Sunday 3 October

Yet again it’s a week during which the feeling of things being out of control is even more in evidence, from queues at petrol stations, HGV driver shortages leading to some empty supermarket shelves to the anger at police failings following the sentencing of Wayne Couzens. On Radio 4’s Today programme, Home Office crime and policing minister Kit Malthouse gave a defensive interview regarding police culture, regarded by many as institutionally sexist, and its head, Dame Cressida Dick. It emerged that he had voted against violence against women and girls being made a serious crime in the forthcoming policing bill. When challenged on this, he demonstrated his poor grasp of this issue by suggesting that measures could be adopted if such violence was a ‘systemic problem’ in particular areas whereas it needs to be across the board. He also grasped at the ‘digital improvements’ straw, which didn’t cut much ice. Sarah Jones, Labour MP, tweeted: I’m afraid Kit Malthouse is being disingenuous about the new serious violence duty in the Police Crime Sentencing and Courts Bill. I had an amendment in committee to include violence against women and girls and the government rejected it out of hand’.

And you couldn’t make up the pathetic police ‘advice’ to women feeling threatened by individual police officers to call out to passers-by or ‘flag down a bus’. Can you imagine that having any effect in London or any other large city? As the Independent headline read: ‘Don’t tell us to flag down buses – vet your police officers properly’. Very pertinent, especially as Couzens was known to have committed offences which should have been a huge red flag long before the Sarah Everard murder and other officers have also been placed under investigation. Establishment figures like Lord Blair (former Met Commissioner) and Inspector of Police Tom Winsor (Chief Inspector of Constabulary) continue to defend the status quo and leaving Cressida Dick in post. A good start would be the no brainer of making domestic abuse training compulsory for all police forces – astonishingly, it isn’t already. A shocking statistic that probably won’t make mainstream media coverage is the 81 women killed by men since the murder of Sarah Everard.

Meanwhile, we hear that, as the country struggles to function, Boris Johnson, ahead of the Conservative Party conference, is fantasizing that he can reinvigorate his party and administration. We’re told to expect ‘big bold decisions’ when what we’ve actually seen is dither, incompetence and corruption and the supreme irony must be the lack of staff to serve the Tory faithful as they descend on Manchester Central Convention Complex. For once, though, it’s doubtful he will be able to evade anger at the combined reality of petrol shortages, worsening supply chain problems, increase in poverty due to furlough ending and the cessation of the Universal Credit uplift and severely undermined confidence in the police and the government. All of these issues will be raising public anxiety considerably. A Guardian podcast discusses the nature of the PM’s complacency: ‘When Boris Johnson returned to the UK from his visit to New York to speak at the UN general assembly, he got off the plane with a spring in his step. He had presented himself as a climate crisis leader on a global stage. He had completed his reshuffle, got rid of some dead wood, and installed party favourites such as Nadine Dorries and Liz Truss in top cabinet jobs. His government was starting to look towards a post-coronavirus agenda, with Brexit a distant memory. The upcoming Conservative conference appeared to be a golden opportunity to tell voters what “levelling up” would really mean – and why they should support Johnsonism. Instead, he flew back into the teeth of a crisis – with shortages of petrol creating media coverage of disgruntled drivers and gridlock on service station forecourts. With energy companies still going bust (12 so far this year) and many observers attributing at least some of the blame to Brexit, his hopes of turning the page on a crisis-ridden two years now appear tenuous at best’.

Boris Johnson won’t have done himself any favours with his shocking ‘definition’ of what ‘levelling up’ will look like in NE England, telling the BBC’s  Luke Walton on Friday:  ‘I’ve given you the most important metric which is, never mind life expectancy, never mind cancer outcomes, look at wage growth’. Even some of his colleagues could be shocked to hear him say something so insensitive and ruthless. The Guardian gives its predictions as to how this conference will go, alluding to ‘research’ which shows that the PM sees the need to ‘shake a sense of national paralysis (not just a sense, is it?) and reassure his party before a daunting winter’.

This kind of pretentious pantomime won’t necessarily fill us with confidence, not least because characters in Greek theatre had something more about them this current crop of politicians.  ‘Above all, Johnson’s aim for the conference will be to try to shake that sense of inertia. He will characterise himself as the delivery prime minister, even if his own MPs complain there has been precious little delivery so far. To symbolise that idea, he will take to the stage at the Tory conference next Wednesday in Manchester quite literally surrounded by his ministers and party members. Reminiscent of an ancient Greek theatre, the stage set-up will be almost entirely in the round’. It also might not cut much ice with the group of senior Conservative MPs which has broken ranks to openly question how Boris Johnson can deliver on his promise to increase prosperity in poorer parts of the UK while at the same time raising taxes for working people and cutting benefits.

All the problems we’re facing were avoidable – lack of foresight and planning has led to what we are witnessing now. Kit Malthouse was also challenged on the petrol shortage and repeated the ministerial mantra that the situation was ‘stabilising’, trying to attribute it to ‘panic buying’, but it’s manifestly not. All over the country there are long queues at petrol stations and motorists have also found them closed altogether. There have also been reports of abuse and violence, knives being drawn in some areas and the latest news is that the problem is getting worse in the South-east, not better. While this situation is distressing for all motorists, it’s particularly acute for those needing to drive for their work, for example the community midwife interviewed this week, where the consequences of their inability to get to their visits could be severe. Cancer patients are among those who have had appointments delayed by the fuel crisis, with patient transport services unable to fill up and NHS staff struggling to get to work.

But the Today programme quoted an EU hauliers union rep as saying ‘we will not go back to England to help them get out of the shit they created themselves’. It will be interesting to see how the recruitment drive goes. The situation has exposed, in common with the agricultural industry, the fault lines in the business model, keeping wages low while not improving working conditions. Many Brits would not want to work long shifts with poor access to washing facilities which amount to little more than cattle trough sinks in some lorry parks. It might prove a wakeup call for employers but also for consumers, who mostly won’t be questioning how the goods they want get to them.

The media seem to be milking predictions about Christmas and potential shortages, as if there aren’t more important issues to engage with. Apparently sales of Christmas goods have been surging already. ‘Millions of Christmas dinners will be saved by importing turkeys from Poland and France’! All the harping on Christmas is in very poor taste considering the challenges this country and the world face’, said one tweeter at the First World Problems hashtag. With food and goods shortages, not to mention potential blackouts depriving us of the internet, we may be back to the Victorian Christmas yet, maybe no bad thing – perhaps there will be a run on second hand pianos to facilitate the traditional sing-songs. Not to mention poaching your own rabbit.  But hey, none of this might need to happen because of the government’s latest U-turn, allowing overseas drivers to stay until March in the interests of ‘saving Christmas’. Besides saving his own skin, could the PM be feeling he owes us for Christmas effectively being cancelled last year?

Perhaps Boris Johnson thinks he doesn’t have to worry about how the conference goes, because of what a commentator calls his ‘rigging of the system’ to stay in power. Four examples of this, according to journalist Jonathan Freedland, are ‘hobbling’ the elections regulator, weakening the courts, limiting protest and devising new rules which would gag whistleblowers and the press. ‘Almost unnoticed, perhaps because it’s done with an English rather than a Hungarian accent, our populist, nationalist prime minister is steadily setting out to weaken the institutions that define a liberal democracy: the ones that might act as checks and balances on him. And he’s moving, Orbán style, to make it ever harder for his government to lose power’.

The likely changes to the justice system are chilling to read about, as are several other categories of change, for example limits on what journalists can report by widening the scope of the Official Secrets Act. ‘But Johnson is bent not only on preventing his government from being held to account. More sinister, he is taking steps to ensure it can’t easily be replaced. He wants to tilt the playing field of electoral competition permanently in the government’s favour, and his first target is the referee’…. There is a pattern here, if we’re only willing to see it. A populist government hobbling those bodies that exist to keep it in check, trampling on democratic conventions and long-held rights, all to tighten its own grip on power. We need to recognise it, even when it wears a smile and tousled hair, and speaks in the soothing cadences of Eton College’.

Meanwhile, mixed news on the health front. NHS Digital statistics show that the proportion of in person GP consultations is now only marginally higher, at 58%, than during lockdown. This is so unsatisfactory because many doctors have said worrying symptoms can be missed because they’re not seeing the whole person and observing their demeanour and some patients will not consult the GP if only virtual consultations are on offer. Long Covid also continues to be an insufficiently acknowledged problem. Researchers at the University of Oxford, the National Institute for Health Research (NIHR) and the Oxford Health Biomedical Research Centre (BRC) shed fresh light on the scale of the problem after studying more than 270,000 people recovering from Covid in the US. They found 37% of patients had at least one long Covid symptom diagnosed three to six months after infection. The most common symptoms were breathing problems, abdominal symptoms, fatigue, pain and anxiety or depression. Not only are these conditions complex to treat but NHS facilities for treating Long Covid are in short supply, with availability determined by postcode lotteries.

Encouraging news comes in the form of the new Covid drug trial, which has involved giving recently diagnosed Covid patients the anti-viral pill (molnupiravir) twice a day. Interim results from the trial by US pharma company Merck suggest that it could cut the risk of hospitalisation and death by half.

What also seems very positive news is the NHS plan to create diagnostic hubs in community venues close to people’s homes, to speed up ‘life-saving checks’. Maybe this initiative (the pandemic has further catalysed the need for radical change in the way NHS services are delivered) could encourage those disliking virtual GP consultations to see a clinician, but the service isn’t planned to be operational until March. Some concerns have been expressed at the difficulties in recruiting staff, suggesting that the initiative could result in clinicians being taken out of hospitals.

On top of all the mental health service deficits discussed here recently, we’re hearing more and more about how young people’s mental health has been detrimentally affected by Facebook and Instagram use. Instagram is particularly in the frame for its tools which allow users to rate the appearance and personalities of others, giving rise to further self-esteem problems. One commentator criticised the ‘monetizing’ of children and apparently children as young as nine are setting themselves up as ‘influencers’, a travesty of childhood, surely. But given that Facebook is unwilling to admit the problems, let alone address them, it begs the question how can tech be controlled? At least there’s more awareness now that the tech Trojan horse has inveigled itself into our lives in ways which can be dangerous as well as convenient.

In many cases social media use by young people will be contributing to the rise in anxiety, and now some cynical operators have stepped into the vacuum left by NHS mental health services. Radio 4’s File on 4 has investigated some of these offerings, highlighting, as another of their programmes did last year, the statutorily unregulated nature of private counselling and therapy services. Parents desperate to help their children with anxiety predictably found long waiting lists for NHS treatment, leading some to seek help privately, some of these therapists also having long waiting lists.

 The programme alludes to ‘rogue operators’ with barely any appropriate qualifications charging huge sums to ‘cure’ children of anxiety, using various cynical marketing methods such as implying if parents don’t pay they don’t care about their child. Some parents were charged £5,000 and encouraged to go into debt to finance the ‘treatment’, which, not surprisingly, did not work in numerous cases. No surprise there: it should be better known that ‘cure’ is an inappropriate concept to apply to this kind of work. The journalists ask – why isn’t the law protecting people who seek help online? Having long pressed for statutory regulation of counselling and therapy, I doubt it’s likely to happen any time soon: Conservative governments have always taken the stance that there’s no evidence to suggest regulation is necessary. There’s plenty of evidence…..

Another situation which has been unregulated for far too long (and obviously more to the fore during the last 18 months) is the opacity of the funeral industry. The vulnerability of many bereaved people has meant that they don’t explore and challenge (and often don’t know they can) what undertakers tell them they need. These companies often issue invoices which aren’t itemised, one heading I recall being quite a sizeable one for ‘funeral director’s fees’. Fortunately, Quaker Social Action has been involved in catalysing a Competition and Markets Authority investigation through its Fair Funerals campaign (2014-2018). QSA also engaged fully with the investigation, giving feedback throughout consultation, informed by detailed (anonymised) evidence from their Down to Earth funeral costs helpline. Two of the main outcomes are disaggregated price lists. It seems shocking that the average cost of a simple funeral in the UK is £3,837 (Royal London, 2020) and during the last ten years prices rose well above the level of inflation. Let’s hope this investigation really makes a difference and that it also prompts the bereaved to find out more about their options, the less expensive ones traditional funeral directors don’t necessarily tell them about. (Useful information can be obtained from Dying Matters, a not-for-profit coalition working to create an open culture to talk about death, dying and bereavement).

Several weeks ago we heard that the UN agency Unesco had taken the radical decision to delist some of its World Heritage sites, including Liverpool, because of excessive development on the water front. It now looks as if a site in Derbyshire could be under threat. In the Derwent Valley mills area there’s a plan to build a 17 storey block of flats opposite an old silk mill, which Unesco is unhappy about. It would be a blow if the site is delisted because it has enjoyed Unesco status since 2001 in recognition of its importance during the Industrial Revolution and would no doubt have encouraged tourism in the area. Again, it raises the conundrum of how we balance preservation of heritage sites with the need to create more housing.

With so much going on in the UK, we could perhaps be (slightly) forgiven for overlooking the key election last weekend in Germany, which saw the departure of Angela Merkel after 16 years and the ‘ascension’ of Olaf Scholz (SPD – Social Democratic Party leader) if he can produce a successful coalition. It’s important stuff as what happens in Germany will impact directly on the EU bloc and generally on the world stage. Scholz, former mayor of Hamburg, is profiled in Radio 4’s useful Profile series, considered a little ‘robotic’ and lacking in charisma. Sholtz is apparently good at rising again after falls from power and his performance during the pandemic has been praised. He’s shown he can make tough decisions. Concerned about his weight, we learn that at the age of 40 he took up running and rowing. He apparently doesn’t mind being considered ‘boring’ and we’ve seen where ‘charisma’ leads in the UK and US – in the longer term sturdy and reliable politicians are likely to do their electorates much more good.

Meanwhile, Angela Merkel’s legacy has been discussed in many fora. While she has performed a valuable role in psychologically holding the nation (not called Mutti for nothing and something we’ve manifestly not benefited from here), especially important during the anxiety generating pandemic. But her conservatism and risk adversity have been criticised by some commentators, for example keeping existing structures going when they need reforming. While critics have to acknowledge that economic performance remains good in terms of exports and GDP growth, they suggest that this has negatively impacted public investment, for example Germany is said to be way behind other nations in ‘the digital revolution’.

Finally, it’s good news that London has two new stations on its elderly Northern Line (used to be known as the Misery Line), no doubt to support the extensive redevelopment about the former Battersea Power station. The new stations, Battersea Power Station and Nine Elms, represent the first major development of the Underground this century. ‘Taking six years of construction and testing, and a longer period again of design and planning, the £1.1bn project – adding nearly two miles of tunnel as well as the two stations – has put the dramatically changing area of south London on the Tube map’. It will be interesting to see how this opens up this area to a wider ‘audience’ and whether the promised 25,000 new jobs and more than 20,000 new homes will actually materialise.

Friday 24 September

Just when you think the government can’t get any worse, it does just that and in spades this last week. As our Prime Minister undermined the climate change message by jetting off to New York with what seemed a sizeable entourage, giving the most embarrassing performance to the UN General Assembly, back at the ranch his colleagues tried to wrestle with rocketing energy prices, shortages of petrol and other supplies (very carefully not attributed to Brexit) and growing opposition to the imminent cut in the Universal Credit uplift. The forever languid and disengaged Business Secretary, Kwasi Kwarteng, gave an unconvincing performance in media interviews to the effect that ‘the lights would not go out’ despite massive energy price hikes which coincide with National Insurance increases and the Universal Credit uplift disappearing, but many will be desperately worried at the prospect that they could be choosing between heating their homes and feeding their families. Several energy companies have already gone to the wall and Kwarteng was oblivious to the irony of his assertion that this ‘responsible government’ would not bale out companies which were not well managed. Pots and kettles.

What this and the Co2 shortage have brought to the fore, however, is the mythology propping up neoliberal economics: ‘the market’ cannot be relied upon as the sole determinant of a nation’s wellbeing. Unfortunately, many are now finding that the longstanding ‘advice’ since the privatisation of utilities to switch providers to obtain a better deal is pretty threadbare – the large ones have a much better chance of surviving than the smaller newbies purporting to offer a good deal when they’re little more than call centres. What these problems also reveal yet again is the government’s lack of planning and sense of urgency: so often ministers say they’re ‘looking at a plan’ when a ‘responsible government’ should have contingency plans to ensure continuity of supply. Relying on an overseas company for a large percentage of our CO2 supply is just reckless. As a Radio 4 listener tweeted: ‘I think the main problem is a shortage of competent leadership. Which is also due to Brexit.’

Having stuck to their guns about not making special provision for recruiting HGV drivers, petrol shortages and long queues at petrol stations have now driven ministers to consider changing their minds regarding relaxation of immigration rules for lorry drivers. A very breezy Grant Shapps, in media interviews, said that he would not rule anything out, including deploying the army to drive petrol tankers, but played down the idea that loosening border restrictions would fix labour shortages. I wonder if army bosses tire of being expected to step into such situations when some contingency planning would have made such a drastic step unnecessary. Finally, a sense of urgency: as ministers met for talks, Sky News suggested that they’re likely to sign off on temporary visas for HGV drivers to ‘avoid a full blown crisis’. Not surprisingly, ‘U-turn’ is trending on Twitter.

Brexit is clearly in the frame despite the government’s sidestepping of it and the media’s collusion in not citing it as a cause. Apparently the shortage is 100,000 drivers but even before Covid it was 60,000, though Covid contributed because of a large backlog in HGV driver tests, making recruitment impossible. The BBC helpfully detailed the reasons for the shortage, effectively including wage suppression and (yet again) lack of ‘succession planning’ as many drivers were over 55. The situation we face today has clearly been building up for some years, another issue not anticipated by the ‘hindsight’ government.

Besides dismissing French umbrage at the Aukus defence and security deal, demonstrating his statesmanship by telling them to ‘prenez un grip’ and ‘donnez-moi un break’, Boris Johnson embarrassed himself and the UK by his ridiculous stance at the UN General Assembly and coming away with  little from his meeting with President Biden.

The BBC obediently colluded with the Johnson pots and kettles narrative, without irony reporting his urging of world leaders to take action on climate change, that COP26 was a turning point for humanity (his personal reputation staked on it, of course) and that it was time for the world ‘to grow up’, also trying to suggest that the US had made concessions to the UK. This prompted a volley of tweets from sceptics, eg: ‘Biden didn’t just lift travel ban for UK, it was for all Europe. US not interested in a trade deal, we are deluding ourselves about that importance…. way overblown by the government to excuse lack of post-Brexit progress’.

 The Guardian’s John Crace lampoons the PM’s humiliating performance (‘Prime minister’s bluster meets real world as promised post-Brexit trade deal fails to materialise’) in which his ego was well and truly punctured: ‘When the highlight of your first trip to the US as prime minister is an awkward minute-long conversation with the president about a shared interest in trains, it’s probably fair to say that things haven’t gone quite as well as hoped. Boris Johnson may feel himself to be the unassailable world king in the UK, but on the other side of the Atlantic he’s pretty much a nobody. Come Wednesday morning, Johnson wasn’t even pretending to put a positive spin on things…. The previous day he had tried to hang on to the veneer that some kind of trade deal with the US was in the offing. Or failing that, a deal with the US, Mexico and Canada that Liz Truss had found knocking around somewhere on the floor when she had been minister for international trade. Though that last option didn’t survive the night before Downing Street dismissed it. Presumably because by then someone had started reading the small print’.

A useful Guardian article attempts to read between the lines of the PM’s UN climate change speech, interspersing what he actually said with what he really meant, or more often, what he unconsciously reveals about himself. ‘He quickly swerves into far different territory, revealing far more perhaps of the preoccupations and psyche of the prime minister himself than of the aims of Cop26 and the task the world faces’. For example, in the bit about humanity being the age equivalent of a teenager, he lambasts our alleged irresponsibility, citing philosophy (to add authority?).  ‘In the words of the Oxford philosopher Toby Ord, ’We are just old enough to get ourselves into serious trouble.’ We still cling with part of our minds to the infantile belief that the world was made for our gratification and pleasure and we combine this narcissism with an assumption of our own immortality’.

This is dissected thus: ‘Name-checking a moral philosopher is a shortcut to signalling high seriousness, and Ord is noted for his work on existential risk at the Future of Humanity Institute in Oxford. But perhaps a psychologist rather than a philosopher might have been more appropriate – Johnson has frequently been accused of narcissism, and what better way to deflect the charge than extend it to the whole of humanity? With its extensive references to mistakes made in the name of gratification and pleasure, and a new willingness to reform, this is definitely the speech of a man on his third marriage’. This article goes on to cite further examples of hypocrisy and disingenuousness, for example excusing his earlier forays into anti-climate change rhetoric, the PM says ‘the facts change and people change their minds and change their views and that’s very important too’. But as the journalist says, facts do not change: ‘The facts, though, have not changed: the IPCC was set up in 1988, to investigate the clear likelihood that human actions were causing changes to the climate. The scientific evidence was forceful enough even then to bring Johnson’s predecessor, Margaret Thatcher, to the UN the following year to call for urgent action’.

In contrast to some newspapers calling this speech ‘a triumph, this article’s conclusion summarises the various disconnects between the PM’s theatrical talk and reality. ‘The rhetoric may soar between Greek tragedy and the Muppets, but the decisions the government has taken – cutting overseas aid; continuing the expansion of oil and gas, and perhaps a new coalmine, in the UK; dropping references to the Paris temperature goals from the Australian trade deal; forming the Aukus defence pact with climate rogue Australia, and so offending ally France and the pivotal player at the Cop26 talks, China, in doing so – will do far more than any words of the prime minister at UNGA to set the diplomatic tone for Cop26’.

As if all this wasn’t enough, at this critical time Boris Johnson refused to say whether he could live on the basic Universal Credit (£118 a week for couples), and the unfortunately named Environment Minister George Eustice (often billed ‘Useless’ in social media) had the nerve to suggest that Joe Biden is wrong about the Northern Ireland Protocol because he does not understand the complicated nature of the post-Brexit trade deal. Interviewed on Sky News, Eustice said: ‘He is probably at the moment just reading the headlines, reading what the EU is saying, reading what Ireland might be saying, which is that they would like the Northern Ireland protocol to work in the way the EU envisage’. Seeking to distance himself from his minister’s comments, Johnson fibbed again by saying the subject of Northern Ireland had not come up in their meeting, when it was widely reported that it did.

As more misgivings continue to be expressed regarding the appointment of Nadine Dorries to the Culture brief, there’s yet more evidence of failing mental health services, which was her previous brief. Last week I said she had been disingenuous in the Commons by implying that problems were due to the shortage of people ‘coming through’ to work in mental health, when thousands of counsellors and therapists who trained at their own expense could have been recruited. Therapy Today, the journal of the British Association for Counselling and Psychotherapy, also reports that BACP wrote to her to correct erroneous statements in the Commons and on social media about deficits in counselling for children and young people. It’s a shocking state of affairs when professional bodies in any field feel compelled to write to government ministers to point out their misinformation, which many through no fault of their own will just believe.

Hardly a week goes by without there being some reporting of mental health service deficits. Now psychiatrists have said how desperate the need for additional funding is. ‘There were 1.5 million people in contact with English mental health services in June, 12.4 per cent higher than the same time last year. About 1.6 million people are waiting for treatment. We need the right resources and decisive action on the long-term challenges to help stretched services that are struggling to meet demand. This means building new mental health hospitals, transforming outdated infrastructure and training more specialist doctors’. This situation doesn’t just impact on the patients themselves, hard enough though this is: for everyone who is waiting for treatment many others including their friends, families and employers will be negatively impacted. I’d just have to disagree with the argument that we need more ‘specialist doctors’: what’s really needed much more is many more NHS psychotherapists to help patients get to the root of their difficulties, rather than going down the short-term medical model road of cognitive behaviour therapy and (often) dependency-inducing medication.

From its alternative universe the Department of Health and Social Care said that its ‘NHS long-term plan would provide mental health services in England with an extra £2.3 billion a year by 2023-24.In addition, our £500 million mental health recovery action plan will ensure we offer the right support over the coming year to help people with a variety of mental health conditions. The government is determined to ensure the NHS has the funding it needs to support those whose mental health has suffered during the pandemic’. As we well know, it’s not just about putting more (but never enough) money in – it’s about the right kind of help and not wasting resources on short-term ‘revolving doors’ pseudo solutions.

It’s also been reported that the ongoing shortage of mental health beds has meant children being inappropriately placed on acute medicine wards, not only unsuitable for them but also preventing those needing those wards getting the beds. A paediatric consultant said: ‘Over the last five years there has been a gradual increase in the number of children admitted on to our acute paediatric unit who don’t need the kind of medical treatment we offer. Consistently this summer, 20% of our beds have been occupied by children who need either a specialist mental health bed or a specialist residential placement in the community…. Many of these patients are not getting the care they need because neither I, nor my colleagues or the nursing staff are trained to provide the level of psychiatric care they require. We are trained to deal with medical problems. The mental healthcare teams don’t have the capacity to provide the level of daily input that these children need’.

A director of children’s social services, while absolutely acknowledging that these aren’t the best places for these distressed and traumatised children, explained that they effectively have very little choice because of lack of provision of the right facilities. ‘We know a hospital is not necessarily the right place for them, but there is a real gap in specialist provision between a “tier 4” psychiatric bed or welfare secure placement, which are both in short supply, and existing residential or foster care provision, where these children can receive bespoke, wraparound support’. The cost of the government ignoring these mounting problems can be seen in this director’s fears for the children concerned: ‘The consequences of nothing changing are stark – an increased risk that children seriously harm themselves or worse, or them harming other people and ending up in the criminal justice system’. Apart from the immediate distress to children and their families, not to mention those trying to help them, failing to fund these services effectively is yet another false economy which will have much heavier long-term costs.

Further proof of the dire situation is that it’s estimated there could be around 4,000 illegal detentions under the Mental Health Act because of sufficient beds to send the patients to and a record number of young people are waiting for eating disorder treatment in England (207 waiting for urgent treatment, up from 56 at the same time last year and many more waiting for ‘routine treatment’). Yet the then minister, Nadine Dorries, insisted that mental health provision is working.

If the government continues to ignore this situation, perhaps some funding at least could be freed up if results of a Public Health England report are implemented. This report showed 10% of the drugs people are prescribed are a waste, can be clinically ineffective and, moreover, increase the likelihood of medical complications and hospital admissions. This is a pretty shocking finding, likely to have been exacerbated by very busy doctors over-relying on prescribed drugs. ‘The landmark review, ordered by the government in 2018 and published on Wednesday (!!), concludes that overprescribing is a “serious problem”. As many as 110m medicines handed to patients each year may be unnecessary and even potentially harmful, it suggests’. Instead, the report recommends doctors doing much more social prescribing, including exercise, gardening, walking and volunteering, which have huge benefits without the unpleasant side-effects some entail. Obviously, some medications are necessary but repeat prescriptions are in the frame and it definitely sounds as if stringent medication reviews are called for across the board. We’re told that Health Secretary Sajid Javid has enthusiastically accepted the report: how long before the recommendations filter down to a GP practice near you?

Positive news, related to the above, comes in the form of the rise of community gardening, a development also facilitated by the pandemic, perhaps. It’s significant that the Royal Horticultural Society has now set up a Community Awards scheme as these gardens become more common. Such places have the capacity to boost mental wellbeing and tackle loneliness through the mutual sharing with others and the well-known therapeutic benefits of growing things and of connecting with nature, the passing seasons and the soil. ‘Where groups like this existed, communities seemed to be more resilient when it came to a crisis [like Covid] because they had a pre-established network of volunteers and people already knew each other so they could easily offer support (Kay Clark, head of the RHS community gardening programme)…. With wellbeing and nature connection becoming top priority during lockdown, we had this massive surge of interest in gardening and the community groups were there to help people learn how to garden, teach skills, share knowledge, plants, tools and all sorts as well as inspire people and cheer them up’. It will be interesting to hear who wins the awards at the end of this month.

On a related theme, several projects focus on rewilding and its benefits for the environment. A vast ‘stretch’ of the Scottish Highlands is to be rewilded in an ambitious 30 year project to restore nature. ‘The project has been launched after two years of conversations and meetings between local communities and conservationists from rewilding charity Trees for Life. Similar to the WildEast project in East Anglia, it is a community-led effort to restore nature over a large area, which organisers hope will be a catalyst for social and economic regeneration’. One of the most challenging aspects of such projects is bringing stakeholders together (in this case over 50) and winning over sceptics. At least Brexit doesn’t seem to have invalidated the UK’s access to Rewilding Europe funds: it helped fund the work with a €300,000 (£250,000) grant and it will be the organisation’s first UK project, so a bit of a flagship of which might be expected. There nine RE projects underway, including those based in Romania’s southern Carpathians, Croatia’s Velebit mountains, Italy’s central Apennines and Bulgaria’s Rhodope mountains.

Again on an environmental theme, it’s very interesting, given the city’s increasing discontent with excessive numbers of visitors, that Venice has now bitten this bullet and imposed an admission charge on visitors, who will have to book time slots in advance. Residents and their relatives will be exempt, as will tourists staying in hotels, so this is clearly aimed at cruise ships, which disgorge thousands of tourists every day who mainly spend nothing to support the local economy as everything they need is provided on board. The scheme isn’t starting until next year, though, so locals will have to put up with the strain on services a bit longer.

Museums and other cultural institutions (as per the Belgian project described last week) also have their part to play in enhancing mental wellbeing and now we know the winner of this year’s Art Fund Museum of the Year. It’s Firstsite, described as a ‘Colchester contemporary art venue’, now it its tenth year and, importantly, focusing on relevance to local communities. ‘Firstsite supported people during the pandemic by lending its building to the Community 360 charity to run a food bank. It also created activity packs that went on to feature 50-plus artists and were downloaded by more than 92,000 households….. Award presenter John Wilson described Firstsite as the “Marcus Rashford of museums” pointing to the fact that it had turned a lobster restaurant into a canteen serving free school meals’. The £100,000 prize should certainly be a further shot in the arm for the museum.

Finally, the highly calorific cronut (croissant and doughnut combo) is at risk of being displaced by a new pastry du jour. A Breton speciality called kouign amann (meaning butter cake in Breton) and pronounced ‘kween ah-Mon’ is now becoming an international phenomenon, according to the Financial Times. It’s been described as the ‘fattiest pastry in Europe’, consisting of 40% flour, 30% butter and 30% sugar, and you could wonder why it’s so popular at a time when people are becoming more health conscious. The answer comes from a Singapore bakery owner, where they’re a bestseller. ‘It’s the texture people crave…it’s heavier than croissant, it melts in your mouth but it’s also crunchy and chewy’. How soon before they appear in a cafe near you?

Sunday 19 September

As the working week ended with our climate-aware Prime Minister jetting off to the States and 178 Covid deaths, it started with ‘acceleration’ of the vaccination programme and continuing debate over autumn and winter strategy – with much in between. It’s been quite some week, which will have been unsettling for many, from the reshuffle to changing ‘traffic light’ system rules and from social care reform proposals to autumn/winter Covid planning. If what we’ve heard can be called a plan. On Wednesday 30,597 new cases (8,000 Covid patients in hospital) and 201 deaths were recorded, but some individuals and organisations seem impervious to this worrying news, firmly attaching themselves to the ‘things are opening up again’ narrative. This is probably due to wishful thinking and lack of awareness but also faulty government messaging.

In the LA Times a respiratory therapist’s account of the 7 stages of severe Covid makes salutary reading, especially the chilling Stage 7: ‘….We extubate you, turning off the breathing machinery. We set up a final FaceTime call with your loved ones. As we work in your room, we hear crying and loving goodbyes. We cry, too, and we hold your hand until your last natural breath. I’ve been at this for 17 months now. It doesn’t get easier. My pandemic stories rarely end well’. I wonder how many Covid deniers and antivaxxers would stick to their guns after reading such an article.

Although re-introduction of restrictions hasn’t been ruled out (the government has at least learned that lesson from last year) the autumn/winter plan seems fairly feeble despite its 30 page length – still, despite evidence to the contrary, treating vaccination as a silver bullet on which they’re relying far too heavily. The imminent easing of travel arrangements, welcome though it is to holidaymakers and the travel industry, surely poses quite some risk, particularly reduction of the red list. As a piece reported on the huge drop in mask wearing (it now seems normalised and unchallenged on public transport, around here in north-east London at least) and predictions of 1000 deaths a week, a sceptic tweeted: ‘We are going to have to watch Boris Johnson dither, delay and obfuscate before announcing a new lockdown under a new catchy three-word title. The delay is going to cost lives. And this government will be responsible’. Another said: ‘How can we rely on people to do the right thing while refusing to tell people what the right thing is? Johnson loves mixed message chaos – it means his opponents have a hell of a job pinning him down’. At least Chris Whitty was the voice of caution, warning against presumptuousness because we haven’t faced a winter with the Delta variant before: ‘Those who say they know how it could pan out have not understood the situation’. Unfortunately, this didn’t stop a deluded and hyperbolic Sajid Javid on Wednesday talking up the ‘amazing’ treatments and ‘fantastic’ vaccination programme. Anyone would think he was trying to deflect from the need for more nuanced thinking.

Meanwhile, the BBC paints a depressing portrait of what this coming winter could look like, flagging up a likely massive rise in hospital admissions, higher food prices driving up inflation, avoiding a ‘lockdown lite’ and a likely rise in school absences because of Covid fears, to name just a few. Others would include the imminent ending of the Universal Credit uplift and of furlough. There’s no substantial evidence that the government is taking these issues sufficiently seriously, which will contribute to public anxiety.

The doctors’ union, the BMA (British Medical Association) weighed into the fray, its chairman suggesting that the so-called Freedom Day on July 19, when many restriction were eased, was a ‘gamble’ that has since then contributed to almost 40,000 hospital admissions and more than 4,000 deaths. Besides criticising ministers for dismissing calls for a rapid inquiry into the crisis before the second wave of infections struck last year, meaning that crucial lessons from the previous six months were not learned, he faulted the ministerial mantra of ‘living with Covid’, which belies the reality that thousands of people continue to need hospital care for Covid, with hundreds dying each week (around 6m people are still unvaccinated, too).

Regarding mask wearing, there have been comments about their lack in the House of Commons and can we have faith in a Health Secretary who thinks you can only get Covid from strangers? Sajid Javid said that Boris Johnson and his ministers didn’t need to wear masks at cabinet meetings because they were not ‘strangers’, yet this is how the PM and others contracted and spread Covid last year, through close contact with colleagues. What’s even more telling is the confirmation that vaccine passports would not be required at the Conservative Party conference next month after senior Tories had threatened to attend a rival event if people had to show their vaccine status to get in. So much government policy seems to be unhealthily driven by the desire to appease certain vociferous groups, whether it’s Tory backbenchers or the travel industry.

A contributory factor in faulty messaging has been seen by some scientists as partly attributable to the sidelining of behavioural experts, who were told their input to SAGE (Scientific Advisory Group for Emergencies) is no longer required. ‘They also warned of an absence of independent advice at a time when the virus’s spread depends largely on individual behaviour and social norms rather than laws. The intervention comes as ministers face criticism for mixed public health messaging on face coverings – including the new cabinet meeting maskless in a packed room on Friday – and a U-turn on vaccine passports in England, while Scotland and Wales press ahead. Professor Stephen Reicher said: ‘I very much welcome the expansion of in-house behavioural science advice but … you want people who can speak uncomfortable truths and it’s very difficult to do that when your job depends on it’. His understandable concern as well is the timing, as individual behaviours are a key factor in the spread or suppression of the virus. Yet another transparent government attempt to control the advice they get to hear?

Not for the first time, Work and Pensions Minister Therese Coffey didn’t cover herself in glory when responding to questions on Radio 4’s Today programme about the Universal Credit uplift issue. Besides suggesting measures which are unworkable, such as working extra hours when many employers have cut down employees’ hours, there was very much a ‘let them eat cake’ attitude on display. There will be a lot of anxiety around about this, as the temporary uplift comes to an end on 6 October, meaning a cut in income to almost six million people. Almost two in five people on Universal Credit have jobs. It’s clearly a difficult issue to resolve, as the Chancellor has said he definitely won’t extend this UC uplift, yet statistics of those on UC have almost doubled during the pandemic, from three million in March 2020 to 5.9 million at the end of July. At least one tweeter wants to alert the government to the reality of this situation: ‘If PR phrases could cure poverty the government of Boris Johnson would be world-beaters. However, ‘levelling up’ and ‘build back better’ are merely words while the £20 cut to Universal Credit is real’.

But perhaps there will be yet another government U-turn as Boris Johnson is facing a backbench rebellion because the cut is thought likely to risk poverty for more than 800,000 people.

On a not dissimilar theme, Labour MPs outed an elephant in the room – the lack of a wealth tax – to fund social care reform, asking for the inclusion of such a clause in the forthcoming legislation. ‘The health and social care levy will become payable only after the Chancellor of the Exchequer has laid before the House of Commons an assessment of the merits of raising at least the same amount of revenue for health and social care as would be raised by the levy by introducing instead a wealth tax on individuals with assets totalling over £5,000,000’.

Meanwhile, the government continues to ignore another elephant in the room (unpaid tax), which could help fund social care reform and the Universal Credit uplift. The amount of tax lost in Britain through non-payment, avoidance and fraud has increased to £35bn, according to official figures but some years ago the number of HMRC investigators was reduced (another piece of ignorant short-termism). And a good number of the avoiders and evaders will be supporters of this government, so there’s little incentive to upset them. As George Turner, the Executive Director of the TaxWatch campaign group, said that fraud was a much bigger problem than had been acknowledged, the timing is terrible because public finances have been so strained by the pandemic. We have to wonder whether any ministers how regret the shortsighted strategy to hobble HMRC in their investigative efforts. From a parallel universe, Jim Harra, HMRC’s Chief Executive, said: ‘It is encouraging to see such a large proportion of businesses and individuals meeting their tax obligations. We want to help everyone get their tax right, which will help fund our vital public services like the NHS and emergency services’. Except he doesn’t seem to recognise that many will be evading any HMRC overtures which would enable or force them ‘to get their tax right’!

In the Guardian parliamentary sketch writer John Crace lampooned the Autumn/Winter Covid plan press conference. ‘For the last few weeks in Westminster, it’s almost been as if Tory backbenchers – and many frontbenchers for that matter – would rather do anything than be reminded that Covid still remains the country’s main public health problem. Despite the many posters pinned up around the parliamentary estate urging people to ‘wear a face covering’, almost everyone on the government benches is snuggling up to one another, defiantly mask free. It’s as though the coronavirus was yesterday’s problem. Or the guidelines are only for the little people’.

If Plan A is thin, Plan B seemed even thinner, Javid even venturing the astonishingly clever advice that if people feel unwell they should stay at home. ‘This involved making face masks compulsory in certain circumstances – cue loud boos from Desmond Swayne and others on the Tory benches – asking people to work from home, though definitely not during the party conference as the Conservatives didn’t want to be out of pocket, and the introduction of vaccine passports. The same vaccine passports that Javid had said only days earlier the government definitely wouldn’t be introducing. More like a case of definitely maybe’.

Several commentators have observed the difference in the stance adopted by Vallance and Whitty at these press conferences – whereas last year they were muted and perhaps even slightly cowed by the unaccustomed attention, they are now openly more aware of this government’s and Prime Minister’s deficits. ‘He (Vallance) looked at Boris with something approaching disdain. He seemed to be thinking that the UK could get similar results (as other countries with far fewer cases) if we didn’t have such a deadbeat for prime minister, who couldn’t even get his own MPs to wear a mask’.

Perhaps one of the most striking things this week was the Cabinet reshuffle – rearranging the deckchairs on the Titanic comes to mind. While it was clear that some would definitely be ‘out’, like Dominic Raab and Gavin Williamson, who nevertheless deludedly tweeted about his ‘transformative reforms’, it was less obvious in the case of others like Roberts Jenrick and Buckland (housing and justice), who hadn’t appeared (beyond the usual Tory low bar) to have done anything wrong. It emerged that what the PM wanted was people who were upfront (tweeted a lot?) about promoting their ‘work’. We heard that Michael Gove, replacing Jenrick, was already getting into his brief so perhaps that clubbing the other weekend gave him a shot in the arm. But appointing Liz Truss as Foreign Secretary and Nadine Dorries as Culture Minister does beggar belief, the main criterion obviously being the candidates’ degree of loyalty to Boris Johnson. Liz Truss has bragged about not being diplomatic, but seriously, a self-confessed non-diplomat as Foreign Secretary? A complete nonsense but presented by the BBC’s Laura Kuenssberg as a good thing, a sign of strength.

A tweeter got it in one (‘PM prizes uselessness above all with new jobs for the likes of Truss, Gove and Dorries’) but the prize for the most classic comment must go to journalist and broadcaster Matthew Parris, who said: ‘He’s a complete charlatan and this is a charlatan’s Cabinet’. But Parris also said the reshuffle was done ‘elegantly’, when we know it had been a very tense meeting between Johnson and Raab.

As for repetitive and waffling Nadhim Zahawi, he’s seen to have done so well as Vaccines Minister that he gets the plum education gig. The move which personally strikes me the most is that of Nadine Dorries to Culture (a former star of I’m a celebrity – get me out of here), given her lamentable performance in the mental health role. Various arts and culture organisations have already expressed dismay, besides noting the government’s lack of interest in this area, as manifested by regular changes of incumbent (ten in as many years). Broadcaster James O’Brien tweeted: ‘It’s appalling, obviously, and conclusive evidence that Johnson holds the Culture department in complete contempt, but Nadine Dorries becoming Secretary of State is straight up hilarious’. The media have made much of her being the author of many books and how many words she commits to writing a day but we have to wonder in such cases about the level of commitment to the day job they’re so well remunerated for. Dorries tweeted: ‘From Breck Road in Liverpool to the Cabinet Room in No 10. Surreal experience but excited to get stuck into the hard work’, which attracted the response: ‘Having once been poor does not qualify you for government’.

Meanwhile, Defence Minister Ben Wallace demonstrated the intellectual heft of those retaining their posts by seeming to suggest that ‘levelling up’ is about government departments moving oop north. The retained postholders may not have felt that comfortable, though, as the reshuffle continued for three days and it wasn’t till day 3 that Lord Bethell (junior health minister found to have used private email for official communications and who ‘lost’ his phone during the crony procurement investigation) was sacked. He had also sponsored a parliamentary pass for the former health secretary’s lover, Gina Coladangelo.

As usual the Guardian’s John Crace goes for the jugular on the reshuffle which ‘reveals the shallowness of the Tory gene pool of talent – the PM prizes uselessness above all with new jobs for the likes of Truss, Gove and Dorries’. It will be interesting to see how they get on, especially those who’ve already bullishly tweeted about getting into their new jobs. We’re told that Johnson gathered his new cabinet together for the first time on Friday morning (minus masks) and gave them what he called a “half-time pep talk”, stressing the need to deliver on their promises and “level up” the country. What a joke.

Sky News produced a useful listing of who’s in, who’s out, who’s moved and who remains.

As reflections and recriminations continue to emerge from the Afghanistan takeover, the key question many of us have been asking (can the Taliban govern as well as conquer) has come even more to the fore. It’s crucial for world leaders that they know who to engage with in the new regime but within a fortnight of the takeover, those said to occupy the top positions had changed. Now it’s emerged, perhaps not surprisingly, that there has indeed been conflict within the leadership, some claiming to have contributed more to the takeover than others. Now there’s been an interview with an individual new to at least some of us: Mawlawi Mohammad Shebani, officially in charge of policing morals throughout Kandahar, the Taliban heartland of southern Afghanistan. ‘He is newly appointed head of the provincial office for the promotion of virtue and prevention of vice, a title which strikes fear into many Afghans old enough to remember its previous incarnation under Taliban rule in the 1990s. Its officers served as the brutal enforcers of the group’s extreme interpretation of Islam, whipping men into mosques to pray, policing beard length, smashing radios and televisions and attacking or detaining women who tried to work, went out without a male guardian or showed their faces in public’.

But Shebani says his officers will now focus on ‘persuasion, not violence’, describing the 1990s approach as ‘the mujahideen without a written code’. But how different is it? Within a four-step process of dealing with perceived recalcitrants, the fourth step does allow for ‘stopping him with your hands’. ‘Some people think we are extremist, but we are not like that. Islam is a religion of moderation, not too much and not too little, everything just right. Media channels are publishing negative things about us, please spread the reality to the world’. This statement will result in some raised eyebrows. ‘The leadership is apparently aware of how the organisation is perceived internationally; when they handed out an English language list of new cabinet appointments earlier this month, the vice and virtue ministry was the only one not translated’. Time will tell, as long as Western journalists are allowed free access.

Another question many will be pondering is just how long Prince Andrew can keep on running from the long arm of US law. Having tried to evade the serving of legal papers, his legal team using a technicality to justify avoidance, the Mail Online reports that Andrew, currently at Balmoral, is likely to emerge from hiding in order to visit his pregnant daughter, Beatrice, in hospital. ‘However, royal aides fear the duke’s ‘wall of silence’ strategy towards the sex abuse lawsuit is increasingly damaging the monarchy, with insiders admitting the prince is ‘stressed’ and ‘worried’ as the pressure to respond to the bombshell allegations mounts. It comes as the High Court last week gave Andrew’s legal team seven days to challenge its decision to begin notifying him about the civil sex case in New York against him. As these legal shenanigans continue, a source suggested the Prince’s mood has changed over the past few days and he has become ‘worried’ and is ‘not his usual blasé self’. Not a moment too soon.

In an initiative which reminds me slightly of social prescribing, some Belgian medics are involved in a three month trial to see how museum visits could help patients deal with Covid stress. ‘Patients being treated for stress at Brugmann hospital, one of the largest in the Belgian capital, will be offered free visits to five public museums in the city, covering subjects from fashion to sewage. The results of the pilot will be published next year with the intention that the initiative can be rolled out further if successful in alleviating symptoms of burnout and other forms of psychiatric distress’. Although this shouldn’t be treated as a substitute for treatment such as talking therapy, there’s no doubt that for many cultural activities like this enhance mental wellbeing. One of the obvious benefits is that the visits will be free of charge, which many UK museums already are, but perhaps this is an initiative Nadine Dorries might take an interest in, especially as it reflects her ministerial segue from mental health to culture.

Finally, in a long-running series involving readers responding to others’ questions, some interesting suggestions come up about when and why men stopped wearing hats. Although this would have gone for both sexes, it’s interesting to reflect that the very tall wardrobes one sees in stately homes, for example, were constructed to accommodate an upper shelf for top hats and the like. The questioner cited a photograph of the 1923 Cup Final, which showed almost every man wearing a cap. Respondents’ offerings include the following: ‘It used to be something of a class signifier (flat cap for the working class, bowler hat for civil service types etc), and related to jobs with uniforms. As dress became less formal, and hair fashion became more widespread, the hat lost its cultural significance’; ‘the rise of private car ownership meant that more and more men weren’t standing around waiting for buses getting cold and wet. Plus, when you had a car – what did you do with your hat? You’d have the ludicrous situation where you’d put on your hat to go to the car – take it off, drive to work, put it on again to walk into the office, and then take it off again. So car owners gave up hats as too much faff’; ‘The Hat Research Foundation (HRF), which was apparently a real thing, found that 19% of men in 1947 who didn’t wear hats said it was because they triggered the trauma of war associated with their uniforms. Maybe that’s when the decline began’.

Here’s one that definitely shouldn’t be overlooked: ‘As a bald old man who lives in a very cold climate and walks to run most of his errands – I think the comments are missing some of the more practical roots of hats. Hats are very effective at keeping you warm. My wife with her luxurious mane will occasionally mock my hat while we are for a walk. She simply doesn’t understand how much heat my bold pate releases’. Let’s just hope it’s not a baseball cap – a most unattractive piece of apparel, in my view!

Sunday 12 September

The 20th anniversary of 9/11 will be concentrating minds even further on Afghanistan and the west’s legacy there. As accounts of Afghans’ distress and persecution continue to emerge, the only guard of the Kabul UK embassy to have made it to the UK with his wife and baby was interviewed on Radio 5 Live last night. He has been pleading for his family in Afghanistan to be rescued and it’s not surprising that when asked whether he thought the UK government didn’t care about the Afghans, he diplomatically said he couldn’t answer because he didn’t know this country or its rules. Naturally, more views have emerged as to the West’s mistakes and lack of political vision, including one citing the hopelessness of the mission given previous abortive British invasions in 1839, 1878 and 1919. Key factors are thought to be the Afghans being easy to conquer but hard to rule, that they’re ‘mosaic of competing tribes’ which make sure no central authority can work there and that liberal democracy is a system of government alien to them. In Newsweek Rod Dreher said that ‘twenty years and $2trn later, our nation building folly has ended in catastrophe, with the Taliban back and the US humiliated’. Another side-effect is the rise of terrorism here – the Director General of MI5, Ken McCallum, has said the threat is ‘real and enduring’ and that more than six Islamic terrorist plots had been foiled during the last year (29 late-stage attack plots disrupted over the last four years).

In Financial Express Muhammad Mahmood pointed out western lack of attention to Afghan losses: over the 20 years ‘at least 164,000 people were killed – by reaper drones and B-52 bombers and by the CIA-controlled militias, who controlled countless atrocities under the guise of rooting out the Taliban’. He also suggests that the West exaggerates its achievements but these are ‘somewhat illusory….only 2% of women, mainly from the Western-backed elite, had access to further education; 84% are still illiterate…. the Taliban may be brutally repressive but to many in a weary embittered nation it offered stability……’. A former diplomat wrote to the Times to challenge government spin about this being the biggest air evacuation since the Berlin blockade (1948-9) when other examples are more relevant, for example one in Kabul in 1928-9, much more challenging because of far less airpower and technology. ‘Politicians ought to do more historical research’. A sceptic tweeted: ‘The neo-cons did *not* want to impose democracy on the world, they wanted to open up new markets & make loadsadosh, mainly by disaster capitalism’.

Meanwhile, the Taliban have strengthened their position politically and symbolically, having claimed to have defeated the rebels in the Panjshir Valley, having raised their flag (a white banner bearing a Quranic verse) over the presidential palace on the 20th anniversary of 9/11 and having finalised their all-male governance structure (different from what was thought a week ago). Three key positions are: Amrullah Saleh, ‘legitimate acting president of Afghanistan’ and leader of forces resisting the Taliban in Panjshir; Mullah Mohammad Hassan Akhund is prime minister; and Ahmadullah Muttaqi is multimedia branch chief of the Taliban’s cultural commission.

Meanwhile, there appear to be two different universes where Covid is concerned due to government mixed messaging, some seeming to believe that it’s all over (‘things are opening up again’, encouraging facemask refuseniks) and others noting with dismay, even alarm, that on Friday there were 147 deaths (compared with 45 in Germany), cases are rising dramatically and the government has denied (aka it will happen but we’re pretending it won’t) plans for a half-term ‘firebreak’. ‘At the top of the Tory party, meanwhile, the political optimism ignited by vaccines is still alive, and there remains a hope that ministers might somehow slip free of the Covid crisis and begin to leave the whole mess behind’. If it wasn’t so dangerous it would be quite touching that the government has so much faith in the vaccination programme – Vaccines Minister Nadhim Zahawi said the booster programme will ‘protect the most vulnerable’ and enable the virus to transition ‘from pandemic to endemic status’ next year. It’s still being treated as a silver bullet, which is manifestly not the case and which the government seems to believe will exonerate them from mandating other important measures.  

 In another important change, Zahawi was on the Andrew Marr programme last Sunday talking up the commitment to vaccine passports, but now, only a week later, Health Secretary Sajid Javid has announced yet another government U-turn, again pathetically demonstrating that this government is in hock to its vociferous backbenchers. Another interesting development is the decision by the chief medical officers to override the JCVI’s recent advice against vaccinating 12-15 year olds. The vaccination is expected to start around 22 September. Whatever the wisdom of this decision, it could surely undermine the authority of JCVI (Joint Committee on Vaccination and Immunisation).

Another polarity is the one between those who believe we should go ahead with a booster programme here (eg ministers) and those of the view that none of us are protected until every country is, therefore donate doses to needy countries. Culture Secretary Oliver Dowden defended the number of doses Britain had donated to other countries and pointed to the fact that Israel had begun giving third doses to its citizens.

We now hear that the Prime Minister is expected to address both parliament and a news conference on Tuesday about the government’s plan for managing Covid through the autumn and winter, prompting a wag to tweet: ‘The government has a plan?!’ No wonder, as we repeatedly witness this government’s reactive and poorly thought out approaches to key issues, followed by a strategy, if it can be graced with that description, which goes off at half cock and only partially addresses the problems. Good examples are the policies adopted on schools and on social care reform. The Covid plan is thought to include repealing some parts of the Coronavirus Act but retaining some elements, including giving sick pay to those isolating from day one rather than day seven, directing schools to remain open if they close against government guidance, and helping the NHS to get the emergency resources it needs.

Gabriel Scally, Visiting Professor of Public Health at Bristol University and a member of the independent Sage group of scientists, has usefully revealed the holes in this plan besides its cynical narrative. He criticised the government for ‘inadequate’ public messaging and not mandating measures like better ventilation and better quality face masks. ‘The government and its senior officials claim that Covid should be regarded as similar to influenza and that we have to ‘learn to live with it’. This worryingly persistent and flawed approach ignores the hazardous and evolving nature of the virus. Buildings need to be modified to improve ventilation, he says, and the public should be encouraged to wear properly designed masks that may protect them as well as others. All too often, messaging has been aimed at transferring responsibility to individuals. Pointing the finger at people who are obese, are reluctant to be vaccinated, or are unlucky enough to have severe underlying conditions and telling them to be ‘cautious’ is no substitute for what has been missing all along – an effective strategy for getting the virus under control’. Exactly.

It’s no surprise to learn that Boris Johnson has fallen to his lowest approval rating since becoming Prime Minister, a net score of -17. Approve: 32% (-3) Neither approve or disapprove: 19% (NC) Disapprove: 49% (+4). But as usual this is likely to be water off the duck’s back.

The debate over social care reform has also dominated the news, some Tories having threatened to vote against the government because of their attachment to the Conservative ideology of a ‘low tax economy’. It seems astonishing that these Tories would prioritise this selfish and doctrinaire approach over the glaring need for this crisis to be resolved, especially when an ‘oven ready deal’ had been promised two years ago. It was a sizeable opposition in the Commons, MPs voting 319 to 248 to back the measures, which include a 1.25% rise in National Insurance paid by employees and employers. I’ve long thought it strange that those over 60 were not required to pay though many could afford to do so. A major problem is that the amount this is predicted to raise, £36bn over three years, will mostly go towards clearing the NHS backlog, with only £5.4bn going to social care.  

Although the PM has radically quadrupled the means test threshold for social care recipients to £100,000, social care experts believe the deal falls far short of what is needed. ‘But in supporting documents published by the government was the reality of the deal Johnson was so far offering: £1.8bn a year extra for social care instead of the more than £6bn extra that the Health Foundation think tank calculates will be needed by the end of this decade just to keep up with demand. Improving services in the often threadbare social care sector could cost an extra £14bn a year’. Is this an example of ‘all fur coat and no knickers’, big claims to progress but with little substance beneath?

A sceptic outed the elephant in the room which is a wealth tax: ‘Sajid Javid: the Nastiz have kept their promise not to raise tax. The sub-text: Albeit it’s their less-familiar promise; by hiking NICs not IC, the Tories have kept the one promise they value, their promise not to tax the super-rich and wealthy more’. The NI increase is thought to unfairly penalise young employees and the whole approach does nothing to resolve intractable problems like staff shortages, low wages and postcode lotteries regarding service provision. Boris Johnson also failed to give an answer to Keir Starmer’s question about a guarantee that no one would have to sell their home to pay for care. Selling one’s home seems to have long been considered the last bastion of social care provision.  I’ve personally seen nothing amiss about homes being sold to pay for care – although it’s true young people have it hard these days the common expectation of an inheritance seems entitled and socially divisive since many will have no opportunity of getting one.

More worryingly and further proof of the ‘half cock’ general approach, the proposals are thought likely to only help a tenth of older people in need. ‘After it comes into effect in 2023, the new policy will directly help about 150,000 more people at any one time, according to government documents. But already about 850,000 older people who receive care have at least some of the cost paid by local authorities. Age UK estimates that a further 1.5 million older people need care but are ineligible for support – up from about a million in 2014. Some pay for it themselves, some get help from their families and some go without any care at all. But while the prime minister’s £36bn national insurance tax rise focused on how care will be paid for after 2023, he made no provision to ensure that the sector survives the crisis engulfing it now’. Experts also point to the likely rise in council tax these proposals will result in. ‘Unless more generous funding for councils is announced at the upcoming spending review, we can still expect significant council tax rises in the coming years, if rising needs and the myriad of pressures facing other council services are to be met’. An unpopular measure indeed.

Not least because of the campaign by Peter Stefanovic, whose video about the Prime Minister’s lying has had 34m views but still no coverage on the BBC, there’s more awareness of this ongoing mendacity. The Guardian’s John Crace shows how the social care reform debate has illustrated this. ‘There can be benefits to being a serial liar. While politicians with a reputation for honesty can find their careers ended by one broken promise, those, like Boris Johnson, for whom the truth is by and large an unknown country, can skate by unscathed. Simply because no one expects him to keep his word. His relationships with family, friends and voters are entirely transactional. They get to hear what they want: he gets to bend reality to whatever serves him best at any given time. One of the great illusions is that so many mistake his constant shape-shifting as a sign of self-confidence. It isn’t. It’s a sign of someone with no self-worth’. Despite some powerful opposition from his own side on the social care vote, the Prime Minister was sure of getting it through, almost as if this justified breaking promises. ‘Another broken promise had paid off. In the short term at least. Whether it would cost him the next election when Tory voters had felt the impact of the tax hike was something he would worry about later. Like most pathological liars, Johnson really only lived for the day’.

Meanwhile, the strained and understaffed NHS soldiers on, a relevant expression in view of news that the Unite union in Scotland has said the army should be drafted in and “pop-up wards” erected at Accident and Emergency departments where patients are waiting hours to be admitted, for example at Aberdeen Royal Infirmary and the Queen Elizabeth University Hospital in Glasgow. The head of the ambulance service has apologised for long waits, but Unite says waiting times of up to three hours puts patients’ lives at risk.

At the same time it’s no surprise that Minister for Care Helen Whately deflected from the longstanding NHS underfunding by warning NHS trusts about some senior managers’ salaries being too high, eg £270k and more. This tendency towards disproportionate salaries has indeed occurred across the entire public sector in recent years but in this case the intention of her intervention comes across as somewhat cynical.

Still on NHS issues, pressure continues to mount regarding the difficulty of getting GP appointments and the rise in virtual rather than in-person consultations. This definitely contributes to people’s anxiety and symptoms could become worse if people are disincentivised from contacting the GP. A GP writing to the Daily Telegraph reinforced the need for the system to change: ‘Ideally we would have many more GPs and a system funded to allow walk-in open surgeries with no barriers’. He attributes the current access problems to the falling number of full-time GPs coupled with the rising complexity of this role. A writer and economist spells it out even more clearly: in The Times James Kirkup, director of the Social Market Foundation think tank, says the main problem is the way GPs are paid. ‘Their financial incentives are at odds with the interests of their patients. GPs now earn so much that fewer feel the need to work full-time….in many cases doctors quit because their pension pot has hit the £1m cap beyond which higher taxes kick in’. He also cites as a major problem a formula (Carr-Hill) intended to get GPs to work in areas of particular need, but this formula doesn’t sufficiently recognise deprivation, leading to GPs opting for easier options in ‘leafy suburbs’. So much for ‘the doctor will see you now’.

The longstanding underfunding of mental health services in this country has now shown itself in a different form – inquest judgements. In a useful piece of work, the Observer identified 56 mental health-related deaths in England and Wales from the start of 2015 to the end of 2020 where coroners identified a lack of staffing or service provision as a ‘matter of concern’, meaning they believed ‘there is a risk that future deaths could occur unless action is taken’. Examples include the case of a woman whose referral to psychotherapy was still outstanding when she died 11 months later, and another individual had waited 7 months for a psychological assessment.

These aren’t unusual. It all begs the question of whether ministers and policymakers are even aware of coroners’ Reports to Prevent Future Deaths (PFD), which register when they believe action should be taken to prevent deaths occurring in future, and which are then sent to relevant individuals or organisations for them to respond. Do Clinical Commissioning Groups ask NHS trusts to submit details of these reports and to what extent they have addressed them? These trusts could well say the circumstances are beyond their control because of insufficient funding and psychiatric beds. Many of the cases are suicides, which are increasingly flagged up by coroners when they didn’t used to be. Dr Rosena Allin-Khan, Labour’s shadow minister for mental health, said: ‘The Conservatives have cut a quarter of mental health beds since 2010. This has put the NHS at breaking point, with devastating consequences for people’s lives’.

Having stuck so rigidly and for so long to an avoidance strategy, Prince Andrew once again has tried to evade the arm of the United States law regarding the sexual assault allegations, this time by fleeing to Balmoral in a story which could run and run. We learned this week that following one failed attempt to serve civil suit papers on the Prince, these papers were actually served. How pathetic it seems, then, that because of Andrew’s refusal to cooperate (despite earlier assurances that he would) a US court will hold a pre-trial conference on tomorrow to determine if the papers were properly served before the case can progress. ‘The prince has repeatedly denied the allegations in the lawsuit brought by Giuffre, 38, a longtime accuser of the late convicted sex offender Jeffrey Epstein. When the suit was filed last month, legal experts suggested it left Andrew with no good options as he seeks to repair his image and return to public life. If the prince tries to ignore the lawsuit, he runs the risk that the court could find him in default and order him to pay damages. If he decides to fight, Andrew faces years of sordid headlines as the case winds its way through court’. So Prince Andrew is between a rock and a hard place, but as long as this saga continues, with the Queen continuing to protect him, the more reputational damage it could inflict on the royals. Surely, whatever the outcome, it will be difficult, if not impossible, for Prince Andrew ever to return to public life.

Finally, some good news for those who detest the mess on our pavements caused by discarded chewing gum. Following government threats to impose a gum tax, manufacturers headed this off by agreeing to pay up to £2m a year for gum removal. We’re told that pilot projects to both remove gum and to encourage people to bin it rather than drop it reduced the problem by 64% but the plan does beg several questions. About 87% of England’s streets are thought to be ‘blighted’ by gum, but how would it be decided which streets benefited and if the money was donated to councils how would it be guaranteed it would be used for this purpose rather than being absorbed into general expenditure? Answers on a postcard…….

As the school term begins and with Parliament about to return, 178 deaths from Covid were recorded on 2 September, the highest number for some time, yet mask wearing on public transport is still patchy, some passengers reporting only around 25% compliance on their journeys. When in Wales recently it seemed to me that compliance was much higher. This could be partly due to restrictions having only just been lifted then, as opposed to the much earlier date in England, but I suspect it’s also because the leadership shown by First Minister Mark Drakeford commands more authority than the chaotic version in England.

But what seems common everywhere is quasi mask wearing, for example masks hanging around the wearer’s neck. A professor of public health, Dr Nisreen Alwat, tweeted about the important debate around ‘normality: ‘Masking in crowded indoor spaces during a raging viral pandemic is ‘normal’. Pretending the pandemic is over with more 245 thousand people testing positive in 1 week is not normal. I feel we need to work on the definition of ‘normal’ away from propaganda’. An even more fundamental debate emerging is the effects of Covid in reshaping people’s ideas about their place in society, the role of the state, individual freedoms versus protecting public health and even about democracy itself. This debate is bound to intensify as holidays end and autumn properly kicks in. Many are rightly asking themselves where they are in their lives: do they want to return to pre-pandemic activities, ambitions and lifestyles or has all this changed irrevocably?

Back to last week…. Education Minister Gavin Williamson, in a typically poor interview on Radio 4’s Today programme, yet again showed how the government is behind the curve. He alluded to Co2 monitors being ‘rolled out this term’, signalling no advance preparation, put the crucial ventilation issue back onto those mostly underfunded schools and kept avoiding key questions by repeatedly playing the vaccination silver bullet card. The Joint Committee on Vaccination and Immunisation has advised against vaccinating 12-15 year olds and the four nations’ chief medical officers will now decide whether or not to override this advice.

Concern is also rising about supply chain problems due to the shortage of HGV drivers, which many media outlets are still reluctant to admit is anything to do with Brexit. Reports about the shortage of chicken in Nando’s and milkshakes at McDonalds might lead some to think less consumption of such items might be a health benefit but the problem is now urgent due to undelivered flu vaccines and with waste collections in some parts of the country.

As Afghanistan continues to dominate the news, a key UK event this week was Foreign Secretary Dominic Raab’s appearance before the Commons Foreign Affairs Committee, during which his hubris and denial were fully on display. He refused to answer the question as to the date he’d gone on holiday, but later it was proved that this was a fortnight after the Taliban takeover of Kabul was predicted. Raab’s key defence was his extraordinary projection of failure onto MOD intelligence and his accusation that those ‘anonymously briefing’ against him were ‘passing the buck’ suggests he doesn’t grasp that as Foreign Secretary the buck stops with him.

During the hearing, Raab apparently appeared to be taken by surprise when he was asked why he had not acted on the Foreign Office “principal risk report assessment” from 22 July, which warned: ‘Peace talks are stalled and US Nato withdrawal is resulting in rapid Taliban advances. This could lead to: fall of cities, collapse of security forces, Taliban return to power, mass displacement and significant humanitarian need. The embassy may need to close if security deteriorates.’ One account of the hearing suggested Raab deliberately adopted an uncharacteristically monotonous tone, suspected to be a technique to deter his interrogators.

On Tuesday Raab gave a defensive and avoidant interview on the Today programme, during which the presenter failed to challenge him on his breathtaking comment that the 5,000 or so unanswered emails from MPs and charities making urgent requests for help for Afghans at risk would be ‘responded to within days’ – when all the flights had already left. The whistleblower who broke the unanswered emails story reckons there are about 9,000 Afghans at risk in Afghanistan, not the ‘low hundreds’, as claimed by Raab during the  hearing. A volley of scathing tweets accompanied the Today interview, one saying: ‘If, at any time, I am stopped by a policeman who accuses me of speeding I shall say: ‘I don’t accept that.’ That’s how Dominic Raab replies on Today when confronted with the truth. No accountability’. Another pointed out the cynical use of semantics: ‘I don’t think it’s worth getting ahead of ourselves on this,’ self-excuses Raab. So that’s it – inaction = ‘not getting head of ourselves’.

Perhaps the most extraordinary remark was when Raab referred to ‘so-called Afghans’, prompting incredulity from some listeners. Such a remark is surely a sign that questioning and dismissal of these Afghans’ nationality could be used as a reason not to help them. Tom Tugendhat, chairman of the Foreign Affairs Committee, was impressed with how active a number of European politicians had been for several months and said that the Foreign Secretary needed to outline what exactly he had been doing for the last four months. In a classic example of buckpassing, Raab spoke on BBC Breakfast about the UK’s role. ‘It did morph, if you like, into something closer, more akin, to nation-building, and I think we need to be realistic, particularly in an inhospitable climate like Afghanistan, about the extent to which over 20 years those objectives are reconciled with the means to achieve them. That’s something that I’m sure Lord Dannatt (former head of the army) would need to reflect on as well, given his role over many years’.

Government briefings have suggested that Raab will be sacked over Britain’s chaotic departure from Afghanistan, but he dismissed anonymous critics today as ‘lacking in any credibility whatsoever’ and now he seems to think he can compensate for his complacency and inaction by dashing around Qatar and Pakistan. The supreme irony, given the government’s recent record on asylum seekers, is its ‘Operation Warm Welcome’ and its disconnect with the tactics of Home Secretary Priti Patel. A Today listener tweeted: ‘Surely there is nobody in the entire country who buys the “warm welcome” for refugees rhetoric from this government this morning? Reporting on it without mentioning plans to reject and criminalise refugees contained in Patel’s Borders Bill is a joke’.

We learned from Victoria Atkins, now minister for Afghan Resettlement, that one third of councils have offered to help, prompting the question from some quarters as to whether all local authorities should be compelled to join the scheme. We can’t necessarily assume that it’s only the most cash-strapped councils which aren’t stepping up. But the minister was keen to assure us that more will come forward – surely something the government really must work ‘around the clock’ on rather than the false ‘straining every sinew’ sound bites we heard early in the pandemic. Chancellor Rishi Sunak is under pressure to double the amount of funding given to councils to house refugees after a leaked Whitehall memo revealed a multimillion-pound shortfall. Ministers are said to be in urgent talks with councils to find permanent homes to resettle more than 8,000 Afghans who were evacuated last month, a complex issue as many already have long waiting lists, those waiting perhaps fearing they could be deprioritised in favour of the refugees

Former Civil Service head Sir Mark Sedwill has said the UK has ‘no coherent plan for the refugee crisis’ and clearly hasn’t been impressed with the bandying around of ‘Operation Warm Welcome’. ‘Mark Sedwill, a former ambassador to Afghanistan and senior adviser to two British prime ministers, said the emergency airlift out of Kabul had only helped “relatively small numbers” and greater pressures were likely to emerge as people fled overland. ‘Forty-five senior officers, including myself, wrote an open letter to the government in July to say that a large proportion of British nationals and interpreters and other locally engaged civilians were at risk from the Taliban. We urged greater generosity and speed because time was not on our side. The response to that was very disappointing. As far as Dominic Raab is concerned, I shake my head because I wonder how people can go on defending the indefensible’.

As Dominic Raab busies himself in Qatar and Pakistan, he’s said the government needs to engage with the Taliban but not recognise their regime, a tricky position to adopt but one some suggest is akin to the relationship we have with countries like Myanmar. He wants to establish a new international ‘coalition’ of interested countries to ‘exert the maximum moderating influence’ on the Taliban, citing four ‘critical tests’ they would be judged on, including allowing Afghan and other citizens with the correct documentation to leave the country, preventing Afghanistan from again becoming a ‘haven’ for terrorists and allowing access to humanitarian aid workers.

Meanwhile, we hear that only one of the team of 125 British embassy guards who were promised help to leave Afghanistan by the Foreign Office has made it to the UK. The plight of those left behind is pretty desperate, sacked by the outsourcing company which employed them, not paid for August and no promise of severance pay. While the US apparently evacuated all their 500 guards and their families, the UK ones were subjected to a hokey-cokey approach, first having been told that as outsourced workers they weren’t eligible, followed by a U-turn. ‘Buoyed by UK promises of assistance, and hopeful they would be evacuated to the UK last Thursday, many sold their possessions – cars, televisions, carpets, furniture – and handed their homes to relatives. When the evacuation attempt failed, some returned to homes stripped of furniture. Others have been forced into hiding, after visits from Taliban representatives’.

The 124 left behind, described by an embassy staffer as ‘loyal and dedicated’, received this final chilling email: ‘You were authorised for evacuation by the British military. The evacuation has now ended. We are sorry if, as we think, you were not able to reach the evacuation point. If you were approved for evacuation, you will be supported if you wish to relocate to the United Kingdom’. Can you imagine what it would be like getting a message like that, knowing your details were left behind at the embassy and with the Taliban on your tail?

There’s still a great deal we don’t know but the key question perhaps is can the Taliban go beyond conquering Afghanistan and actually develop the infrastructure of government needed to support a population (nearly two thirds under 25) much better educated and with higher expectations than was the case in 1996? Will it be held back by its ideology, including separation of the spiritual and political roles and will it be able to convince the world of its capacity to distribute foreign aid appropriately, tackle the corruption hindering its progress and to form effective relationships with world leaders? Let’s hope that those not normally engaged with the news and politics understand how important all this is: not only will the events in Afghanistan shift tectonic plates in the geopolitical sphere, but here in the UK there are the refugees to manage and Taliban regime could lead to a resurgence in terrorist attacks on these streets.

You couldn’t make up the deluded concerns of some Conservatives, though. Writing in the Observer, Tobias Ellwood has demanded ‘an immediate end to the “unseemly and unprofessional” row between the foreign and defence secretaries over Afghanistan, warning that it is further damaging the UK’s already battered reputation on the world stage……’. He thinks ‘the crisis has exposed the weakness of the UK as a global player, and calls for a complete overhaul of the way foreign policy is handled in Whitehall’. He wrote: ‘We’ve lost the passion and the art of leadership – and have caused further reputational damage in the unattractive blame game over Afghanistan that has played out so publicly. This unseemly, unprofessional squabbling must stop’. He seems to have no idea that in the eyes of many the UK’s reputation on the world stage was shot to hell some time ago but it’s surely extraordinary that he believed this government ever had ‘passion and the art of leadership’.

Several developments on the home front risk raising public anxiety further. It’s shameful that, in 2019 having announced a long-awaited plan to reform social care, our Prime Minister still hasn’t produced said plan but now has announced a possibility, based on rising tax and national insurance. As ever ministers have different views on this and it was striking that former Health Secretary Jeremy Hunt, while pressing for reform, also seemed to agonise about this being the reverse of Conservative economic policy and a breach of a 2019 manifesto commitment not to raise taxes. But so many such promises are broken and what better cause than social care, which is currently in such a dire state?  Although not held in high esteem by many, former Tory leader Iain Duncan-Smith stressed how important it was to decide what needed to be done and how, before discussing how it should be paid for.

He has a point, but there’s a more immediate catalyst for reform and how many of those needing care could fall through the net because of these problems? We already know that Brexit has caused some to leave this area of work, as has the low pay and in some cases the requirement for compulsory Covid vaccination. Now it’s emerged, not surprisingly, that care workers have been leaving for better paid jobs, which, interestingly, includes Amazon, not known for employee care. It’s thought there could be 170,000 vacancies by the end of the year. This comment from a care home manager about one of the leavers puts the situation in a nutshell: ‘She said she loves her job and doesn’t want to leave but going to Amazon she can work three days a week and earn more. Society doesn’t value the work being done in social care’. This is an important issue in itself, how society values certain jobs, or not. Carers should be valued, no doubt about it, but how is it possible to change attitudes and quickly?

It’s been pointed out that it’s the strained NHS which will have to step into the breach, but how, given their own challenges? The Department of Health and Social Care spoke from its alternative universe: ‘We are working with local authorities and providers to ensure we have the right number of staff with the skills to deliver high-quality care to meet increasing demands. The vast majority of care staff are already vaccinated and we are focusing on encouraging even more staff to get jabbed to protect their colleagues and those they care for’.

As we hear that the NHS needs a £10bn boost to deal with its backlog and the effects of Covid, anything less regarded as inadequate, perhaps it’s not surprising that it’s been suggested free prescriptions for the over 60s should go and the age of eligibility raised to 66. What a false economy this could well be: analysis by Age UK already suggests that such a measure would have a ‘devastating impact on the health of tens of thousands of older people’. As so often, the false economy would lie in the likelihood that those unable to afford the charges could well feel reluctant to consult their GP in the first place or find their conditions worsening, perhaps with fatal consequences but also additional costs to the NHS over the longer term. It seems to me that governments really must learn to adopt long-term planning, not just short term thinking suited to the length of parliaments.

A consultation apparently attracted 32,000 responses and ‘in a joint open letter urging the government to reconsider proposals to scrap free prescriptions for over-60s in England, 20 healthcare organisations expressed “deep shared concerns” that the move would leave many patients unable to afford medication, intensifying existing health inequalities and having a devastating impact on some older people’s health. It’s been described as ‘a tax on the sick’, but as usual the parallel universe of the DHSC attempts to minimise the potential impact: ‘90% of community prescriptions in England are free of charge, and people don’t pay if they are on a low income, over 60, or have certain medical conditions. The upper age exemption has not changed since 1995 and that is why we are consulting on restoring the link between this and the state pension age. No final decisions have been made and we will publish the consultation response in due course’.

In recent weeks the media have been criticised for low to zero coverage of the forthcoming German election, but this is important for a number of reasons, including Germany’s key role within the European Union and its role on the world stage via the G7 and NATO, etc. Long-term Chancellor Angela Merkel is leaving the stage, her potential successors in the CDU (Christian Democratic Union) party thought to be somewhat unimpressive.  

A useful Radio 4 exploration of Merkel’s impact and legacy was interesting for several reasons, one being the role she embraced (hence the ‘Mutti’ (mum) nickname) as container of the nation’s psychological wellbeing. Exactly what we’ve never had recently in the UK. Whatever challenges the nation faces, the qualities of its leaders, ideally including steadiness and consistency, go a long way towards making the population feel in safe hands, reducing individual anxiety levels. BBC Europe correspondent Katya Adler spoke to a number of interesting interviewees about how they experienced the 16 years of ‘phlegmatic Angela Merkel…… ‘unassuming and hard to pin down….. an enigma’ and so on. One who hadn’t liked the CDU told Adler she’d completely changed her mind about Merkel – ‘I love her very much (laughs) She gave me security… she’s steadfast, consistent in her decisions….’.

This was a common view, including ‘she has a good deal of trust’, ‘she’s a great manager with a deep sense of duty’, a quality Germans value very highly. During big global crises like the euro, refugee and Covid crises, one said ‘it was good to have someone calm and thinking, not jumping forward’. A psychologist spoke about her diamond shaped hand gesture (hands folded over the lower stomach), which carries ‘a great deal of symbolism……a caring, protective boundary (inside which) people can pursue their own hobbies, interests and desires while she ensures nothing bad happens’. Such statements capture exactly what we don’t have in the UK, where incompetence, cynicism and self-interest are more to the fore in our leaders, resulting in the population missing this protective boundary.  

After Merkel started on this positive tack, but then swerved, it seemed to me, towards criticism of Merkel, citing all the things she had allegedly not achieved. Merkel has apparently become a byword for prevarication in key policy areas eg not investing in her own country, seen as reactive, a manager without a big vision without a big vision, she’s over-protected the German car industry, hasn’t got rid of coal production and risked opprobrium at home by allowing 1m refugees into the country (a policy which seriously impressed President Obama, though). But could it be that this is less important than the other qualities she’s brought to the table? As for the ‘enigma’, it’s said she likes singing and making potato soup and is a splendid mimic – interesting combination.

An article by the Guardian’s Berlin correspondent constitutes an exit report, detailing her approach and performance regarding key policy areas including Russia and China, Europe, refugees and the climate crisis. He quotes Stefan Kornelius, the foreign editor of Süddeutsche Zeitung and author of her authorised biography, as saying ‘She has two core qualities. She is risk-averse and a centrist in the sense that she wants to bring people together rather than alienate them. These qualities apply to domestic politics as well as the European Union, which is a political constellation that has an intrinsic tendency to drift apart’. It’s quite something that ‘Unlike all her seven male predecessors, she will be stepping down of her own will, at the end of a full term, and while her popularity ratings remain so phenomenally high that her three most likely successors have all in different ways modelled themselves on her’.

She comes across as an arch-diplomat, but ‘Critics say the cost of Merkel’s success has been an erosion of the political landscape: by co-opting other parties’ policies and programmes, she has made Germany’s traditional parties increasingly indistinguishable. The CDU has struggled to put up a united front as it approaches the post-Merkel era: party insiders fear a defeat at the September vote could throw the once-dominant force of German postwar politics into an existential crisis that could culminate in a split between centrists and conservative hardliners’. We will see, but one thing’s for sure – she will be a hard act to follow.

More organisations opting for a hybrid model (some days working from home, others in the office) and Parliament returning this week has turned attention once again to matters sartorial. An article featured in The Week by someone clearly keen on more formal dress, especially the suit, suggests that the apparent freedom to wear what we like at work following the wearing of underwear for zoom calls at home isn’t real freedom. He cites the school uniform argument, that a more genuine kind of freedom arises from not having to think too hard about what to wear, the choice of which will inevitably invite judgements and expose inequalities.

But has the Speaker now shown some much-needed authority? Sir Lindsay Hoyle has repeatedly failed to challenge Boris Johnson on his misrepresentations and question avoidances but has now updated the ‘Rules of behaviour and courtesies’ in the House. He stressed the required dress standards, clothing such as jeans and chinos being disallowed. The guide states: ‘the way in which you dress should demonstrate respect for your constituents, for the House and for the institution of Parliament in the life of the nation…Members are expected to wear business attire in and around the Chamber…Jeans, chinos, sportswear or any other casual trousers are not appropriate. T-shirts and sleeveless tops are not business attire. Smart/business shoes are expected to be worn. Casual shoes and trainers are not appropriate. Men are encouraged to wear a tie, and jackets must be worn. It is a privilege to serve as a Member of Parliament and your dress, language and conduct should reflect this’. A wag tweeted: ‘Surely the scruffiest MP in most need of cleaning up his act is the PM Boris Johnson…’.

Finally, in a lovely piece of community engagement and cultural ‘nurturing’: la Barraca de Cinehas been travelling around remote Spanish villages showing films where this wouldn’t normally prove viable. ‘We want to create magic… Our motto is cinema for everyone and anywhere’, say the founders. ‘It is a cinematic take on an effort launched nearly a century ago by Spanish poet Federico García Lorca. In the early 1930s, Lorca along with writer and film director Eduardo Ugarte, launched an initiative to bring classical theatre to villages across Spain.The project was named La Barraca, referring to the makeshift wooden stalls set up at fairgrounds. “Lorca did it with theatre and we do it with cinema,” said De Luna. Theirs has a bar, too’. Great stuff – something similar has happened in remote Scottish areas but it would be interesting to know what similar initiatives have taken off.

Monday 30 August

Not for the first time, key issues dominating the news and causing distress and anxiety bear a common imprint – government incompetence. Afghanistan, Covid and climate change have all been aggravated by the government’s approach of too little, too late, zero planning and with only days before schools reopen, there’s still no effective guidance on Covid safe practices eg ventilation and whether to vaccinate 12-15 year olds.

As the tragic events in Afghanistan continue to unfold following the deadly terrorist attack and the US drone strike, the crisis has given rise to numerous views as to what went wrong, what could have been managed better, and more fundamentally whether the West should have gone in there in the first place. Some commentators say 20 years is nothing in terms of changing such a country and that a much longer investment was needed, others feeling that trying to introduce Western democracy to this intensely tribal and fragile country was always flawed, if not hopeless. What must have been an additional blow for desperate Afghans was President Ashraf Ghani fleeing at the earliest opportunity, called a ‘mistake’ by the Taliban. The US withdrawal and how it was done certainly scotched Joe Biden’s ‘America is back’ mantra and the myth of the ‘special relationship’ between the US and UK.

Although it would be true to say the whole world was taken aback, even blindsided, by the speed of the Taliban takeover, especially given the numbers, (80k militants versus 300k US trained soldiers) it doesn’t excuse governments not having seen the writing on the wall the minute the US announced its withdrawal. Ministers’ excuses have been generally pathetic, along the lines of ‘no one saw this coming’.  But the sheer impact of this lack of anticipation and planning has been made much worse by the emergence of contributory factors like Foreign Secretary Dominic Raab remaining on holiday (having been given permission by his boss), the lie about the phone call to the Afghan government opposite number and failures in the system for rescuing Afghan citizens who worked for the UK. A tearful Defence Secretary Ben Wallace admitted that some would unfortunately be left behind, later getting flak for euphemistically describing the situation as ‘sub-optimal’ and a ‘matter of deep regret’. What seems particularly unforgiveable and incompetent is that fleeing British embassy staff left behind on their desks details of Afghans for the Taliban inevitably to find.

General Lord Richard Dannatt, former head of the British Army, has added his voice to others criticising the government for its inaction, thrown into sharp relief by the contrast with France, which started taking its people out in May. ‘Dannatt said it was ‘unfathomable’ that the UK government appeared to have been ‘asleep on watch’ when it came to ensuring the safety of Afghans who helped soldiers and officials. Amid bitter recriminations between government departments over who was to blame for leaving behind thousands of people with links to the UK, Dannatt questioned why ministers had not engaged earlier on the safety of Afghan allies, given that the issue had been raised repeatedly by senior army officers.

Demanding an inquiry, Dannat said: ‘On the particular issue of those who we knew were in danger, people who had worked for us, interpreters, former locally engaged civilians, this issue has been in the media…. This issue has been on politicians’ desks for two to three years and, certainly, it’s been there during the course of this year … Back in July, 45 senior officers wrote to the government … saying there are people we are concerned about and if we don’t do the right thing, their blood will be on our hands’.

As the country’s collapse is on the cards due to widespread hunger, homelessness and a crashed economy, prompting calls for major humanitarian aid, questions continue to be asked about how it came about that the Foreign Secretary, the Prime Minister and various civil service departmental heads were on holiday at the same time. There’s a clear sense of entitlement here and zero sense of urgency, eg Raab and his stay in a Cretan 5 star resort.  But surely, those occupying such key positions need to understand that there are limits to their holiday entitlement – when crises occur they need to be back at base, not trying to defensively bat them away from the beach.

For once ministers were subjected to challenging interviews on the BBC, Raab desperately trying to claw back some semblance of authority by constantly repeating that no one could see it coming and playing the old ‘speculation in the media’ card:  ‘I am not going to add to speculation in the media – the idea I was lounging on the beach is nonsense’. Ministers can’t keep repeating that they did as much as they could when shocking revelations emerge, such as the huge backlog of 5,000 unread emails from MPs and charities notifying government of urgent cases of Afghans in fear of Taliban reprisals needing rescue from Kabul. No wonder some newspaper headlines have screamed ‘Asleep at the wheel’. The government suggests that numbers left behind could be around 1,100, but the whistleblower who alerted the media to this catastrophic procedural vacuum believes it could be many more because these people have families but also because of the unread emails. ‘They cannot possibly know [how many people have been left behind] because they haven’t even read the emails. Even among those who’ve been registered, many have been left behind. But there’s also a much, much larger group of people who just haven’t been dealt with at all’. The government almost boasts about bringing 15,000 out and while this is an achievement, some estimates put those left behind as close to 9,000.

A Radio 4 Any Questions listener tweeted: ‘Trump’s unilateral “deal” with Taliban should have been a signal to prepare for an orderly withdrawal. Biden’s decision to carry through with the US withdrawal should have meant plans were stepped up. Instead, Johnson just had an “it’ll be all right on the night” approach’.  Despite the Taliban’s declaration that they’re not the same as 20 years ago, evidence on the ground suggests there’s been no change. Besides accounts of massacres, summary executions and unmarried women being handed over to fighters, numerous desperate Afghan teachers, women’s rights workers and others likely to be targeted by the Taliban have spoken to UK media outlets – heartbreaking to listen to. One wanted his family to be given safe passage to the UK, saying ‘I know I will be killed’.

As to the cynically framed rhetorical question about an alternative approach, one tweeter had had some substantial suggestions: ‘What more could the UK government have done? 1. Recognise it has never been only “interpreters” 2. Start evacuating them in 2015 3. Really think about Trump’s unconditional withdrawal, then Biden’s acceptance of it 4. Start withdrawing far more under ARAP, early’. Another added: ‘Create safe routes to asylum, scrap the Nationality and Borders Bill, don’t criminalise refugees and show them compassion’.

What’s been striking is the hubristic and deluded stance of the US and UK governments, implying they have some power in this crisis and some clout with the Taliban when they actually have very little. Joe Biden described the US service personnel as ‘heroes’, insisted they would not be deterred by terrorists: ‘We will not forgive, we will not forget. We will hunt you down and make you pay’. Meanwhile, the UK government believes that because Afghanistan is 75% dependent on foreign aid, this automatically gives the West leverage, when the complex means of aid distribution and desire not to disadvantage the Afghan people mean this surely can’t be taken for granted. Yet the government still affects a high-handed and faux authoritarian attitude. A Radio 4 listener tweeted: ‘We will judge them on their actions not their words’ says James Cleverly about the Taliban. ‘If they act like a proper government, then we will engage with them Shame the UK electorate didn’t apply the same criteria to him and his cronies’.

An interesting article focuses on what a Taliban government could look like, quoting leadership sources as suggesting there will be a 12-man council, including offering ‘some pliant members of the former U.S.-supported government the ministries of their choice as they strive to form an administration that is acceptable to the international community’. This sounds like they’ve more than understood the need to at least appear acceptable to the West. The article reckons that the main four men mentioned ‘represent one of the world’s biggest criminal and terrorist cartels…. The Taliban make billions of dollars each year producing and trafficking heroin and methamphetamine, as well as smuggling mining assets including marble, lithium, and gemstones’. It also suggests that this and discontinuing the presidential role will lead to problems and ‘open the door to factional struggles’. We will see.

A Radio 4 profile of Taliban leader Mullah Abdul Ghani Baradar is useful listening – politicians who find leaders like Putin and Xi Jinping challenging will no doubt have to step up to an even more demanding plate. ‘He says very little, he’s very secretive, we really don’t know what he believes in….’ observed one contributor. Regarded as a ‘skilled political operator’ and now thought to be a linchpin for bringing different factions together, he has been active since before the Taliban last took control in 1996 with its ‘draconian’ laws and punishments and suppression of women’s rights. It will be interesting to see what further insights emerge about him.

Meanwhile, Covid hasn’t gone away despite the widespread focus on holidays and world events. On Wednesday 149 deaths were registered, 141 of deceased having been vaccinated once, a situation we would not have anticipated months ago. Despite the Office of National Statistics reporting that the number of weekly deaths is at its highest level since March for the third week in a row, there seems no sense of urgency about addressing this. There were 571 deaths in England and Wales registered in the week ending August 13 mentioning Covid-19 on the certificate. That was up from 527 the week before, and 404 a week earlier. These numbers (people testing positive – 35,847; admitted to hospital – 859; patients in ventilation beds – 957), are substantially attributed to the Delta variant, which apparently doubles the risk of hospitalisation. Meanwhile, those opposing reintroduction of any restrictions, like the Covid Recovery Group’s Mark Harper, continue to spin the outdated narrative which paints the vaccine as almost a silver bullet.

If some people and politicians are too sanguine about this, health professionals are not, reporting themselves ‘braced’ for a surge of cases after the Bank Holiday, due to packed beaches and music festivals, etc. Newquay in Cornwall has been badged England’s Covid capital and a local director of public health said: ‘The lifting of restrictions and the successful vaccination programme has caused people to drop their guard against Covid, adding to a really high pressured situation for Cornwall’s health system. Living with Covid is not the same as pretending it doesn’t exist, and I think that’s what has happened. It’s not just younger people, that’s a general picture for people who have been told that all gloves are off and they’re taking that at face value’.

An interesting article about the profiles of patients dying (about a hundred a day) suggests key differences between now and the second wave in January. One relates to the age factor: at the height of the second wave in January, when the under-65s accounted for just 11% of deaths but recently it’s been about 25%. Deaths amongst the over 65s have now fallen. ‘If vaccine coverage was equal in all age groups, experts would expect to see the same proportion of almost all deaths from Covid in elderly people. But the younger age groups are not vaccinated at the same rate as older age groups and this is resulting in a relative increase in younger people dying’. I’d have thought the rise in younger people’s deaths was also attributable to a persistent number of antivaxxers (at least two high profile cases in the media this week, both being parents leaving young children behind) and far greater attendance at crowded events such as festivals.

Scientists also suggested that men were more at risk and warned that cases will rise as schools return. Teachers and others have been very concerned that with only a few days to go before the school term starts, they have received no guidance about Covid safe practice and a decision about vaccinating teenagers still hasn’t been taken. Needless to say, Education Secretary Gavin Williamson has assumed the usual ministerial ostrich-like stance, brushing off these concerns and adopting a wing and a prayer approach. He told the Financial Times: ‘We don’t want to see the same level of disruption … My hope is that, combined with the mass testing we’re doing, children aren’t going to be in the situation of having to self-isolate’. Is his ‘hope’ enough?

A key point made by one article and the central theme of this blog (the anxiety caused when we cannot trust our leaders, who abdicate their role as psychological ‘containers’) was the unacknowledged role of distrust in governments in vaccine hesitancy and refusal. ‘What all these doubters have in common, whether they’re from Kansas or Khartoum, is that they don’t believe the state has their interests at heart. The trust has gone’. For example, sceptics reportedly see ‘outrageously profitable’ healthcare and pharma companies spending huge amounts on lobbying, leading to suspicions about profit motives behind the developments. Maybe this alone wouldn’t be that damaging but coupled with many governments’ incompetence in dealing with the pandemic it makes for a powerful influence. ‘You might, if you lived in the UK, doubt the government’s assurances that the vaccine had been rigorously tested, after seeing senior officials appear to make up pandemic policies as they went along, dragging the nation with them through U-turns and lockdowns whose rules they did not follow themselves. State failure breeds paranoia. And when trust in government breaks down, people turn to personal vigilance. This climate of hesitancy and wariness is heightened by poorly regulated media that trade in falsehoods. In the UK, for example, a misleading report about ethnic minority people being excluded from vaccine trials was resolved only with a short correction in a footnote. Vaccine rejection doesn’t happen in a vacuum…. it’s a measure of how political systems work. We should spend less time haranguing anti-vaxxers for their stupidity and more time scrutinising the systems that have lost their trust’. Hear, hear.

Naturally, this time of year has put the knotty issue of PCR tests further the spotlight, and it seems that for some time some rogue operators have been given a home on the government’s website, companies which charge excessively, don’t return results in time or worse, not even sending the tests for analysis, obscuring additional charges and customers even being sent the wrong results. This is unacceptable anyway but especially because customers are spending hundreds of pounds on tests to take families on holiday.

After Health Secretary Sajid Javid said ‘rogue’ companies could be removed from the list of approved suppliers (but how did they get onto it in the first place?) the regulator, the  Competitions and Markets Authority, came on stronger and said they could face enforcement for breaching consumer law. But could is the operative word – this laissez faire approach means all kinds of unethical and unfair practices can slip through the net in all fields. Another reason why this is an intolerable situation is the knock on effects on the struggling NHS – it has to step in when such companies don’t deliver. Isn’t it interesting that some entrepreneur hasn’t created an app to review and rate PCR tests?

Climate change is another thing that’s not gone away, of course, and many are concerned that the clock is ticking in the lead up to COP26 and there’s been little planning as to how to dramatically reduce emissions. Extinction Rebellion has been active again, disrupting traffic in central London and elsewhere. Although it’s annoying to have journeys interrupted it doesn’t seem to have been universally grasped that this is the only way protesters have found to puncture people’s complacency. A wag tweeted: ‘Who knew saving the planet would be so inconvenient?’

One woman was astonished at what she experienced as police brutality, ripping apart women who’d glued themselves together so that bandages were needed afterwards. ‘I’m a white middle-aged woman; I’ve not experienced police violence before … now I have direct experience of police violence. The public need to know that women and mothers trying to protect their children are being violently attacked by our state police. We pay their wages and they basically attacked us for trying to protect all life on earth’. How the Met from its parallel universe put it was that ‘officers intervened when protesters were building a structure at Oxford Circus. Some individuals have glued themselves to the structure, specialist officers are working to support their removal’.

It seems clubbers at the Pipe in Aberdeen got even better value than expected on Saturday night when Michael Gove, tipped to replace Foreign Secretary Dominic Raab at the next Cabinet reshuffle, joined them for several hours. The Guardian revealed that ‘arms aloft, suit jacket on, Michael Gove has been filmed giving it his all in an Aberdeen nightclub after reportedly trying to avoid a £5 entrance fee by stating that he was the Chancellor of the Duchy of Lancaster’. Which was the most embarrassing, I wonder – Gove’s ‘dad dancing’ or trying to wriggle out of paying to get in? ‘His hands flailed wildly, and occasionally swung in time to the music, in the clip filmed by a fellow clubber. Friends of Gove denied that he had attempted to avoid paying’.

Finally, the biblical expression ‘there’s nothing new under the sun’ must have come to archaeologists’ minds when they found the remains in Pompeii of a ‘remarkably well preserved’ fast food joint which ‘closed for business’ (that’s one way of putting it) almost 2,000 years ago. Excavators made the discovery in 2019 and it opened to the public last week. Experts believed it served hot meals made from pork, goat and even snails, typically purchased by poorer Pompeii residents who had no kitchen of their own. Will future archaeologists be excavating a McDonalds  at some point, we could wonder…..

Sunday 15 August

Last week’s news, much of it a continuation or repetition of what we’ve seen before, served as a timely reminder of what an uncertain world we’re living in, this naturally impacting on our mental wellbeing. As we move closer to the global climate change conference, COP26, experts and politicians deliver ever starker messages but often with no actual plan to reduce emissions as radically as global policies dictate. Boris Johnson wants to be seen as a world leader on climate change, but there’s a lack of urgency and the absence of a plan has partly been attributed to two opposing factions within the Conservative Party. There are the ‘blue environmentalists’, including his wife Carrie Johnson and there are the sceptics, including some climate change deniers, who worry about the cost to consumers. Other groups outside the Conservative Party with a powerful agenda are the ‘climate change warriors’ and the ‘Labour net zero pragmatists’. The dire climate emergency raises a conundrum which will surely test the capacity of COP26 deliberations – how much individual responsibility can governments expect their citizens to take when some regimes like China, Russia and Saudi Arabia at the G20 deliberately prevented a decision to end fossil fuel subsidies? And what can individual countries achieve when China’s emissions are 28% of the global total and are continuing to increase? There’s the intrinsic challenge that these forums like COP26 take place on the global stage, far removed from the localised government mechanisms which actually get things done. In the Financial Times Philip Stephens said ‘the gap between the soaring rhetoric of international conferences and policy inaction at home will have to be bridged, and soon…… Look at the weather’.  

Just before the release of the Intergovernmental Panel on Climate Change (IPCC) report, Business, Energy and Industrial Strategy minister Kwasi Kwarteng gave a car crash interview on Monday’s Radio 4 Today programme, consisting largely of sound bites and clichés which didn’t add value to the discussion. His perpetually languid and disengaged manner doesn’t help. Meanwhile, evidence of climate change is undeniable, many parts of the world experiencing unprecedented levels of flooding and wildfires. At least there’s a glimmer of hope that the IPCC report has been described as a massive alert that the time for climate action has nearly gone but crucially not gone yet.

The situation in Afghanistan is surely another lesson, as if we needed one, on the folly of Western intervention in such countries. More specifically, Western intervention without a genuine plan for sustained support for the Afghan government and the people. Having taken so many other cities and areas, the Taliban are now ‘at the gates of Kabul’ and unlikely to be halted now. It’s striking how hard some politicians and generals have been working to try to justify the last 20 years, whereas many, especially those who have lost family and friends there, feel it has been a waste. The main justification seems to be that during this time we have seen very little Al-Qaeda terrorism here but what about the Afghans? Those interviewed express despair about the return of the Taliban, pointing out the difference between their new propaganda and what’s actually happening on the ground. A sceptic tweeted: ‘The Taliban has changed – its PR is better’. Another said: ‘Western leaders are saying “but we educated millions of girls in Afghanistan” over the last 20 years. How does it help to now abandon 20m women to the Taliban and condemn them to a life in the Middle Ages’? It was heartrending to hear an Afghan woman say that the Americans had shown them a beautiful world and now President Biden had abandoned and betrayed them.

There’s also the key issue of the former interpreters: some have been welcomed to the UK but there are still many others there at risk of Taliban persecution and elimination. Shadow Foreign Secretary Lisa Nandy said there needs to be some genuine UK leadership on this (and what about the massive cut in foreign aid recently decided?), but it seems the complexity of the situation and the summer holidays are slowing down a considered response. At least Boris Johnson has recalled Parliament for Wednesday, though it seems he did initially resist this. The BBC also reported that Afghan students offered scholarships by the UK government won’t now be able to take up those offers because of paperwork not being completed in time by the British embassy there. Surely there must be a way around this.

Regarding the speed at which the Taliban has effectively toppled the Afghan government, one commentator interestingly attributed this partly to this government not being perceived as truly Afghan, having been built up from returning exiles. Former Tory MP and Afghanistan expert Rory Stewart tweeted: ‘At the centre of this is the most astonishing failure of intelligence + analysis from the US and its allies. The US presence was small, sustainable and vital to the country. It was removed in an utterly reckless fashion – as this shows with no understanding of the impact’.

As in previous years, there’s the usual August debate about exam results but this year, with two years of pandemic-related challenges, there’s rightly been a sharper focus on inequalities within the system, grade inflation and, because of teacher assessments, many more qualifying for university places than before. Labour has said that this makes Education Secretary Gavin Williamson’s position untenable, but needless to say, both he and Schools Minister Nick Gibb carry on regardless, not even acknowledging the problems.

‘Asked whether private school teachers had been too generous in their grading, Keir Starmer said the attainment gap appeared to be to do with a ‘lack of a coherent framework to do the assessment provided by the government. Some were testing very often and some not very often…It led to the widening and now yawning gap between private and state schools. The hallmark of this government is wherever there is an inequality they can make it bigger and they are very busy doing that’. It’s not only Labour calling for Williamson’s sacking – he’s apparently held in very poor esteem by Tory MPs and the Cabinet, but it’s not clear that   those touted as a possible successor (Vaccines Minister Nadhim Zahawi and Equalities Minister Kemi Badenoch) would be much of an improvement.

Meanwhile, as the gap between private and state schools comes under yet more scrutiny, an interesting article by Brooke Masters in the Financial Times, featured in The Week, aims to demonstrate how private schools have lost their grip on Oxbridge. Admissions tutors have moved towards a more inclusive policy, focusing more on state school pupils who have worked hard to overcome barriers, rather than simply privileging public school products from wealthy backgrounds who have also been groomed for the interview process. These parents who have shelled out thousands over years trying to ensure Oxbridge for their offspring find themselves in a new moral conundrum. Whereas many will publicly espouse the need for equality of opportunity, when it comes to this situation they see what they had assumed for their children as being under threat. One ‘grouchy’ father was heard to ask a school head to explain how he would protect the boys there from ‘social engineering’. A firm sense of entitlement accompanies this level of spend over years. ‘I feel genuine sympathy for anyone concerned for their child’s future, but complaining about a loss of privilege comes across as tone deaf’.

We’re told that since 1981, annual applications to Cambridge rose from 5,000 to 20, 426. It’s now four times harder to get a place than when these parents were applying and the pandemic has exacerbated the situation because of teacher-assessed grades leading to hundreds of extra students. I feel sorry for the children of these parents who went to Oxbridge themselves, expecting their sons and daughters to follow suit but without understanding what has changed. But rather than parents engineering their children’s futures, a healthier approach is for those students to determine their own future. One sixth form college principal has long tried to convince parents that Oxbridge entrance isn’t the be all and end all: ‘Things have changed very dramatically in 30 years… for parents it’s about learning to let go a bit and learning to let students drive the process… our job is to walk alongside them. It’s not to go in front and drag them’.

The shocking shooting in Plymouth raised a number of issues which need closer scrutiny, such as what seems a dereliction of duty in the police reissuing the gun licence to this disturbed man after it had been removed following Jake Davison’s involvement in an assault. We know how depleted police forces are but this is surely an area of their work they cannot afford to carry out negligently. Three other key issues are Davison’s association with the incel movement (which not everyone is yet familiar with), whether this should be treated as a form of terrorism, and yet another situation in which inadequate mental health services have played a part.

‘Davison had shared hate-filled views on Reddit forums used by incels – men who express hostility and resentment towards those who are sexually active, particularly women. Earlier this year, authorities in the US warned that attacks linked to the incel movement were on the rise, and authorities around the world have begun to treat the ideology as a more serious terrorism threat.

‘The condition of Davison’s mental health has been questioned, with one person familiar with his family claiming relatives had requested help from mental health authorities. Writing on Facebook, the neighbour said: “His family [pleaded] for help to the mental health team, the NHS basically said that they are short-staffed and that was it. The family even asked for the police to come out to see him as he was talking and acting strange but they didn’t do a welfare check’.

A useful article describes what ‘incel’ culture is and how it could be on the rise. ‘Incels are men who describe themselves as “involuntary celibates”. Laura Bates, author of Men Who Hate Women, said: ‘In other words, they’re not having sex and they want to be. They see women as completely commodified and dehumanised sex objects [that] are there purely for male sexual pleasure. And they blame women for the fact that they’re not having sex’. Bates estimates that the incel community in the UK could be as large as 10,000, with hundreds of thousands more worldwide and that the movement is actively grooming and recruiting young men.

The policy of ‘living with the virus’ is being manifested in various ways, especially the normalisation of substantial numbers of new cases and of daily deaths (around 90 each day). One of the key disillusionments of recent times must be the realisation that vaccination doesn’t prevent us getting Covid and doesn’t prevent hospitalisation. When the vaccines were first developed we didn’t have the lethal variants to contend with, but now we hear that the double jabbed only have a 59% protection, down from 83% earlier this summer, due to the Delta variant. The decline in protective antibodies after the second job has strengthened calls for autumn booster jabs, although no decision on this has yet been taken. This and related decisions must be taken soon since experts are advising the government that vaccine-resistant variants could ‘set us back a year’. Various scientists and commentators (including Dominic Cummings) have urged the government to produce a Covid risk assessment strategy relating to contingency plans, but so far we’ve mainly seen reactive short-termism.

‘Stephen Reicher, Professor of Psychology at the University of St Andrews, said: ‘It very much makes sense to be prepared. Scotland is setting up its standing committee on pandemics. It will be interesting to see what emerges on a UK level. In the longer-term we need a systematic inquiry into what went wrong (and right) so we are prepared and also so that we can institute systemic changes to protect us. The pandemic has been like a barium meal which has exposed so many deficiencies in our society. We can no longer pretend we are not aware of them. This has been a deafening wake-up call. Let’s make sure we don’t press the snooze button’. Government sources have said Public Health England and other bodies are monitoring the situation ‘through rapid surveillance and genomic sequencing of the virus’ but it could be argued this already doesn’t reflect the urgency of the situation.

We heard this week that Baroness Dido Harding will be stepping down from her role as chair of NHS Improvement in October in the wake of her unsuccessful attempt to become the next NHS England Chief Executive. Well overdue, some may say. In another embarrassing but not surprising revelation, the government has also admitted that it had the data on deletions and disabling of the NHS Covid app amid the ‘pingdemic’, but refused to release the figures. The Department of Health and Social Care again demonstrates how it takes us for fools, in trying to suggest that the release of such information was not yet in the public interest, also declining to say when this time might come.

Meanwhile, for those travelling abroad, there’s been increasing disquiet about profiteering by the companies (over 400 according to Transport Secretary Grant Shapps) offering PCR tests. The Competition and Markets Authority has now entered the fray, concerned about pricing and test results being delayed or not returned. The CMA is providing data for the Department of Health and Social Care to act on. As a reminder and to see the contrast with other countries: ‘PCR tests are needed to travel to some overseas holiday destinations and on return from amber and green-list countries. Similar tests for days two and eight after return to England listed on the government’s website can cost more than £300 or as little as £20. On average, prices in the UK are £75 for a single test, compared with about £40 in France and Greece’. Some travellers have found that the cheaper tests listed on the website aren’t available when they come to book them, prompting questions about the authenticity of the apparently low costs. This situation again throws up inequalities, with only those able to afford these tests able to go abroad. Even a Tory MP observed: ‘It’s almost as much as the holiday that they’re having to fork out in Covid tests which means for a vast majority it’s a no go. I couldn’t afford to with a family of five’.

Meanwhile, the ‘staycation’ industry continues at pace despite the UK’s unpredictable weather and amid complaints about crowds, inflated accommodation prices, shortages in shops and queues for restaurants and cafes. But not everywhere – after this summer there will no doubt be positive accounts of less popular holiday spots, some quite off the beaten track. Anonymous street artist Banksy is also doing his bit for the British seaside, as he tours the UK in his campervan, his works already appearing in Lowestoft (Suffolk), and Gorleston and Great Yarmouth in Norfolk. I wonder how many media outlets already have a team combing the roads and resorts for the elusive artist.

‘In one work on the concrete sea-defence wall of a British beach, a rat lounges in a deckchair, sipping a cocktail. In another, sticking to the seaside theme, a mechanical claw dangles above a public bench – as if anyone who sits there is about to be plucked up like a prize in an arcade game. Another shows a giant seagull hovering above a skip full of oversized “chips”. A fourth shows three children in a rickety boat. One looks ahead while another is busy bailing out water with a bucket. Above them, appears the inscription: “We’re all in the same boat.”On the roof of a bus shelter, a couple also dance to the tune of a flat-capped accordion player, in a black and white painting evoking the faded, down-at-heel feel of many of the country’s once-prosperous seaside resorts’. It will be exciting to find out what further works appear and in which resorts.

Prince Andrew is once more in the news since his legal team has not responded to lawyers representing the woman accusing him of sexual assault when she was a teenager, Virginia Giuffre. The main lawyer, Daniel Boies, has said that Andrew cannot ‘hide behind castle walls’ and that his client had ‘tried every way she can to resolve this short of litigation’. Apart from the hiding not being good for the Prince himself, it gives a poor impression of this country and of the Royal Family.

 ‘The lawsuit seeks unspecified damages. Giuffre accuses Andrew of sexual assault and intentional infliction of emotional distress. The lawsuit said that 20 years ago, ‘Prince Andrew’s wealth, power, position, and connections enabled him to abuse a frightened, vulnerable child with no one there to protect her. It is long past the time for him to be held to account’. If he doesn’t respond to this current request, he will anyway be drawn back into these accusations because the delayed trial of Jeffrey Epstein consort Ghislaine Maxwell will take place in the autumn.

Again, mental ill health hits the news, from several different sources. Besides the failure of services in Plymouth to respond to the alerts regarding Jake Davison, the Guardian tells the story (and this will be the tip of the iceberg) who had to give up their jobs to care for mentally unwell children because of service failures. One mother had to give up her work as a much-needed ITU nurse to care for her daughter. ‘Leese is one of many parents who are the collateral damage of the funding crises in children’s mental health services (Camhs) and the special needs education (Send) system. The Observer revealed last month that up to half of all children and teenagers referred to mental health, learning disability and autism services in 2019-20 were left without proper support. But the effect on parents is often overlooked – forced to abandon their careers so they can look after their children full-time and fight endless battles with cash-strapped bureaucracies for the most basic support’.

One of the shocking things is how much money these parents have had to spend on assessments and legal fees in order to get their children’s needs met. ‘Ruth Cliff has spent £20,000 in two years on legal support and private assessments for her 17-year-old adopted son, draining her savings and sending her into debt. Her son, who has ADHD, hasn’t attended school since March 2019. She had to go to her GP three times just to get a Camhs referral’.

But on top of all this what a lonely place for the parents to be in, their own mental health also compromised. ‘As a parent of a child who struggles with mental health and with special educational needs you basically have to become the expert, not only of your child and their needs, but also of what needs to be put in place to support them..It doesn’t seem that services that are supposed to help will willingly help – you literally have to fight every battle to get them to help you’. Needless to say, Department of Health and Social Care issues statements about how much it’s ‘invested’ but it’s never enough or in the right places. A distressed and sceptical parent said: ‘I watched them in the Commons saying by 20-whatever year it was they’re going to have this, this and that done, and how much progress they’ve made. And it was like, if you think you’ve made progress for the pathway into assessments then come to my house and see the state of my child, because I can tell you that you haven’t. I would welcome any of the health ministers into my house to look at my child, to spend a day in my shoes, so they can see they’ve not changed anything. Nothing has changed’.

 Meanwhile, counselling and therapy, which many initially seek through their GP, have moved substantially online and via apps, a trend reinforced by the pandemic but one which started with the ill-conceived (in the eyes of some) IAPT (Increasing Access to Psychological Therapies) programme, which privileged short-term work and Cognitive Behavioural Therapy when what many need is relational therapy which goes to the roots of difficulties. There’s no doubt the programme has broadened access to therapy but it has also unhelpfully removed elements of the special relationship between client and therapist. It was appealing to politicians and policymakers because it appeared to deliver ‘treatment’ at much lower cost and achieve success rates, but now we know how these figures have been fabricated.

‘Elizabeth Cotton, a former psychotherapist working in the NHS, is an academic based at Cardiff Metropolitan University whose recent research is focused on the “Uberisation of mental health”. She carried out a series of surveys (including three about the impact of Covid on working life in mental health) and has published them under the title The Future of Therapy. We speak on Zoom, of course, and I marvel inwardly at how we have taught ourselves to communicate in this new land, our own faces hovering meanly to the right. “Essentially,” she says, her argument is that “an industrialisation has taken place, a downgrading of therapy, which opens the doors to digital providers, and what is emerging now is the Uberisation of mental health services.” Cotton shows how the original intentions of IAPT have been undermined and explains how figures are manipulated.

She stresses that there are still good therapists and services. ‘But the model is designed in a particular way, to downgrade the service. To shorten the interventions, to reduce the number of highly trained clinicians that you need to take on a supervisory role rather than a direct clinical role. To reduce expectations. To reduce what people think is a treatment’. The NHS has a major conundrum to wrestle with, on top of very inadequate investment in mental health, despite what some disingenuous ministers maintain: it tries to help a greater number of people, though waiting lists are often still long, but often at the expense of choice of treatment and work which can genuinely help them, resulting in revolving doors and people having to seek help privately, which not everyone can afford. ‘The gold standard of therapy remains two people in a room, one talking, the other listening. In Britain right now, that level of care is reserved for the very wealthiest and the very sickest, while those in between have traditionally relied on luck and compromise’. While the new digital approaches will help some, many will not experience them as helpful, leaving patients to finance the work themselves or continue as best they can. The frustrating irony is that for years counselling and therapy professional bodies have been urging the NHS to recruit their qualified and experienced members to meet the need but this hasn’t happened.

Finally, on a positive note, related to the earlier piece about addressing educational inequalities, it’s good news that another 30 black students will get £20k a year scholarships to Cambridge, thanks to rapper Stormzy. Having started with two students a year in 2018, it’s now ten for the next 3 years, enabled via a partnership with HSBC. The star said: ‘I hope this scholarship continues to serve as a small reminder to young black students that the opportunity to study at one of the best universities in the world is theirs for the taking’.  

Sunday 8 August

Although we’ve now officially entered the ‘silly season’ regarding news, there’s plenty of it and, more insidiously, ‘living with Covid’ seems to have been conflated with normalising the damning statistics (92 Covid deaths on Friday and 31,808 new cases), not to mention the terrible health, financial and societal side-effects. Our Prime Minister continues to shame this country, first refusing to accept Nicola Sturgeon’s invitation to meet on his visit to Scotland, his ‘crass’ joke about Margaret Thatcher giving a “big early start” to green energy by closing coalmines, and by demonstrating yet again what’s now trending on Twitter – #oneruleforthem. He has refused to self-isolate after having been in close contact with a staffer who tested positive, although Downing Street denied this, of course. Anneliese Dodds, Labour party chair, said it was clear Boris Johnson ‘hasn’t learned anything from what happened last time he tried to cook up a reason to be above the rules everyone else has to follow…Senior Conservatives are really taking the public for fools. This is yet another example of one rule for them and another for everyone else’. It’s not surprising, then, that we hear Johnson’s approval rating has dropped to its lowest level since October 2020, now -16, according to the Observer poll Opinium.

While the Prime Minister is at Chequers again for the weekend, COP26 supremo Alok Sharma has attracted flak for jetting around the world in his diplomatic mission to get a global climate deal agreed, although this has been defended by some experts and campaigners. The timing is important as Monday a ‘landmark report’ will be published by the Intergovernmental Panel on Climate Change. ‘Details are still under wraps, but the Guardian has confirmed that the warning from the IPCC will reinforce how vital it is to try to prevent temperatures from reaching more than 1.5C above pre-industrial levels. Beyond that threshold, scientists will warn, the consequences of extreme weather will be devastating. The world must act urgently: if greenhouse gas emissions are not halved in this decade, 1.5C of heating will be inevitable and probably irreversible’. This does raise an interesting debate, though: to what extent should high-level activity of this nature be allowed to release those involved from obligations they’re desperately trying to get the rest of us to wake up to?

Meanwhile, much in the news again this week is what some describe as the ‘obsession with foreign holidays’, as the government’s ‘traffic light’ system comes into further disrepute, thought to be driven more by politics (eg regarding the withdrawal of quarantine requirement for those coming from France) than science. Ministers have not released data on which their decisions are based and the latest change to get people up in arms is Mexico moving to the red list. If those tourists don’t make it back to the UK before the deadline, they face large bills for the required stays in quarantine hotels.

The ‘amber watch list’ was also abandoned after it emerged a top adviser had left. In yet another scenario you couldn’t make up, it seems Transport Minister Shapps was the author of the scheme he later turned against. His colleagues were reportedly ‘furious’ as he initially briefed for it, then against, then tried to blame the Prime Minister. You have to love the way Boris Johnson said that he wanted ‘a simple traffic-light system for international travel’ – right. The current hokey-cokey can hardly be described in such terms. Citing the two week delay before putting India on the red list in April, Labour’s Ben Bradshaw said decisions about the traffic light system were an ‘absolute scandal’ and had ‘nothing to do with public health and everything to do with politics…The government has repeatedly failed to publish the detailed data on which its decisions are made…Every other country in Europe does this, so the public and business can plan. Air passenger numbers in Europe have already recovered to about 60% of pre-Covid levels, while the UK figure is 16%’.

But what seems increasingly clear is that ‘staycations’ aren’t always the answer. The BBC showed packed beaches in Cornwall (lifeguards estimated 14,000 on Perranporth beach at one point last week), local services including the NHS under severe pressure, long queues for everything and some people complaining about empty shelves in shops, staff shortages in restaurants and inflated accommodation prices. This is surely another example of a serious issue not being thought out by the Westminster government – they would have known long ago that Covid measures would put much more pressure on the UK’s seaside resorts but what help did those local authorities get when most are already suffering from significant cuts in their budgets?

And this is only if you can afford a holiday in the first place – for many low-paid workers it’s proving impossible. ‘Ministers have urged Britons to holiday at home but big rises in the cost of accommodation and limited availability have made that impossible for many. Inevitably, it is the people who have been most stretched during the pandemic, poorly paid frontline workers, who are in greatest need of a break and least able to afford one’. Another Observer Opinium poll registered findings which aren’t surprising, eg people in higher social and economic groups were much more likely to have taken a holiday abroad, but this is a stark finding: ‘almost two-thirds (64%) of the poorer group said they had not taken and had not booked a holiday this year; that figure was 52% for the wealthier group’. What a shame this is: those frontline workers really need a break yet one NHS worker quoted said she was now only looking to 2023 for a holiday.

The forever jaunty Grant Shapps came in for a second dose of opprobrium last week. When interviewed on Thursday’s Radio 4’s Today programme and asked about the secret ‘advisory board’ of rich Tory donors and their potential influence on government policy, he described them, in an outrageous example of disingenuous gaslighting, as people ‘who love their country and want to see it prosper’. For ‘prosper’ read changing policy to support crony profitmaking.

Three other ministers have also been in the news and not for positive reasons. Prominent Brexiteer Steve Baker has now called Brexit ‘a fiasco’, Foreign Secretary Dominic Raab failed to quarantine on returning from France and, maskless, met Princess Anne only days later, and health minister Lord Bethell continues to be under pressure for appearing to take steps to avoid scrutiny regarding the award of crony contracts and use of private messaging rather than official email. He claimed to have broken and replaced his mobile phone, thereby rendering inaccessible the WhatsApp exchanges which could otherwise incriminate him. At issue is the controversial award of £85 million in contracts to Abingdon Health last year, for Covid testing kits, following a private meeting which Bethell did not declare.

We shouldn’t have to depend on private organisations taking the lead on this but again, the Good Law Project is leading the way. During an interview with James O’Brien on LBC, director Jolyon Maugham said: ‘These [contracts] involve epic amounts of public money so we need to be sure that they’re not doing what Dominic Cummings admits he’s done twice, which is giving contracts to his friends. You have a duty to account to those who give you that public money through our taxes and explain how it is that you came to award these weird and wonderful contracts to your friends or Tory donors…If you deliberately destroy evidence or break your phone… it’s very possible that you’re committing the criminal offence of perverting the course of justice. Once we receive the answers to the questions that we put to the lawyers acting for the Department for Health, we will be taking a close look at whether a criminal offence has been committed’.

Last week we heard that the NHS had gone down from 1 to 4 in a list of 11 countries’ health systems compiled by an American think tank, the Commonwealth Fund. Numbers 1-3 are now Norway, the Netherlands and Australia. Siva Anandaciva, chief analyst at leading UK health think tank the King’s Fund said: ‘According to this report, our previously world-beating health service is at risk of moving to the middle of the pack, largely due to growing delays across the system in people’s ability to access care quickly’. It’s hardly a surprise, because of this government’s longstanding underinvestment in the NHS, and this analyst makes clear the situation can’t be attributed solely to Covid. ‘We can’t brush this under the carpet as being solely a consequence of the impact of the pandemic on patients, staff and services. Even before Covid, waiting lists for treatment were already sizeable after a decade of stalling funding and a growing workforce crisis. As Covid put the NHS under unprecedented pressure, the waiting list for routine NHS care has ballooned to levels not seen since the early 2000s. Whilst the NHS is doing its best to keep services running, increasing demand for hospital, mental health and GP services means the whole health and care system is now facing a capacity crunch’.

This article is interesting, if depressing, on the criteria used for ranking countries. The UK’s rating declined on three important criteria: access to care; care processes, which look at the co-ordination of treatment and how well patients are involved; and equity, or the ability to obtain healthcare regardless of income. The UK was described as ‘a remarkably lean spender among high income countries’. Apparently ‘nearly 60% of adults in the UK found it somewhat or very difficult to obtain after-hours care, one of the highest rates among the countries surveyed’, and as we well know, mental health services have been inadequate. ‘Just 33% of patients said that they got counselling or treatment for mental health problems when they sought help from a specialist in psychological or psychiatric illness – a new indicator that the think tank had not previously analysed. The NHS was the second worst performer of the 11 countries on that criterion, just ahead of France’. This doesn’t surprise me at all – there are long waiting lists for most IAPT (Improving Access to Psychological Therapies) services and often poor choice of treatment, Cognitive Behaviour Therapy being privileged when what many actually need and want is relational therapy.

We hear, not surprisingly, that with the NHS on its knees, funding will be a stand-off between Health Secretary Sajid Javid and ‘hard-nosed’ Chancellor Rishi Sunak. While GPs report having to deal with many more patients in pain because of long-delayed procedures, the crisis overall is attributed to a convergence of ‘Covid issues, the emergence of health problems hidden during the pandemic, soaring waiting lists, an exhausted workforce and the continued pressures on capacity caused by increased infection control’. In turn, NHS Providers chief executive Chris Hopson attributes the funding crisis to an insufficient settlement in the first place, expensive new manifesto commitments, a social care crisis, a massive care backlog and ongoing Covid costs. ‘Any one of those by themselves would be a major pressure. The problem is the combination of all five of them at once…. “There’s real danger of a very large gap between the Treasury and the NHS, the Treasury insisting that they have to regain control of the public finances and get back to the May settlement as quickly as possible – the NHS saying that the demands on the service have changed dramatically and they can’t provide the right quality of patient care in a world of Covid-19 unless those pressures are recognised. It’s difficult to see how those two views get reconciled’.

It was shocking enough hearing recently that the NHS waiting list was about 5 million – it’s now predicted it could rise to 13 million before it starts to fall. Two key factors add to the conundrum’s mix – the new NHS Chief Executive, Amanda Pritchard, and Javid himself, who, as former Chancellor, had a reputation as a ‘fiscal hawk’. But the Prime Minister will also be involved, the King’s Fund said. ‘There won’t just be wrangling between the Department of Health and Social Care and the Treasury. No 10 always has a strong hand in NHS funding decisions and will have a keen interest in showing the electorate that a Conservative government can be trusted on the NHS’. Unfortunately, we’ve seen plenty of signs suggesting that the Conservatives cannot be trusted with the NHS but some commentators think that the 2024 election on the horizon might concentrate minds this time around.

There have been a number of reports in recent years on the need for better investment in mental health services and we need these more than ever, as the pandemic has given rise to much higher demand. The latest report is from the Centre for Mental Health (Now or Never) and calls for strategic government spending on mental health and for services in England to radically change to be fit for the future and respond to the aftermath of the pandemic. Crucially, it points out that it’s not only about investment but about addressing longstanding structural problems in the way services are conceived and delivered, including the inappropriate historical divide between physical and mental health services. Staff shortages are significant, but as the British Association for Counselling and Psychotherapy (BACP) has long pointed out, thousands of well qualified and experienced counsellors and therapists are available for recruitment to help resolve this. But unfortunately the NHS has pursued a policy of training up a separate workforce, primarily in CBT (Cognitive Behavioural Therapy), which is not only wasteful but also continues to sideline approaches to therapy which are often found to be much more helpful to patients. The report also highlights the important need for focus on preventative work, less costly in the long run.

BACP makes the good point that health inequalities across England reinforce the need for mental health services to feature in any real ‘levelling up’ agenda. Centre for Mental Health chief economist and report author Nick O’Shea said: ‘Mental health care needs to change if it is to meet the challenges of the twenty-first century. Our Mental Health Act remains a direct descendant of nineteenth-century predecessors. We still see people being placed in long-stay hospitals and nursing homes far from home for mental health treatment’. A review was conducted of the Mental Health Act a while back but it’s unclear what has been planned as a result of the review’s recommendations. Yet another can the government has kicked down the road? Nick O’Shea reckons ‘the NHS is going to need two to three times current capacity to adequately meet and treat the expected increase in mental health problems resulting from the pandemic’. That’s quite some investment.

Worrying yet predictable findings from another report (by Carnegie UK) concern the decline in wellbeing and rise in loneliness in England, which had already been the case pre-pandemic but increased with lockdown. Governments continue to measure success in terms of GDP and the like, but wellbeing and our degree of connection with others are key determinants of quality of life. It’s appalling and it speaks volumes that such data have been so badly delayed – 17 months for Office of National Statistics data on wellbeing compared with 8 months for economic data. 

Within the context of loneliness in adults in England rocketing by 44% during 2020, from 2.6 million to 3.7 million, the charity is proposing a new measure of national progress – Gross Domestic Wellbeing, or GDWe – to measure whether life is getting better or worse. Chief Executive Sarah Davidson makes clear that this isn’t to minimise the importance of economic data: ‘We’re not saying that economic factors are not important, because they are, and the model of wellbeing that we talk about highlights the importance of balancing social, economic, environmental [and] democratic outcomes … In order to properly capture what’s important to people’s lives, you really need to measure all these things…. if we used GDWe instead of GDP growth ‘as the guiding star” for economic policymaking, it would be a major step towards measuring what matters most to people’.

Meanwhile (and the major principle of this blog), trust in government was found to be at an-all time low following a nearly 40% drop from 2018/19 to 2019/20 (from 31% to 19%). There’s a direct relationship between ability to trust our government and our mental wellbeing, this drop leading to the rise in public anxiety.

Following news last week of Boris Johnson’s ‘weird and gimmicky’ crime plan, which involved offenders being made to wear high viz jackets, a ticking off has been delivered in the form of shoe repair firm chief James Timpson’s tweet, which caused a stir: ‘Instead of making offenders wear high viz jackets in chain gangs, how about helping them get a real job instead? In my shops we employ lots of ex-offenders and they wear a shirt and tie. Same people, different approach, a much better outcome’. This is a much more intelligent approach, of course, the Prime Minister’s plan instead appealing to a certain mentality amongst his voters.

‘Since 2008, when he opened a shoe repair workshop in HMP Liverpool (no key-cutting skills were practised), his company has employed more than 1,500 ex-prisoners. Just four have returned to jail. Many of those who turned their backs on crime – including some with drug and alcohol issues – have progressed to senior roles in the company, including a current board member’.

Crucially, he addresses the root causes of crime. As his parents successfully fostered 92 children, many from the care system, he’s well placed to understand how often these children have poor attachment patterns, leading to unmet emotional and educational needs, difficulties trusting others and poor relationships with authority. ‘What are we going to do with people we release from prison? Unless we stop putting offenders down, they will continue to distrust us and carry on down the paths their lives have led them to. Our evidence shows there is another way, which most certainly does not involve showing them up in public’. Quite so, but a problem for governments in addressing this is the polarity we often find between those wanting to prioritise punishment of offenders and those wanting the greater emphasis to be placed on rehabilitation.

Recently the media rightly made an issue of the unprecedentedly high number of drugs deaths in Scotland. What the BBC at least spent less time on was not dissimilar findings for England and Wales. Sky News reported that ‘There were 4,561 deaths related to drug poisoning in England and Wales in 2020, up 3.8% from the previous year and the highest number since records began in 1993….. Two thirds (2,996) deaths were related to drug misuse, while around half (2,263) involved an opiate’. The opioids crisis is another serious issue in this country which has been under-reported in the media. Experts know that the problem has worsened during the pandemic, and while the Office for National Statistics attributes the rise to some concrete causes like people using benzodiazepines besides heroin and morphine, the root causes like despair and poverty can be overlooked.

While the government has set up a new unit to tackle the problem, experts point to the underinvestment and closure of much-needed drug and alcohol services over recent years. Sky quoted Dr Emily Finch, Vice-Chair of the addictions faculty at the Royal College of Psychiatrists: ‘Years of cuts have left addictions services ill-equipped to treat people and prevent these deaths from rising. The government needs to wake up to the fact that cuts to services, disconnecting NHS mental health services from addiction services and shifting the focus away from harm reduction to abstinence-based recovery is destroying lives and fuelling the increase in drug-related deaths’. The perennial question is can government detach itself from short-term sticking plaster measures in order to effectively address this situation?

In case you missed it there was a bit of really life-enhancing tv last week, in the form of actor Richard E Grant’s travels around Italy, referencing books which had demonstrated the country’s impact on the writers. What a great gig to get but well-deserved: Grant comes across as a lovely bloke who has numerous jolly and informative encounters with locals. Two worth watching out for are his experience of the sulphuric lemon drink and his obvious enjoyment of a freshly made Neapolitan pizza, during which his agent reprimanded him on his table manners.

Finally, something else you couldn’t make up… Health Secretary Sajid Javid is one of five and he’s let it be known that his mother always wanted one of her sons to be a doctor. This didn’t happen but now she is apparently delighted that Sajid is finally something ‘in healthcare’! You could say that….

Sunday 1 August

Although the news continues to be dominated by Covid-related issues, there was another stark reminder last Sunday of the climate crisis, parts including London once again experiencing flash floods. We’ve become used to seeing these in other countries but it feels even more alarming when you see for the first time footage of local places under feet of water. It seems at least two local authorities in London don’t have a regular regime of drain inspection and in one borough councillors denied there was a problem despite being sent evidence of blocked drains. No doubt there will be more of this and more media coverage as we approach COP 26 in November.

News yesterday that the Johnsons are expecting their second child (the PM’s 7th or is it 8th?) already has some sceptics wondering what bad news this has been timed to push under the radar, although the news we already have couldn’t get much worse. It seems strange, if not extraordinary, that politicians, media and commentators are mostly pushing the view that Covid cases are declining (based on a very limited time span) when medics yet again feel overwhelmed, conveying quite a different experience. More young people are being admitted to hospital than before and a 34 year old anti-vaxxer died last week. We don’t even yet have the data reflecting the effects of ‘Freedom Day’ and what too many are ignoring is that recorded case numbers aren’t reflecting actual numbers because so many have deleted or disabled the Covid app to avoid its ‘pinging’. Professor Neil Ferguson of Imperial College, London, opined that we’re ‘not out of the woods yet’ (too true, with deaths of 91 and 131 on a couple days last week) and perhaps we will have to go much further into those woods before emerging from them.

Oddly, it was suggested for a while that it wasn’t possible to obtain statistics on the amount of app deletion and disabling but now YouGov has polled it and according to them, 40% of people say they never downloaded it, 34% did but have since disabled it to avoid being pinged and only 22% continue to ‘use it correctly at all times’. This is quite a low figure!

It’s worrying that progress with the vaccination programme has revealed that numerous young people have opted not to be vaccinated when they could be, often not realising that they are at risk of becoming seriously ill and perhaps not grasping the disabling effects of Long Covid. ‘NHS England said one-third of 18- to 29-year-olds had still not had at least one dose of the vaccine – a figure that falls to one in 10 for the whole adult population. While young people are generally at a much lower risk of dying from Covid, doctors say they are increasingly witnessing them become severely unwell. Dr Samantha Batt-Rawden, senior intensive care registrar, said the patients they were seeing were “getting younger and younger”…… ‘The latest data from the Office for National Statistics shows that coronavirus in England is now largely an infection among young adults, with cases in 16- to 24-year-olds almost six times more common than in 50- to 69-year-olds’.

A serious point is why, apart from blatant protection of the government, are so many media sources spreading what could well be false optimism without giving the bigger picture? For example, ‘hospital bed occupancy for coronavirus patients has also increased significantly in the last week, with occupancy of mechanical ventilation beds rising by 31% and other bed occupancy up by 33%’.

The Times conveys the contradictory nature of this debate and speculation about the trajectory of Covid, with some commentators trying to cover all bases. Professor Ferguson said we could be looking mostly at the back of it by October, but cases could well rise, for example when schools re-open in September. At least some sources recognise that the reduction in app use and in testing is contributing to the apparently positive (but possibly misleading) data. ‘Some scientists believe this reflects less testing as schools break up for the summer, while another theory being taken seriously in Whitehall is that a big part of the reduction is because people are avoiding tests in case their summer holiday plans are ruined’.

Following the recent ejection from the Chamber of MP Dawn Butler for calling out the Prime Minister’s serial lying, coupled with the longstanding efforts of journalist Peter Oborne and lawyer Peter Stefanovic, the mainstream media is now finally paying some attention to this mendacity. It was beyond embarrassing this week to see Work and Pensions minister Therese Coffey, interviewed on Sky News by Kay Burley, trying to dismiss such evidence as trivial social media stuff, saying she was ‘proud’ of the Prime Minister and that he was doing ‘a great job… leading from the front’- manifestly what he is not doing. But an equally serious issue is how helpless this can make us feel, when such behaviour is not called to account even in the House of Commons. One tweeter said: ‘Our political system can’t cope with a Johnson. His misdemeanours are so numerous, his lies so incessant, his morals so non-existent, his incompetence so gobsmacking, his chutzpah so breathtaking, the system has no answer. He goes ploughing on. We spectate – powerless’.

If it wasn’t so serious you could almost feel sorry for these ministers, one after another having to submit themselves to media interviews (as their boss won’t) during which they have to defend the indefensible, or, in the case of Foreign Secretary Dominic Raab and Transport Minister Grant Shapps, misrepresent the government’s kneejerk and defensive policy switches as part of a carefully laid plan. It shows how desperate the government has become about the lack of tourists and their spending power that they’ve suddenly agreed that double jabbed visitors from the US and EU no longer have to quarantine, but the exclusion of France from this arrangement, allegedly due to their Delta variant prevalence, is a shameless projection of the UK’s situation.

But despite at least some now being away on holiday, a number of ministers have been in the news this week because of intractable situations they’ve done little to effectively address, for example the significant increase in migrants, demands for more former Afghan interpreters at threat from the Taliban to be allowed to settle here and the ‘advice’ for Latin to be on state schools’ curricula, allegedly to tackle elitism. Insufficient desire to resolve these situations and lack of brainpower to do so are only going to increase public anxiety further when confidence in the government has long been in marked decline. One tweeter summed up the views of many: ‘The police have no confidence in Patel; the teaching profession regards Williamson with contempt; Javid is a disaster zone for health workers; Dowden has left the highly successful creative industries in a state of despair; and Johnson is an embarrassment to all and sundry’. The latest example must be his antics at the unveiling at the memorial for fallen police officers, when he showed himself incapable of managing an umbrella. Several video versions of this have gone viral and Prince Charles could be seen joining in with the general amusement, though this was clearly an occasion warranting some gravitas from our Prime Minister.

Details have recently emerged of what many must have suspected for some time, that is, quite apart from regular lobbying, government policy is being influenced by a select group of Tory donors. One tweeter described The Financial Times piece about this as ‘Great article showing how this government is rotten to the core and reliant on money from anywhere. Cash for policy is not democracy it is autocratic and corrupt’. Lawyer and Good Law Project founder Jolyon Maugham tweeted: ‘There’s a rather charming frankness about the Tories’ decision to call the fantastically wealthy donors who give vast sums to push their personal agendas an Advisory Board’.

‘The club, some of whose members have given at least £250,000 to the party, has been developed by Ben Elliot, Tory co-chair, as a means of connecting major Conservative backers with its top figures. The club does not appear in party literature but Conservative officials confirmed the Advisory Board “occasionally” meets with Johnson and Sunak “for an update on the political landscape”.

Wouldn’t you just know that the Conservative Party denies the existence of this ‘250 club’?

‘Government policy is in no way influenced by the donations the party receives, they are entirely separate. Donations to the Conservative party are properly and transparently declared to the Electoral Commission, published by them, and fully comply with the law. Fundraising is a legitimate part of the democratic process’. Maybe not this kind of fundraising, though.

The Week summarises an article from US magazine The Atlantic about the enigma who is Boris Johnson, revealing the different sides of his character lurking beneath the superficial bonhomie. ‘Johnson is unlike other prime ministers I’ve covered’, said author Tom McTague…contrasting him first with Blair and Cameron (‘polished and formidable’), then with Brown and May (‘rigid, fearful, cautious’), he says Johnson is ‘scruffy, impulsive, exuberant – the first British leader I’ve seen who genuinely seems to be having a good time’. At our expense, perhaps? McTague details ‘his ambition, his outrages, his scandals’ over the years, saying that what ‘drives opponents mad’ is that nothing ever seems to stick. The most recent revelations of mendacity would appear to prove this. During a conversation about John le Carre’s views on ‘England’s failing ruling class’, he more or less admitted to being a cynic as well as a romantic, being determined to ‘squeeze out’ ‘world-weariness’ within the government and re-energise it with ‘some of the energy and optimism that this country used to have’.

This sounds alarmingly simplistic: it’s not without merit but ‘energy and optimism’ need to have firm foundations, some track record and surely can’t be achieved simply by jollying people along. It’s probably no understatement to suggest that for many, Brexit knocked the stuffing out of the country. The article emphasises what appears to be his unrealistic optimism, his close aides concerned that he’s too reliant on faith that things will be fine. ‘The duality of his character continued to fascinate me. There is the light and the colour he wants the world to see. But there is also a darker side that most who know him acknowledge, the moments of introspection and calculation’.

Shortly after the unveiling of Boris Johnson’s rather simplistic-sounding Beating Crime Plan (for England and Wales), it’s timely though arguably strange that a police review has been announced which will explore the reasons for the rise in the teenage murder rate. ‘Every government agency involved in the victim’s life – health services, local authorities, children’s services, probation, and even voluntary groups – will contribute to an examination of what went wrong and consider how to identify the signs of a life at risk. Police hope to see patterns that will help to prevent future murders. If the pilot scheme is successful, it will be introduced across England and Wales’. While the cross-sectoral approach in this review sounds promising, it’s surely way overdue: so far this year 22 teens have been murdered, compared with 14 in 2020. While it’s clear to authorities that Covid restrictions, lockdowns and the drugs trade have contributed, partly because gangs have targeted pupils out of school, it’s surely a significant factor that so many youth clubs have closed. Apparently, between 2010 and 2019 (coinciding with Conservative governments) 760 youth clubs closed in England and Wales, related to councils’ expenditure on youth services declining by 70%. While these places cannot be a panacea, they’ve provided much-needed structure and opportunities for personal development and friendships that won’t be available to all of these young people at home.

Some good news for the NHS this week must be that Baroness Dido Harding, who has presided over the massive Test and Trace shambles, didn’t get the Chief Executive job. ‘Lord Stevens of Birmingham’s deputy is to replace him as head of NHS England in a decision that signals continuity as the health service attempts to recover from the pandemic. Amanda Pritchard was confirmed as NHS chief executive yesterday after a protracted recruitment process that was overshadowed by rows over the candidacy of Baroness Harding of Winscombe, the former head of Test and Trace’. Pritchard has over 20 years experience in the NHS and apparently knows her way around Whitehall, but the fact that two very corporate candidates were seriously considered for the job would yet again indicate the government’s privatisation intentions. On a related issue, Stevens does sound worthy of a peerage but how many more peers can be created when numbers already exceed those of MPs? ‘He became a crossbench peer three weeks ago and is expected to become a prominent advocate for social care reform and related issues’.

As an aside, the efforts of former Health Secretary Matt Hancock to rehabilitate himself were dealt a blow last week when Newmarket Town Council passed a vote of no confidence in him. ‘The full motion said: “Newmarket Town Council states its concerns that the West Suffolk MP Matthew Hancock neglected the best interests of his constituency. As secretary of state for health he has demonstrated hypocrisy and hubris in the pursuit of his own interests. Newmarket Town Council states that we no longer have confidence in Matthew Hancock MP representing Newmarket’. Although this motion only passed because the Mayor used his casting vote and the local constituency party is still backing Hancock, such a judgement won’t help him.

Worrying news about the NHS, though, is the crisis in primary care, with GP practices groaning under their workloads while staff shortages undermine patient care further. Many have experienced the effects of this, for example their GP practice perhaps going into special measures, the difficulty of getting to see the doctor in person because of the massive move to virtual and telephone consultations and the knock-on effects these have for onward referrals. ‘Doctors are warning that general practice clinics risk cracking under the pressure of “unsustainable” workloads unless the government ramps up the recruitment of medical staff and takes steps to reduce burnout. The Royal College of GPs is calling on the government to introduce an emergency rescue package to shore up general practice clinics after the pandemic, including recruiting 6,000 more GPs and 26,000 additional support staff, such as nurses and receptionists, by 2024 as well as reducing paperwork and investing in £1bn worth of improvements to infrastructure and technology. Without these changes, patients will not receive the care they need, the college said’.

The ‘rising and ageing population’ is thought to be the main reason for the rise in consultations but perhaps the after-effects of Covid are adding to this as well, not to mention issues patients didn’t feel able to consult their doctor about during lockdowns and restrictions. Over the last 5 years the number of qualified GPs in England has apparently declined by 4.5% and it’s shocking that many are considering leaving the profession because of stress and burnout. Needless to say, a Department of Health and Social Care spokesman detailed all the investment the government is apparently putting in, but also falls back on that old bribing chestnut of saying how ‘incredibly grateful’ the government is ‘for the tireless efforts of GPs’, when gratitude isn’t going to do the business.

Following the controversial news last week that Unesco was removing World Heritage Site status from Liverpool because of ongoing waterside development, it’s good news that this status is now being granted to Snowdonia’s slate landscape. ‘The landscape in Snowdonia National Park became the world leader for the production and export of slate during the 18th century, when the industrial revolution saw demand for slate surge. The industry had a considerable impact on global architecture and urbanisation in Europe and North America, with Welsh slate used on buildings, terraces and palaces across the globe. According to Unesco, the status was awarded in recognition of the region’s 1,800-year history of slate mining, its people and culture, and its role in “roofing the nineteenth-century world”…. The region is the UK’s 32nd World Heritage Site and the fourth in Wales, following the Pontcysyllte Aqueduct, Blaenavon industrial landscape and the castles and town walls of King Edward in Gwynedd’. We hear that Boris Johnson backed the bid – how long before he claims credit for it, we could ask ourselves.

It’s worrying, though, that several UK sites are under threat of having this status removed, including Stonehenge, the Lake District, Devon and Cornwall, Edinburgh and Westminster, the urban ones being related to what are felt to be inappropriate developments threatening to dwarf the skyline. Some commentators have been critical of Unesco’s decision making, citing the need for regeneration and other social issues – perhaps in Unesco’s eyes these aren’t reconcilable with recognising key heritage sites.

Last week saw the publication of this year’s Booker Prize long list, in which the latest novel by Rachel Cusk was thought to stand out. ‘Mercilessly anatomising privilege, creativity and ambition, male-female relationships and lockdowns Covid-driven and emotional, Cusk is brutally funny and honest about shame, ego and our sense of self. The novel is truly one of a kind’. It does sound a very interesting list of contenders but I do hope the judges avoid the temptation often given into that the winner should be unreadable by anyone except academics and critics.

Finally, in the current circumstances of needing to adapt our ways of greeting others, it seems to me another book would be well worth reading. The handshake: a gripping history, by ‘evolutionary biologist Ella Al-Shamahi’, focuses on how the shaking of hands has persisted over years despite attempts to ban it during previous pandemics. She reckons that since chimps and uncontacted tribes of humans have similar gestures, we could be genetically hard-wired to shake, ‘perhaps to deliver things like smell-related chemosignals to each other’. Although people don’t often seem to expect women to shake hands, I’ve always liked it and regarded it as very civilised, with the exception of the wet haddock hand shake most of us will have experienced at some point. I hope the other kind persists despite this pandemic!  

Sunday 25 July

Yes, I seem to say this most weeks but you really couldn’t make up what happened last weekend. On the cusp of the much trumpeted Freedom Day, the Health Secretary tested positive and the PM and Chancellor were told to self-isolate, taking out at one fell swoop three key government figures. ‘Beyond satire,’ as one commentator put it, but, for a while, it was suggested that a special scheme would enable Johnson and Sunak to continue with their duties in Downing Street, before an absolute outcry about one rule for them, one for the rest of us forced a humiliating u-turn just hours later. But not before Boris Johnson had hightailed it to the much more comfortable setting of Chequers, thereby breaking more rules. While Housing minister Robert Jenrick said this scheme had been set up last December, it was odd no one had heard anything about it and claims that Transport for London were participants were immediately rebutted by TfL.

Actor and director David Schneider tweeted: ‘It’s almost like they know millions self-isolating undermines their countrycidal “Freedom Day”. So by not self-isolating themselves they push everyone else not to do it. £37bn on Test & Trace and now they’re making sure it’s ignored. We’ll be back in lockdown in weeks’. Palliative care doctor and broadcaster Rachel Clarke outed the PM’s ‘explanatory tweet’, which had read ‘Like so many people I’ve been pinged by NHS Test and Trace as I have been in contact with someone with COVID-19, and I will be self-isolating until Monday’ by saying ‘Unlike so many people, you had to be publicly shamed before you did the decent thing’. On Monday there was a car crash interview with Vaccines Minister Nadhim Zahawi on Radio 4’s Today, during which the minister tried to suggest that the PM proactively did the right thing instead of being shamed into the U turn.

What a different experience for Boris Johnson from the one most of us will have – Chequers reportedly has splendid leisure facilities and an excellent wine cellar, not to mention those lovely grounds and the surrounding countryside. What’s surely way overdue is a tv documentary about Chequers: it would be most informative.

It was noticeable during the week that there was even less compliance than usual with the mask wearing requirement on public transport, around here at least. Apparently transport staff unions won’t be enforcing it and just to take one Underground carriage as an example, just one individual was wearing a mask correctly. The other passengers had no mask (or put it into their bag when boarding the train) or were wearing it under their nose or around their throat. I’ve also observed several times people not wearing a mask on the train but putting it on to exit the station, clearly when there’s a likelihood of more officialdom. Interestingly, the public being once more ahead of the government, The Week describes public polling suggesting that two thirds think masks, distancing and travel limits should have continued for another month and ‘a sizeable minority’ want freedoms restricted permanently. One in four of us even want nightclubs closed for good and two in ten want a permanent 10 pm curfew.

Again, the government narrative makes itself apparent, creating a false polarity between restrictions and a total lack of them, ‘living with the virus’ being taken to mean just allowing it to take over. In a letter to the Observer, all four of the UK’s independent public health bodies warned: “Living with Covid-19 is not the same thing as letting it rip. We should proceed carefully, not recklessly … The government must promote effective public health measures because personal responsibility will not be enough’. This is certainly true – we’ve seen plenty of evidence that many aren’t capable of using their ‘common sense’, if they have any in the first place.

The extra time being holed up at Chequers will afford Boris Johnson extra time to deliberate his hubristic legacy, since we’re told he wants to ‘echo Blair’s promise of an ‘opportunity society’ and energise those who feel left behind’. A source sounding as if hailing from a parallel universe disclosed the comparison of ‘levelling up’ with Blair’s programme: ‘We’re going to do the thing that Tony Blair failed to do for the people who voted for him. We’re going to energise the towns and regions that feel left behind: we’re going to reach out to those places and improve people’s life chances’. How on earth do they think they’re going to do that, since Red Wall voters are already beginning to see the light about the Emperor’s lack of clothing and in any case ‘levelling up’ has proved to be vacuous waffle? ‘Johnson’s biographer, Andrew Gimson, told Politico’s Playbook on Friday that as Johnson celebrates two years in power this weekend, “he’ll be pretty pleased because he’s a bit like Tony Blair, oddly enough, with the wider public. He’s having an unnaturally prolonged honeymoon. He’s high in the polls and the Labour party have got terrible difficulties at the moment. I think Boris Johnson will think to himself: ‘This is just the start – if I play my cards right, then I can win three more elections’’’. We could well ask why there’s been no evidence of his ‘opportunity society’ after 11 years of Conservative government and Johnson has led the party for two years.

Meanwhile, who is running the country while Covid cases rise rapidly (on Tuesday 46,558 new cases and 96 more deaths were recorded, the highest number of fatalities since March), the frequency of Covid app pinging has resulted in staff shortages  and cross-party work found a significant decline in analysis of red list country arrivals’ positive tests for variants? ‘The analysis of NHS test and trace data was carried out by the House of Commons library, commissioned by the chair of the all-party parliamentary group (APPG) on Coronavirus, Layla Moran’.

Various industries are pressing the government to urgently review the way the Covid app works, as it’s been shown to often ‘ping’ people unnecessarily and staff shortages across the economy, especially transport, are having a serious impact. A news bulletin today suggested that without urgent action in the distribution and retail sectors, the supply chain would break down within two of three weeks. The system will change on August 16, when the double jabbed will no longer be expected to self-isolate when pinged (an advisory system, as opposed to the Test and Trace phone calls, which confer a legal requirement to isolate), and new adjustments to allow some key workers to continue have been criticised for their longwinded procedures. ‘The government has said supermarket depot workers and food manufacturers will be exempt from the ten-day self-isolation rule if pinged by the Covid app or contacted by a Test and Trace official, regardless of vaccination status. Instead they will do daily Covid testing and can carry on working if they test negative’.

Up to 10,000 workers are expected to qualify for the scheme across 500 key sites. The measures have started at 15 supermarket depots, to be followed by 150 depots this coming week. As ever, we can sense the government’s reluctance to properly take responsibility for a difficult situation as they go off on holiday, but this latest abdication will further raise public anxiety. They seem repeatedly to demonstrate poor capacity for nuanced thinking, resorting to blunt instruments and one-size-fits-all approaches, which prove unhelpful. The daftest example must be the plans to introduce Covid passports for nightclubs and other venues in September, a good example of trying to close the stable door once the horse has bolted.

 As if all this wasn’t enough, Health Secretary Sajid Javid was lambasted this morning for an ‘insensitive’ tweet in which he’d appeared to boast about recovering from Covid within 8 days, advising that people shouldn’t ‘cower’ before the virus. Notice that government narrative again? If you’re being careful given the premature ending of restrictions you’re somehow being cowardly. Hours later he was forced to remove the post and apologise but he can’t undo this so easily: ‘I’ve deleted a tweet which used the word “cower”. I was expressing gratitude that the vaccines help us fight back as a society, but it was a poor choice of word and I sincerely apologise. Like many, I have lost loved ones to this awful virus and would never minimise its impact’. Even this could be seen as a non-apology as it resorts again to government narrative – ‘we’re all in this together’ (‘Like many, I have lost loved ones’). One of the main organisations to complain was the Covid-19 Bereaved Families for Justice group. Co-founder Jo Goodman said earlier that the ‘flippancy and carelessness’ of Mr Javid’s comment had ‘caused deep hurt and further muddied the waters of the government’s dangerously mixed messaging’. As one tweeter put it: ‘I am not in a position to delete tweets due to poor choice of words. A health minister who cannot consider impact of choice of words until some time after tweeting perhaps needs to consider if twitter is an appropriate medium for communicating re serious issues’.

Meanwhile, numerous commentators point out the trivialisation of the pandemic by alluding to the ‘pingdemic’, which proves the app is actually doing its job, albeit perhaps too effectively in some instances. Observed one tweeter: ‘The pinging problem is being framed in terms of the sensitivity of the app. The real problem is the number of infections’. Anecdotally (crazy that the government can’t supply statistics on this) it seems many are disabling the app because they don’t want to be pinged, so an unsatisfactory situation all round.

The government continues to get it in the neck from various critics, including Sage member Sir Jeremy Farrar, who runs the Wellcome Trust. ‘Boris Johnson’s failure to start a public inquiry into Covid this year is a disgrace that is all about “political manoeuvring” to protect his reputation, according to a leading scientific adviser to the government. The comments from Sir Jeremy Farrar came in the third extract from his book Spike – The Virus vs The People: The Inside Story, where he claims that Johnson’s pledge to wait until 2022 to start the inquiry into what happened with the management of the pandemic is for “no reason other than political manoeuvring”. Farrar’s latest comments come after he revealed that he nearly stepped down as a member of Sage over Johnson’s decision not to lock down the UK last autumn’. Sir Jeremy is highly critical of Boris Johnson’s lack of strategic thinking at the start of the pandemic (although surely this has been the case throughout) and reckons what we need is ‘hard-nosed independent assessments of political and structural capability’, not a likely outcome of anything the government controls.

Another regular critic, of course, is the Guardian’s Polly Toynbee, who also reveals in this piece that, not for the first time, some NHS trusts have been gagged so the public doesn’t get to hear how bad things are. So much for ‘not overwhelming’ the NHS. ‘The prime minister had planned a Churchill-style speech. But his U-turn reveals the true cost of his Covid bungling. ‘Please, please, please be careful’, Boris Johnson urged in full U-turn, but that’s not what his lot practise. His “irreversible” pledge has vanished because, right here and now, disaster has already struck an exhausted NHS all over again.

But so as not to spoil freedom day, the public was not supposed to know about it. The Health Service Journal reports that three NHS chief executives have been banned from speaking to the media about the “unsustainable pressure” their hospitals are facing, and banned from commenting on the reckless removal of masks, social distancing and indoor gathering limits’. Citing the example of the Health Secretary testing positive and who had recently visited a care home and had attended Cabinet meetings, she points out what at least some ministers don’t grasp, that there’s no invincibility however much the rules are bent: ‘That’s the story: the virus is everywhere, disease-inducing and still deadly to VIPs and little people alike…. Boris Johnson’s “Do what I say, not what I do” freedom day won’t be remembered for Churchillian declarations, but for foolish boasting, toxic politics, and calamitous health policy misjudgement’.

But the news making most impact this week must be Dominic Cumming’s latest silo in the form of the documentary on BBC2, which featured him being interviewed by the BBC’s political editor Laura Kuenssberg. Coming over as supremely arrogant and Machiavellian, it was nevertheless telling that when she asked ‘How do you see yourself?’, he had to ask what she meant. Of numerous revelations, one of the most damaging must be the one in which Boris Johnson appeared to refuse an autumn lockdown because those at risk of death were only those in their 80s. Or it could be the one where he had to be dissuaded from visiting the Queen, although Downing Street denies this, or was it the one where Johnson said the Telegraph was his boss? The most humiliating suggestion must have been that ‘Boris Johnson’s closest aides decided he was unfit to be prime minister within weeks of his 2019 election victory and began plotting to oust him’. Downing Street can deny away because, despite the obvious faults and curious amorality of Cummings, his description of events rings too true to be dismissed, as with his previous revelations. Will Cummings keep them coming till he engineers Johnson’s defenestration, as he did with Matt Hancock? Hell hath no fury like an adviser scorned.

The BBC produced a useful piece about this interview called Dominic Cummings: eight takeaways from his interview, the eighth concerning his alleged ease with criticism. ‘Portraying himself as someone who wanted to reform government and was opposed by the “establishment”, Mr Cummings says he wasn’t afraid to upset people to get things done. People thought of him “generally as a nightmare”, he said. ‘If you are airing big difficult things, it’s going to be upsetting for a lot of people… A lot of people have a pop at me, but you don’t see me crying about it’. I suspect he would see being considered ‘a nightmare’ as a badge of honour.

If we needed any further proof that many government ‘inquiries’ these days are whitewashes, the Greensill inquiry outcome will supply it. Although it concluded that David Cameron showed ‘significant lack of judgement’, it didn’t find him guilty of breaking any rules, demonstrating the weakness of those very rules rather than Cameron’s exoneration. To be fair, the report did suggest that the rules needed strengthening, but we have to ask why chairman Nigel Boardman was allowed to get away with consistently refusing evidence from Lady (Suzanne) Heywood, the widow of former Cabinet Secretary Jeremy Heywood, who feels that her husband has been scapegoated by this inquiry. The inquiry said Lord Heywood had failed to fully consider conflicts of interest over a government role for the financier Lex Greensill, but Lady Heywood said there had been insufficient scrutiny of ministers who signed off the Greensill appointment. ‘In a statement after the report’s release, Lady Heywood described the report as ‘nothing less than a travesty….His absence is being exploited to distort the facts of a decade ago and divert attention from the current government’s embarrassment at the collapse of Greensill Capital long after Jeremy’s death’. Not surprisingly, a Cabinet Office spokesman said the inquiry had been a fair process, that they had listened to Lady Heywood’s concerns, and that they would respond ‘in due course’.

Another clear example of faulty procedure is the ejection from the Chamber on Thursday of Brent MP Dawn Butler, for outing Boris Johnson as a liar. There’s been no end of evidence for this assertion but the old parliamentary rule disallows calling a member a liar even if they manifestly are. It’s an absurd anachronism that you can be ejected for calling someone a liar but not for lying in the first place. In Byline Times Hardeep Matharu argues that Butler’s removal exposes the structural failings at the heart of the British state. This is a key point and I believe the Speaker is very much at fault in this: ‘Johnson has not been required to correct the record in the Commons over his many misleading statements – which have been catalogued by the journalist Peter Oborne and others – and is hardly ever robustly challenged by the Speaker when he repeats them weekly in Prime Minister’s Questions… There is nothing to compel Johnson to demand greater accountability of his ministers or to offer greater responsibility himself. As the Ministerial Code – a guide rather than a guard-rail – states: “Ministers who knowingly mislead Parliament will be expected to offer their resignation to the Prime Minister.” It makes no mention of to whom Prime Ministers who knowingly mislead Parliament should present themselves’. Matharu makes the key point that besides the current procedures not being fit for purpose, the government isn’t being held to account by a robust media, especially since BBC governance has been packed with those with links to the Conservative Party. All of this can make us feel rather disempowered.

Yet again NHS mental health services have been in the news, with further evidence, if any was needed, of the deficits which have caused pain and distress to many. An area of acute need is eating disorders, with deaths and suicides amongst young people having resulted from service inadequacies and the continual raising of the bar allowing someone to even qualify for treatment. For some time it’s been very difficult to even ‘qualify’ for a place on the CAMHS (Child and Adolescent Mental Health Service) waiting list. Across the whole of mental health, the most recent statistics showed that ‘up to half of all children and teenagers referred to mental health, learning disability and autism services in the run-up to the pandemic were left without proper support, with parents telling the Observer of children waiting years for treatment and a seven-year-old girl denied support as she was not suicidal’. It’s an appalling situation that parents have to prove their child is suicidal before help can be considered, and not always then. Following her own ‘horrendous’ experience, one parent last week ‘posted on Facebook asking for people’s experiences of CAMHS and got 500 responses within a day. Parents described years of waiting for help, with many saying CAMHS refused to help unless their child was suicidal’. Not surprisingly, ‘he pandemic has seen a rise in demand for young people’s mental health services. It was revealed last week that referrals rose by a third in 2020-21 compared to 2019-20. Mental health minister Nadine Dorries recently tweeted that “we lead the world in the delivery of [mental health] services” and “we are not in the middle of a MH crisis” after a deluge of parents described their negative experiences of CAMHS’.

Nadine Dorries, not unlike most NHS spokesmen, is severely in denial here, as it’s well known that there’s been serious underinvestment in mental health services for years. One of the most galling misrepresentations was when she tried to suggest in the House of Commons that some service issues were caused by ‘lack of people coming through’ (to work in mental health, when there are thousands of qualified and skilled counsellors and therapists not recruited by the NHS. We find many not benefiting from cheap options like apps and computerised Cognitive Behaviour Therapy: what they want and need is relational work during which their difficulties are explored and understood rather than quick fixes being foisted upon them which don’t work long term anyway.

Last week Liverpool received the unwelcome news that, after several warnings, it was going to lose its UNESCO listing as a World Heritage site, because of what the United Nations agency considers unacceptable waterside development. Liverpool officials are fighting back, regional mayor Steve Rotherham saying that ‘places like Liverpool should not be faced with the binary choice between maintaining heritage status or regenerating left-behind communities and the wealth of jobs and opportunities that come with it’. Others have found it shaming, though, because only two other sites have lost this status since the scheme started in 1978: Oman’s Arabian Oryx Sanctuary in 2007 and the Dresden Elbe Valley in Germany in 2009. It seems there is no appeal process so Liverpool will have to live with this and see to what extent it will dent tourism.

Finally, good news about museums: the Art Fund’s Museum of the Year shortlist rightly focuses on institutions which have focused on their local communities during the pandemic. ‘The Art Fund museum of the year prize is the world’s biggest museum prize, with the winner receiving £100,000. The five shortlisted museums were named on Wednesday: the Centre for Contemporary Art (CCA) in Derry, Experience Barnsley, Firstsite in Colchester, the Thackray Museum of Medicine in Leeds and Timespan in Helmsdale, a village on the east coast of the Scottish Highlands’. In recent years the competition has helpfully focused on smaller museums rather than large, national museums – it makes sense as those institutions already benefit from other funds. The competition also usefully alerts us to museums we may not previously have heard of. The winner will be announced on 20 September.