Thursday 24 September

This blog post is late because I was in North Wales over the weekend, where I found people much more compliant than in London about wearing masks and venues much more consistent about requesting contact details for Track and Trace but the most nightmarish part of the journey was the third ‘leg’, courtesy of Transport for Wales (formerly Arriva Wales). The two carriage train from Chester to Holyhead was packed to the rafters, marshalls seemingly having no choice but to allow this and the driver had the nerve to tell anxious passengers ‘You shouldn’t be travelling’. One rejoinder was ‘You shouldn’t be selling tickets, then’. Another pointed out that more carriages should have been attached. This week Transport Minister Grant Shapps announced (finally!) that rail franchising was to be brought to an end because of ‘fragmentation’ – not a minute too soon.

Again, it was an eventful news agenda last week, notably the second reading, which passed by 77 votes, of the Internal Market Bill, with controversial clauses potentially leading to breaches of international law. Many, including senior Conservatives, have been appalled that such a thing would even be entertained, and despite obfuscation by some ministers, Brandon Lewis, Northern Ireland Secretary,  admitted that it ‘does break international law in a very specific and limited way’. This gave rise to a series of amusing (if it wasn’t so alarming) social media posts, about something reprehensible being ok, as it would only be done in a ‘very specific and limited way’. Many politicians and commentators, including former PMs Blair and Major, spoke out against this legislation and former Attorney General Geoffrey Cox accused Boris Johnson of doing “unconscionable” damage to Britain’s international reputation. In what sounds like an example of brinksmanship, the Times told us that ‘in a move being seen as an attempt to assuage European concerns, ministers have indicated that the internal markets bill may not be debated in the House of Lords until after a make-or-break summit with EU leaders in mid-October’.

The severely underperforming Covid testing and Track and Trace programmes came in for more flak, when further evidence emerged of there being no tests available in many areas and people being directed to test centres hundreds of miles away. It was barely credible that the Health Secretary then sought to blame the public for ‘frivolous’ use of tests and some politicians, notably Jacob Rees-Mogg, accused desperate self-isolators waiting endlessly for tests, of ‘carping’. It’s been estimated that as many as 20% of those meant to be self-isolating are not doing so: in some cases this will be wilful non-compliance but in others it will be those unable to get a test and not being able to afford time off work. Even now, ministers continue claiming that 240,000 tests are carried out daily, whereas it’s more like 80,000, because the first figure is actually the much-trumpeted ‘capacity’ – a point Fiona Bruce pursued at some length with Nadhim Zahawi on BBC’s Question Time. Health Secretary Matt Hancock continued to defend testing boss Dido Harding, despite her rough ride at the Commons Science and Technology Committee, at the same time as admitting testing will take 3 weeks ‘to sort out’. His various claims were deconstructed as skilfully as ever by the Guardian’s parliamentary sketch writer, John Crace: ‘MPs try to talk Matt Hancock down from the heights of delusion’.

Concerning as all this clearly is, it’s been supplanted by the announcement of further restrictions in response to the marked rise in COVID infection rates. Typically, the PM made his announcement when the ground had been well and truly prepared by the media and by Chris Whitty and Patrick Vallance the day before. I doubt whether I’ve ever seen a more abjectly embarrassing political broadcast than the ‘Covid briefing’ last night: packed full of clichés, faux Churchillian rhetoric and over-optimistic reassurances, its blustering and over-emphasised delivery was painful to watch. John Crace began his analysis: ‘Where to start with the prime minister’s TV address to the nation? The trademark smirk? The nervous hand gestures? The fact he thinks he’s fighting a war, not a pandemic? Or just the brazen cheek as Boris tried to claim the credit for what he called the stunning triumph over the coronavirus so far?’ Many fear that the measures don’t go far enough – perhaps, not for the first time, England won’t be too far behind Scotland in adopting stronger measures, if not full lockdown then restrictions on numbers of households meeting. Such restrictions capture the key dilemma: the health of the nation or the health of the economy? High profile hospitality figures such as Tim Martin (Wetherspoons) and Julian Metcalfe (founder of Pret a Manger and Itsu) are livid about the restrictions, their stance seen by some as concern for their workers and their jobs and by others as more cynical concern for their wallets.

With rather more focus on the PM’s increasingly bizarre performances at Prime Minister’s Questions, contrasting with the increasingly impressive one of Labour leader Keir Starmer, it shouldn’t be overlooked how impressive shadow Business Secretary Ed Miliband was when standing in for Starmer. Described as having ‘comprehensively ripped Boris Johnson’s facile and fraudulent arguments to shreds….. Miliband knew he had Johnson bang to rights as a second-rate conman and wasn’t going to let him off the hook. All his arguments were delivered with the panache and flourish of a man who knew he had right on his side. Even the Tories sensed it with only Bernard Jenkin foolish enough to intervene on the prime minister’s behalf…It turns out that Boris does have a humiliation threshold after all. And Miliband had just found it’. Good to see Miliband back on fighting form and let’s hope this isn’t a flash in the pan.

It remains to be seen how the Chancellor’s newly announced Job Support Scheme will be received, already thought to be far less generous than furlough. It looks generous at first sight but there are key omissions, eg the 3m freelancers (again). Rishi Sunak has been firm that they won’t be supporting ‘zombie’ businesses – many more job losses are predicted. An estimate of a million newly unemployed has been made, partly due to the hospitality industry having to operate shorter hours.

The mental health ‘pandemic’ resulting from COVID19 and restrictions has been increasingly recognised in recent months, if not acknowledged and acted upon by the government. The latest set of restrictions and the fact that a significant areas of the country are already in lockdown will further aggravate this situation. A major study (University of Nottingham and King’s College, London) found that in the early stages of lockdown 57% of participants reported anxiety symptoms, with 64% recording common signs of depression. The situation improved when lockdown was eased but there’s concern that difficulties will recur as restrictions are reimposed in response to the rising infection rate. Gloomy winter weather will also not help. ‘Women, young people and those in high-risk categories for Covid-19 were most affected, the researchers found, though different factors probably drove the mental health difficulties in each group. While the fear of catching the virus was likely key to those with underlying health conditions, young people and women may have felt more distress through work insecurity, loneliness and domestic violence’. Although the government has got a lot on its plate, it needs to recognise this other, very damaging crisis and reengineer and fund NHS mental health services to enable availability to those who need them, rather than putting obstacles in the way such as eligibility threshold tests.

A separate, large scale study based at University College, London, concluded there has been an “explosion” in anxiety in Britain over the past decade. Anxiety is thought to have tripled among young adults, affecting 30% of women aged 18 to 24. It also increased generally among people under 55. The study is one of the largest of anxiety undertaken in the UK for many years, examining trends in diagnosis and treatment by GPs since 1998 by analysing 6.6 million patients at 795 practices across the UK. This anxiety has been attributed to the financial crash, austerity, Brexit, climate change and social media but (as per the theme of this blog) it will also be attributable to the lack of psychological ‘holding’, known as ‘containment’, offered by this government which many have lost trust in. Generally but especially in dire circumstances, people need to at least feel that their leaders are actually in charge (not just in office), know what they’re doing and have well-reasoned and consistent strategies for addressing the crises we are having to navigate.

Partly thanks to the Black Lives Matter movement, the issue of unconscious bias has come more to the fore and now a crossbench peer and anti-racism campaigner, Simon Woolley, has spoken up when it emerged that up to Tory MPs are thought to have refused to participate in classes. ‘Every parliamentarian should undertake unconscious bias training if asked so they can be better at their jobs’, he said, ‘appalled’ that any MP would refuse. Mansfield MP Ben Bradley (described in his Twitter profile as The first blue brick in the red wall), said: “In my view we should be unabashed in our cultural conservatism, sticking up for free speech and the right to ‘make my own bloody mind up, thank you very much’, and stepping in to block this ‘unconscious bias’ nonsense.” I was struck by how very nice, tolerant and jolly Simon Woolley sounded when he was interviewed about this alongside Conservative stalwart Sir John Hayes.

It’s long been known that diagnosis of concerning symptoms was way below the norm during the pandemic, partly due to patients’ fears of contracting COVID19 but also due to lack of resources and constant pressure to ‘protect the NHS’, despite this being a legitimate use of the NHS. More research has now emerged which puts figures on these concerns, including analysis of GP records which reveal diagnoses of conditions from cardiovascular problems to mental health problems were up to 50% lower over the spring than expected. (This research only covered Salford, but the researchers were confident that these figures could potentially be extrapolated to other areas of the country).The government’s guilt tripping was successful, demonstrated by an NHS England poll in April, showing that 40% of patients said they were avoiding contacting their GP so as to avoid ‘burdening the NHS’.

Urging anyone concerned about symptoms to come forward notwithstanding a COVID19 second wave, Professor Martin Marshall, chair of the Royal College of GPs, said: ‘During a pandemic, other health conditions do not cease to exist, and we’ve seen from health crises in the past that there are sometimes more deaths from conditions unrelated to the pandemic than the virus causing the pandemic itself’. Related to this is the anger some GPs are now  experiencing for being criticised by the government for not having seen more patients, at a time when the government was urging as many virtual GP consultations as possible. Various GPs and their representative professional bodies have been warning for some time that much can be missed via virtual consultations. Let’s hope the GPs get sufficient resources to deliver more in person consultations, which would save resources long term by enabling early diagnosis of conditions potentially missed via virtual appointments.

Housing is such an important issue in its own right, but especially as it links to mental and physical health and other aspects of living. It’s been clear for some time that the situation facing older people in this country is far from ideal, not least because so many people living alone is a key contributor to loneliness and social isolation in this age group. Now a Swedish experiment in multigenerational community housing is attracting international interest. In the UK we’ve seen several innovatory schemes which co-locate nurseries with care homes, with good results. Sällbo ‘a radical experiment in multigenerational living’ is located in Helsingborg, a small port city in southern Sweden. We’re told its name is a combo of the Swedish words for companionship (sällskap) and living (bo), summing up the project’s goals of combating loneliness and promoting social cohesion by giving residents incentives, and the spaces, for productive interaction. About half the 72 residents are 70 and older, the other half aged 18-25, described as ‘a mix of personalities, backgrounds, religions, and values’ and including some refugees. Everyone had to sign a contract promising to spend at least two hours a week socialising with their neighbours. Some touching examples are given, such as older residents teaching English to refugees, and the younger ones helping the older ones with social media and new technology. We’re told the Swedes are fiercely independent, with social policy aimed at enabling people to stay in their own homes. It could be Brits would also like to be more independent but housing and social policies have militated against that. British policymakers, take note.

This relates to support the public has given to a plan for the UK to become ‘a greener, fairer more equal society’ as it emerges from the pandemic (perhaps that should read if it emerges…).  An inquiry by the All Parliamentary Group on a Green New Deal found that the pandemic had further boosted a strong desire for change. ‘On housing, fewer than one in five thought the government’s housing policy was working and there was strong support for rent caps and more investment in social housing. Participants were also concerned about homelessness and, having seen government intervention during lockdown, want action to end street homelessness permanently’. Effectively, this could amount to a new social contract for the UK and it’s interesting that people are evidently enthusiastic for change, wanting to build on community connections, in direct opposition to what often seem like government attempts to sew division. The Green Party’s Caroline Lucas, the co-chair of the Group, said the UK was at a crossroads: ‘This is not a moment for timid tinkering with the status quo, it’s the time to build a fairer, greener Britain where the national effort is focused on health and wellbeing. There is a popular mandate for deep-rooted changes in our economy and society. The government must seize this moment and deliver on people’s hopes for a better Britain’.

Finally, it was interesting to read that, as part of last weekend’s London Open House festival, a company of tour guides put on walks which focused not simply on the general history and architectural details, etc but on the less savoury aspects of history, such as links to slavery. The walks were fully booked but the company plans to run the same walk on various dates in October. This reminded me of someone some years ago who offered alternative tours of galleries and museums, again highlighting the less positive aspects of the exhibits. I can imagine that directors of cultural institutions may not have been too keen on this initiative, but in recent times, related to the Black Lives Matter movement, organisations such as the National Trust have come to terms with the colonial history associated with many of the objects and properties in their care, with some actively promoting better understanding of these issues.

Published by therapistinlockdown

I'm a psychodynamic therapist in private practice, also doing some voluntary work, and I'm interested in the whole field of mental health, especially how it's faring in this unprecedented crisis we're all going through. I wanted to explore some of the psychological aspects to this crisis which, it seems to me, aren't being dealt with sufficiently by the media or policymakers, for example the mental health burden already in evidence and likely to become more severe as time goes on.

One thought on “Thursday 24 September

  1. Your blog is becoming more and more political as the weeks go by, and rightly so IMHO. Two points though, I think Julian Metcalf’s articulate and righteously outraged evisceration of the govt’s handling of the pandemic on R4’s World At One (and since usefully referenced elsewhere in the media) was both an expression of his concern for his staff and of his commercial self-interest – the two not being mutually exclusive. Secondly, as a regular traveller on Transport for Wales’ rural services on the same line you referred to Roslyn, I can confirm that they are invariably woefully overcrowded and as I have pointed out both in my own blogs and in letters to their management, this will not change unless and until they replace their rolling stock which they have repeatedly promised but notably failed to do. Perhaps if the government weren’t spending £106billion – and rising – on the white elephant vanity project that is HS2, then they might’ve actually been able to grant TfW the funds to do so.


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