In 2009-ten, the figure was 165,910.
The data comes from tables of ambulance exercise in England, published by the Health and Social Care Details Centre.
Labour stated the figures confirmed that cuts to social care funding have been driving up the want for hospital interest amongst the elderly, who usually suffered a range of situations.
Andy Burnham, the shadow health secretary, explained data in the Residence of Commons library showed that regional authority spending on grownup social care had been lower by £1.8bn given that 2009-10. “These surprising figures expose the expanding crisis in older people’s care on David Cameron’s observe,” he mentioned. “The government’s extreme cuts to social care have left 1000′s of older folks without having the help they want – at risk of going into hospital and receiving trapped there. It is one of the root leads to of David Cameron’s A&E crisis.
“It is appalling to believe that, every week, there are thousands of frail and frightened people speeding by means of our towns and cities in the backs of ambulances to be left in a hectic A&E.”
“This is typically the worst location for them to be and a disorientating expertise that can result in true distress. With suitable help in the house, this could all be prevented.”
Burnham stated it did not make financial sense to lower assistance to men and women in their homes: “It is no reply to the challenges of the ageing society to let our hospitals to turn into more and more full of older men and women. David Cameron must take private charge and reverse these terrible trends.”
Caroline Abrahams, charity director at Age Uk, stated: “It is crucial that older people receive the treatment and care they need to have and sometimes this indicates going to hospital. Nonetheless, we know that, in some situations, currently being admitted to hospital is the consequence of not getting good high quality care at residence.
“Access to substantial high quality social care is more and more hard as numerous crucial companies are withdrawn or reduced as a outcome of the present crisis in care.
“Smarter pondering about how to prevent people reaching crisis point and by meeting their requirements will not only improve the encounter and outcomes for individuals but also has the possible to save income.
“The core of the problem is that funding for social care has failed and is even now failing to preserve up with growing demand. Legislative reform is essential but pointless unless of course sufficient funding is in place.”
