The politician and former chancellor chooses five favourite books. He will be speaking about his book “Can We Be Great Again?” at the St Andrew’s Book Festival in London on 25 November.

Peak Human

Johan Norberg, 2025

If you’re worried that Western civilisation and democracy is in decline, this is for you – in fact, it’s the best book I have read this year. Johan Norberg looks at civilisations from Athens to the Anglosphere, and traces the reasons for their rise and fall. His conclusion: all is not lost.

Super Agers

Eric Topol, 2025

Eric Topol is my favourite American doctor, and has given me superb advice on many occasions. His latest book looks scientifically at all the diseases that cause ageing, from heart disease to cancer to dementia – and exactly what the latest clinical trials say works and does not work. For someone like me who is turning 60 next year, it was unputdownable!

Broken Threads

Mishal Husain, 2024

Not every broadcaster can write – but Mishal Husain certainly can. This is a beautiful account of the impact of partition in India on both branches of her family, setting their painstakingly researched stories against the backdrop of deep historical currents.

How Countries Go Broke

Ray Dalio, 2025

A book about something no one wants to talk about, but should: our looming debt crisis. In surprisingly readable prose, Ray Dalio explains why we should all be terrified of what is around the corner. As someone who has made his billions building up the world’s largest hedge fund, he knows his stuff.

The Optimist

Keach Hagey, 2025

Finally, a book on the forthcoming AI revolution. A biography of Sam Altman, founder of OpenAI, the company that gave us ChatGPT, which has become something of an addiction for me (try asking it your life expectancy). Worth reading for a window on where we are going, through the eyes of one of the most powerful people in the world.

Titles in print are available from The Week Bookshop

Thursday's "night of political drama" will begin when the exit poll is published at 10pm, said Tim Glanfield in The Sunday Times. 

This poll is only a sample of voters from 150 constituencies across the UK, but usually provides a pretty accurate picture of how each party has performed. 

The first of 650 constituencies to declare will be Sunderland, a safe Labour seat where a result is due by 11.30pm. By 2am, about 50 more will have been declared – many also safe Labour seats in northern urban areas.

The seats to keep an eye on

Watch the bellweather seat of Nuneaton: the party that wins here has gone on to govern after every election except one since 1983. In Rochdale, we'll see if George Galloway holds the seat he won in February's by-election.

"The excitement will really ramp up" from 3am, when several Tory "big beasts" will discover their fates, said Dominic Penna and Rachel Slater in The Daily Telegraph. They include Chancellor Jeremy Hunt, who is at risk of losing to the Lib Dems – as are ministers Alex Chalk and Gillian Keegan. Others, such as Grant Shapps, Iain Duncan Smith, Jacob Rees-Mogg, and leadership hopeful Penny Mordaunt are at risk of losing to Labour.

The final election results

Sunak's constituency will be declared at about 4am – some polls suggest that even he could slump to a historic defeat.

There are pitfalls for Labour too, said Robert Ford in The Observer. Jeremy Corbyn is challenging his old party in Islington North, a seat he has held for 40 years; shadow culture secretary Thangam Debbonaire's Bristol Central seat is a target for the Greens. Both of those results will be in by 4am, when we'll also find out whether Reform UK's Nigel Farage has won in Clacton, to become an MP at his eighth attempt, said Jamie Grierson in The Guardian.

By 7am, any remaining seats will have been declared – and whoever is set to lead the next government will be preparing to address the nation.

The economy is "returning to full health for the first time since the pandemic", Chancellor Jeremy Hunt declared last week as latest figures revealed the fastest rate of economic growth in two years. 

According to the Office for National Statistics (ONS), the UK economy grew by 0.6% in the first quarter of 2024, outstripping forecasts by the Bank of England and representing the strongest growth for any G7 country, with the eurozone lagging behind on 0.3% and the US on 0.4%.

But while the UK has emerged from the mild recession that began at the end of last year, triumphant noises from the government have been met with "a mixture of resignation, laughter and annoyance" from a public still feeling the pinch from the cost-of-living crisis and high inflation, said BBC economics editor Faisal Islam.

What did the commentators say?

Paraphrasing Australia's former prime minister Paul Keating, ONS chief economist Grant Fitzner said latest data shows the UK economy is "going gangbusters".

In one sense, he is right, said Ed Conway, economics and data editor at Sky News. An economic growth rate of 0.6% is near enough to what economists used to call "trend growth" and "signifies the economy growing at more or less 'normal' rates".

"And normality is precisely the thing the government wants us to believe we've returned to."

Adding to the positive growth figures, inflation is expected to hit the Bank of England's target of 2% this month. Hopes are growing that interest rates could start to fall as soon as next month, after BoE governor Andrew Bailey said that "we're now getting back to more normal times". UK wage growth has also remained strong in the first quarter of the year – rising by 2.4% – even as the employment rate continues to rise.

All this suggests Britain has "turned a corner", said Reaction, "but there is an important caveat". When measured per head, GDP is still 0.7% lower than a year ago. This "arguably more accurate measure of the country's economic well-being – which takes account of the UK's considerable population growth – helps to explain why many Brits won't be feeling much better off despite this seemingly sunny economic news".

It is also a question of context, said Conway, because while this latest set of GDP figures is "undoubtedly positive, the numbers that came before are undoubtedly grim".

GDP per head is considerably lower, in real terms, than in 2022, before Liz Truss's disastrous mini-budget, and than before the pandemic hit and the country last went to the polls in 2019.

What next?

Rishi Sunak's "hopes of pulling off the greatest comeback in British political history rely on him being able to convince voters that the economy is turning a corner and that Britain’s economic prospects are improving" said The Times. "Labour's economic narrative relies on the polar opposite – hammering home the idea that the Tories have trashed the economy over the past 14 years and left them significantly worse off."

Shadow chancellor Rachel Reeves appeared to anticipate this changing economic narrative in a speech last week in which she said the Tories were "gaslighting" the British people by claiming things were getting better when many families were still struggling.

"They do not speak to the economic reality," she said. "All they hear is a government that is deluded and out of touch with realities on the ground."

Recent polling bears this out. Only 15% of voters surveyed by The Times thought the economy was in a better place than it was 12 months ago, while 53% said it had got worse.

In truth, the "narrative doesn't comfortably, convincingly suit either party", said Kate Andrews in The Telegraph.

Sunak will be "aware that any attempt to over-sell this will open his party up to political attack" while many voters will feel it is "too little, too late". As for Labour, while there is "no guarantee that the UK will continue on its upward swing", even bad economic news puts the party on "shaky territory".

There was plenty in Chancellor Jeremy Hunt's Spring Budget this week to woo voters ahead of an expected general election later this year, but what difference will it actually make to your finances?

Hunt's latest fiscal update was labelled a "Budget for long-term growth" by the Government. And it included several key policies focused on growing the economy after it entered a recession at the end of last year.

Headline announcements included a 2p cut in National Insurance and changes to high-income child benefit charge thresholds, but the Budget "has the potential to affect us all", said NerdWallet.

However, it may not all be positive, said columnist Henry Mance in the Financial Times, as the government's "fiscal drag act" – the freezing of tax thresholds – means "more income will keep getting caught in higher tax brackets".

Here is how the Budget could hit your wallet.

Workers

Employee National Insurance (NI) contributions will be cut by 2p from 10% to 8% in April, having already fallen from 12% to 10% in January. So the average worker earning £35,400 a year will be more than £900 better off this year, according to the Treasury.

Additionally, the chancellor announced a further 2p cut to Class 4 NI for the self-employed to 6%, after it was reduced to 8% in the Autumn Statement. The Treasury said this would save the average worker £650 compared with last year.

These cuts will "boost take-home pay", said This Is Money, but it won't help those above state pension age as they typically don't pay NI.

Additionally, income tax thresholds have been frozen until at least 2028, the BBC highlighted, so "any kind of pay rise could drag you into a higher tax bracket, or will see a greater proportion of your income taxed than would otherwise be expected".

The Institute for Fiscal Studies estimated that the combination of the NI cuts and threshold freezes since 2021 mean only those on £26,000 to £60,000 a year are really better off.

Investors

Hunt has unveiled plans to boost investment in UK stocks with the launch of a new British ISA. It provides a "dedicated tax-free individual savings account (Isa) allowance" of £5,000 to back UK shares, said Investors’ Chronicle, to "entice investors to allocate more to UK stocks". This is on top of the existing £20,000 annual ISA allowance and will be consulted on.

However, the British ISA has received a mixed reception. The product "seems a good way to think about UK equity opportunities", said Ollie Smith on the Morningstar website, but it is already possible to back these types of stocks in the tax wrapper and many other types of ISA already exist so "further iterations of exactly the same thing amount to nothing more than tinkering".

Some savers may have preferred an overall increase to the annual ISA allowance, said MoneyWeek, and a separate product could "add to the complexity" and "result in a lower take up".

Parents

Hunt "finally bowed to pressure", said The Guardian, on the high-income child benefit charge (HICBC). 

Currently, if one parent in a family earns above £50,000 per year, they have to pay 1% of the amount back. This created "unfairness", said MoneySavingExpert, where a couple earning £49,000 each could get the full benefit but a family where one person or a single parent earning £60,000 or over would see the money clawed back.

Instead, the chancellor said the HICBC will be "administered on a household rather than an individual basis by April 2026" and in the meantime the threshold will rise to £60,000 from April and the level at which it needs to be fully repaid will increase to £80,000. This could mean 485,000 families gain an average of £1,260, the Treasury said.

Landlords

The chancellor also unveiled plans to make it "easier for local people to find a home in their community" with a clampdown on holiday lets.

He said he would raise £245 million per year by scrapping the furnished holiday lettings regime from April 2025, which previously let landlords claim full mortgage interest relief and pay lower capital gains tax when they sell.

The move will save the Treasury money and "ease the housing crisis" in popular holiday destinations such as Cornwall and the Lake District, said the Mirror, where locals struggle to get on the property ladder.

Landlords aren't impressed, though. Writing in The Telegraph, the Secret Landlord said the move will risk tourism jobs and force property investors to sell, while "it's doubtful they'll be bought by local people". Instead, it means the government will "crucify anybody who owns a private property who intends to make any money from anything to do with it".

If more landlords do want to sell their properties, said MoneyWeek, Hunt has at least said he will cut the higher rate of capital gains tax on additional property sales from 28% to 24% in April.

Homebuyers

Despite "historical proof that a strong property market always boosts the economy", said Property Reporter, the chancellor failed to listen to calls for stamp duty reform and first-time buyer support.

The Office for Budget Responsibility (OBR) has revised its outlook for the property market, though, and suggests it could “bounce back faster than expected”, said The Telegraph.

The OBR forecasts that falling interest rates mean house prices will drop by around 2% this year, "slightly under half of the 5 per cent we expected [in the Autumn Statement]", before rebounding by 2% in 2026.

It expects mortgage rates to peak at 4.2% by 2027, which could be a boost for borrowers. This is still higher than the typical 2% rate that many borrowers were on at the end of 2021 and "above the average mortgage interest rate in the 2010s of around 3 per cent".

A majority of Britons favour keeping taxes higher if it means more money is spent on public services.

The findings from a new poll are a "major blow" to the government's "hopes of enticing voters with a tax giveaway", said The Independent. Rishi Sunak and Chancellor Jeremy Hunt are believed to be considering cuts to public spending to enable them to announce a reduction in income tax or national insurance at next week's Budget – possibly the last before voters go to the polls in a general election.

But polling by the Fairness Foundation found just 16% of voters favour tax cuts if it means reducing funding for public services, compared to 64% who support keeping taxes as they are or increasing them. Even among Conservatives, half want to see public spending maintained (50%), and almost a quarter would like it increased (23%).

"Public services are in the last chance saloon," warned Christina McAnea, the general secretary of Unison, the public service trade union. "Years of underfunding mean they're already close to collapse and slashing spending further still is the last thing anyone needs."

What did the commentators say?

Speculation over the chancellor's plans has been growing since the Financial Times (FT) reported earlier this month that Hunt was "considering slashing billions of pounds from public spending plans to fund pre-election tax cuts if he is penned in by tight finances" in his 6 March Budget.

The problem, said Robert Colvile in The Sunday Times, is that economic forecasts have moved "relentlessly against" Hunt in recent months, with the Office for Budget Responsibility calculating that his "fiscal headroom" has more than halved to just £13 billion. To "expand his freedom of manoeuvre", the chancellor is reportedly "considering squeezing future spending, which he already squeezed to pay for the last round of tax cuts" at November's Autumn Statement.

Hunt's widely touted 1% annual real-terms increase in public spending until 2029 would "imply serious cuts to some stretched public services", said the FT. The paper reported that Treasury officials were "considering going further" and reducing projected spending rises to about 0.75% a year.

With some ring-fenced departments such as health and defence earmarked for spending increases, said The Guardian, most public services would likely face "swingeing cuts across the next five years" that are equivalent to those undertaken by David Cameron's coalition government.

The idea that tax cuts are affordable "rests on undeliverable spending plans", said the Resolution Foundation. They "imply requiring real per-capita spending cuts of around 18% for unprotected departments like the Home Office, justice and local government by 2028-29" – all of which are already in a state of crisis. The think tank's research director, James Smith, said this was "essentially returning to austerity levels of cuts in terms of the implied spending cuts" – something the foundation's chief executive Torsten Bell called "ludicrous".

And "this comes on the back of large real-terms cuts for those departments from 2010 to 2015 and quite restrained spending since then", said Andrew Goodwin, chief UK economist at Oxford Economics. These "efficiency savings have long since been exhausted", he added. "You're now really talking about choosing which services not to provide any more."

The proposals have been met with a stern warning from the International Monetary Fund (IMF), which deemed the planned spending cuts as unrealistic following a downgrade in its growth forecasts.

With Britain's economy in recession and living standards suffering the longest sustained fall since records began almost 70 years ago, unions have also taken aim at the chancellor's plans. Sharon Graham, the Unite general secretary, said it was an "outrage" that the government was looking to balance the books by forcing more austerity on to services that were already on their knees, said The Guardian.

"The current state of public services are generally pretty poor across the board," said Stuart Hoddinott, a senior researcher at the Institute for Government. Further spending cuts risk "a deterioration in performance that would be unacceptable to any government".

What next?

With increasingly dire economic forecasts limiting options for the chancellor, "the fate of critical tax cuts – which Conservative MPs are banking on as a game-changing moment before the election – hangs in the balance", said The Telegraph.

The effect of public spending cuts would in most cases not be felt until after the election, which Labour is widely expected to win. Keir Starmer's party has plans to "relieve some of the spending pressure with particular tax rises, such as ending the non-dom regime, which will raise money to pay for more weekend and evening GP appointments, among other things", said The Guardian.

But when it comes to the "major working taxes", Labour "will be in lock-step with the Tories", said The Telegraph. Shadow chancellor Rachel Reeves has already ruled out raising income or wealth taxes to fund daily departmental spending.

The Tories' desire to reduce the tax burden is "storing up huge spending cuts down the line, compounding national decay", said Freddie Hayward in The New Statesman, while also "forcing Labour on to the back foot".

Unlike in 1997 or 2010, however, the next government will take office with public services "already at breaking point", said The Guardian.

Chancellor Jeremy Hunt's scope to deliver a pre-election giveaway in his March budget has been given a boost but economists are divided on whether the country can really afford more tax cuts.

Data from the Office for National Statistics (ONS) showed that increased VAT and income-tax receipts, coupled with reduced spending, led to a deficit of £7.8 billion in December 2023, marking "the lowest for the month since the pre-pandemic year of 2019", said The Guardian.

With lower debt-interest payments also contributing to the improvement in the government's financial position, analysts told the paper the prospects for a multi-million-pound giveaway package "had brightened".

Hunt could use the windfall in a number of ways, including tax cuts, increased public spending, or debt reduction – or "a combination of all three", noted The Guardian – but it was tax cuts that he hinted at during last week's World Economic Forum in Davos.

What the papers said

The Chancellor may be plotting fresh tax cuts, but the Office for Budget Responsibility (OBR), fired a "warning shot" yesterday when it said that Hunt has left himself a "tiny" margin of error against the government's own debt-reduction rules, said the Financial Times (FT). 

In November, the watchdog forecast £13 billion of budget headroom, but OBR chair Richard Hughes has issued a warning over the forecast's vulnerability to interest rate assumptions and data revisions.

And the independent public finance watchdog has not yet provided its forecast for the government's headroom in the upcoming budget, a figure that will be a "crucial determinant of the chancellor's scope to cut taxes or increase spending", said the FT.

In simple terms, "fiscal headroom" refers to rules set by chancellors to control government borrowing, said Sky News's economics editor Ed Conway. One of the rules Hunt has set as himself as chancellor concerns the UK's national debt: he has to show that he is bringing down Britain's net debt as a percentage of gross domestic product (GDP) within five years.

But this rule is less "strict" than it sounds, said Conway, akin to the "fiscal equivalent of St Augustine's prayer: 'Lord, make me good. But not yet.'" It allows for an increase in national debt, as long as it appears to decline within five years.

According to last November's autumn statement, the government aims to meet its fiscal rules, with its preferred measure of national debt rising from 90.2% of GDP in 2023/24 to 95% by 2026/27. 

It then declines to 94.9% of GDP in 2027/28 and further to 94.4% of GDP in 2028/29. The crucial "fiscal headroom" is derived from the difference between the last two figures: 94.9% of GDP and 94.4% of GDP, amounting to approximately £13 billion in potential spending for the Treasury.

But it is important to remember that this rule is not an "immutable law of economics" but a self-imposed regulation, added Conway. Despite seeming like a monolithic number, it constantly changes, influenced by fluctuations in the size of the economy and tax receipts, leading to a tendency to "yo-yo around from one year to the next".

What next?

The wisdom of pinning the future of the economy "not on the question of the smartest long-term policy but on the difference between a few decimal places on a spreadsheet" is up for debate, said Conway.

But the ONS's current assessment suggests that, due to higher-than-expected tax receipts and favourable economic conditions, Hunt is likely to meet his fiscal rules with £20 billion to spare. 

And there are several ways he could use this cash, "some more likely than others" said The Times's economics correspondent Jack Barnett. 

He will almost "certainly" extend the freeze on fuel duty at a cost of about £6 billion, said Barnett. But with a general election on the horizon, the Conservatives will be keen to begin "accruing favour with voters", with many in the party "convinced that tax cuts are the means to seize this political capital".  

How effective a round of tax cuts will prove in boosting the Conservatives' electoral chances is questionable; current polling also suggests a round of tax cuts "would make little inroads" in luring voters away from Labour, with just 22% of the public wanting tax cuts if it means lowering spending on public services. 

Fears the UK is heading for a recession are growing as the economy unexpectedly shrank slightly in the third quarter, with gross domestic product falling by 0.1%.

The "tepid numbers" from the Office for National Statistics (ONS) for the three months to September represent a "downward revision" from the earlier estimate of a 0.2% increase, and highlight the economy's struggle to "shake off low-growth performance", said the Financial Times.

The figures mean the UK is "at risk of recession", said the BBC. So how might the nation's economy perform in 2024?

What did the papers say?

The UK's economy is "stuck in a lacklustre state" as it wrestles with "high borrowing costs and the legacy of the worst inflationary upsurge for a generation", said the FT.

Projections released by the Bank of England in November suggested there is "little immediate prospect of a bounceback", as the central bank forecasts "near-zero growth through next year, even as the worst of the inflation subsides".

But speaking to the paper, Chancellor Jeremy Hunt insisted that 2024 was "when we need to throw off our pessimism and declinism about the UK economy".

Hunt has "sought to give Tory MPs an early Christmas present" with "another hint he could cut taxes ahead of a general election next year", said The Independent. The chancellor said the government would "cut the tax burden if we are able to".

He also raised the prospect of the Bank of England reducing interest rates in 2024, which is "when people will begin to have more confidence about their own personal prospects and the prospects of their family".

However, the FT said that his talk of rate cuts will "jar" with the Bank of England, which "jealously guards its independence and has been insisting it is too soon to discuss easing policy".

If employment "stays solid" then the economy "should do OK", John Stepek wrote for Bloomberg, but if unemployment "really surges (as opposed to rising a bit), then all bets are off".

Stepek also forecast that 2024 would be "sluggish for the housing market". Although Hunt "probably doesn't have much room for fireworks at his next budget", he added, it's "hard to see him resisting some sort of freebie" in the form of a tax cut.

But there could be big problems from further afield. Philip Pilkington warns in The Telegraph that the West is "sleepwalking into an economic catastrophe in the Red Sea". The Houthi rebels "could well manage to enact a de facto blockade of the Suez Canal by preventing commercial maritime vessels entry to the Red Sea", he wrote, and "the economic effects of this could be nothing short of profound".

If the Red Sea "remains a no-go zone for some time", it "looks like the Western world is going to have to brace for another wave of inflation", and "frankly, it is not clear that our economies, beaten and bruised from the last wave, can take it".

What next?

The latest ONS figures "show how close the UK could have come to a formal recession, which is marked by two consecutive quarters of negative growth", said The Times, but it will "not be clear until February" whether the UK has entered or avoided recession when figures are released for the October to December quarter.

Samuel Tombs, chief UK economist at Pantheon Macroeconomics, told The Times he expected growth to hold steady in the final three months of the year, "before then rising at an average quarter-on-quarter rate of 0.3% during 2024".

However, one of the world's biggest active bond fund managers has "dampened the festive mood" by warning of a serious economic downturn next year, said The Guardian.

Daniel Ivascyn, chief investment officer at Pimco, compared the UK economy with the US, and said that "in the case of the UK – a smaller, open economy, with a consumer that's feeling the brunt of central bank policy far more than their US counterparts – you just have a higher probability of more significant economic deterioration".

He added that "there's potentially more hard landing risks", a term that refers to a marked economic slowdown or downturn following a period of rapid growth.

Rishi Sunak used a somewhat low-key speech on Monday to signal the UK economy is finally on the right track and it was time to "turn our attention to tax cuts".

It follows weeks of speculation ahead of tomorrow’s Autumn Statement. With inflation finally falling and official figures showing the government borrowing £16.9 billion less than expected this year and enjoying higher tax revenues, commentators expect Chancellor Jeremy Hunt to "pull out a couple of rabbits, while saving a bit of cash in the locker to splash in a pre-election giveaway in the spring", reported Politico.

Having previously declared personal tax cuts to be "virtually impossible", the chancellor and PM appear ready to perform a dramatic U-turn; one driven as much by political expediency as economic responsibility.

What the papers said

Both The Times and The Sun suggest Hunt is preparing to deliver his budget bunny in the form of a cut to National Insurance (NI). Other mooted giveaways, such as a reduction in stamp duty, inheritance tax and income tax, are likely to be delayed until the spring. This means "workers' wallets are likely finally to get a long-overdue break", said The Sun. 

Hunt is also set to cut taxes for businesses by extending so-called "full expensing" – a tax relief allowing businesses to offset their investments against corporate tax – seen as a priority for the chancellor to boost the economy.

While "the overwhelming focus of the cuts will be aimed at helping businesses to invest", said BBC economics editor Faisal Islam, a tax cut that helps "make work pay" and "so improves the supply of workers, helping relieve a key constraint on growth" will be announced. And NI "seems to fit the bill", he said.

The arguments for both business and household tax cuts have been "well rehearsed for decades, albeit with inconsistent supporting evidence", said Mohamed El-Erian in the Financial Times (FT). They are said to stimulate both short and longer term growth "through increased consumer spending and corporate investment", said El-Erian, president of Queens’ College, Cambridge, and an adviser to Allianz and Gramercy. They also encourage "efficient resource allocations throughout the economy" and attract a higher level of foreign investment.

With a looming general election and the Conservatives badly trailing Labour in the polls, there is a political incentive to cut taxes, too. In doing so "the government appears to have finally decided to try to win the next general election rather than face a 1997-style wipeout", said Camilla Tominey in The Telegraph.

This is effectively "buying back popularity with tax cuts", argued Will Hutton in The Observer. It is also "breathtakingly wrong", he said, specifically citing mooted cuts to inheritance tax, which will "do little for growth – instead choking off a much-needed source of revenue and inflating inequality".

The Conservatives are keen to create clear dividing lines with Labour and regain their reputation as the party of low tax. However, shaping the budget around tax cuts would "not only yield minimal short-term gains but also impede a necessary and already-delayed journey towards higher productivity and inclusive and more sustainable long-term growth", said El-Erian in the FT.

According to Hunt's own logic for the past year, "shot-in-the-arm tax cuts risk keeping inflation high", as more money in people's pockets can raise or maintain demand for goods and services, said Mehreen Khan, economics editor at The Times.

Paul Johnson, from the Institute for Fiscal Studies, warned i news of the danger of interest rates staying higher for longer if the Treasury stokes inflation with premature tax cuts. This would have very real consequences for homeowners, keeping mortgage rates higher, he said.

Instead, said Hutton, "every spare pound should be consecrated not to tax cuts but to raising public investment – a key trigger for increased private sector investment and, ultimately, a better future".

What next?

The "contours of the argument" set to play out this week will be the government claiming that "an economic turnaround has created space for a tax cut", said the BBC's Islam. The opposition, meanwhile, will say the PM is "jumping the gun at the behest of backbenchers and in any case only reversing one of two dozen tax rises".

In making a turnaround argument, however, it is worth waiting for what the independent Office for Budget Responsibility (OBR) says in its forecasts for the economy, with the latest predictions from the Bank of England putting overall growth for 2024 at zero.

"That's why the government's celebration of any tax cuts for millions of people this week should be taken with a pinch of salt," said Khan at The Times. "When inflation is still more than double the Bank's target, where the government gives with one hand, the [Bank's Monetary Policy Committee] will be ready to take away with the other."

Microsoft's new offer to buy "Call of Duty" maker Activision Blizzard has been approved by the UK's Competition and Markets Authority (CMA), bringing an end to a near two-year bid to secure the gaming industry's biggest-ever takeover.

The approval follows a "restructuring of the deal" and a "major concession made by Microsoft" to the regulators, said PC Mag. This comes after the CMA blocked the original $69bn (£59bn) bid in April over concerns that Microsoft, which makes the Xbox console, would dominate the new cloud gaming market.

The Financial Times saw the approval differently, saying it "marks a win" for Brad Smith, the Microsoft executive who "led the company's legal campaign to defend a deal that many investors and analysts had written off earlier this year".

Writing on social media, Smith said Microsoft was "grateful" for the CMA's thorough "review and decision", which "we believe will benefit players and the gaming industry worldwide".

The CMA said the revised deal would "preserve competitive prices" in the gaming sector and offer more choice and better services, but the BBC said it has "proved controversial and received a mixed response from regulators around the world". It is the "biggest ever tech deal", said The Telegraph.

Even as it finally approved the takeover, the CMA reprimanded Microsoft, which had criticised the watchdog's initial rejection as "bad for Britain". The CMA's chief executive, Sarah Cardell, said that businesses and their advisers "should be in no doubt that the tactics employed by Microsoft are no way to engage with the CMA".

Chancellor Jeremy Hunt had earlier intervened, urging the CMA to "understand their wider responsibilities". The UK regulator had "appeared increasingly isolated" in blocking the takeover after its EU counterparts passed the deal and the US competition regulator failed to secure a court injunction to stop it, said The Guardian.

A great "will he, won't he" of British politics rumbled on today after Rishi Sunak repeatedly refused to say if the northern leg of HS2 will be scrapped.

Asked on "BBC Breakfast" whether he was set to axe the planned line from Birmingham to Manchester, the prime minister failed to give a direct answer six times. Sunak insisted that he had “absolutely not” given up on the multibillion pound rail scheme but that he was "not going to be forced into a premature decision because it’s good for someone’s TV programme".

Speculation has been rife since a Treasury official arriving at No. 10 for a "super-secret meeting" three weeks ago accidentally "flashed" briefing notes suggesting HS2 was under review, said the BBC's chief political correspondent Harry Zeffman. As MPs and the party faithful gathered in Manchester for the Conservative Party Conference on Monday, fresh reports emerged that the second phase of the project was being ditched. 

 The yet-to-be-confirmed news – which broke moments before Chancellor Jeremy Hunt's flagship speech – "could not be more disruptive", said Sky News's deputy political editor Sam Coates.

What did the papers say?

"It's probably safe to assume that there wasn't a grand plan in Downing Street for the Conservative Party conference to become overwhelmed by speculation about HS2," wrote the BBC's Zeffman. But "make no mistake: that is what's happened".

The prime minister's great re-set has been completely overshadowed by the row, which has "sparked fury" among northern business leaders and politicians including the "most senior Tory outside Westminster", West Midlands Mayor Andy Street, reported The Independent.

Street called an impromptu press conference on Monday night at which he urged the PM not to "cancel the future" and refused to rule out resigning over the matter. Framing the decision in terms of a "once-in-a-generation opportunity to level up", Street suggested that major businesses could be brought in to invest in the scheme.

This idea has also been floated by Boris Johnson. In his Daily Mail column last week, the former Tory leader argued that failing to save the project by securing private financing or any other means would be "betraying the North of the country and the whole agenda of levelling up".

He added: "Cancel HS2? Cut off the northern legs? We must be out of our minds."

What next?

Sunak was expected to convene an emergency cabinet meeting in Manchester later today to sign off his HS2 decision ahead of his conference speech on Wednesday.

According to The Times, the PM will pledge to invest "every penny" saved from scrapping the northern leg – an estimated £36 billion – into regional road and rail schemes. "But much of this money is not scheduled to be spent until the 2030s," said the paper, "limiting Sunak’s room for immediate giveaways." 

The PM's expected announcement will, at least, afford him "an opportunity for his voice, finally, to become the loudest" at the Tory conference, said the BBC's Zeffman. Once Sunak has revealed "what investments the government might be making instead in transport links within the North, the discussion will move onto those specifics rather than the communications difficulties the Conservatives have had on this subject".

Sunak's supporters "will be hoping that the uncertainties of recent days aren't what lingers in the public's memory", Zeffman added.

The HS2 decision "speaks to the policy merry-go-round of recent years and the failure of the British state to complete large projects", said Freddie Hayward in The New Statesman, but the "political damage will partly depend on Labour’s response".

Jon Stone argued in The Independent that "it is difficult to see how Labour could fail to build HS2 without declaring open warfare on its city and regional mayors, including Andy Burnham, Tracy Brabin and Sadiq Khan – who all want the network to be completed".

Yet while Labour will also "want to create a dividing line" with Sunak's Tories, Keir Starmer's probable chancellor, Rachel Reeves, will face "many of the same cost pressures as the current government, and has so far committed to very similar spending plans".

And if Labour struggle to find the billions needed for HS2, concluded Hayward, "consensus between the two parties could see the issue eventually laid to rest".

Jeremy Hunt has vowed to "make work pay" by boosting the minimum wage and cracking down on benefit claimants who refuse to look for a job.

Setting out a series of changes to the welfare system, the chancellor will use his speech at the Conservative Party conference in Manchester today to announce that the National Living Wage will rise to "at least" £11 an hour from next April, providing a pay rise to two million people. Hunt will also argue that the welfare safety net is "a social contract that depends on fairness to those in work alongside compassion to those who are not".

The government will review the way benefits sanctions work. "It is a fundamental matter of fairness," he is expected to say. "Those who won't even look for work do not deserve the same benefits as people trying hard to do the right thing."

'More radical approach'

Hunt will use his keynote speech to "declare war on 100,000 work-shy benefit claimants", the Daily Mail reported. The full details of how the benefits regime will be made tougher are still being hammered out and will be unveiled in the chancellor's autumn statement next month. 

According to the Department for Work and Pensions (DWP), there are currently around 5.2 million Britons on out-of-work benefits – a figure that soared during the pandemic and has not yet returned to pre-2020 levels.

Few Conservatives will argue against tougher sanctions for benefits claimants but Hunt "could and should go far further", said Ross Clark in The Spectator. 

Clark suggested a "more radical approach" would be to abolish unemployment benefits altogether and instead offer anyone who wants it three days a week guaranteed work at the National Living Wage. The government's opponents would deride it as "US-style workfare", Clark argued, but "forcing people to turn up and do some work in return for their keep would ensure that they remain in the practice of employment".

Fair, financially responsible or politically motivated?

The measures are driven by spending pressures on the welfare budget, one Whitehall source suggested to The Guardian, and presented as reforms to get benefit claimants back into work. 

Indeed, some leading Tories are "keen to bring down the benefits bill, partly with a major drive to reduce the numbers of economically inactive, and also by encouraging more over 50s back into the workplace", added Politico's London Playbook.

Work and Pensions Secretary Mel Stride will also use his speech to conference today to unveil plans for a crackdown on "deadbeat dads" who refuse to make maintenance payments for their children.

The Conservatives are also trying to "create a dividing line with Labour" ahead of the general election, said The Times.

The focus on benefits has "echoes of the policy promoted by David Cameron and George Osborne", said The Telegraph. "Their framing of the Tories as being on the side of 'workers not shirkers' helped win the 2015 general election," said the paper.

Amid the clamour for tax cuts – not least from the former PM Liz Truss – the development minister, Andrew Mitchell, warned that this should not be done "on the backs of the poorest", said The Guardian.

"We need to be very clear that we have very properly protected throughout the last 13 years of Conservative government the most vulnerable by maintaining and in some cases increasing the value of their benefits" he said. "That's the right thing for any government to do in any civilised society."

The winter of strikes finally appears to be drawing to a close this week as unions back a new pay deal for more than a million NHS staff in England.

The offer, which covers almost all NHS workers except for doctors, includes a one-off payment of at least £1,655 as well as a 5% pay rise from April. Unions have agreed to suspend strike action while their members vote on the deal.

Chancellor Jeremy Hunt told LBC that the government hoped the negotiations breakthrough “will be the start” of a wider settlement of public sector pay. The deal was announced shortly after he delivered his first Budget, which includes plans to extend free childcare and remove the cap on tax-free pension savings. The government's energy price guarantee is being extended too, for another three months from April to June.

In other financial news, Switzerland’s central bank was forced to throw a $54bn (£45bn) lifeline to the country’s second-biggest bank, Credit Suisse, following a sell-off by spooked investors amid broader concerns about the global banking sector..

To find out how closely you’ve been paying attention to the latest developments in the news and other global events, put your knowledge to the test with our Quiz of The Week

1. Who won the Oscar for Best Supporting Actress at the 95th Academy Awards?

• Angela Bassett
• Kerry Condon
• Jamie Lee Curtis
• Stephanie Hsu

2. What has Chancellor Jeremy Hunt’s Spring Statement been dubbed?

• The “levelling up” Budget
• The “back to work” Budget
• The “inflation buster” Budget
• The “future building” Budget

3. UK ministers and civil servants have been banned from having which social media app on their work phones?

• WhatsApp
• Twitter
• Instagram
• TikTok

4. A US man with the world's longest tongue has set another Guinness record by using it to do what?

• Remove five Jenga blocks from a stack in 55.526 seconds
• Lick his elbow 72 times in 30 seconds
• Lap up a litre of ice cream in 94.45 seconds
• Seal 84 envelopes in 60 seconds

5. Which popular holiday destination wants to swap British holidaymakers for “higher quality” tourists?

• Lanzarote
• Gran Canaria
• Santorini
• Madeira

6. Which annual sports event declared a “war on wee”?

• Royal Ascot
• London Marathon
• Cheltenham Festival
• Six Nations

7. Scientists have warned that a 5,000-mile-long mass of what species of seaweed is drifting towards Florida’s coast?

• Cladophora
• Ulva
• Sargassum
• Fucus

8. The newly revealed format for the 2026 World Cup features a total of how many matches?

• 68
• 80
• 96
• 104

9. A property dubbed “Britain’s loneliest home” after being put on the market is located where?

• Yorkshire Dales
• Outer Hebrides
• Cumbria
• Dartmoor

10. The UK Space Agency has given £2.9m to Rolls-Royce to develop what for a future Moon base?

• a thermal battery system
• a lunar exploration buggy
• a nuclear micro-reactor
• a hovercraft for collecting samples

1. Jamie Lee Curtis

Bassett was considered the front runner for the gong, for her role in Black Panther: Wakanda Forever, but lost out to Everything Everywhere All at Once star Curtis, in one of the biggest upsets of the night at Sunday’s awards ceremony.

2. The “back to work” Budget

Presenting his first Budget to Parliament on Wednesday, Hunt laid out a range of measures intended to encourage economic growth by boosting employment, including extending free childcare and lifting a cap on tax-free pension savings.

3. TikTok

The ban on using the Chinese-owned video app on government devices follows a review by the National Cyber Security Centre and brings the UK in line with the US, Canada and the EU, amid worsening relations with Beijing.

4. Remove five Jenga blocks from a stack in 55.526 seconds

California resident Nick Stoeberl also uses his record-breaking tongue, which measures 3.97in (10.1cm), to paint pictures.

5. Lanzarote

The head of Lanzarote’s local government told a tourism trade fair in Berlin that the Canary island’s resorts had become overly reliant on “mass market” holidaymakers from the UK and should be focusing on visitors from Germany, “who spend more when they are here”.

6. Cheltenham Festival

In a bid to prevent racegoers from urinating in public during this week’s meeting, Cheltenham Council provided liquid-repelling hydrophobic paint to residents and businesses. Officials in the Gloucestershire town also produced a poster showing a man and a woman peeing against a tree, with the slogan: “Have fun this race week but remember our town isn’t your toilet.”

7. Sargassum

The Great Atlantic Sargassum Belt extends from West Africa to the Gulf of Mexico and is on course to reach Florida during the region’s busiest summer months. As well as wreaking havoc on local ecosystems, after coming ashore the rotting seaweed emits toxic fumes that may be harmful to humans. Find out more with The Week Unwrapped podcast.

8. 104

Football’s global governing body Fifa has confirmed that the tournament – being co-hosted by the US, Canada and Mexico – is expanding from 32 to 48 teams, which will require 40 games more than the 64 played in Qatar last year.

9. Yorkshire Dales

Estate agent Fisher Cooper has slashed £50,000 off the original £300,000 asking price for 3 Bleamoor Cottages, which isn’t accessible by car and is seven miles from the nearest town, Ingleton.

10. a nuclear micro-reactor

Engineers and scientists at the British engineering giant are aiming to create a small and lightweight nuclear micro-reactor to provide power needed for humans to live and work on the Moon.

Financial markets across the world have plummeted in the wake of the Silicon Valley Bank collapse despite central banks’ attempts to quell fears of a repeat of the 2008 banking crisis.

Amid a global rout in stocks, European banks shed as much as 6% in this morning’s trading, putting them on track for their worst two-day drop since the Ukraine war began.

Fears of a potential global contagion appear to be receding thanks to swift action from financial authorities on both sides of the Atlantic over the weekend, but many predict the impact on the tech sector may be felt for years to come.

What is SVB and why did it collapse?

Founded in 1983 in California, Silicon Valley Bank (SVB) became the go-to bank for tech start-ups and claimed to have provided financing for almost half of US venture-backed technology and healthcare companies in 2021.

Yet despite being among the top 20 American commercial banks, with $209bn in total assets at the end of last year, it collapsed last week in a matter of hours.

In short, “SVB encountered a classic run on the bank”, said CNN Business, although “the longer version is a bit more complicated”, with several forces colliding to take it down.

Higher interest rates introduced over the past year by central banks around the world, including the US Federal Reserve, led to higher borrowing costs, which stalled the momentum of tech stocks. It also eroded the value of long-term bonds just as venture capital began drying up, forcing start-ups to draw down funds. It meant the bank “was sitting on a mountain of unrealized losses in bonds just as the pace of customer withdrawals was escalating”, said CNN.

Attempts to shore up its balance sheet by selling off securities at a loss last week triggered a panic among investors, who began pulling their money out, prompting SVB’s share price to plummet, with regulators called in on Friday.

Vox said the “sudden, swift collapse” was the second largest bank failure in US history – behind only Washington Mutual, which had $434bn in assets when it crashed in 2008 – and the biggest since the height of the financial crisis in that year.

What is the wider impact?

“The incident has sent shock waves across the tech sector,” said Vox.

Garry Tan, president and CEO of start-up accelerator Y Combinator, called SVB’s failure “an extinction level event for startups” that “will set startups and innovation back by ten years or more”, said Wired.

The immediate impact aside, “the collapse of the leading specialist in providing financial services to tech companies could make it harder for the next generation of startups to find what they need to build their business”, said the magazine.

“And after witnessing the herd-like, Twitter-fuelled rush to pull money out of SVB, other banks may be cautious toward tech out of fear of experiencing the same problems SVB faced.”

Beyond the sector, “SVB’s blowup is a big deal and a symptom of bigger forces in motion in tech, finance, and the economy”, Vox added.

Amid warnings from the likes of Axios that the US was “in danger of a catastrophic banking crisis”, financial regulators and the Biden administration moved quickly on Sunday to introduce emergency measures to reduce potential contagion that included ensuring SVB depositors would have access to all their money on Monday morning.

The Guardian reported that “banks will also now be allowed to borrow essentially unlimited amounts from the Federal Reserve for the next year”. This is to avert a situation where financial firms would have to “sell a class of investments that have been losing value because of the Fed’s own high interest rate policies”.

Yet despite efforts to shore up confidence, concerns over America’s regional banks do not appear to have fully abated with shares in several US lenders down by double-digits in pre-market trading.

What about the UK specifically?

There was widespread relief within the UK tech sector on Monday after it was announced that HSBC had bought the British arm of SVB, which had deposits of around £6.7bn and provided banking services for 40% of the UK’s biotech sector, for a “symbolic one pound”, Reuters reported.

The deal with one of the world’s biggest banks with trillions of dollars in assets “brought to an end frantic weekend talks between the government, regulators, and prospective buyers”, said the news agency.

Brokered by the Bank of England, it “involves no taxpayer money”, said the BBC, and means “customers and businesses who had been unable to withdraw their money will now be able to access it as normal”.

Chancellor Jeremy Hunt said: “We were faced with a situation where we could have seen some of our most important companies – our most strategic companies – wiped out, and that would have been extremely dangerous.”

This doomsday scenario has now been averted even if the short-term market turmoil continues.

The chancellor has warned that “we are not out of the woods” despite new figures showing that the UK narrowly avoided falling into recession in 2022.

The economy flatlined in the final three months of last year, following a drop of 0.3% between July and September, meaning the UK is not technically in recession – which is defined as two consecutive quarters of economic decline.

“The fact the UK was the fastest growing economy in the G7 last year, as well as avoiding a recession, shows our economy is more resilient than many feared,” said Jeremy Hunt.

However, economists and commentators warned that the outlook remains bleak and that even if the UK has not entered a recession yet, for many it will still feel as if it has.

What did the papers say?

Britain has avoided a recession “in the least glamorous way possible”, wrote Kate Andrews for The Spectator, because “it is not a story of growth, but a story of stagnation, that has kept the dreaded label of ‘recession’ at bay”.

There is “no guarantee that people feel better off”, she added, because “with real wages taking such a hit, many will feel as though we’re in recession anyway”.

“Whether we’re ‘technically’ in a recession isn’t actually so important,” said Politico’s London Playbook, because “when such small changes are involved, a plus sign is not a conveyor belt of milk and honey, any more than a minus sign is Armageddon”.

The National Institute of Economic and Social Research told the newsletter that “this year will feel like a recession for many, regardless of the data”. It added that “a focus on the economic crisis faced by most of the British population, rather than technicalities, offers a more insightful perspective”.

Political economist Richard Murphy agreed. “Who cares if we are not in a technical recession if millions of people cannot make ends meet, heat their homes, pay the rent or mortgage and feed their children?” he asked on Twitter.

Reuters put the data in a global context, noting that the UK’s output in the fourth quarter was still 0.8% below its pre-pandemic level, “in sharp contrast to other major advanced economies which are now above their pre-pandemic size”.

Despite the good news of a recession averted, City AM noted that the markets were un-buoyed: the FTSE100 index was trading slightly lower, down 0.24% this morning.

What next?

The Bank of England is still expecting a recession to occur sometime in 2023 but believes that the period of negative economic growth will be shallow and shorter than previously predicted.

Most analysts agree. Paul Dales, chief UK economist at Capital Economics, told the Evening Standard: “Given that the drags from high inflation and high interest rates are very large, we still think the economy will enter a recession this year.”

And Jeremy Batstone-Carr, from Raymond James Investment Services, told the Daily Express that “we are still in for the downturn which so far has been barely kept at bay”.

Although “there is greater hope that a downturn may never materialise at all or could be shallower or much more short-lived than initially feared”, Alice Haine, personal finance analyst at Bestinvest, told The Sun, the economy is “not out of the woods yet”.

A “milder recession” would mean that “unemployment rises more slowly, wage growth stays strong and domestically generated inflation falls at a slower pace than expected”, Thomas Pugh, an economist at RSM UK, told This Is Money.

However, he added, this could in turn be bad news for homeowners as it “could result in the Bank of England raising rates by more than expected”.

Rather than the economy going into recession, it may just remain flat, argued one pundit. Instead of “doing the timewarp and bracing for a recessionary return to the seventies, sparked by energy shocks, soaring inflation and industrial strife”, Susannah Streeter, head of money and markets at Hargreaves Lansdown, told the Daily Mail, “we could be heading for an early noughties-style period of stagnation”.

Thousands of nurses and ambulance staff are striking today in the biggest round of industrial action by NHS workers in the health service’s 75-year history.

With disruption planned across public services throughout February, trade unions and the government are locked in disputes over pay and working conditions. Ministers argue that raising public sector pay in line with inflation could lead to a wage-price spiral – a “perpetual loop” of price hikes leading to wage hikes that further increase prices, said Sky News.

But latest official data shows that workers are suffering significant salary cuts in real terms.

Spiralling wages

Rishi Sunak insisted last week that he would “love” to give nursing staff “a massive pay rise”. But the government is facing tough “choices” about how best to distribute the “record amount of money” being pumped into the health service, with recruitment and resources among the priorities, the prime minister told Piers Morgan during an interview on TalkTV.

The government’s key concern is that a wage-price spiral could cause “entrenched inflation”, said Paul Whiteley, a professor of government at Essex University, on The Conversation. The fear is that rising prices will “prompt increased pay settlements, which in turn produce further price rises, wage increases, and so on”.

Jeremy Hunt warned last month that the government “must not do anything that risks permanently embedding high prices into our economy, which will only prolong the pain for everyone”. Rather than raise public sector wages in line with inflation, the chancellor tweeted, the “single best way to help people’s wages go further is to stick to our plan to halve inflation this year”.

Matthew Lynn argued in The Telegraph in November that while “no one should blame” unions for fighting for pay raises for their members, “decisions that make perfect sense at the individual level can add up to a catastrophe when everyone is doing the same thing”. A wage-price spiral could prove “very” bad – and once it gets going, “it is incredibly hard to stop”, he added.

Miscalculations?

According to the Office for National Statistics (ONS), average total pay rose by 6.4% between September and November last year.

But with inflation so high, workers are suffering “one of the biggest pay cuts in real terms that we’ve seen this century”, said the BBC’s economics correspondent Andy Verity.

Adjusted for inflation, real-term wages fell by 2.6%, one of the “largest falls in growth since comparable records began in 2001”, said the ONS.

Economists say that increasing public sector pay would not necessarily increase inflation. “Reasonable” agreements could “easily solve the present impasse”, said Whiteley on The Conversation, “without triggering a wage-price spiral”.

The Guardian’s economics writer Phillip Inman said the wage-price spiral “is an academic concept based on a theory of inflation expectations” rather than “empirical evidence”.

Alex Bryson, professor of quantitative social science at University College London, told Sky News that the government was “missing much of the bigger picture – unemployment and shrinking of the size of the economy”. The “chief reason” that inflation has risen so rapidly was “not wage-push but Covid-induced restraints”, he said, and energy prices and the ongoing conflict between Russia and Ukraine have further contributed to the UK’s economic instability.

The government’s position “looks like it’s based on both bad economics and bad politics”, Whiteley agreed. The reality is that there is “little prospect” of wage inflation while the public sector faces significant labour shortages.

And Sunak’s stance “does not seem like a winning strategy” in political terms either, he added. “Many voters think the government is basically hostile to the public sector”, an impression that “could strengthen” in the run-up to the next general election.

The UK economy surprisingly grew by 0.1% in November, raising hopes that the country avoided entering a recession at the end of last year.

Output “edged up over the month”, said The Times, helped by growth in the dominant services sector, with pubs and bars enjoying a boost as people piled in to watch World Cup games.

December’s GDP figures will need to drop by about 0.5% for fourth-quarter growth to be negative and the UK economy to technically enter recession, which is defined as two consecutive quarters of negative growth.

“To add to the growing optimism”, said the Evening Standard, Tesco and Marks & Spencer have both recorded “bumper Christmas trading figures”, suggesting Britain’s economy “may be showing greater resilience than predicted in the face of the cost of living crisis”.

The UK “may avoid a recession for now but it won’t feel like it for many”, wrote Larry Elliott, economics editor of The Guardian. GDP figures are “notoriously erratic”, he said, so the UK “could yet” fall into recession “in the face of rising interest rates and higher taxes over the coming months”.

Ruth Gregory, senior UK economist at Capital Economics, said in a note to clients that “even if the economy does a bit better than expected in quarter four, it is at best stagnating” and “we still think a recession is on its way in the first half of 2023”.

Chancellor Jeremy Hunt responded to the latest figures with caution, pledging to “stick to the plan to halve inflation this year so we get the economy growing again”. Labour’s Rachel Reeves said: “Today’s results are just another page in the book of failure that is the Tory record on growth”.

This week Jeremy Hunt enacted “the latest cut of his short tenure as Chancellor”, said Alex Lawson in The Observer. Once again, he moved to rein in the largesse of his predecessor Kwasi Kwarteng: in this case, the energy bill relief scheme for “non-domestic” customers. Hunt’s message to business was “unapologetically blunt”, making clear that the existing package was “unsustainably expensive” and that, after March, support would continue only at a much lower level.

The main change, said BBC Business, is that energy costs will no longer be “capped”. Companies will instead receive “a discount on wholesale prices” when energy bills are high – with heavy users, such as the glass, ceramics and steel industries, getting the largest discounts. To the extent that the notion of a cap has been retained, it is now based on what the Government is prepared to spend. Hunt confirmed a maximum support package of £5.5bn over the year from April – down from an estimated £18bn over the six months of this winter.

The Federation of Small Businesses described the announcement as a “huge disappointment” that could spell “the beginning of the end for tens of thousands of small businesses”. Luckily, “the unusually mild winter” has prompted sharp falls in wholesale prices, said The Times.

If it hadn’t, you can bet the language would have been stronger. But, as ever with these schemes, the devil lies in the detail, said the FT. Because some companies signed fixed-cost contracts when prices were higher, many may be paying similar costs from April, but with “a massive reduction in support”, according to Investec analyst Martin Young.

The biggest worry among industry groups, though, is that “the flat-rate discount will not give enough protection” if prices jump sharply again. Even after recent price falls, the new scheme means companies will typically pay “more than six times more for their energy than before the pandemic”.

There’s no question that this deal – worth £2,400 a year to the average pub – is “far less generous”, said Alistair Osborne in The Times. Even so, with the national debt now standing at £2.48trn, it’s in the “national economic interest” to stop subsidising businesses. “Britain is awash with zombie companies addicted to state handouts.” The taxpayer shouldn’t be propping them up. At least now they have an incentive “to get on with energy efficiency”.

Hunt’s new package is “broadly reasonable”, said Nils Pratley in The Guardian – at least for the time being. But if we’ve learnt anything over the past 15 months of volatile energy markets, it is that it pays to keep options open. “Tweaks and even serious overhauls may yet be needed.”

Just months before “Brexit ejected him from the Treasury”, George Osborne “gave City bankers one final bashing for their sins”, said Simon Foy in The Daily Telegraph.

In March 2016, the then-chancellor introduced a new law allowing senior bankers to be jailed for up to seven years “if their risk-taking was deemed to be egregious enough”. The move terrified City executives; but now, after years of stagnation, priorities have changed.

Last week, Chancellor Jeremy Hunt watered down the “senior managers’ regime” – in one of “30 regulatory reforms” designed “to awaken the Square Mile” and bolster its position as an international financial centre. Dubbed the “Edinburgh Reforms” (because they were announced there), or Big Bang 2.0, the measures will also loosen the capital “ringfencing” rules for retail banks; mandate financial regulators to focus on economic growth and competitiveness; and allow pension funds to invest in a wider range of assets. “Risk-taking in the City is back with a bang.”

Mixed reactions

The plan was applauded in the City. But elsewhere, the reaction was one of horror, said Kalyeena Makortoff in The Guardian. Sir John Vickers, the economist who led the inquiry into the UK banking industry after the 2007-08 crisis, said the Chancellor may be taking Britain down an “extremely dangerous path”.

Vickers is “particularly concerned” about plans to roll back ringfencing rules that protect savers by separating their deposits from riskier investment banking operations. Although targeted at smaller banks, they could also result in larger operators, such as NatWest and Lloyds, “facing fewer restrictions on how they fund their operations”, while enabling them “to sell more complex products to customers”.

‘Debatable’ proposals

Hunt is right, said Lex in the FT: “over-stringent banking regulation fosters the stability of a graveyard”. But while some proposals, such as loosening the EU-imposed Mifid II regulatory regime, are “undeniably welcome”, others are “debatable”.

Rather than abandoning “the principle of accountability” for senior managers, it would be better to enforce it narrowly but strictly. And anything other than “minor tweaks” to ringfencing would be a mistake – it might boost competition, but at the cost of requiring “future bailouts”.

The regulatory cycle follows “a well-worn pattern”, said Patrick Hosking in The Times. “A market crash, or consumer scandal leads to howls for something to be done and an abrupt tightening of the rules.” Then these safeguards get slowly chipped away – until the next crash. “Too much City ‘growth’ and innovation… is built on nothing more than complexity and leverage.” They’ve tried “unleashing the City’s potential before”. It didn’t end well.

Rishi Sunak was praised as a man of “integrity” by CBI director-general Tony Danker when he addressed the business group’s annual gathering in Birmingham this week. Members may have concluded that anything is better than “blathering on about Peppa Pig World” like his predecessor, said Ross Clark in The Spectator. But Sunak’s performance was hardly inspiring: “his usual enthusiasm sounded more like a desperate appeal”.

The PM, after all, knows as well as his CBI audience that last week’s Autumn Statement “was not about stimulating growth. It was 90% fiscal consolidation.” Sure, businesses were “thrown a few cherries in the form of R&D incentives”; but the “underlying story” is that they’re “going to pay more tax”. Neither the rise in corporation tax to 25% nor higher capital gains tax bills will stimulate investment.

Chancellor Jeremy Hunt did offer one other sweetener, said Daniel Thomas in the FT: a five-year relief on business rates worth £13.6bn. But critics, such as the Federation of Small Businesses, said that the Chancellor’s statement was “high on stealth-creation and low on wealth-creation”, and would pile more pressure on the UK’s 5.5 million small firms. Others “expressed dismay that the Government had not done more to try to stimulate the economy” – by, say, forging “a new deal” on immigration to solve staff shortages, or loosening EU trading rules.

Here, again, the PM disappointed, said Harry Horton on ITV. Sunak categorically denied talk of a move towards a “Swiss-style EU deal”, featuring more liberal migration rules and the possibility of more frictionless trade. Few in the audience were mollified by his assertion that better “robotics and automation” could do the trick instead.

In prioritising financial stability over anything else, said Alex Brummer in the Daily Mail, the Treasury is “stifling enterprise and entrepreneurship”. Yet, bizarrely, they take Silicon Valley as their model, said Dominic O’Connell in The Times. And when Hunt outlined the “future engines of the economy”, he listed just five: digital, life sciences, green tech, financial services and hi-tech manufacturing. If you run a traditional manufacturing business, “you would definitely feel unloved”. Trade bodies say that British firms are “in survival mode”.

They’re right, said Matthew Lynn in The Daily Telegraph. The Autumn Statement may have gone down pretty well with markets, but it’s “a recipe for stagnation”. Britain has “chosen” to become a zero-growth economy – as in “Italy or Japan, whole decades will go by with no increase in total output”. If they adapt, firms can survive even this challenging environment. But let’s not pretend it will be anything but “a grind”.

Jeremy Hunt confirmed that the UK was “now in recession” as he announced tax hikes and public spending cuts totalling £55bn in his Autumn Statement this week.

Revealing the government’s budget plans, the chancellor said the UK needed to give “the world confidence in our ability to pay our debts”. His plans leave Britain facing the highest level of taxation since the Second World War, as households nationwide feel the effects of the cost-of-living crisis and a record fall in living standards.

Hunt told the BBC this morning that his fiscal plans were necessary to “get through” the recession, “bring inflation down and grow the economy healthily when we get to the other side”.

Labour’s shadow chancellor Rachel Reeves said the Autumn Statement was effectively “an invoice for the economic carnage the government has created”.

To find out how closely you’ve been paying attention to the latest developments in the news and other global events, put your knowledge to the test with our Quiz of The Week.

Need a reminder of some of the other headlines over the past seven days?

• Donald Trump announced plans to run for the US presidency in 2024, setting the stage for a showdown with Ron DeSantis, his main rival to be the Republican candidate
• An Iranian court issued the first death sentence related to the anti-government protests that have rocked the country following the death of Mahsa Amini
• Nato said a missile strike that killed two people in Poland was likely to have been fired by Ukrainian forces in response to a Russian attack
• EU negotiators at Cop27 backed a “loss and damage” fund for poor countries hit hard by the effects of climate change.

1. Four in 10 French voters wanting to make a neo-fascist their president is no cause for celebration

Sean O’Grady for The Independent

on a divided country

Emmanuel Macron has beaten Marine Le Pen to remain president of France, but “it’s premature to dance on the grave of French neo-fascism”, writes Sean O’Grady at The Independent. Le Pen “won the highest vote of any such candidate in French modern history” and so “we have to process and accept the fact that she is popular”. As the “proud heiress of her father’s antisemitic ideology, the Vichy regime, and various crackpot sects over the decades”, Le Pen is “a woman who wanted to ban Muslim people from wearing culturally harmless headgear, and much else”. Yet, “faced with a liberal man of the centre, she commanded the support of more than four in ten French voters”. The “traditional mainstream parties of the left and Gaullist right have been smashed”, with “no signs of them recovering”, concludes O’Grady. With Macron unable to stand for president again, “the next campaign to save France should start today”.

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2. Biden’s decline is obvious to everyone but the press

Karol Markowicz for the New York Post

on a question of acumen

“Something is wrong with President Joe Biden, and everyone knows it,” writes Karol Markowicz. Last week, she says, he started “rambling” when he was asked about a pandemic immigration restriction and it “turned out he was talking about mask mandates on airplanes”. This isn’t “simply misspeaking”, Markowicz writes. “He seems fully out of it, and we’re all watching quietly.” After touching on other moments of awkwardness for Biden, she asks: “Is the president OK? He doesn’t seem like it.” During the Trump reign, the president’s acumen was “full-on debated and often”, says the New York Post columnist, “but now we’re supposed to disregard what we see with our own eyes”. Many of us have had our “own confused grandpa”, who is “starting one story and finishing another or rambling from one topic to the next nonsensically”, she writes. “The trouble is this confused grandpa has a bit more power than your own.”

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3. Why the Tories can’t replace Boris with a Remainer

Patrick O’Flynn in The Specator

on a political deathwish

Jeremy Hunt has “assumed the mantle of favourite” to take over if and when Boris Johnson is moved on, writes Patrick O’Flynn, but this could be a “deathwish” for the Tory Party. “Imagine the smart and smooth Jeremy on a stool next to smart and smooth Keir, also from Surrey, and Ed, the wannabe-smoothie MP for Kingston-Upon-Thames, Surrey.” The Spectator writer says that “peas in a pod comes to mind, and eminently forgettable ones at that”. All three “energetically” backed Remain and appear to have no worries about the impact of immigration on social cohesion and access to public services. O’Flynn imagines Red Wall voters will be unimpressed if the Tories “dump the charismatic figure who won them over and present them instead with an identikit ‘liberal’ Conservative of the sort that had never won them over in the first place – a lower wattage version of David Cameron”.

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4. Angela Rayner’s treatment shows that Westminster’s women are still treated as objects of sexual speculation

Kate Maltby for The i

on crass bait

“We all know how unhealthy cycles of outrage on social media can be,” says Kate Maltby, writing about the claim that Angela Rayner crosses and uncrosses her legs to distract Boris Johnson. “So why did so many women working in Westminster – myself included – rise this weekend to a crass bit of bait?” The i columnist explains that “the answer is that women in Westminster… are sick of working in an environment where they are routinely reduced to objects of sexual speculation”. She adds that “walking into the House of Commons still feels like entering a 70s time-warp” because “the comments made about women’s bodies – and about people of colour, or LGBT+ people – would have HR down on you like a ton of bricks in any other workplace”. Turning her fire on the newspaper that published the claims about Rayner, Maltby says: “Women in our highest political assembly are more than their bodies – time the Mail on Sunday caught up.”

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5. WhatsApp is ruining our lives

Lucy Burton in The Telegraph

on constant chatter

“We all know we should spend less time on our phones, but few of us do it,” writes Lucy Burton. Screen use has increased since the pandemic, with 54% of UK adults now using their screens more regularly, and employers are becoming “aggravated” that “more and more of their customers and staff are becoming phone zombies”. For Burton, the employment editor of The Telegraph, WhatsApp is a particular culprit. A pub boss told her he is considering imposing a formal ban on staff WhatsApp group chats outside of certain hours, and members of a major teaching union said late-night WhatsApp messages from headteachers were “grinding down” morale. Meanwhile, she writes, bosses fear bankers can “too easily share potentially sensitive work information via the app” and a report from the Institute for Government said Whitehall “needs to ‘get a grip’ on how WhatsApp was being used by ministers”. She writes that “businesses and individuals have clocked that our addiction to our phones and the instant, constant chatter inside them has come at a cost” and that “we have reached peak WhatsApp”. The movement away from “excessive use” will “only get stronger from here on in”, she writes.

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Jeremy Hunt has proposed the creation of a European-led maritime taskforce to protect ships sailing through the Strait of Hormuz, amid rising tensions between Europe and Iran.

The foreign secretary announced the plan in the Commons on Monday, following an emergency Cobra meeting to discuss the Stena Impero, the British-flagged tanker seized by commandos from the Islamic Revolutionary Guard Corps (IRGC) on Friday.

The Independent reports that Hunt told MPs that discussions on the forming of a protection force “have taken place with a number of allied states in the last 48 hours”, with further talks to be held later this week.

He also used the opportunity to condemn the actions of Iran as an “act of state piracy” and said that Tehran had “no right to obstruct the ship's passage”. He continued: “It is with a heavy heart that we are announcing this increased international presence in the Gulf, because the focus of our diplomacy has been on de-escalating tensions in the hope that such changes would not be necessary.”

Hunt’s goal seems to be to “coordinate with a US push to create a coalition to provide escorts to international vessels transiting through the region but - significantly - for it to be a separate entity”, says Sky News. But despite what he calls “constructive talks” with other European states, some experts worry that such a move could be viewed by Iran as a major escalation of tensions.

What is Hunt proposing?

Under the plan, the UK would develop a maritime protection and escort mission alongside other European nations, in order to allow ships to pass safely through the area.

Sky News reports that “details were rather light from the foreign secretary on who would be involved, how many warships and surveillance aircraft would be deployed and when the thing would be up and running”.

According to the BBC, the foreign secretary secured support for the initiative from both French and German foreign ministers on the phone on Sunday.

“If Iran continues on this dangerous path, they must accept the price will be a larger Western military presence in the waters along their coastline,” Hunt said as he announced the proposal. “Not because we wish to increase tensions but simply because freedom of navigation is a principle which Britain and its allies will always defend.”

He also confirmed that the Department for Transport has raised the security level for British-flagged shipping to Level 3 - the highest classification - while also advising against any passage through Iranian waters. Vessels that must use these routes are being asked to notify the UK authorities, so that an escort can be arranged.

Will this further damage relations with Iran?

The Independent suggests that the move is “certain” to further escalate tensions between Britain and Iran, adding that some Iranian officials are already adopting the view that the UK “may start to take a tougher line with Tehran”.

Iranian Foreign Minister Mohammad Javad Zarif this week warned the West against “starting a conflict”, saying Tehran was not seeking confrontation. “Starting a conflict is easy, ending it would be impossible,” Zarif told reporters on Monday.

The Daily Telegraph reports that the UK has been attempting to “defuse pressure”, despite Iran making attempts to “goad London” by releasing pictures of the Stena Impero’s detained crew and of an Iranian flag flying on the ship’s mast.

Will this damage relations with the US?

Hunt’s controversial proposal may draw the ire of US President Donald Trump.

In early July, the US announced that it is planning to create an international military coalition to safeguard strategic waters off Iran in response to the tanker conflict, but the BBC reports that it has had “few takers”.

According to broadcaster’s defence correspondent, Jonathan Marcus, countries “do not want to be seen as joining what might appear to be a US coalition against Iran”, especially as the Trump administration does not support the re-signing of the Iran nuclear deal, from which the US withdrew in 2018.

Hunt - along with most of his European counterparts - has been pushing for the deal to be reimplemented, allowing for sanctions on Iran to be lifted. As a result, Hunt announced that his proposed task force would seek to “complement” US proposals rather than join Washington’s so-called “maximum pressure” policy on Tehran.

The Daily Telegraph reports that US Secretary of State Mike Pompeo has stepped up the pressure on Hunt in recent weeks, claiming that Britain needs to “pull its weight”.

On Monday, prior to Hunt’s announcement, Iranian Foreign Minister Zarif tweeted that “having failed to lure @realDonaldTrump" into the “War of the Century”, US National Security Advisor John Bolton was now “turning his venom against the UK in hopes of dragging it into a quagmire”.

Following Zarif’s conclusion that “only prudence and foresight can thwart such ploys”, Tehran may take a little solace from the UK’s decision not to join the US in its hard-line stance against Iran.

Meanwhile, BBC Newsnight’s defence editor Mark Urban warns that in military terms, there is “no rapid fix” for the shipping security problem.

“Even if the present crisis caused the Government to open its cheque book, swelling the destroyer and frigate force back up, even say to 30, could be a decade’s work, not least because of the need to train up thousands of additional sailors,” Urban writes.

The Week’s daily round-up highlights the five best opinion pieces from across the British and international media, with excerpts from each.

1. Henry Deedes in the Daily Mail

on last night’s Tory leadership TV debate

It felt like seeing the Head Boy debate the class clown

“Mr Hunt was Captain Sensible, Mr Reliable, pressing his opponent on detail every which way. Boris, hair once again a shambolic bird's nest, hands in pockets, shrugged and shuffled his feet and often rambled incoherently. At times, it was like watching the head boy debating with the popular class ragamuffin.”

2. James Moore in The Independent

on Labour’s ongoing Brexit fudge

Labour’s new, fuzzy Brexit position won’t go far enough for ardent Remainers

“In a public vote on a Tory deal, or no deal, Labour is campaigning for your favoured option. With a Labour government in power it’s a lot more fuzzy. The trouble is that among the public, and certainly a large majority of Labour members and, yes, trade unionists, there isn’t much appetite, or belief, that a ‘jobs first Brexit’ can be achieved. It looks like a unicorn. But as things stand, so does a Labour government.”

3. Alice Thomson in The Times

on how Whitehall staff are leaving in droves

Civil servants are sick of being the fall guys

“Now the service is attacked daily and many are leaving, having had enough. The younger generation don’t see the advantages; there is no potential public glory unless you count the small possibility of a gong at the end of your service. They are still working on everything from preventing the spread of ebola to sorting out universal credit. But they are also gaming endless scenarios, depending on who ends up in No 10 and how Britain leaves the European Union. As one says: ‘We’ve become glorified rubbish collectors, clearing up the mess created by politicians’”.

4. Steven Longden in The Guardian

on education’s class ceiling

Labour must be bold, and finally abolish private schools

“There are models of excellent education systems that exist without private schools. Finland is often held up as a system that consistently achieves some of the best educational outcomes across Europe and the OECD countries. In Finland, private schools were effectively brought into the comprehensive education system over the course of a decade. It is time England started to seriously plan a school system without private schools, so that in the future teachers like me can look their students in the eye and tell them that this country has removed one of the biggest barriers that the richest people erected to unfairly advantage their progeny.”

5. Sarag Jeong in The New York Times

on the truth behind Britain’s national obsession

‘Love Island’ Is a Lesson in Surveillance

“The Love Islanders, after all, eventually get to go home. We should fear how our liberties and our own behaviors will be warped by the proliferation of cameras on every street corner, on every car dashboard and in every pocket. But we should be more afraid of how impossible it will be to tell that we’ve changed. There will be no ‘outside’ for us to leave for, no surveillance-free home to return to. In a real surveillance state, even the surveillants must live under the all-seeing eye. Without an ‘outside,’ there are only other contestants within the bubble to film, monitor and confront one another. And what’s worse — being watched by Big Brother, or being watched by your fellow increasingly crazed and desperate comrades?”

The Week’s daily round-up highlights the five best opinion pieces from across the British and international media, with excerpts from each.

1. Ian Birrell in The Times

on Britain’s social care crisis

Social-care funding is a scandal that stains our nation

“Listen to the debate and you might think this is simply about middle-class folks cashing in homes to fund elderly care. But this crisis goes far deeper. It is shrouded in hypocrisy as our health service is sanctified and stuffed with cash while social-care funding shrinks in real terms and support for despairing citizens dries up. This is the impact of local authority budgets being cut deeper than those in Whitehall during austerity by a coalition government to deflect criticism. Now desperate calls for help from cash-strapped councils are surging, led by working-age adults. The means test has become meaner. Worst hit are those reliant on inadequate state support as the care market gravitates towards self-funders paying higher fees.”

2. Jack Bernhardt in The Guardian

on Tory members

Why stop at foxhunting, Jeremy? What about hanging, drawing and quartering?

“Forget bringing back the death penalty – the real Tory member will only accept you if you bring back criminals being hung, drawn and quartered. You’ll have to bring back section 28 too, and go further – make it illegal for anyone to mention Freddie Mercury or Megan Rapinoe within three miles of a school. And for a real vote winner, you’ve got to at least explore the idea of getting back the empire. Bring back national service, get the children to build galley ships (made out of the finest British oak), and then make them row to the subcontinent, dammit, ready to invade again.”

3. Labour deputy leader Tom Watson in The Independent

on how the digital dream turned into a nightmare

As ​Amazon turns 25, let's call time on the tech oligarchy and their dystopian ‘disruptions’ to our lives

“A decade ago I was a digital utopian. I believed in a digital future where the internet would allow us to access all the world’s knowledge in a few clicks and would lead to a level of human flourishing never seen before. The reality is not so much disappointing as dystopian. We now have terrorists live-streaming massacres on digital platforms. Algorithms are sending child users into a rabbit warren of content about suicide and self-harm. Elections are being influenced and even infiltrated by dark online political adverts paid for overseas. Conversations had in the privacy of our own homes are being recorded by Alexa and listened to by anonymous Amazon employees far away across the globe.”

4. David Brooks in The New York Times

on the revolt against baby-boomer morality

Will Gen-Z Save the World?

“Many [young people] seem to have rediscovered the sense, buried for a few decades, that one calling in life is to become a better person. Your current self is not good enough. You have to be transformed through right action. It’s often uncomfortable and over the top, but we’re lucky to have a rebellion against boomer quietism and moral miniaturization. The young zealots may burn us all in the flames of their auto-da-fe, but it’s better than living in a society marked by loneliness and quiet despair.”

5. Ben Lawrence in The Daily Telegraph

on diversity in the arts

Fleabag ‘just for posh girls’? That kind of inverse snobbery threatens creativity

“Of course we need a diversity of voices, but those with the power to commission need to think in terms of meritocracy and balance. For hundreds of years, we have been able to enjoy masterpieces without having to think about their provenance.”

The Week’s daily round-up highlights the five best opinion pieces from across the British and international media, with excerpts from each.

1. Rafael Behr in The Guardian

on Jeremy Corbyn

Corbynism’s greatest liability is now Jeremy Corbyn himself

“Brexit is degrading the Corbyn brand at a rate that alarms ideological devotees. It has been disorienting for many Labour supporters that the leader, normally quick on the draw with a megaphone, refuses to broadcast pro-European resistance. He sounds tongue-tied on the subject and looks like a man hiding from battle, which undermines the image of a candid crusader. When the hero no longer embodies principles on which his movement was founded, the whole edifice wobbles. The attention of young idealists drifts; affection turns conditional; benefit of the doubt is withdrawn.”

2. Con Coughlin in the Daily Telegraph

On the diplomatic challenges facing the Tory leadership hopefuls

Can we trust either of our potential prime ministers with the nuclear codes?

“Much of the criticism concerning Boris Johnson’s tenure in King Charles Street has centred on his handling of the case of Nazanin Zaghari-Ratcliffe, the British-Iranian woman jailed in Iran on false spying allegations. Her supporters claim her plight has been made worse by Mr Johnson’s suggestion that she had taught journalism in Iran prior to her arrest, an activity guaranteed to attract the ayatollahs’ ire. Mr Johnson has vigorously defended his corner, pointing out that it is the Iranian authorities, not him, who are ultimately responsible for Mrs Zaghari-Ratcliffe’s incarceration. Nevertheless, the suggestion that Mr Johnson misspoke when commenting on the case has raised questions about his judgment when handling delicate diplomatic issues. In times of crisis, the country cannot afford to have a leader with their finger on the nuclear trigger who has misread the situation.”

3. Angelica Malin in The Independent

On the gender pay gap

‘Rapid and real change’? The BBC’s pay gap shows women in the media are still underappreciated

“The BBC sets the tone for all media companies in the UK. So long as there is a gender imbalance at the BBC, the message is clear: gender inequality is acceptable. But that also means that achieving gender parity at the Beeb will go a long way to driving gender parity elsewhere. And by placing a greater emphasis on women at the BBC, and on their potential to be role models for others, they will encourage a flow of women towards higher and higher positions.”

4. Gideon Rachman in the Financial Times

On how environmental policy has become a battle ground in the culture wars

The perilous politics of climate change

“All this public attention suggests that putting climate change at the heart of their political programmes is not just a moral imperative for the left. It could also be smart politics. But there are warning signs that show how this could backfire. The urban riots that shook France in recent months had their origins in the government’s decision to raise fuel taxes. President Emmanuel Macron saw this as a vital step in the battle to save the planet. The gilets jaunes demonstrators saw it as an assault on the living standards and lifestyles of rural and small-town France.”

5. Alice Thomson in The Times

On drug reform

Only fools rush in to cannabis legalisation

“It is businesses that are pushing the weed agenda hardest because they are keen to replace the dealers. They will be equally determined to get as much of the population (legally) hooked as possible. For them it’s just a lucrative new market. But there’s no rush. We should wait to see the long-term results in Canada and Colorado before we start enabling people to order a spliff with their takeaway pizzas.”

The Week’s daily round-up highlights the five best opinion pieces from across the British and international media, with excerpts from each.

1. Polly Tonybee in The Guardian

On Jeremy Hunt’s hardening no deal Brexit position

Jeremy Hunt seemed the sensible Tory option. No longer

“The only useful role for the inevitable loser in the Conservative leadership contest was to pull the next prime minister back into the realms of reality. But in the death throes of this contest, Hunt emerges as a swiveller too, a turncoat peddler of the same hyper-dishonesty, just as ready as his opponent to wreck the economy and people’s lives.”

2. Hugo Rifkind in The Times

On how environmentalism stole the show at this year’s Glastonbury festival

Sir David Attenborough was this year’s Glastonbury hero

“In referendum year, the whole site felt like a defensive liberal fortress. The next, it felt like a hotbed of potential revolution. This time, it felt more like an escape. No politics this time, thank you. Give us a week off. It’s why we came.”

3. Freddie Sayers in UnHerd

On the Brexit Party’s ‘manifesto for the regions’

Farage has found Boris’s weak spot

“Never mind that the sums are highly dubious; the politics are significant. Farage’s offer is a hybrid of anti-corporate populism and Thatcherite appeal to small business owners. He is responding to a deeply held feeling across the country that London has benefited over recent decades as the regions have declined. And crucially it makes Boris Johnson, inextricably associated with London as its twice-elected Mayor, a highly vulnerable adversary.”

4. Malcom Rifkind in the Daily Telegraph

On Britain’s response to the Hong Kong protests

Crushing dissent in Hong Kong will not be as easy for China as Tiananmen Square

“The Chinese have always been adamant that they are punctilious in respecting international treaties that they have signed. If China disavows the commitments it has made to protect the freedoms of Hong Kong then the British government cannot just make ritual protests. To keep its honour there would have to be a deep and lasting breach in relations between the UK and China for many years. This would not only damage our trade with China, it would leave China with a reputation as a country that does not honour its obligations.”

5. David Skelton in the New Statesman

On English cricket's declining popularity in the UK

English cricket only has itself to blame for the forgotten World Cup

“In losing terrestrial coverage, cricket has also lost the benefit of capturing accidental viewers and has shut off its heroes from national view. Terrestrial TV coverage lends enormous oxygen of publicity to a sporting event and means that viewers who accidentally tune in might end up hooked. That isn’t the case when you have to buy a satellite dish and a Sky Sports subscription and then make your way to the relevant channel.”

Iran has fired more than a dozen ballistic missiles at Iraqi military bases housing American and British forces as tensions escalate following the assassination of General Qasem Soleimani last week.

Tehran is demanding the withdrawal of US troops from the region and has warned that any further aggression against Iran “will be met with a more painful and crushing response”.

Iranian state television has claimed that 80 “American terrorists” were killed or injured during the attack, at 1.30am local time (0.30pm GMT) on Wednesday, reports The Independent. But both US and Iraqi officials insist there were no casualties.

The targeted military bases, in Irbil and Al Asad, west of Baghdad, are believed to also host UK personnel. The Foreign and Commonwealth Office told the BBC: “We are urgently working to establish the facts on the ground. Our first priority is the security of British personnel.”

What has the UK said?

Foreign Secretary Dominic Raab has said that the UK “condemn[s] this attack on Iraqi military bases hosting Coalition – including British – forces”.

“We are concerned by reports of casualties and use of ballistic missiles,” he said in a statement. “We urge Iran not to repeat these reckless and dangerous attacks, and instead to pursue urgent de-escalation.”

Meanwhile, Metropolitan Police Commissioner Dame Cressida Dick said that the head of UK counterterror policing, Neil Basu, had been in discussions with security agencies and government agencies about how the UK might be affected by the crisis.

“We’re extremely alert to what this could possibly lead to [in London], but it’s a very complex situation,” said Dick. “We are very, very adept at seeing what’s happening around the world, reaching out into communities and looking at the possible threats and risks that might come. That's what we're doing on a day by day basis, and in response to this.”

Prior to the Iranian missile strikes, Prime Minister Boris Johnson said that General Soleimani had played a “leading role [in] the deaths of thousands of innocent civilians and Western personnel”, adding: “We will not lament his death”.

Around 400 British troops are stationed in Iraq, where Soleimani was killed. Amid fears of further reprisal attacks, HMS Montrose and HMS Defender are set to accompany UK-flagged ships through the Strait of Hormuz in the Gulf, where a tanker was seized by Iran last July, reports the BBC.

How has Iran responded?

Following the retaliation strikes, Iran’s Foreign Minister Mohammad Javad Zarif said: “We do not seek escalation or war, but will defend ourselves against any aggression.”

Iranian Supreme Leader Ayatollah Ali Khamenei has described the missile strikes as a “slap in the face” for the US, and is demanding that Washington withdraw its troops from the region.

President Hassan Rouhani added that the US may have “cut off Soleimani’s arm”, but Iran would respond by “cutting off your leg”.

Who opposed the Soleimani assassination?

Opposition leader Jeremy Corbyn has called the killing “an extremely serious and dangerous escalation of conflict”.

The Labour boss later tweeted that the strike was “reckless and lawless” and said that Johnson’s sympathy for the action was “craven and dangerous”.

Echoing that view, Labour leadership candidate Keir Starmer accused Johnson and Raab of “blindly following the Americans”, adding: “We have done this before and it is the wrong place to go.”

Speaking on the BBC’s The Andrew Marr Show, Starmer added that he would support legislation that ensured military action could only be taken if a lawful case for it had been made and a viable objective given, and if the Government had the consent of the House of Commons.

Shadow foreign secretary Emily Thornberry told Sky News that the crisis was “a major lurch towards war” and warned that British interests in the region are “now vulnerable”.

What is the precedent for US-UK military intervention?

The UK has a history of following the US into conflict. In 2003, the UK joined a US-led invasion of Iraq with the primary goals of finding weapons of mass destruction and deposing Saddam Hussein.

Then-PM Tony Blair later admitted the invasion had been based on unchallenged and flawed intelligence. Following the publication of the highly critical Chilcot Inquiry, Blair released a statement acknowledging those failings with “more sorrow, regret and apology and in greater measure than you can know or may believe”.

The UK also joined an international coalition that supported US military action after Washington in 2001 ordered bombing attacks on Afghanistan - notionally in response to the 9/11 terror attacks.

A total of 454 British forces personnel or government civilians were killed in Afghanistan. During the Iraq campaign, 179 British service personnel and three UK government civilian staff lost their lives.

British-Iranian charity worker Nazanin Zaghari-Ratcliffe has been given diplomatic protection by the UK Foreign Office in an escalation of the campaign to get her freed from prison in Iran.

In a statement published this morning, Foreign Secretary Jeremy Hunt’s department said: “The Foreign Secretary has today decided that the UK will exercise diplomatic protection in the case of Nazanin Zaghari-Ratcliffe as part of the Government’s continuing efforts to secure her release.”

Diplomatic protection is a “rarely used tool under international law, which gives a country the right to challenge another state over the treatment of one of its nationals or companies”, says Sky News. It formally elevates a dispute from being a consular matter to being a formal state-to-state issue, and officially functions as a way for countries to take action on behalf of a national whose rights have been breached by another country.

Diplomatic protection can take the form of “consular action, political and economic pressure, negotiations with the other state, judicial proceedings or other forms of peaceful dispute settlement”, says the i news site.

It is different to diplomatic immunity, which applies to accredited diplomats and provides them with immunity from prosecution for most crimes when serving abroad.

Zaghari-Ratcliffe was arrested at Tehran airport with her one-year-old daughter, Gabriella, in April 2016 following a visit to her family. She was subsequently sentenced to five years for spying - an accusation she has denied.

Her daughter, now four, lives with her maternal grandparents in Iran, and has not seen her British father for three years.

The move to give Zaghari-Ratcliffe diplomatic protection is based on UK government claims that her treatment “fails to meet Iran’s obligations under international law”, and is “likely to lead to increased tensions between the two countries”, The Guardian suggests.

BBC diplomatic correspondent James Landale says that the jailed woman’s new legal status will not force Iran to change the way it treats her, but “will allow Britain to raise her case with greater ease at international forums such as the United Nations”.

Hunt said today that the move “is unlikely to be a magic wand that leads to an overnight result”, but added that it “demonstrates to the whole world that Nazanin is innocent and the UK will not stand by when one of its citizens is treated so unjustly”.

This is first time in recent history that this diplomatic tool has been implemented, with Hunt admitting the step was “very unusual”.

The British government has directly accused Russia’s GRU military intelligence agency of being behind a spate of “reckless and indiscriminate cyberattacks” across the world.

A new report by the UK’s National Cyber Security Centre accuses Russian intelligence services of masterminding six acts of cyberwarfare that served no legitimate Russian national security interests.

In an unprecedented statement, Foreign Secretary Jeremy Hunt said: “The GRU’s actions are reckless and indiscriminate. They try to undermine and interfere in elections in other countries, they are even prepared to damage Russian companies and Russian citizens.

“This pattern of behaviour demonstrates their desire to operate without regard to international law or established norms, and to do so with a feeling of impunity and without consequences.

“Our message is clear - together with our allies, we will expose and respond to the GRU’s attempts to undermine international stability.”

The UK Foreign Office has identified 12 code-named hacking groups believed to be linked to the GRU - Fancy Bear, Voodoo Bear, APT28, Sofacy, Pawnstorm, Sednit, CyberCaliphate, Cyber Berku, BlackEnergy Actors, STRONTIUM, Tsar Team and Sandworm.

“Some of the groups are well known, like Fancy Bear, and others less well known,” says the BBC’s Gordon Corera. “The British statement puts them all together in one place and confirms that in the view of British intelligence, they all belong to the GRU.”

The alleged attacks by the intelligence agency include the hacking of the US Democratic National Committee in 2016, which resulted in a mass leak of private emails and message logs from party officials.

Also on the list is the hacking of an unnamed small UK-based TV station between July and August 2015, when multiple email accounts were accessed and content stolen.

And UK cyber experts believe the GRU was almost certainly behind the Bad Rabbit ransomware attack last year, which “targeted a Ukrainian international airport and Russian media outlets, as well as the hacking of the World Anti-Doping Agency in Switzerland”, says the Radio Free Europe/Radio Liberty news site.

Former UK diplomat Lord Ricketts told the BBC that Russia may have targeted the doping watchdog “to distract from the very serious allegations about Russian athletes”, while the Ukraine attack was probably intended to “destabilise” the region.

But some of the other attacks appear to have been random, Ricketts added, and might have been part of a “pilot project” to “see what they can do at a point where they wanted to use” cyberwarfare.

Professor Malcolm Chalmers of London-based defence think-tank Rusi told The Guardian: “Most intelligence services try to gain advantage through stealing the secrets of their adversaries. But the GRU’s activities go well beyond this traditional peacetime espionage role.

“By launching disruptive operations that threaten life in target societies, they blur the line between war and peace.”

The allegations in the new report “are bound to be dismissed as propaganda by Russia, but experts claim [Russian President Vladimir] Putin would be taken aback by the depth of the exposure of his intelligence service’s actions”, adds the newspaper.

The Health Secretary admitted that as many as 270 women in England may have died because of a mix-up over breast-cancer screening.

The NHS screens all women between the ages of 50 and 70 for breast cancer every three years. They should receive a letter from their GP about the test, which aims to catch cancer early when it is easier to treat.

But Jeremy Hunt told the Commons that 450,000 women aged 68 to 71 did not receive invitations to a final routine breast cancer screening because of a computer glitch.

The error was caused by a computer algorithm failure that happened in 2009 but was only discovered in January this year after a review by Public Health England (PHE).

This meant women approaching their 71st birthday were not sent an invitation for a final breast scan, with subsequent computer modelling suggesting that between 135 and 270 women may have had their lives shortened as a result.

Hunt apologised “wholehearted and unreservedly” to the women and their families and announced an independent review to investigate the scandal, but the medical profession has warned the implication for GPs will potentially be “significant”.

According to The Daily Telegraph, the inquiry will examine how the failings were allowed to continue for almost a decade.

The review will examine whether the problems, which began under Labour, were detected at any level, and whether any matters were referred to ministers.

Hunt added that his department would contact the families of women who had died of breast cancer and whom it believed had missed a screening, to apologise, while family members would have their concerns investigated and compensation may be payable if the error was found to have led to an earlier death.

Physicist Stephen Hawking and a group of health campaigners have won permission to pursue a court challenge to Jeremy Hunt’s plans to restructure NHS England.

Hawking and the campaigners, who use the name JR4NHS, argue that the proposals could lead to a US-style privatisation of the health service. They also claim the Health Secretary’s plans are so far-reaching that an Act of Parliament is required, allowing MPs and Lords to scrutinise the proposed changes.

Hunt’s proposals could “allow commercial companies to run health and social services across a whole region”, says The Independent. Responsibility for patients in these regions would be held by new healthcare overseers called Accountable Care Organisations (ACOs).

Although a High Court judge has granted permission for JR4NHS to pursue a judicial review, there is no cap on the legal costs that the group would have to pay if they lost the case. The campaigners are said to be considering their next steps. A crowdfunding page has raised more than £150,000 for legal costs.

The Department of Health and Social Care dismissed the group’s case as “irresponsible scaremongering”, the BBC says.

In scenes reminiscent of BBC political satire The Thick of It, hospital bosses in England and Wales were forced to chant “we can do this” by a senior NHS official, in an effort to improve their accident and emergency performance.

Hospital trust chief executives say they were left feeling “bullied, patronised and humiliated” by the incident at a meeting attended by Jeremy Hunt, the health secretary, and Simon Stevens, the head of the NHS in England.

The leaders of 59 trusts which “NHS national bodies deemed to have the worst record on meeting the politically important four-hour A&E treatment target were called into a meeting held in London on Monday 18 September,” says The Guardian.

The hospital bosses were then divided up into smaller groups based on their geographical positions.

According to the Health Service Journal, which revealed details of the meeting, Paul Watson, NHS England’s regional director for the Midlands and east of England, encouraged those in the group he was leading to chant “we can do it” as part of his plan to improve their A&E performance.

One hospital chief executive at the meeting told the HSJ: “It was awful – the worst meeting I’ve been at in my entire career. Watson said: ‘Do you want the 40-slide version of our message or the four-word version?’ Everyone wanted the four-word version, obviously.”

“He then said ‘I want you to all chant ‘we...can...do...this’. It was awful, patronising and unhelpful, and came straight after the whole group had just been shouted at over A&E target performance and told that we were all failing and putting patient safety at risk.”

The story prompted complaints from within the NHS that the chanting was “Bob the Builder for NHS leaders,” says The Guardian, referring to the TV character's “Can we fix it? Yes we can” catchphrase.

Another HSJ reader posted a comment on its website saying the practice was: “More akin to North Korea than the NHS”.

Watson has since apologised saying the chanting “was meant as light relief rather than brainwashing.”

The purpose of the meeting appeared to be so the health secretary could “send a message that those who failed to hit A&E targets must do more or risk losing their jobs,” says The Sun.

But one of the paper’s well-placed sources said the event offered them “nothing new” to learn and that trust leaders were upset at being told to “own their problems, not externalise them”.

NHS trusts will be forced to collect upfront payments from overseas patients before giving them non-urgent care, Health Secretary Jeremy Hunt has announced.

The move, which starts in April, is designed to cut down on so-called "health tourists", who "could be refused operations unless they agree to cover their costs in advance", the BBC says.

Emergency treatment will still be provided for overseas patients and an invoice will be sent afterwards.

Hunt said the proposal would help government efforts to recoup up to £500m each year, which it plans to reinvest in the NHS.

"We have no problem with overseas visitors using our NHS as long as they make a fair contribution, just as the British taxpayer does," he said.

The new rule also "raises the prospect of patients having to produce their passports and other identity documents before receiving most kinds of treatment", The Guardian reports.

Shyamantha Asokan, from medical charity Doctors of the World, told the paper that forcing identity checks on patients could have a negative impact for vulnerable people.

She said: "They're often very worried about going to a hospital because they are worried about being asked for documents they don't have or being asked to pay.

"A lot of the doctors who volunteer for us don't want to be made into border guards."

The British Medical Association is seeking more information about how the new rules will be implemented.

"There is no detail as to how upfront charging will be introduced from scratch in just three months in an NHS already unable to cope with normal operations," it said.

Health Secretary Jeremy Hunt has told restaurants and cafes to reduce the size and sugar content of their puddings or face public scrutiny.

The government is already urging supermarkets to reduce sugar content in their products by 20 per cent, but the latest initiative acknowledges that eating out has become more common and subsequently more damaging to the nation's waistline.

Going out to eat is "no longer a treat", said Hunt, citing research that suggests a quarter of families with children eat fast food every week as he addressed representatives of 100 food companies, including McDonald's, Starbucks and Pizza Express.

"This means we expect the whole of the out-of-home sector… to step up and deliver on sugar reduction," he added

Duncan Selbie, the chief executive of Public Health England, which has long warned of a growing obesity crisis in the UK, told the meeting that he wants to see "uniform and comprehensive reduction and reformulation" of food and drink.

Companies will be asked to either cut the amount of sugar in their products, reduce their serving sizes or replace them with healthier alternatives.

Although there is no legal path to compel the food industry to comply, chains that continue to serve up gut-busting desserts now risk being named and shamed.

The Health Secretary vowed that the government would "shine a light" on companies that fail to make the necessary changes, which will apply to restaurants, takeaways, cafes and food manufacturers.

Next year, savoury foods will also be the target of an attempt to reduce calories, salt and fat.

Hunt's warning marks a "toughening of approach", says The Times, despite the government's childhood obesity blueprint being "castrated" by Theresa May.

The Prime Minister has been accused of being soft on tackling obesity after she jettisoned a plan to curb junk food advertising.

More than 1,000 NHS patients in England have suffered from medical mistakes so serious they never should have happened in the last four years, according to new analysis.

The blunders, described by NHS as "never events", include operations on the wrong patient and the wrong limb, a woman having her fallopian tubes removed instead of her appendix and "foreign objects" being left inside patients.

In one case, reports the Daily Telegraph, a man had a testicle removed instead of just the cyst on it, while one woman had a kidney removed instead of an ovary. Another patient had a biopsy taken from their liver instead of their pancreas.

The analysis, carried out by the Press Association, saw a fairly steady trend of medical mistakes as catalogued by NHS England.

The research showed there were:

• 254 "never events" from April 2015 to the end of December 2015

• 306 from April 2014 to March 2015

• 338 from April 2013 to March 2014

• And 290 from April 2012 to March 2013.

"It is a disgrace that such supposed 'never' incidents are still so prevalent," said Katherine Murphy, the chief executive of the Patients Association.

She added: "With all the systems and procedures that are in place within the NHS, how are such basic, avoidable mistakes still happening? There is clearly a lack of learning in the NHS.

"These patients have been very badly let down by utter carelessness. It is especially unforgivable to operate on the wrong organ and many such mistakes can never be rectified."

In response to the analysis, an NHS England spokeswoman said: "One 'never event' is too many and we mustn't underestimate the effect on the patients concerned.

"However there are 4.6 million hospital admissions that lead to surgical care each year and, despite stringent measures put in place, on rare occasions these incidents do occur."

Jeremy Hunt, the Health Secretary, takes 'never events' so seriously that he "famously keeps a whiteboard updated with the latest disasters on a wall in his ministerial office", says The Guardian.

"I want to normalise openness and transparency," Hunt told the newspaper in a recent interview, stressing the need for healthcare staff to learn from previous mistakes.

Jeremy Hunt is to increase the number of medical school places by 25 per cent under plans to make NHS England "self-sufficient".

Addressing the Conservative Party conference today, the Health Secretary will announce an extra 1,500 training places a year aimed at student doctors from within the UK. The move will begin in 2018.

Currently, as many as one in four medical workers are trained outside the UK, but Hunt will warn the impact of Brexit and a global shortage of doctors could make it harder to recruit so many in the future.

Praising foreign-trained doctors for doing a "fantastic job", he will tell delegates the government wants "EU nationals who are already here to be able to stay post-Brexit", but will add: "Is it right to import doctors from poorer countries that need them while turning away bright home graduates desperate to study medicine?"

Prime Minister Theresa May told the BBC: "We want to see the NHS able to recruit doctors from this country. We want to see more British doctors in the NHS."

As medical degrees take five years to complete, it will be 2024 before the impact of these extra places is felt, says the broadcaster.

The move represents a partial U-turn by Hunt, says The Guardian: "Until now he has repeatedly responded to evidence of under-staffing by pointing out that the NHS in England has more doctors now than when the coalition took office in 2010."

Hunt's news was welcomed by the British Medical Association (BMA), but the body's chairman, Dr Mark Porter, questioned whether it would achieve the desired effect of self-sufficiency.

"We desperately need more doctors, particularly with the government plans for further seven-day services, but it will take a decade for extra places at medical school to produce more doctors. This initiative will not stop the NHS from needing to recruit overseas staff," he said.

The Health Secretary is also risking a fresh clash with the medical profession by vowing to punish newly trained doctors who leave the UK for countries such as Australia, Canada and New Zealand, says The Independent.

Medics will be required to work for the NHS for at least four years after graduation or face a hefty fine.

A source told The Independent: "We are announcing a commitment to fund many more home-grown doctors. What we want is for them to guarantee us a period of service in the NHS in return.

"It's people who are trained at the taxpayer's expense and then very quickly move abroad – that's what we are trying to disincentivise.

"It costs £200,000 to train every doctor, so we think it's reasonable to expect that the NHS will benefit from that investment," added the source.

More doctors' strikes - is the medical profession at war?

2 September

Junior doctors are planning a series of monthly five-day strikes between now and the end of the year, arguing there is neither the staff nor the money to support a new contract guaranteeing extra weekend care in hospitals.

In a year that has already seen six strikes by the medics, yesterday's escalation of industrial action has divided health professionals.

"The medical profession are at war," says the Daily Telegraph after the Academy of Medical Royal Colleges announced it did not consider the planned strikes "proportionate".

Niall Dickson, the chief executive of the General Medical Council, said the strike was "a matter of great concern for everyone, especially patients".

But Dr Mark Porter, the chairman of the British Medical Association (BMA), which took the vote to strike, said: "The council, as is the rest of the BMA, is absolutely behind the decision".

Several newspapers have been critical. "Not only would action be unethical but also illogical," says the Telegraph, while The Times warns: "Five days is a long time to be 45,000 staff short" and urges the BMA to reconsider its decision.

The Daily Mail, meanwhile, says the "the doctors' decision to barter lives for cash drags their profession into deep disgrace".

Patients Association chief executive Katherine Murphy, quoted in The Guardian, said her organisation was "gravely troubled" at the "catastrophic impact this will have on so many patients and their families".

Meanwhile, Nigel Edwards of the Nuffield Trust, an independent health charity, told BBC Radio 4's Today programme the strikes would be significant for senior staff, who stepped in for junior doctors during the last walkout.

Questions have also been raised about the BMA vote – Porter, in an interview with Nick Robinson, refused to give details after failing to deny the result was as close as 16-14. Dr Hamed Khan was similarly uncommunicative during an appearance on Iain Dale's LBC radio show, prompting the host to label him "pathetic".

The Guardian says the strike decision was a 16-12 vote.

Junior doctors to stage first five-day national strike in history

1 September

Junior doctors in England will go on an unprecedented five-day strike later this month in protest over a new working contract, the British Medical Association (BMA) has announced. Staff will down tools from 8am to 5pm during 12-16 September.

The doctors' union says the new contract, which is being imposed by the government, "did not do enough to reward those who work the most weekends" and was "unfair on part-time workers".

Dr Ellen McCourt, the BMA junior doctors' committee chair said "time is running out" for negotiation, as the first group of medics are due to start the contract in the coming weeks.

"We have a simple ask of the government: stop the imposition. If it agrees to do this, junior doctors will call off industrial action," she said.

Health Secretary Jeremy Hunt described the strike as "devastating news" for patients and called for fresh talks "to resolve the ongoing dispute".

The strike will have an enormous impact on health services, with an estimated "30,000 operations and a quarter of a million out-patient appointments" needing to be cancelled, says the Daily Telegraph.

This month's strike could be the first of many five-day walkouts by junior doctors. "Confidential papers drawn up by the BMA have suggested there could be five days of strikes each month for the rest of the year," reports the BBC.

NHS faces more disruption as junior doctors reject new contract

5 July 2016

The NHS is facing fresh disruption after junior doctors and medical students across England voted to reject a proposed new contract.

On a turnout of 68 per cent – around 37,000 junior doctors and medical students – 42 per cent voted in favour of the contract, while 58 per cent voted against it, the British Medical Association said.

Johann Malawana, who led the BMA’s junior doctors’ committee and had recommended that his members accept the new deal, is to stand down to allow a new leader to take negotiations with the government forward.

Malawana said that, having spoken to many medics across the country, it had become clear that some had "reservations about what it would mean for their working lives, their patients and the future delivery of care in the NHS".

There was "considerable anger and mistrust towards the government’s handling of this dispute", he added.

Health Secretary Jeremy Hunt said the outcome was "extremely disappointing" given that the contract "was agreed with and endorsed by the leader of the BMA junior doctors’ committee".

It is unclear what will happen next, says The Guardian, but there is the possibility of further industrial action as the Hunt had warned previously he would impose the contract from October if it were rejected.

In a statement today, the Health Secretary highlighted the turnout, saying it meant only 40 per cent of those eligible had actually voted against the deal. "We will now consider the outcome," he said.

In an article for The Independent, entitled: "Why my fellow junior doctors have rejected Jeremy Hunt's contract, despite the BMA's endorsement", junior doctor Rachel Clarke lamented Hunt's "year of slandering, smearing and undermining" junior doctors.

"Gaps in our rotas are rife as missing doctors have quit the profession in despair. Every one of these gaps puts patients at risk," she writes.

Junior doctors: Hunt accused of 'computer says no' attitude

19 May

Health Secretary Jeremy Hunt has been criticised for having a "computer says no" outlook in the long battle over the new junior doctors' contract.

A deal has finally been struck between government negotiators and the British Medical Association (BMA) after drawn-out talks and several strikes, but Labour says the pact could have been made months ago.

In a House of Commons debate today, Heidi Alexander, the shadow health secretary, said: "What is now clear, if it wasn't already, is that a negotiated agreement was possible all along. So I have to ask you, why couldn't this deal have been struck in February? Why did you allow your pride back then to come before sensible compromise and constructive talks?

"When you stand up you might try to blame the BMA for the negotiations breaking down, but you failed to say what options you were prepared to consider in order to ensure that the junior doctors who work the most unsociable hours are fairly rewarded. It was a 'computer says no' attitude and that's no way to run the NHS."

Hunt rejected her claims, although he admitted on BBC Radio 4 earlier in the day that he had "lessons to learn" from the protracted dispute.

"I don't say I was responsible for the industrial action because I think that was a decision taken by the BMA and initially caused by the fact that at the time there was not willingness to engage with the big issues that we needed to resolve to deliver a seven-day NHS," he said.

Dr Johann Malawana, the BMA's junior doctors' leader, said "intense but constructive talks" had led to a deal that offered the "best and final way" of resolving the dispute.

The key points of the deal include:

• Premium pay for Saturdays and Sundays if doctors work seven or more weekends in a year, ranging from three per cent for working one weekend in seven to up to ten per cent if they work one weekend in two.
• A premium of 37 per cent for any night shift from 8pm onwards that lasts more than eight hours.
• A basic pay increase of 10 to 11 per cent, down from the 13 per cent originally offered.

However, The Guardian points out that the BMA still needs to put the deal to its 45,000 members for ratification and is "facing a growing backlash from junior doctors furious at what some called 'a sellout' and 'a joke'."

Junior doctors: Hunt willing to pause introduction of contract

05 May

The government has said it is willing to pause the introduction of the new junior doctors' contract for five days from Monday.

The move comes after the Academy of Medical Royal Colleges issued a plea to both Health Secretary Jeremy Hunt and the British Medical Association to commit to a "serious attempt to reach a resolution through genuine dialogue".

In a letter to the academy, Hunt said the government remains committed to introducing the new contract in August, but is willing to agree to a temporary suspension "to play our part" in attempting to reach an agreement.

"This is a significant show of good faith by the government to break the deadlock," he said. "We now need the BMA to agree to negotiate on Saturday pay, the biggest single area of difference, in order for the talks to proceed."

In return, the BMA said it was prepared to suspend any new threats of strikes for five days, but warned Saturday pay was not the only sticking point.

"As suggested by the academy, we are keen to restart talks with an open mind. It is critical to find a way forward on all the outstanding issues – which are more than just pay – and hope that a new offer is made that can break the impasse," said Dr Johann Malawana, the chairman of the BMA junior doctor committee.

Shadow health secretary Heidi Alexander welcomed the pause offer and urged her Tory counterpart to "put his pride to one side" and resume negotiations.

The pause "raises the prospect of fresh talks being held at the start of next week", says The Guardian.

But the new development does not guarantee new discussions will take place, says the Health Service Journal's Shaun Lintern.

Junior doctors' strike 'would be settled with Brexit'

26 April

Junior doctors taking part in an all-out strike today would be given pay rises if the UK voted to leave the European Union in June, Vote Leave has suggested.

Thousands of junior doctors walked out at 8am this morning to protest a new contract due to be imposed upon them by the government this summer.

It is the first time in NHS history that services such as A&E, maternity and intensive care have been hit by strike action.

In a statement, Vote Leave declared the pay dispute "could be settled with just over two weeks of our EU contributions".

Promoting a new campaign video on its website, it said: "We send £350m to the EU every week, money which would be much better spent on our priorities like the NHS.

"Our public services are already under huge pressure from uncontrolled migration.

"The only way to take back control of our borders and ease the pressure on our NHS and public services is to Vote Leave on 23 June."

The move was greeted with "dismay and anger" in Whitehall, where a source dismissed the claim as "bonkers", says The Times.

Downing Street insists the dispute is "not about how we save money but how we put the NHS on a stronger footing to deliver better patient care", while Health Secretary Jeremy Hunt has said that "no trade union has a right to veto a manifesto promise voted for by the British people".

Today's strike is due to end at 5pm, but another will take place during the same hours tomorrow.

"Hospitals can request that junior doctors return to work if needed, but as yet no NHS trust has raised the alarm," says the BBC.

An Ipsos Mori poll for the broadcaster found that 57 per cent of voters supported the strike and 26 per cent were opposed.

Infographic by www.statista.com for TheWeek.co.uk

Jeremy Hunt turns down chance to stop junior doctors' strike

25 April

Junior doctors providing emergency care are to go on strike for the first time tomorrow after Health Secretary Jeremy Hunt rejected a cross-party plan for a new work contract to be piloted before a national roll-out.

MPs had called for the contract to be "independently evaluated in operation and a study made of its impact on mortality rates at weekends", reports the BBC.

However, Hunt dismissed the Labour-brokered proposal as "opportunism".

The Health Secretary said that only 11 per cent of junior doctors will start new contracts in August, meaning they are already being brought in gradually.

"We're staging implementation to ensure it works as intended. Any further delay just means we will take longer to eliminate weekend effect," he said.

Doctors union the British Medical Association had said its representatives "would discuss the possibility of calling off the strikes if the government agreed to limited trials of the contract", but speaking on the BBC's Andrew Marr Show yesterday, Home Secretary Theresa May said the decision to impose contracts unilaterally would stand.

Lose-lose situation

Clare Marx, the president of the Royal College of Surgeons, said the dispute was a "lose-lose situation" for all parties and that the college strongly backed Labour's proposal as a way out of the current impasse.

With the mass walkout due to begin tomorrow morning and expected to affect accident and emergency, maternity and intensive care units, as well as general services, hospitals have been making "desperate efforts" to prepare, reports the Daily Telegraph.

It adds that heavily pregnant women and cancer sufferers are among more than 125,000 NHS patients whose treatments have been postponed.

Almost 13,000 operations have been delayed and 113,000 appointments cancelled in an attempt to ensure essential services can still be run.

Lindsay Hoyle, the deputy speaker of the House of Commons, said he had requested the help of the Army to support a "chronically understaffed" A&E department in Lancashire.

Junior doctors begin fourth 48-hour strike

06 April

Junior doctors in England went on strike this morning at 8am, their fourth 48-hour stoppage this year. More than 5,000 non-urgent operations have been cancelled, NHS managers say.

The BBC says un-named sources believe there is "now little dialogue between ministers and the union" after the government said it would impose new contracts this summer.

Doctors' groups warn the revised conditions are unfair and will lead to them working longer hours, which they say will be unsafe for patients.

The NHS has produced advice for patients during the strike, most of which is "common sense", according to The Guardian. The service's Twitter account said hospitals would get in touch if they needed to rearrange operations.

Support for the doctors remains strong. Actor Stephen Mangan tweeted that he and four of his co-stars from the medical TV comedy, Green Wing, will today visit Northwick Park Hospital, where the series was filmed.

Meanwhile, actress Vanessa Redgrave was due to join a rally in central London this morning, along with junior doctors, nurses, teachers and members of the fire service union before a petition of 120,000 signatures opposing the new contracts is presented to the Department of Health.

In addition to the current series of walkouts, emergency care staff are expected to go on strike for the first time in the NHS's 68-year history at the end of this month.

Junior doctors launch three strikes and a legal challenge

24 February

The bitter conflict between the British Medical Association and the government has entered a new phase, with the union launching a legal challenge against Health Secretary Jeremy Hunt's plan to impose new contracts on junior doctors.

Three more 48-hour strikes have also been announced to take place over the next two months. The stoppages will be held on Wednesday 9 March, Wednesday 6 April and Tuesday 26 April, beginning at 8am.

Dr Johann Malawana, the BMA's junior doctor leader, said he has spent the past two weeks consulting with members who "cannot and will not accept" the imposition of the new contracts, which include paying doctors less to work on Saturdays.

"The government must put patients before politics, get back around the table and find a negotiated solution to this dispute," he said.

The union claims ministers have "failed to assess whether the contract might discriminate against particular groups of junior doctors", says The Independent.

Politicians have imposed the contract on junior doctors "knowing there is a potential for further industrial action", says The Guardian. "But they are also convinced that the opposition will start to ebb away once the contract comes into force, arguing that most will see a small rise in pay and an improvement in their working hours."

David Cameron's official spokeswoman said: "It's regrettable if they are going to strike again. I'm sure discussions will continue."

Junior doctors to 'speak with their feet' over enforced contracts

12 February

The government's decision to impose changes to junior doctors' working hours and contracts in England could prompt a mass exodus of medics that would seriously harm the NHS, unions say.

Thousands of junior doctors returned to work yesterday, after a second 24-hour strike over plans for a seven-day health service.

After its final offer was rejected, the government said it will impose the new contracts, "setting the scene for renewed confrontation and the possibility of further strikes", says The Guardian.

Junior doctors reiterated that imposing contracts was a "huge gamble" because it would lead to dangerous working practices that would put patients at risk.

But while the BMA leadership is "considering all options", it fears more strikes would damage the public support junior doctors have so far enjoyed, says The Independent. A YouGov poll said 49 per cent of people support the strike action.

Union leaders say some doctors could chose to "speak with their feet" and leave the NHS altogether.

While the NHS is effectively a monopoly employer, it would be a risk to assume that means there will be "no impact on the numbers staying in the health service", says the BBC's Nick Triggle. "Imposition may solve a short-term problem, but the long-term effect is unknown," he adds.

Already, half of doctors who finish their training step off the career ladder by not specialising. Some go abroad while others are drawn to opportunities in alternative sectors, including the pharmaceutical industry.

"To lose a large swath of doctors in the early stages of their careers would be a disaster for the NHS," says Kitty Mohan, the co-chairman of the BMA's junior doctors committee.

The Welsh government has already extended a "very warm welcome" to English doctors seeking to escape new contracts, says The Independent. Wales and Scotland have previously said they will maintain the existing contractual arrangements, prompting some junior doctors to plan an "escape" to Scotland, according to BuzzFeed News.

Junior doctors reject Hunt's 'final' pay offer

11 February

The dispute between junior doctors and the government has intensified, with reports suggesting the medics have rejected a final "take-it-or-leave-it" pay offer.

The package included a concession on Saturday pay but the British Medical Association said it was not enough. The rejection "is expected to lead ministers to announce that they are going to impose a contract on doctors", says the BBC.

According to the Daily Telegraph, Health Secretary Jeremy Hunt could act within days to force through a new deal.

"We do need to have resolution on this," Hunt has said.

A second strike by junior doctors yesterday showed "signs of dwindling support", the newspaper says. Including those on emergency duties, 43 per cent of doctors turned up to work, compared with 39 per cent in January.

The dispute stems from changes to payments for unsocial hours as part of the government's plan to introduce seven-day services within the NHS.

The government has made several offers to the doctors, including one in November that promised an 11 per cent rise in the basic levels of pay. However, that offer would have treated Saturday as a normal working day, with no anti-social working-hours bonus.

The BMA proposed instead that basic pay should rise "by about half the 11 per cent offered by ministers in return for Saturday not to be treated as a normal working day", the Telegraph says.

The two sides failed to reach agreement before a deadline set by Hunt elapsed last night.

Junior doctors' strike: second 24-hour walkout begins

10 February

Junior doctors are holding their second 24-hour strike this year, in response to the continued deadlock over changes to their contracts.

From 8am Wednesday to 8am Thursday, the majority of the medics will be providing emergency cover only. Almost 3,000 scheduled non-urgent operations have been cancelled.

Tensions have been high between the British Medical Association (BMA) and the government since the new contract was unveiled as part of Health Secretary Jeremy Hunt's "seven-day NHS" plan to lower weekend mortality rates. Around 38,000 doctors – around two-thirds of the workforce - took part in last month's walkout in protest at the changes.

Currently, junior doctors receive higher pay for night-time and weekend shifts. The government wants to include Saturday as a normal working day and reduce the hours eligible for higher pay during the evenings. The BMA says this could represent a pay cut of between 15 and 30 per cent.

There are also concerns the new contract could force the medics to work longer shifts, with a potential impact on patient safety as well as doctors' wellbeing.

The Health Secretary has suggested a "nuclear option" could be used if no agreement is reached, using the government's power to forcibly impose the terms of the new contract without further negotiation.

However, a new survey seen by The Independent says 90 per cent of junior doctors would consider quitting the NHS if the new agreement was imposed in its current form.

BMA chief Dr Mark Porter told the newspaper that committed young doctors had been driven to the drastic step of industrial action by the government's insistence on "putting politics before common sense".

Meanwhile, polls from both Ipsos Mori and YouGov show the strike action has the public's backing, with 45 per cent of YouGov's respondents blaming the government for the deadlock compared to 12 per cent who blamed the BMA.

Junior doctors' stirke back on after talks flounder

05 January

A series of strikes by junior doctors in England, called off at the end of last year, is back on after talks with the government broke down.

A 24-hour strike next Tuesday will be followed by a 48-hour walkout starting on 26 January and another one-day strike on 10 February, the British Medical Association (BMA) has announced.

The dispute between junior doctors and the government was prompted by the introduction of a new contract.

A last-ditch offer made before last night's midnight deadline is believed to have included a larger increase in basic pay. But the talks broke down because the increase was offset by curbs to other parts of the pay package, including unsociable hours payments.

The government has said the changes are needed to create more seven-day services, but the BMA has warned it could lead to doctors being over-worked because safeguards designed to prevent excessive hours are being weakened.

The Health Secretary Jeremy Hunt told BBC Radio 4's Today programme that the talks "lasted less than an hour" and that he had thought they were "making very good progress".

"We've offered protection for 99 per cent of doctors, so 99 per cent will either see their pay protected or go up," he said.

In response, the BMA's chairman Dr Mark Porter described the 99 per cent figure as "Government propaganda".

He told the Today programme: "The Government is, understandably, putting round the fact that agreement is almost there.

"It's almost there in their mind but not in the minds of junior doctors."

He added: "An 11% pay increase doesn't compensate when you take away a 31% average payment for working the unsocial hours. Anybody can do the maths on that."

All three of the strikes will start at 8am. During the first two stoppages, junior doctors will provide only emergency care, the BMA says, while the final strike will involve a full withdrawal of labour.

Health Secretary Jeremy Hunt wants people to be given full access to their medical records with their smartphones by the end of the next financial year.

His target is for one in four smartphone users to be able to access the NHS in some form by April 2017, says The Independent.

Hunt also said patients should be able to use activity monitoring devices such as the Fitbit, a bracelet which counts steps and connects with a smartphone, to send information about their health to their GPs.

The health secretary said all NHS patients would be able to view their entire medical records online – not necessarily with a smartphone – by 2018. GP records, including appointments and blood tests, will be available by next year.

Empowering patients in this way would encourage them to take responsibility for their health and lifestyles, said Hunt, and would break the old paradigm of a powerful doctor instructing a suffering patient.

He told the NHS England's annual conference in Manchester on Tuesday: "The evidence from all over the world is that when patients start to access their medical records, they start to think about their health care in a different way.

"When you have shared access to a medical record, it becomes a shared endeavour, a shared responsibility, and the world's most powerful patients become the world's healthiest patients."

But The Guardian says doctors' groups have concerns about the health secretary's plans, as well as worries about confidentiality and patient safety. The British Medical Association (BMA) fears vulnerable patients with abusive partners could be coerced into revealing their medical secrets.

Other doctors expressed concern that the notes they write in patients' files would now be revealed. For example, a doctor might have recorded that a smoker was at risk of cancer but had chosen not to tell the patient.

There are also worries that avaricious private companies might try to get hold of the data contained in medical records in order to sell drugs to patients, or otherwise exploit them.

As for the Fitbit plan, the Royal College of GPs warned that doctors are already overburdened with work and would not have time to analyse extra data sent to them by patients wearing the device.

Jeremy Hunt has pledged to introduce a "new deal" for GPs to ease their workload and make the profession more appealing to young doctors.

In a speech today, the Health Secretary will promise increased investment in under-pressure services, and the introduction of an extra 5,000 new GPs by 2020 as well as 5,000 clinical support staff.

Hunt says that the funding increases will help England's 8,500 surgeries to cope with the challenges associated with an ageing population. But he will say that in return for the additional investment, GPs will need to sign up to his plans for weekend opening, the BBC reports.

"I want to be upfront: this is not about change I can deliver on my own," Hunt will tell GPs. "If we are to have a new deal, I will need your co-operation and support.

"Within five years, we will need to look after a million more over-70s. Put simply, if we do not find better, smarter ways to help our growing elderly population remain healthy and independent, our hospitals will be overwhelmed."

Dr Chaand Nagpaul, of the British Medical Association, said GPs were "ready to work with the government", but insisted there could are problems with trying to introduce a seven-day service.

"Pilots of seven-day routine working are increasingly demonstrating a low uptake of routine weekend appointments," Nagpaul said. "Therefore, to make the most of the limited GP workforce and precious NHS resource, the government should focus on supporting practices during the day and further develop the current 24/7 urgent GP service so that patients can be confident of getting access to a quality GP service day and night."

Andrew Gwynne, the shadow health minister, said that the problems within general practice in the UK were due to Conservative mismanagement.

"David Cameron's fingerprints are all over the Tory GP crisis," Gwynne said. "He made it harder to see a GP, scrapping the right to an appointment in 48 hours and cutting the scheme for evening and weekend opening. And he has created a GP workforce crisis by training fewer GPs and sending morale plummeting to rock-bottom."

People suffering from mental health problems are not being given adequate care because the system is struggling to cope, the Care Quality Commission has warned.

In a damning report, the regulator revealed that almost half of all patients in need of urgent medical care did not receive the help they needed and many were faced with a "lack of compassion" from A&E staff.

"The report will not come as a surprise to anyone who has found themselves in crisis or who is involved in supporting people when they are at their most unwell," said Paul Farmer, chief executive of mental health charity Mind.

"We take for granted that when we have a physical health emergency we will get the help we need urgently," he told the BBC. "It should be no different for mental health."

The government has promised to ensure that mental and physical health conditions are given equal priority, but campaigners and health care workers warn that they are unlikely to deliver on many of their campaign promises on mental health.

What did the Tories promise to do in their manifesto?

• Increase mental health spending
• Improve access to talking therapy and ensure therapists are available in "every part of the country" for all of those who need it
• Introduce new waiting time standards
• Ensure women have access to mental health support during and after pregnancy and strengthen the health visiting plan for new mothers
• Honour the Military Covenant by ensuring veterans suffering from mental health problems receive proper care
• Provide health and community based places of safety for people with mental health problems who are detained by police

The party ran into controversy during its election campaign earlier this year when one its parliamentary candidates suggested people with mental health problems should wear colour-coded wristbands to identify their conditions. The Tories were also criticised for making vague promises and failing to commit to specific targets.

"Overall the Conservative manifesto seems preoccupied with mental health problems as a 'burden'; something to be curtailed as soon as possible, with a return to gainful employment as the ultimate goal," says Mental Health Chat. "That is unless you happen to be a new mother or an ex-serviceman, in which case you are deemed worthy of treatment in your own right."

Will they deliver on these promises?

Care minister Alistair Burt said the government has already begun tackling the mental health crisis with new treatment targets and extra funding. "Improving mental health care is my priority," he said.

But campaigners and mental health experts are unconvinced. In a letter to the Daily Mirror in the run-up to election, more than 100 nurses, doctors and councillors warned that another Tory government would put mental health services at serious risk.

Health Secretary Jeremy Hunt, who once said he didn't understand how Alastair Campbell could be depressed as it looked like he had "a great life", is not known as a great champion for mental health care, says The Guardian. "There have already been concerns raised by experts about whether the money pledged to mental health in the Conservative party’s pre-election budget will see the light of day," says the newspaper.

Liberal Democrat Norman Lamb, who campaigned for better mental health services in the coalition government, agrees, arguing that the Tories "lack the commitment" to make the necessary investment in mental health care.

Health Secretary Jeremy Hunt is calling for a clampdown on excessive spending and an over-reliance on agency doctors and nurses in order to meet NHS savings targets.

"Expensive staffing agencies are quite simply ripping off the NHS," he wrote in the Daily Telegraph.

Hospitals paid out £3.3bn in agency fees last year and are increasingly hiring expensive management consultants, which cost the NHS nearly £600m last year, the BBC reports.

Health service managers are also facing calls to justify their large pay packets, with more than a fifth of all directors in the NHS earning more than £142,500 – equivalent to the Prime Minister's salary.

The government has promised to increase healthcare spending by £8bn a year by the end of the decade in order to plug the funding gap and maintain services. In return, health bosses have vowed to make £22bn in savings

Hunt said the government had delivered on its end of the deal. "Now the NHS must deliver its side of the bargain for patients by eliminating waste, helped by the controls on spending we're putting in place," he said.

The measures that will be phased in over the next two months include:

• A maximum hourly rate for agency doctors and nurses
• The use of unapproved agencies will be banned
• A cap on total agency spending for NHS trusts in financial difficulty
• A limit of £50,000 will be placed on all management-consultancy contracts
• The introduction of a centralised system for buying goods in order to cut procurement costs

The curbs on spending have been criticised by the Recruitment and Employment Confederation, which represents the agencies. It said they were being made scapegoats "for the NHS's own mismanagement of workforce planning".

“What happens, for instance, if there is a cold snap and a trust needs staff instantly to manage an influx of demand but they have already reached their newly imposed cap?" asked Tom Hadley, director of policy at the organisation.

The head of the Royal College of Nursing, Dr Peter Carter, welcomed the clampdown on spending but said it would "only work alongside longer term solutions, like converting agency staff to permanent staff, and continuing to increase training places to catch up with demand".

The government has announced a £300m cash boost for NHS England this winter, increasing the available funds to £700m, as concern is raised that the health service may struggle to cope with the usual seasonal increase in admissions.

Health secretary Jeremy Hunt insisted he expected "performance to improve on current levels" over the coming months because of the extra cash, which will mainly be used to increase staffing levels, particularly at the weekends.

The BBC quotes Hunt as saying: "We are boosting front-line services and expect the NHS to ensure strong performance is delivered locally, drawing on the multi-million pound support package that the government has provided."

However, A&E units have been struggling to meet their target of seeing 95 per cent of patients within four hours. Since April, they have only averaged 94.8 per cent. In recent weeks, the figure has dipped below 94 per cent.

In one week in mid-October, the figure was 93 per cent - worse than at any point during the whole of last winter.

The BBC's health correspondent, Nick Triggle, points out that "with little more than six months to a general election, all eyes are on how the health service copes".

Richard Murray, director of policy at health care think tank the King's Fund, told Triggle the "pressure is high" on the government as the winter approaches.

He said: "The big question is whether we will see a winter crisis like we used to: patients waiting in corridors and on trolleys, unable to get a bed. We are not there yet, but if pictures like that start emerging the debate goes to a whole other level."

Winter is a difficult time of year for the service because the cold weather can increase the number of falls and the amount of respiratory illness, says Triggle. The norovirus vomiting bug can also take hold on hospital wards.

The NHS urgently needs a "radical" overhaul and extra funding in order to prevent "severe consequences" to patients, health bosses have warned.

The chief executive of NHS England Simon Stevens has presented the government with a five-year plan he says will relieve the pressure on hospitals and GP practices and provide patients with better care.

"We have no choice but to do this. If we do it a better NHS is possible," he told The Guardian. "If we don't the consequences for patients will be severe."

An extra £8bn on top of the NHS's £100bn budget will be required by 2020 to fund the plan, known as the NHS Forward View. It will also require the full support of future governments to be successful, warned Stevens.

He said the NHS was now at a "crossroads", and the country needed to decide "which way to go".

Where has this proposal come from?

The plan was drawn up by Stevens in partnership with five other national bodies; Public Health England, the regulator Monitor, the NHS Trust Development Agency, Care Quality Commission and Health Education England.

What does it involve?

One of the key points in the proposal involves "breaking down the boundaries" between hospitals and GP surgeries so that they help each other, according to ITV News.

The measures he suggested include:

• Turning GP surgeries into 'mini-hospitals' where procedures such as MRI scans and minor surgeries can take place in order to relieve the pressure on hospitals.
• Allowing hospitals to set up their own GP practices in areas where GPs are under strain
• An "all-out assault" on obesity, smoking and alcohol consumption
• Giving ambulance services the power to make more decisions about patient care
• Creating new bodies that will provide hospitals and GP surgeries with mental health and social care
• Getting employers to offer cash incentives such as shopping vouchers to encourage staff to lead healthier lifestyles and lose weight.

What has the reaction been?

The report was welcomed by Health Secretary Jeremy Hunt and health minister Norman Lamb who said it was "really imaginative thinking".

"I think this combines case of more investment but also change... is absolutely the right message," he told BBC Breakfast.

Hunt said the report "demonstrates conclusively that the NHS has improved dramatically in recent years and can do so in the future, but only if it continues to implement important reforms and is supported by a strong economy."

However, Labour has responded by alleging that some of the measures were ones it has already proposed. The party's shadow health secretary Andy Burnham said: "We've said that the NHS will be our priority in the next Parliament, and alongside that, we're saying that the time has come to bring social care into the NHS."

The government is planning a "significant" expansion of a new class of medic known as physician associates, but critics have attacked the idea as "doctors on the cheap". Health Secretary Jeremy Hunt says the role – somewhere between a doctor and a nurse – is needed to free up busy doctors.

How does a physician associate qualify?

Training is currently offered at three universities, with three more planning to offer courses in the next academic year. Applicants usually need a science degree or a qualification in healthcare such as nursing or physiotherapy. Upon successful completion of the two-year course, each student is awarded a postgraduate diploma, usually followed by a one-year internship. It is a much shorter route into medicine than for doctors, who normally take five years to complete a medical degree, followed by a two-year foundation programme. Training to become a GP takes a further three years, while training in other specialty areas can take up to eight years. Unlike doctors, physician associates do not have to be registered with any regulator, but some employers require employees to enrol on a voluntary register.

How many physician associates will there be?

There are currently around 300 physician associates working for the NHS, says The Guardian. The Department of Health says it is hoping to "significantly increase" the number, and training places are due to double from 105 to 225. But the department says the number recruited would be down to individual hospitals.

What can physician associates do?

Under the supervision of a doctor, physician associates can work in local surgeries and hospital emergency departments, examining patients, diagnosing illnesses, analysing test results and taking medical histories. They cannot prescribe drugs but can prepare prescriptions for doctors to sign off.

What are the benefits?

Physician associates are paid around £30,000 to £40,000, less than half the salary of a doctor, reports The Independent. The government believes that increasing the number of physician associates is a cost-effective way of enabling doctors to focus on more complex care. Hunt says the NHS is treating a record number of people. "That's why we are growing the workforce further with a new class of medic so busy doctors have more time to care for patients," he says. Health Education England, the NHS training body, has pointed to the role's success in the US where around 80,000 physician associates are employed.

What concerns have been raised?

With hospital trusts expecting to record a deficit of more than £750m for the current financial year, medical experts have warned that physician associates must not become "doctors on the cheap". Roger Goss, a co-director of Patient Concern, says: "We can be certain that some people in management will introduce the system as intended but you can guarantee that others will see this as a glorious opportunity to cut costs."

Today'sTimes editorial claims that health practitioners "with little more training than a nurse and much less than a doctor, are liable to miss symptoms, misdiagnose those they see and overestimate their knowledge". The newspaper claims an increase in supply of physician associates is "fraught with peril" and could be a "false economy". Mark Porter, chairman of the British Medical Association council, tells The Times the concept could be useful, but that the government needs to be clear about its limits. "These new posts cannot replace doctors," he says.

Responding to the leak of a taped conversation in which the Polish foreign minister Radek Sikorski accuses David Cameron of having "f***ed up" his negotiations for reform of the EU, Britain's Health Secretary Jeremy Hunt admitted this morning that Cameron is "isolated" in Europe.

Hunt sought to make a virtue of that, telling Radio 4's Today listeners: "I want a Prime Minister who fights for Britain… Sometimes leadership is lonely but if it is the right thing to do for Britain, I am glad we have got a strong Prime Minister prepared to take those steps – even if it means he is isolated from time to time."

"Isolated" is putting it mildly. BBC political editor Nick Robinson said Cameron could be in a 27-1 minority on Friday in his effort to force a vote at the EU Council of Ministers to stop the federalist Jean-Claude Juncker being appointed president of the European Commission. The best Cameron can hope for is that Hungary might support him.

"A few weeks ago David Cameron insisted he was winning allies, that many people agreed with him on the need to block Jean- Claude Juncker," said Robinson, "but it is clear now he may now have no allies at all.

"What this tape of a private conversation between the Polish foreign minister and one of his colleagues reveals is just how much contempt there is in Europe for Mr Cameron’s negotiating position."

In the tape, Sikorski – an avowed Thatcherite and well-connected Anglophile, who was in the Bullingdon Club at Oxford at the same time as Boris Johnson and send his sons to Eton - said Cameron had shown “incompetence” in his negotiations with EU partners and accused him of "stupidly" pandering to the eurosceptics on the Tory backbenches.

"He is not interested, he does not get it, he believes in the stupid propaganda, he stupidly tries to play the system... his whole strategy of feeding [his critics] scraps in order to satisfy them is just as I predicted, turning against him.

"He should have said, f*** off, tried to convince people and isolate [the sceptics]. But he ceded the field to those that are now embarrassing him…"

Sikorski was in conversation with another senior Polish politician, former finance minister Jacek Rostowski, who is taped saying: "For the Polish government to agree [to Britain's demands to block Juncker's appointment], someone will have to give us some mountain of gold.

"The Brits won’t give it to us, and the Germans, in order to keep the Brits on board, won’t give it to us either in all likelihood."So the answer will be: f*** off."

Eurosceptic Bernard Jenkin could barely conceal his glee at the prospect of Cameron being forced to accept he has no power to reform the EU from within. Jenkin told the Today programme: "Juncker is the tip of a very large federalist iceberg."

Illustrating just how keen some Tory MPs are for Britain to pull out of Europe, one Eurosceptic tweeted this week: "God let it be Juncker".Cameron is committed to reforming the EU’s freedom of movement rules to stop people from poorer east European countries having the automatic right to come Britain.

The attitude of Rostowski and Sikorski shows just what little chance Cameron of securing an EU agreement for his flagship reform - which leaves his European policy in tatters and the Tories edging ever closer to supporting Britain’s exit from the EU.

There could be one benefit for Cameron in this looming disaster – he could get the support of Ukip at the next election.

The CDC says the hoard is necessary because emergency services across the country need to have access to the suits in case they come into contact with an infected patient in an emergency room or responding to a 911 call.

There are only a few manufacturers capable of making the suits, which are considered a key weapon in protecting healthcare workers from infection and containing the disease. Manufacturers have been struggling to meet demand, leading to price increases.

Over 15,000 people have been infected with Ebola in West Africa and at least 5,400 people are known to have died from the disease. In contrast, there have been just 6 cases in the US and two deaths.

"The shortage shows how the deep anxiety over Ebola’s arrival in the US has complicated efforts to fight it in Liberia, Sierra Leone and Guinea," writes the Wall Street Journal's Drew Hinshaw.

A spokesperson for World Vision, the Christian humanitarian group, working in Sierra Leone said that the scarcity of biohazard suits was causing "sleepless nights" for volunteers in the region.

Similar shortfalls have been reported with powdered bleach and rehydration solution. Both play an essential role in disinfecting treatment centres and treating patients.

“If you have an earthquake, your stress on your supply chain will be for maximum one month," said Jean Pletinckx, the medical emergency coordinator for the charity Medecins sans Frontieres. "But in an Ebola situation, because the situation is not under control, you never know if a new wave will come," he added. "It’s like if you have a permanent earthquake."

Ebola: first team of NHS volunteers arrives in West Africa

24 November

The first team of British volunteers from the NHS has arrived in Sierra Leone to join the fight against Ebola.

The team, made up of more than 30 GPs, nurses, clinicians, psychiatrists and consultants in emergency medicine will work on testing, diagnosing and treating people with the virus across the country.

"Every one of these NHS heroes will play a vital role in the fight against Ebola," said development secretary Justine Greening.

One of the volunteers, senior sister Donna Wood, explained why she and the others were heading to Africa. "I'd been following the stories on the news and I felt I had to do this straight away: I could use the skills I've got to make a difference and join a team to help bring the disease under control,"

The volunteers attended a nine day intensive training course run by the Ministry of Defence in York in order to prepare them for the conditions in Sierra Leone.

They will receive an additional week of training in the capital Freetown, before moving to treatment centres across the country where they will be working with established medical charities. The group will spend five weeks away, returning at the end of December.

Dr Gordon Gancz, general practitioner and senior lecturer at the University of Oxford described how the team would cope with being away from their families and in such a challenging environment during the festive season. "We've all got little things hidden in our suitcases for Christmas and we've already started planning a pantomime for ourselves," he told the BBC.

Hundred of NHS volunteers have signed up to help contain the deadly outbreak which has killed over 5,000 people in Sierra Leone, Liberia and Guinea. Further deployments will continue in the coming weeks.

"I want to thank the brave NHS volunteers who are heading to Sierra Leone today to help in the fight against Ebola," said Health Secretary Jeremy Hunt. "They embody the values at the heart of our health service, and their expertise and dedication is second to none."

There are now over 1,000 British military personnel, scientists, healthcare and aid workers helping across West Africa as part of the UK's £230m aid package to help contain the disease.

Ebola: health fears stop British journalist from hosting awards

19 November

A British journalist has pulled out of an awards ceremony in London over health and safety fears after returning from West Africa where he had been reporting on the Ebola outbreak.

Alex Thompson, Channel 4 News chief correspondent had been due to co-host tonight's Rory Peck awards for freelance journalists in London, but will now be replaced by his colleague, international editor Lindsey Hilsum.

Thompson had been on assignment in Sierra Leone until last week and has been widely praised for his brave reporting of the deadly outbreak.

And although the event "honours those who typically take risks to report difficult stories", The Guardian reports that organisers may not have been able to secure approval from all audience members. "The fact Thomson would have to shake hands with the award-winners might have caused some concern," it reports.

The incubation period of Ebola can be up to 21 days, but a patient is not infectious until they begin displaying symptoms.

The ceremony co-host, Sky News correspondent Alex Crawford, who has also been covering the outbreak in West Africa but has passed the incubation period, said it was "shame" Thompson would not be joining her as it "would have dispelled myths around the disease".

Crawford has previously spoken to the Guardian about how her team were treated as "social pariahs" after returning from the region. She also criticised mandatory quarantines, saying such measures were used "to pacify people who are ignorant".

"Just because people are a bit scared – it's ridiculous," she said. "We're going back to the Dark Ages"

In other developments:

• William Pooley, the British nurse who has returned to Sierra Leone to treat Ebola patients after recovering from the disease himself, says he is "frustrated" by the "woefully slow" international response to the outbreak, the BBC reports.
• The Bill and Melinda Gates Foundation has pledged a further $5.7m to help fund the development of experimental drugs to fight the disease, particularly the use of blood plasma. The organisation has already donated $50m.
• A doctor treating Ebola patients in Sierra Leone has become the first Cuban national to ever contract the disease, Reuters reports. He is being treated by British healthcare workers and is expected to be flown to Geneva for more specialist treatment.

Ebola: experimental drug trials to begin in West Africa next month

13 November

Clinical trials for three experimental Ebola treatments are set to begin in West Africa next month, as the official death toll surpasses 5,000.

"This is an unprecedented international partnership which represents hope for patients to finally get a real treatment," MSF spokeswoman Dr Annick Antierens, told the BBC.

The virus is now believed to have infected over 14,000 people, mostly in Sierra Leone, Liberia and Guinea, according to the latest figures from the World Health Organization (WHO).

Three different treatments will be trialled at hospitals managed by Médecins Sans Frontieres, the medical charity that has been leading the fight against the current outbreak. Two of the trials will take place in Guinea, while the location of the third is yet unknown.

Professor Peter Horby, from the University of Oxford said the trials are crucial to containing the disease. "There's both the humanitarian need, a tragedy for individuals and for communities and we need to do everything we can to offer some hope to those communities," he said.

"But there's also scientific need, we have these products which may or may not work in patients with Ebola and the only way we can test them is during an epidemic."

Ebola: US declared virus-free as the doctor recovers

13 November

An American doctor who was diagnosed with the Ebola virus last month has made a full recovery, according to health officials in New York, and the virus is now no longer believed to be present in the US.

Dr Craig Spencer caught the disease while working for the charity Medecins Sans Frontieres (MSF) in Guinea. He has been under quarantine in a New York hospital and received a wide range of treatments, including an experimental drug and blood plasma donated by a recovered Ebola patient, the New York Times reports.

"After a rigorous course of treatment and testing, Dr Craig Spencer has been declared free of the virus," said the city's health officials. He is expected to be released later today.

They say he now poses "no public health risk" but the World Health Organization warns that men are still able to transmit the disease through their semen for almost two months after their recovery.

His case sparked a national debate on how healthcare workers returning from affected regions should be treated and led to some states imposing highly controversial quarantine methods.

Eight out of nine Ebola-positive patients treated in the US have survived, showing that with early intervention and more intensive care, the fatality rate outside of West Africa is much lower.

The current outbreak has killed an estimated 5,000 people in Liberia, Sierra Leone and Guinea.

In other developments:

• Leading charities have warned that one in seven women in Ebola-affected countries could die in pregnancy or childbirth because hospitals are so overwhelmed.
• Bill Gates has said he believed that progress was being made in the fight to contain the virus in West Africa. "Ever since the big intervention that started in August I think the world's done quite well - the United States and the UK stepping up with the most resources," he told the BBC.
• Google has pledged to give $2 for every dollar donated through its site to the fight against Ebola. Its CEO also said the company would immediately donate $10m to support the charities "doing remarkable work in very difficult circumstances", in West Africa.
• Bob Geldof and Midge Ure are re-releasing the iconic song Do They Know It's Christmas to raise money for the victims of the outbreak. It was originally released 30 years ago and raised £8m for famine relief in Ethiopia.

Robots could be sent to join the fight against Ebola

07 November

White House officials are meeting scientists to discuss the potential role of robots in fighting the Ebola outbreak in West Africa.

Robots are routinely used in some hospitals in the West and are often deployed to some of the world’s worst disaster zones, but their presence could soon be extended to countries facing disease epidemics.

There is significant interest in developing robots that could help save lives in the current outbreak, according to the BBC's Jen Copestake.

"We're trying to pull the workers further away from the disease," Velin Dimitrov, a robotics engineering PhD candidate told her.

Robots could perform a variety of dangerous tasks such as waste removal, the burial of bodies, helping healthcare workers safely remove their protective clothing as well as the decontamination of surfaces. This would significantly reduce the risk to health care workers, almost 300 of whom have died during the current outbreak.

According to scientists, using robots would be relatively inexpensive. Existing robots could also be deployed to the worst affected areas, saving millions that might otherwise be spent developing new ones.

The robots will not be autonomous, but remotely operated by someone at a safe distance, say developers at the Worcester Polytechnic Institute (WPI) in Massachusetts. There is no suggestion that they would be used as a replacement for health care workers.

"We have a moral obligation to try and select, adapt and apply available technology where it can help," Gill A. Pratt, a roboticist at the federal Defense Advanced Research Projects Agency told the New York Times.

Scientists are aware that they will face numerous challenges on the ground if "Ebola robots" become a reality.

"We don’t want to be seen as capitalising on the tragedy," said Dr Ken Goldberg, a professor of industrial engineering and operations research at Berkeley. Nobody, he says, wants to be seen as someone who says, 'We’re sending in the robots,’ which sounds "insensitive and crass."

Scientists also have to be aware of cultural attitudes, as many West African people may be unwilling to accept the fact that a machine is handling the body of a loved one. "It’s something we can do, but it has to be culturally sensitive," said Robin Murphy, a specialist in rescue robotics.

Scientists also need to make sure that the use of robots will not inflict any additional mental trauma on patients. People with Ebola already feel stigmatised by their communities, so it’s important this situation is not exacerbated.

Ebola: UK-funded treatment centre opening in Sierra Leone

05 November

A British funded treatment centre and laboratory are opening in Sierra Leone as part of the UK’s contribution to the fight against the Ebola outbreak in West Africa

Located south of the capital in Kerry Town, the facility is able to treat nearly 100 patients at a time and is the first of six British-funded centres built to help fight the deadly outbreak. It will be jointly run by the Department for International Development and the charity Save the Children.

Further treatment centres and laboratories are expected to be completed in the coming weeks and will be staffed with British volunteers from Public Health England, the NHS and universities as well as army medics.

Save the Children’s chief executive Justin Forsyth told the BBC: "We’ve never done something like this treatment centre. It’s enormous for us and it was a risky decision, but it’s something I feel very proud about." He added that he and his team were in a "race against time" to contain the outbreak.

In total, the UK government has committed £225 million to help fight the outbreak in West Africa which is thought to have killed over 5,000 people so far. The government’s response includes the deployment of 800 military personnel, the construction and staffing of treatment centres and laboratories as well as the training of local healthcare workers.

"Tackling Ebola at the source is key to beating it and stopping the spread, said development secretary Justine Greening on a recent visit to the region."Some of Britain’s best and brightest scientists will be at the forefront of our UK-funded testing facilities ensuring that people with Ebola are isolated and then treated as soon as possible."

Visiting the new treatment centre, Sierra Leonean president Ernest Bai Koroma told the BBC that it was "very impressive," adding that he hoped it would "give a lot of confidence, not only to locals but internationally, to come here and work with us".

Ebola: infections rise 'frighteningly quickly' in Sierra Leone

03 October

The number of people infected with the Ebola virus in Sierra Leone is increasing nine times faster than it was two months ago, according to a new report by a leading charity.

There have been at least 1,500 deaths in Sierra Leone, with the fatality rate increasing the quickest in rural areas, ABC reports. On average, there had been 12 new cases every day in October, compared to 1.3 in early September.

"Whilst new cases appear to have slowed in Liberia, Ebola is continuing to spread frighteningly quickly in parts of Sierra Leone," the report by Tony Blair’s Africa Governance Initiative said.

Nick Thompson, chief executive of AGI, praised the Sierra Leonean government for making positive strides in tackling transmission by improving access to treatment and making burial methods safer, but said much more needed to be done.

"We can’t rest until Ebola has nowhere to hide. And we can see from growth in new cases in some rural parts of Sierra Leone that we still have no time to lose if we’re going to get on top of this."

Over 13,000 people are infected with the virus and at least 5,000 are now known to have died, mostly in Sierra Leone, Liberia and Guinea.

Separately, a UK appeal for donations to help fight Ebola in West Africa has raised millions of pounds in just two days.

The Disaster Emergency Committee has raised over £4 million, telling the BBC that it was "overwhelmed" by the "extraordinary generosity of the UK public. The government has also agreed to match the amount raised up to £5 million.

But the charities involved are appealing to the public to do even more to help. "It is getting worse, not better, on the ground here," said Justin Forsyth, chief executive of Save the Children. "We are not ahead of the curve, we are in a race against time and we need to urgently act – and money is very, very important."

Ebola: should returning medics and troops be quarantined?

30 October

A nurse who was put into quarantine after treating Ebola patients in West Africa is threatening to leave and take legal action, arguing that the isolation is a violation of her civil rights and will deter other volunteers from helping fight the disease.

Kaci Hickox, who returned to the US from Sierra Leone last Friday, was initially placed under precautionary quarantine in hospital in New Jersey. After several days, she was allowed to leave and serve the remainder of her 21-day isolation period at home in Maine.

She has twice tested negative for the Ebola virus and is displaying no symptoms, but state officials say precautionary measures must still be taken as the virus' incubation period can be up to three weeks.

Hickox points out that even if she was infected, she would not be contagious until she started displaying symptoms. She insists that the policy of quarantining health care workers returning from Ebola stricken countries is neither "scientifically nor constitutionally just", and a violation of her civil rights. Now she is threatening to take action.

"If the restrictions placed on me by the state of Maine are not lifted by Thursday morning, I will go to court to fight for my freedom," she told Reuters.

In another interview with the BBC, she said: "I am not going to sit around and be bullied around by politicians and be forced to stay in my home when I am not a risk to the American public."

Hickox also warned that the policy would be a "big deterrent" to health care workers thinking about responding to urgent calls for volunteers in West Africa. "It's already difficult for people to take time out of their lives to go and respond," she said, explaining that an additional three-week confinement could prove too much.

Her case has sparked widespread debate in the US over its quarantine polices, which vary from state to state. A three-week quarantine period for health care workers returning from Sierra Leone, Liberia and Guinea has been imposed in New York, New Jersey and Maine, with California issuing them on a case-by-case basis.

Officials in Maine in New Jersey say the measures are designed to keep the public safe. "[Quarantine] is a reasonable request to ensure – out of an abundance of caution – that we are protecting the people of this state," Mary Mayhew, Maine health commissioner, told CNN.

"While we certainly respect the rights of one individual, we must be vigilant in protecting 1.3 million Mainers, as well as anyone who visits our great state," said the Republican Governor Paul LePage.

The policy has been condemned by President Obama on several occasions, and he has called on states not to impose their own measures as science does not support the need for quarantines.

He said healthcare workers who have risked their lives to care for patients were "American heroes" who "deserve our gratitude, and they deserve to be treated with dignity and respect".

Obama has, however, authorised the forced quarantine of all military personnel returning from the region – even though many of them have not come into contact with Ebola patients and were in the region building treatment centres. When questioned about the discrepancy in policies by journalists at CNN he said: "We don't expect to have similar rules for our military as we do for civilians."

Ebola: DEC launches 'unprecedented' appeal

29 October

The Disasters Emergency Committee (DEC) has launched an unprecedented appeal for funds to help stop the "explosive" spread of the Ebola virus in West Africa.

The group, made up of 13 of the UK's leading aid charities, has never before called for public donations for a disease outbreak.

"This appeal is completely unprecedented and that is a sign of just how serious the situation in West Africa has become," said DEC chief executive Saleh Saeed.

In its 50-year history, the committee has made appeals for humanitarian disasters caused by natural disasters and conflicts, but "we have never run an appeal in response to a disease outbreak - until today", he said.

Nearly 5,000 people are known to have died from the disease and more than 10,000 have been infected, but the World Health Organization (WHO) believes the real number could be up to three times higher. It warns that without large-scale intervention, there could be 5,000-10,000 new cases of the virus every week by December.

Saeed told the BBC that donations were urgently needed to help the affected countries and to prevent the outbreak from spreading further, warning that the committee currently faced a shortfall of £69m to carry out their work in West Africa. "This is a race against time," he said.

"Without urgent action to stop the spread of Ebola and to help those affected by the crisis, parts of West Africa face catastrophe within 60 days," Saeed warned.

Funds raised will be used to run treatment centres in the worst affected areas of Sierra Leone, Liberia and Guinea, provide protective clothing and medical supplies for healthcare workers, provide food aid to affected families and protect children who have been orphaned by the disease.

Just £25 will provide three families at risk of the disease with chlorine cleaning kits, while £50 will allow the charities to provide three healthcare volunteers with basic protective clothing.

To make a donation to the DEC Ebola Crisis Appeal visit www.dec.org.uk, call the 24 hour hotline on 0370 60 60 900. You can also donate £5 by texting the word DEC to 70000.

Ebola: 'thousands' more medics needed to fight virus

28 October

Thousands more volunteers are needed to help combat the Ebola crisis in West Africa, according to the president of the World Bank.

In an "emotional appeal", Jim Yong Kim said at least 5,000 more healthcare workers were urgently needed in Sierra Leone, Liberia and Guinea, the BBC reports.

Over 10,000 people have been now been infected with virus, nearly half of whom have died.

"Right now, I'm very much worried about where we will find those health care workers," he said, as most would be too afraid to travel to the region. The World Health Organization (WHO) estimates that at least 443 health workers have contracted the virus and 244 have died.

He said he hoped that they would "understand that when they took their oath to become a health worker it was precisely for moments like this".

Meanwhile, US authorities have decided to quarantine troops returning from West Africa for 21 days in Italy, while Australia has become the first country to issue a visa ban on the affected countries, angering West African leaders. Critics say both moves will prevent volunteers from travelling to the region to help.

"Western countries are creating mass panic, which is unhelpful in containing a contagious disease like Ebola," Ugandan government spokesman Ofwono Opondo told Reuters.

"If they create mass panic ... this fear will eventually spread beyond ordinary people to health workers or people who transport the sick and then what will happen? Entire populations will be wiped out."

Ebola: paper tests for the virus in development

27 October

A simple and inexpensive genetic test for Ebola, using discs of paper, has proved effective at detecting two strains of the virus, say scientists at Harvard University.

The technology involves printing sequences of DNA onto paper and freeze-drying them. They can then be stored at room temperature and reactivated by adding water, like "living powdered soup". Once reactivated, the discs will change colour if they come into contact with the virus.

The tests are simple, cost effective and take just 30 minutes to display a result. The technology costs just £13 to produce and as the tests are easy to mass produce, they could end up selling for less than 2p, New Scientist reports.

"The fact you can leave these freeze-dried systems for a year, and they'll still work - that's quite remarkable," Professor Lingchong You, an expert in cellular reprogramming at Duke University, told the BBC.

However, more testing is needed before they can be distributed in West Africa. "Potentially, it's wonderful, but it's one thing to do it in the lab and quite another to manufacture it up to the standards required for it to work in real situations," says Ruth McNerney of the London School of Hygiene and Tropical Medicine.

Currently, testing for Ebola needs to take place in laboratories and is expensive. One of the main tests for the virus called RT-PCR can cost between £40-£130 per test and results can take up to six hours to develop, according to the New York Times. They are also less than 100 per cent effective and so need to be run twice for each sample.

Over 10,000 people have now been infected with the Ebola virus, almost half of whom have died.

In other developments:

• The US ambassador to the United Nations, Samantha Power, is currently on a tour of the West Africa and has criticised the global response to the outbreak. "The international response to Ebola needs to be taken to a wholly different scale than it is right now," she said.
• Mandatory 21-day quarantines for health care workers returning from West Africa are causing controversy in the US. The procedures were implemented in New York, New Jersey and Illinois but experts warn it could discourage medics from travelling to the region to help.
• An American nurse is taking legal action after being quarantined under these measures. The woman, who had been treating patients in Sierra Leone, says said she was made to feel "like a criminal". Here lawyers say her case raises "serious constitutional and civil liberties issues," the BBC reports.

Ebola: New York confirms first case of the virus

24 October

An American doctor who returned from treating patients in West Africa has become the first person in New York to be diagnosed with the Ebola virus.

Craig Spencer had been working with the medical charity Medecins sans Frontieres (MSF) in Guinea and returned to the US last week. He has been placed under quarantine in New York and is receiving treatment.

The 33-year-old doctor, who lives in Harlem, is now the fourth person to have been diagnosed with the disease in the US, along with a Liberian man and two nurses who treated him in Texas.

Spencer's wife and two friends have also been isolated and are being monitored for signs of the disease.

Mayor Bill de Blasio attempted to reassure New Yorkers that the threat of an outbreak in the densely populated city remained low.

"There is no reason for New Yorkers to be alarmed," he said. "Being on the same subway car or living near a person with Ebola does not in itself put someone at risk."

He told the public that Ebola is an "extremely hard" disease to catch as it is only transmitted through contact with an infected persons blood or bodily fluids and not through "casual contact".

He emphasised that New York City has the world's strongest public health system and the world's leading medical experts. Authorities in the city have been preparing for the arrival of the virus "for months", according to the New York Times.

MSF says Spencer complied with protocol, alerting them as soon as he began displaying symptoms on Thursday. "The individual engaged in regular health monitoring and reported this development immediately," it said in a statement.

Meanwhile, Mali has also confirmed its first case of the virus, the [2]BBC reports. A two-year old girl tested positive after returning from Guinea, making Mali the sixth West African country to be affected by the outbreak, although Nigeria and Senegal have since been declared Ebola-free.

More than 4,800 people have now died of the disease, with Liberia, Sierra Leone and Guinea the worst affected. The World Health Organization (WHO) also estimates that at least 443 health workers have contracted the virus, of whom 244 have died.

Ebola: blood serum leads the global race to find a cure

22 October

Serum extracted from the blood of Ebola victims who survived the virus could be made available to patients in Liberia in the coming weeks, according to the World Health Organization (WHO).

The body is fast tracking several experimental drugs and vaccines to be ready by January, according to the BBC.

There is currently no proven Ebola vaccine or cure, but several pharmaceutical companies are racing to develop safe and effective methods of treating and preventing the disease.

What is blood serum and how does it work?

Serum is part of blood plasma and, in this case, is taken from a patient who has recovered from Ebola as it contains essential antibodies that can fight the virus. It has proven effective in earlier outbreaks, but the WHO has previously been hesitant to use it widely until stricter safety controls were introduced. Healthcare workers warn that the blood needs to be screened carefully for diseases such as HIV and the serum only be administered by health care professionals.

When will it be ready?

The serum has already been used to treat infected healthcare workers. Earlier this month, William Pooley, the British nurse who recovered from the virus donated his blood to infected healthcare workers in Texas. The WHO expects the serum to be more widely distributed in Liberia, the country worst affected by the outbreak, "within weeks".

Vaccines

Human trials are currently underway for several different vaccines developed by the large pharmaceutical companies GlaxoSmithKline and NewLink Genetics as well as the US National Institute of Allergy and Infectious Diseases. Scientists hope that patients will react to the small amount of the virus and develop immunity against it.

When will they be ready?

The latest announcement from the WHO suggests that a vaccine could pass safety and efficacy tests as early as January next year. However, just last week, GlaxoSmithKline said their vaccine would not be ready in time for the current outbreak as safety trials would not be completed until the end of 2015.

ZMapp

The experimental drug is made up of a cocktail of antibodies harvested from an infected animal's blood and grown in specially-modified tobacco leaves. It works by stopping the virus from entering and infecting new cells. It has been used to treat dozens of healthcare workers, many of whom have gone on to make a full recovery. However, doctors say it is too early to know whether the drug is effective or safe in the long-term.

When will it be ready?

ZMapp takes a long time to produce even in small quantities and all available doses have now been distributed, according to its manufacturers. Supplies of the drug "will not be sufficient for several months to come" the WHO warned recently.

TKM-Ebola

Developed by a Canadian pharmaceutical company, the drug works by interfering with the virus's genetic code and stopping it from producing disease-causing proteins.

When will it be ready?

Human trials were halted earlier this year over safety concerns, but the company recently announced that the US Food and Drug administration had partially lifted the ban, raising hopes that the drug could be made available in the near future.

Ebola: fresh deployment of UK troops to West Africa

21 October

Soldiers from the Royal Army Medical Corps have been deployed to Sierra Leone as part of the UK's pledge to help fight the Ebola outbreak.

Nearly 100 medics were joined by International Development Secretary Justine Greening, who is travelling to the region to oversee the UK's training centres. The medics will be working alongside 90 military personnel already stationed in the country.

The deployment forms part of the UK's £125m aid package to help the tackle the disease in West Africa. This includes setting up treatment centres, training healthcare workers and sending around 750 personnel to the region along with the Navy's RFA Argus.

"Halting the disease in West Africa is the most effective way of preventing Ebola infecting people here in the UK," she told ITV news.

"I look forward to seeing for myself how British Army medics and engineers, as well as our humanitarian and health workers, are spearheading the UK's efforts to contain and ultimately defeat Ebola."

The outbreak has killed over 4,500 people, mainly in Sierra Leone, Liberia and Guinea.

Ghana's President John Mahama has said that vital medical supplies are finally beginning to reach the worst affected countries. Aid agencies have criticised major airline carriers such as British Airways for cancelling direct flights to the region as it impedes their ability to deliver essential goods and personnel.

European countries have already pledged £400m in aid to help stem the crisis, but the UK is pressing for that amount to be doubled, the BBC reports.

The BBC's international development correspondent Mark Doyle has said that while the UK's contribution is "significant", it has come "very late", as aid agencies had been warning of a humanitarian crisis since April.

Meanwhile, enhanced screening methods have now been extended to Gatwick Airport. Passengers arriving from West Africa face temperature checks, will need to fill in a questionnaire and will be observed for visible signs of the virus.

The measures are expected to be introduced at Eurostar terminals by the end of the week and at Manchester and Birmingham airports in the coming weeks.

William Pooley: British Ebola nurse returns to Sierra Leone

20 October

William Pooley, the British nurse who recovered from the Ebola virus has returned to work in West Africa.

The 29-year old, thought to be the first Briton to be infected with the disease, contracted Ebola while working as a health care volunteer in Sierra Leone. He was flown back to the UK, where he was quarantined and received the experimental drug zMapp and later made a full recovery.

Pooley said returning to work in a region where over 4,500 people have died from the disease was an "easy decision" to make.

He has said he could not stand "idly by" while more people died. "I chose to go before and it was the right thing to do then and it’s still the right thing to do now," he told The Guardian.

It is still unclear whether or not Pooley is immune to the virus or how long it could last. "They have told me I very likely have immunity, at least for the near future, to this strain of Ebola," he said. "I have also been told it's a possibility that I don't, so I will just have to act as if I don't."

Pooley will join a team of British health care workers from King's College London and three NHS trusts working at a hospital in the capital Freetown.

He urged the West to direct more attention to the heart of the outbreak in West Africa. "The risk of a really damaging outbreak here [in the UK] is negligible. There's an absolute catastrophe happening in another part of the world," he said. "That should be our focus."

In other developments:

• Liberian president Ellen Johnson Sirleaf has warned that a generation of Africans were at risk of being lost to the disease, adding that the whole world has a stake in the fight against Ebola.
• Nigeria has been officially declared Ebola-free, six weeks after the last infection was reported. The successful containment of the virus was due to early detection, a co-ordinated response from government healthcare workers and quick and effective contact tracing.
• The Spanish nurse who was the first person to contract Ebola outside of Africa has now recovered from the disease, according to the Spanish government.

Ebola: new vaccine will be 'too late' for current epidemic

17 October

An Ebola vaccine currently undergoing safety testing will not be ready in time to combat the current outbreak, according to the pharmaceutical company GlaxoSmithKline.

Dr Ripley Ballou, head of GSK's Ebola vaccine research has said that the safety and efficacy of the drug will not be established before the end of 2015. Two other vaccines are also currently in development.

Experts fear that the only way to contain this outbreak is with a safe and effective vaccine as the scale of the epidemic now means that traditional methods of containment will no longer work.

Over 9,000 people are now known to be infected with the virus and more than half have died, according to the latest figures from the World Health Organization (WHO). But the virus is spreading exponentially and the WHO has predicted that there could soon be 10,000 new cases a week.

Professor Peter Piot, the director of the London School of Hygiene and Tropical Medicine who discovered Ebola in 1976, warned that outbreak could last well into next year.

"Then only a vaccine can stop it, but we still have to prove that this vaccine protects, we don't know that for sure," he told the BBC.

In other developments:

• The WHO has warned that 15 countries, neighbouring or trading with the three countries at the heart of the outbreak, face a real risk of the disease spreading across their borders. These include Ivory Coast, Ghana, Mali and the Central African Republic. "It could lead to major destabilisation of societies and also political destabilisation," Piot told The Guardian.
• President Barack Obama is facing mounting pressure from Republicans to ban all incoming flights from Liberia, Guinea and Sierra Leone. He says he remains open to issuing travel bans, but only if recommended by public health experts.
• David Cameron has urged European leaders to implement enhanced screening at airports, introducing measures like those in place at Heathrow airport, which will be extended to Gatwick and Eurostar terminal next week.

Ebola: Obama orders 'Swat team' response to outbreak

16 October

President Barack Obama has outlined enhanced measures to combat an Ebola outbreak in the US, including dispatching rapid response teams to hospitals.

Speaking after heading an emergency meeting in Washington, Obama promised "much more aggressive" monitoring of Ebola cases in the US.

He has also cancelled immediate travel plans in order to oversee the government's response to the Ebola crisis. This comes after a second nurse, Amber Joy Vinson, tested positive for the disease in Texas.

The Centres for Disease Control and Prevention (CDC) has been instructed to send 'Swat-teams' of experts to hospitals that report an infection within 24-hours, USA Today reports. Obama said that hospitals across the country were on stand-by for further cases and that an investigation into how the virus spread in Texas was ongoing.

Obama yesterday took part in a conference call with David Cameron and the leaders of France, Germany and Italy on how to respond to the crisis.

But despite the concerns, Obama continues to downplay the risk of an outbreak in the US, saying the chance of non-healthcare workers contracting the virus is currently "extremely low."

"I am absolutely confident that we can prevent a serious outbreak of the disease here in the United States," he said. "But it becomes more difficult to do so if this epidemic of Ebola rages out of control in West Africa. If it does, it will spread globally."

Over 4,500 people have now died from the outbreak in West Africa.

In other developments:

• The CDC has come under intense criticism following allegations that Vinson informed them that she had a symptom of the virus, yet was allowed to board a plane and travel across the country. The CDC is now trying to contact all 132 people on board her flight.
• The UN has warned that the West African region affected by Ebola is facing an impending food crisis as farmers abandon their crops and the movement of goods remains restricted.
• The campaign group Avaaz says it has identified over 3,000 volunteers, including doctors and other health care workers, who are willing to travel to West Africa to help fight the outbreak.

Ebola remains 'out of control' with death toll rising to 4,447

15 October

An end to Ebola in Nigeria and Senegal looks near, but elsewhere the outbreak remains "out of control", the World Health Organisation has warned.

New cases in Guinea, Liberia and Sierra Leone "continue to explode in areas that looked like they were coming under control", said the United Nations agency.

The estimated death toll, which multiplies confirmed cases to take into account under-reporting, currently stands at 4,447, reports the BBC.

Bruce Aylward, WHO's assistant director-general, has warned there could be up to 10,000 new cases a week within two months in Guinea, Liberia and Sierra Leone if efforts are not stepped up.

"An unusual characteristic of this epidemic is a persistent cyclical pattern of gradual dips in the number of new cases, followed by sudden flare-ups," the agency said in a statement. "WHO epidemiologists see no signs that the outbreaks in any of these three countries are coming under control."

Yesterday, Barack Obama said that "the world as a whole is not doing enough" to contain the Ebola threat. He will be discussing the crisis in a video conference later today with British, French, German and Italian leaders.

Nevertheless, WHO said it will declare the end of the outbreak in Senegal on Friday and in Nigeria on Monday so long as no new cases arise. In what the agency describes as a "piece of world-class epidemiological detective work", all confirmed cases in Nigeria have been linked back to a Liberian air traveller who introduced the virus into the country on 20 July.

Passengers arriving at Heathrow airport from countries affected by the disease are beginning to be screened by health officials. Passengers have had their temperatures taken and been asked to fill in health forms, which include questions about the traveller's temperature and whether or not they have come into contact with anyone who has died of unknown causes.

Ebola: 'protocol breach' blamed for first US transmission

13 October

A nurse in Texas has tested positive for the Ebola virus, marking the first transmission of the disease on US soil. The unidentified woman became infected after caring for Liberian national Thomas Eric Duncan, who later died of the disease.

The US Centers for Disease Control and Prevention (CDC) said a "breach in protocol" had led to the transmission, while health officials were quick to stress that there is little threat of a wider outbreak, the Wall Street Journal reports.

The nurse has been placed under quarantine at Texas Health Presbyterian Hospital and is said to be in stable condition.

"While this was obviously bad news, it is not news that should bring about panic," said Dallas County Judge Clay Jenkins who oversees the county health department. Officials said they had been working hard to establish exactly how the virus had spread.

Meanwhile, England's Chief Medical Officer Dame Sally Davies has said that the UK needs to be prepared for the arrival of the virus, saying she expects "a handful of cases in the next few months", the Daily Telegraph reports. Her views were echoed by London Mayor Boris Johnson who said that he had "little doubt" that the disease would reach the capital.

Over 4,000 people have now died from the disease in West Africa according to the latest figures from the World Health Organization (WHO), but experts predict that the actual figure could be at least twice as high.

In other developments:

• Elections in Liberia have been postponed, as large groups of people gathering at polling stations would put lives at risk in a country that has been the worst affected by the outbreak.
• Healthcare workers in Liberia have gone on strike after the government refused to increase their hazard pay. At least 200 medical staff have contracted the virus in the country, where personal protective equipment is scarce, Al Jazeera reports.
• UN secretary-general Ban Ki-moon has urged the international community to step up response to the humanitarian crisis in West Africa, saying a 20-fold increase in resources and health care professionals is urgently needed just to slow down the rate of infection.
• The Spanish nurse infected with Ebola is showing sign of improvement, according to the Spanish health ministry. Another 15 people remain in quarantine, but so far are showing no symptoms of the virus.

Ebola virus: UK to begin airport screening, but will it work?

10 October

Passengers arriving in the UK from West Africa will face enhanced screenings for Ebola virus, following an abrupt U-turn from government.

More stringent check are expected to take place at Heathrow and Gatwick airports and the Eurostar terminal in London in the coming days, as Downing Street said the measures would offer "an additional level of protection to the UK".

The government had previously ruled out enhanced screening, saying current policy was in line with World Health Organization (WHO) guidelines.

The decision was based on advice given by chief medical officer Professor Dame Sally Davies who cited "concern about the growing number of cases" of the virus and recommended the measures to ensure "potential cases arriving in the UK are identified as quickly as possible", The Guardian reports.

What measures are being introduced and who will be affected?

• Passengers arriving from the worst affected nations of Sierra Leone, Liberia and Guinea will be pulled aside after passport control and will have their temperatures taken to check for fever, one of the many symptoms of the Ebola virus.
• Health officials will also monitor passengers for any visible signs of illness.
• Passengers will then be asked to fill out a questionnaire on their health and possible exposure to the virus.

If any of these measures lead health officials to suspect a person may be infected with the virus, they could be placed under precautionary quarantine until blood tests are done. If not, they will be given information about what to do if they develop symptoms at a later stage.

What has the reaction been?

The move has been welcomed by ministers who argued that more stringent detection methods needed to be implemented in order to prevent an outbreak in the UK.

"The announcement will absolutely reassure the public the everything is being done at our border and our ports to ensure that cases are being identified," said Keith Vaz, Labour MP and chairman of the Commons home affairs select committee.

However those in the health sector have their doubts. Public Health England had advised against fever screening, saying it was "almost never worthwhile".

Why might it not work?

• As the virus has a long incubation period of up to three weeks, people who have the disease may not be exhibiting symptoms at the time of screening.
• There are no direct flights between Britain and Liberia, Sierra Leone and Guinea and critics argue it will be difficult for officials to trace the movement of people, particularly those with long stopovers in Ebola-free countries.
• Health experts argue that there is little point to entry screening in the UK as passengers are already screened in West Africa, and will be denied boarding if they exhibit symptoms. "They say it is extremely unlikely that many people would develop symptoms during a flight, so additional screening on entry would not pick up many cases," the BBC reports.
• Most healthcare workers argue that fever screening is ineffective. This was evident in Australia during the SARS epidemic where 1.8 million passengers were checked and only 800 people with a fever were identified, and no cases of the disease were found.
• People may lie out of fear of being detained or quarantined, something that has been witnessed across West Africa during the outbreak.

So why has it been introduced?

"[Governments] are under a lot of pressure to do something [to] make the public feel reassured, even if it really doesn't make them safer," Larry Gostin, a professor of global health law at Georgetown University told National Public Radio in the US.

Lucy Moreton, general secretary of the UK's Immigration Services Union agrees. "Screening for Ebola is not effective. All the medical evidence says it isn't," she told The Times. "The only reason to do this is presentational and for political reasons."

Ebola: US to begin airport screening, why won't the UK?

09 October

The US is set to begin enhanced screening of travellers arriving from West Africa in order to prevent a wider outbreak of the Ebola virus.

President Obama said the measures would "give us the ability to isolate, evaluate and monitor travellers as needed, and we'll be able to collect any contact information that's necessary", the BBC reports.

"If we don't follow protocols and procedures that are put in place, then we're putting folks in our communities at risk," he added.

As screening comes into force in the US, the UK is facing increasing criticism for failing to introduce similar measures to prevent the global spread of the virus.

At least 8,011 people have been infected with the disease and 3,857 have died according to the latest figures from the World Health Organization (WHO).

Where will the screening take place and how will it work?

Enhanced screening is expected to begin this weekend and will take place at five major airports in New York, Atlanta, Chicago, Washington and Newark, USA Today reports.

Travellers who began their journeys in Sierra Leone, Liberia or Guinea will have their temperature taken and will be asked question about their health by border patrol officers. More than 160 people from the region enter the US each day, over 90 per cent of them arriving at these airports. Fact sheets will also be distributed to passengers, informing them of symptoms of the disease.

If a traveller has a fever or has reason to believe they were exposed to the disease, an officer from the Centers for Disease Control and Prevention (CDC) will assess whether or not to place them under precautionary quarantine.

So, why is this not being adopted in the UK?

Public Health England says it has no plans to introduce the measures as it had not been recommended by the World Health Organization (WHO) and would involve screening "huge numbers of low-risk people", the BBC reports. Currently, immigration officials are only advised to take action if a traveller is showing visible signs of the disease.

The government is coming under widespread pressure to introduce more stringent screening methods, and in the US, Secretary of State John Kerry says there is "no time to wait".

Some British MPs agree. "What we need to ensure is that the public feel there is confidence at our borders and that means, we need to put in screening at our borders in order to give the public that confidence," Labour MP Keith Vaz told the Daily Telegraph.

In other developments:

• The US has experienced its first Ebola fatality. Thomas Eric Duncan, who contracted the disease in Liberia but was diagnosed in Texas, died yesterday despite receiving the experimental drug brincidofovir. At least 50 people he came into contact with are being monitored by health officials.
• Teresa Romero Ramos, the Spanish nurse with Ebola, believes she was infected due to error she made, recalling that she touched her face after treating a patient in Madrid. It has also emerged that Ramos informed health officials about her symptoms three times before being placed under quarantine.
• Britain will deploy a further 600 troops to Sierra Leone, joining 150 already stationed there, to help fight Ebola. They will be responsible for building treatment centres as well as training healthcare workers.
• The World Bank has warned that the Ebola outbreak could cost West African economies more than £20bn by the end of 2015 unless it is quickly contained.

Spain monitoring 50, but more cases 'unavoidable'

08 October

Spanish authorities are investigating how a nurse became infected with the Ebola virus, as health workers blame substandard protective clothing and equipment for the spread of the disease.

The woman, identified locally as Teresa Romero, was the first person to contract the virus outside West Africa, apparently while treating two infected missionaries in a Spanish hospital.

"We don't know yet what failed," a government representative told The Guardian. "We are investigating the mechanism of infection."

Romero, her husband and three other people remain under quarantine in Madrid. Another 50 people she is believed to have been in contact with are also being monitored. A court has also ordered that her dog be put down as a precaution.

A World Health Organization (WHO) Ebola advisor has warned of the risks to healthcare workers treating Ebola, saying that the disease can spread even in high level isolation units in Western hospitals. "The smallest mistake can be fatal," he told the BBC.

Over 3,400 people have died in the current outbreak across West Africa, with Sierra Leone, Liberia and Guinea the worst affected.

Meanwhile, US scientists have forecasted that there is a 50 per cent chance that the UK will see its first case of Ebola in the next three weeks. However, health officials in England insist the risk "remains low".

Despite this, four major NHS hospitals in London, Sheffield, Liverpool and Newcastle have been put on standby to receive infected patients, the Daily Telegraph reports. David Cameron is also expected to convene an emergency Cobra meeting this morning to discuss the UK's response to the outbreak.

This comes after the WHO warned that further cases of Ebola in Europe are "quite unavoidable".

The United States has drawn up plans to screen international arrivals for the disease, however public health officials have ruled out a similar response in the UK.

Ebola: Spain confirms first case of virus contracted in Europe

07 October

A Spanish nurse has tested positive for the Ebola virus in the first confirmed case of the disease contracted outside of West Africa.

The 40-year-old woman was part of the medical team who treated two Spanish priests who were infected with the disease while working with charities in West Africa and later died, the BBC reports.

"All measures have been taken to give the best care to the patient and guarantee the safety of all citizens," said the Spanish health minister Ana Mato. "We are working hard to verify the source of the infection," she added.

The nurse, who has not yet been named, is currently under quarantine in a hospital in Madrid and her condition is reportedly stable. At least 30 health care workers who were involved in the treatment of the priests are now under observation.

Authorities in Spain have launched an investigation into how the disease could have spread in hospital with specialist equipment and isolation facilities.

"Exposure of health-care workers ... continues to be an alarming feature of this outbreak," said the World Health Organization. At least 382 health-care workers have been infected by Ebola in West Africa and 216 of them have died, according to the Washington Post.

The death toll from the outbreak has now reached over 3,400 with over 7,500 confirmed cases, though experts warn the actual number is much higher. Sierra Leone, Liberia and Guinea remain the worst affected.

Meanwhile, the first person to be diagnosed with Ebola in the US, Thomas Duncan is said to be in a critical but stable condition and is being treated with the experimental drug Brincidofovir.

President Obama has urged other world leaders to take action to combat the outbreak in West Africa. "Countries that think that they can sit on the sidelines and just let the United States do it, that will result in a less effective response, a less speedy response, and that means that people die," he said.

"And it also means that the potential spread of the disease beyond these areas in West Africa becomes more imminent."

Ebola: US NBC cameraman diagnosed with virus in Liberia

03 October

An American television cameraman working in Liberia has tested positive for the Ebola virus and will be flown back to the United States for treatment, his network has announced.

Ashoka Mukpo, a 33-year-old freelancer who was working for NBC, is believed to be the fourth US citizen to contract the disease in Africa.

He was hired by the network on Tuesday and began to suffer from symptoms the following day, reports The Guardian. NBC says he told colleagues he felt "tired and achy". He visited a Medicins Sans Frontieres treatment centre to be tested for the virus, and was given the positive result within hours.

"The doctors are optimistic about his prognosis," Mukpo's father told his family and friends, says the Washington Post. "Ashoka was well aware of the risks but felt strongly about trying to help provide honest perspective from the ground level," he added.

In a memo to network staff, NBC News president Deborah Turness said: "We are doing everything we can to get him the best care possible. He will be flown back to the United States for treatment at a medical centre that is equipped to handle Ebola patients."

The rest of the NBC crew, which includes the network's chief medical editor, Dr Nancy Snyderman, are being flown back to the US on a private charter flight. They will be placed under strict quarantine for three weeks, Turness said.

More than 3,330 people have died from Ebola in four West African countries in what has become the world's worst outbreak. US president Barack Obama has pledged federal support to contain the spread in the US.

Ebola conference begins amid warning over infection rate

2 October

International leaders will meet in London today to discuss the world's worst outbreak of Ebola.

The conference, held jointly by the UK and Sierra Leone, comes as Save the Children issued a warning that healthcare demands are far outstripping supply in the West African state. The charity says an estimated 765 new cases of Ebola emerged last week in Sierra Leone – a rate of five new cases an hour – but there are only 327 hospital beds in the country

The outbreak, which has developed at an unprecedented scale, has so far killed 3,338 people, nearly half of the 7,178 confirmed cases, with Sierra Leone, Liberia and Guinea suffering the most.

Save the Children says the disease is "massively unreported" because "untold numbers of children are dying anonymously at home or in the streets".

Rob MacGillivray, the charity's country director in Sierra Leone, told the BBC: "We are facing the frightening prospect of an epidemic which is spreading like wildfire across Sierra Leone, with the number of new cases doubling every three weeks."

MPs on the International Development Committee have warned that cuts in UK health aid to West Africa have "compromised the fight" to stop the spread of Ebola. A report from the committee, published ahead of the conference today, claimed that UK aid to Liberia and Sierra Leone had been cut by nearly a fifth.

However, the UK government says the report is "out of date" and that it has made a £125m pledge to "contain, control and defeat" the disease.

Foreign Secretary Philip Hammond says he hopes today's conference at Lancaster House will "encourage ambitious pledges" for Sierra Leone and the region.

It has also emerged that the Liberian man who became the first person to be diagnosed with Ebola in the US had come into contact with five children. The man arrived in Texas from Liberia on 20 September and became ill four days later, but was not admitted to hospital until 28 September, reportedly because of a mix-up. He is now being treated at the Texas Health Presbyterian Hospital in Dallas, where he is said to be in a serious but stable condition.

Ebola: US confirms first case of virus

01 October

The first case of the Ebola virus in the US has been confirmed by the Centers for Disease Control and Prevention (CDC).

The patient, currently quarantined in a hospital in Dallas, Texas, is believed to have been infected while in Liberia, and flew back to the US before he was symptomatic or contagious.

While a number of American healthcare workers infected with the disease have been brought back to the US for treatment, this is the first time a case has been diagnosed within its borders.

Health officials were quick to allay fears of an outbreak in the US.

"I have no doubt that we will control this importation or this case of Ebola so that it does not spread widely in this country," said Thomas Freidan, director of the CDC, according to CNN.

"It is a severe disease, which has a high-case fatality rate, even with the best of care, but there are core, tried and true public health interventions that stop it," he said.

Friedan explained there was "all the difference in the world" between the public health infrastructure in the US and parts of West Africa, where it has killed more than 3,000 people.

"The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities," he said.

Officials refused to confirm the man's identity, nationality or what treatment he is receiving, due to privacy concerns.

The crew on board his flight have been isolated, according to the chief of staff for Dallas Mayor Mike Rawlings and CDC officials are en route to Dallas to trace – and potentially isolate – people who may have come into contact with the man.

Meanwhile, US health officials say they believe that the Ebola virus may have been contained in Nigeria and Senegal after no new cases were reported in the last month, the BBC reports.

The response "shows that control is possible with rapid, focused interventions," said Friedman, in a separate statement.

However, the virus continues to spread across Liberia, Sierra Leone and Guinea, with the World Health Organization now reporting more than 6,000 confirmed cases of the disease.

Ebola: Sierra Leone quarantines 1m people 'indefinitely'

25 September

More than a million people in Sierra Leone have been ordered into indefinite quarantine in an attempt to stop the spread of the Ebola virus.

The move has come into immediate effect, meaning that more than one third of the country's population is now unable to move freely, Al Jazeera reports. Only those delivering essential supplies and services are allowed into the quarantined areas.

The decision was made after a three-day quarantine imposed across the country last week exposed "areas of greater challenges," said Ernest Bai Koroma, the country's president. Earlier this week government officials had said that the quarantine would not be extended.

"The isolation of districts and chiefdoms will definitely pose great difficulty," Koroma told the nation in a televised address. "But the lives of everyone and the survival of our country takes precedence over these difficulties."

The latest figures from the World Health Organization reveal that over 6,000 people have been infected with the virus, and nearly half of them have died. They also suggest that the spread of the disease has stabilised in Guinea, where the outbreak first originated, but is accelerating in Liberia and Sierra Leone.

Yesterday a Liberian minister warned that the disease could cause his country and others in the region to descend into civil war.

Lewis Brown, the country's information minister, told Al Jazeera: "Hospitals are struggling, but so too are hotels. Businesses are struggling. If this continues the cost of living will go to the roof. You have an agitated population.

He urged international action, saying "the world cannot wait for Liberia, Sierra Leone and Guinea, to slip back into conflict".

Ebola: 1.4 million people could be infected by January, experts warn

24 September

The Ebola virus could potentially infect up to 1.4 million people in Liberia and Sierra Leone by January next year, according to a statistical forecast by the US Centre for Disease Control (CDC).

However, scientists at the CDC caution that this estimate reflects the number of cases that would result if no action is taken.

Infections are doubling every 20 days in the worst affected areas of Sierra Leone and Liberia. Over 2,800 people are now known to have died from the disease and over 5,800 have been infected, but the CDC warns that the actual number of cases could be at least 2.5 times higher.

The US health institute has been accused of scaremongering, but scientists there say they are merely trying to help inform those planning responses to the outbreak by presenting them with a worst-case scenario, showing what could happen if no action is taken to contain the disease.

"It is still possible to reverse the epidemic, and we believe this can be done if a sufficient number of all patients are effectively isolated," CDC Director Tom Frieden told the Washington Post.

However, the World Health Organisation's (WHO) director of strategy told Sky News that predicting the spread of the outbreak is not an exact science. "This is a bit like weather forecasting. We can do it a few days in advance, but looking a few weeks or months ahead is very difficult," he said.

In a separate development, 164 NHS staff have volunteered to travel to West Africa to help treat victims of the virus, following an appeal by the chief medical officer Professor Sally Davies. According to the Department of Health, the number of volunteers continues to rise, with doctors, nurses and paramedics most needed.

The UK has contributed £5m to international health agencies working in the region and is training 90 health care workers a week in the Sierra Leonean capital of Freetown.

Ebola curfew in Sierra Leone will not be extended

22 September

A three-day curfew in Sierra Leone, under which the West African country's six million residents were confined to their homes while health workers went door-to-door to investigate the spread of the ebola virus, will not be extended.

Officials had earlier suggested that the emergency measure might be prolonged but last night they said that the lockdown had been successful and would not need to be extended, the BBC reports.

Around 30,000 medical volunteers spent the three days visiting affected neighbourhoods looking for infected patients, educating residents about the disease, handing out soap - and looking for bodies of victims.

Yesterday, Sky News reported that 92 bodies and at least 56 previously unknown infections had been identified – though it is unclear whether all of the 56 were 'new' cases, with the BBC today reporting just 22.

Deputy chief medical officer Sarian Kamara said discovering the new cases was crucial. He said: "Had they not been discovered, they would have greatly increased transmission."

He said that up to 70 victims had been buried in the past two days. Ebola-infected bodies are highly contagious, so quick burial is essential to stop the spread of infection.

The curfew is the most aggressive measure taken against the disease in West Africa yet, says the BBC. Its introduction was controversial, with Medecins Sans Frontieres warning it could alienate the public from health workers and unnecessarily criminalise people.

However, the head of Sierra Leone's Emergency Operations Centre (EOC), Stephen Gaojia, said it had been a "huge success". It was largely respected, with some residents of the capital, Freetown, coming on to the streets to celebrate when it ended.

Three days of ‘house arrest’ for entire population of Sierra Leone

19 September

Almost all of Sierra Leone’s six million citizens have been ordered to stay inside for three days. The curfew, which began at midnight last night, is to allow health workers to assess and tackle the Ebola epidemic which is raging in West Africa.

As 30,000 volunteers begin to make house calls this morning – educating residents about the disease, distributing soap and checking for infected patients and bodies – the UN said the outbreak was a threat to world peace, The Guardian reports.

The country’s president, Ernest Bai Koroma, said that “extraordinary times” required extraordinary measures and claimed the action would be “a very big boost to our collective effort to stop the outbreak”.

However, Medecins sans Frontieres said the lockdown, from which security services are exempt, was too draconian and could be counterproductive. The medical NGO said the measures might criminalise people and “jeopardise the trust between people and health providers”.

The Daily Telegraph reports that the UN Security Council in New York yesterday declared the rise of Ebola in West Africa a “threat to international peace and security”. Ban Ki-moon, the UN secretary-general, announced a special mission to fight the disease.

“The gravity and scale of the situation now require a level of international action unprecedented for a health emergency,” said Ban, who announced he would be appointing an envoy to head the newly-created UN Mission for Ebola Emergency Response.

He added: “This international mission ... will have five priorities: stopping the outbreak, treating the infected, ensuring essential services, preserving stability and preventing further outbreaks.”

Ebola: outbreak a threat to global security, warns Obama

17 September

President Barack Obama has promised to make the current Ebola outbreak in West Africa a top national security priority, saying yesterday that the world has "a responsibility to act" to tackle the deadly outbreak.

"This is an epidemic that is not just a threat to regional security, it’s a potential threat to global security,'' he said. ‘’If these countries break down, if their economies break down, if people panic, that has profound effects on all of us, even if we are not directly contracting the disease."

Almost 2,500 people have died from the disease since March, more than from all of the past outbreaks combined.

Obama's remarks came as the White House pledged $175 million to fund a military operation to the worst affected areas. US troops will be responsible for setting up a regional headquarters in Liberia as well as training thousands of healthcare workers and building Ebola treatment centres.

However healthcare leaders at the World Health Organization (WHO) say that at least $1 billion is now needed to fight a health crisis that is "unparalleled in modern times", the BBC reports.

The US Centre for Disease Control (CDC) warns that without further funding, cases of the virus could increase into the hundreds of thousands.

Kent Brantly, the American healthcare worker who was infected with the disease while working in West Africa and has since recovered, described the outbreak as a "fire straight from the pit of hell", according to Vox. Speaking to the US senate, he said: "We cannot fool ourselves into thinking that the vast moat of the Atlantic Ocean will keep the flames away from our shores."

Meanwhile, human trials for an Ebola vaccine have begun in Oxford. The vaccine, developed by GlaxoSmithKline and the US National Institute was proven to be 100 per cent successful in animal tests and has now been fast-tracked for safety trials on humans.

Ebola: Obama to send US troops to fight West Africa outbreak

16 September

President Barack Obama is expected to announce plans to send 3,000 US military personnel to Liberia to help tackle the deadly Ebola virus that continues to spread across West Africa.

Last month Obama said he was prepared to lead an international response to the crisis in Liberia and will today outline details of the US military operation.

Aid agencies and the World Health Organization have previously criticised the international community for failing to respond to the humanitarian crisis which began over six months ago.

Almost 2,500 people have died and nearly 5,000 people have now been infected with the disease. Over half of the deaths have occurred in Liberia, with the World Health Organization warning that thousands more cases are to be expected. "We all recognize that this is such an extraordinary, serious epidemic," a senior government official told the New York Times.

'Operation United Assistance' is expected to involve:

• Setting up a regional headquarters in the Liberian capital of Monrovia to coordinate the international response
• Training up to 500 healthcare workers a week
• Building 17 Ebola treatment centres across the country with 1,700 beds in total
• Distributing healthcare kits and tests to thousands of households
• Educating and training locals about the disease

Dr. William Schaffner, an infectious disease and public health expert at Vanderbilt University, said the response was "coordinated and coherent" and showed a serious commitment from the US government. Others have criticised the government for waiting this long to act.

Ebola: Bill and Melinda Gates donate $50m

11 September

Following calls from the UN for $600 million to fight the Ebola outbreak, philanthropists Bill and Melinda Gates have pledged $50 million to help fight the spread of the disease across West Africa.

Their organisation had previously donated $10 million to the emergency operations, treatment and research.

The money will go towards the purchase of medical supplies and the strengthening of existing healthcare systems, as well as towards research into possible cures and vaccines.

"We are working urgently with our partners to identify the most effective ways to help them save lives now and stop transmission of this deadly disease," said Sue Desmond-Hellmann, the Gates Foundation's chief executive officer, according to AP.

The funds will be split between the United Nations, the World Health Organization (WHO), the US Centre for Disease Control and various other organisations working towards containing the virus.

Liberia, the country facing the largest Ebola outbreak in West Africa, is "fighting a biological war", according to Sarah Crowe, a Unicef health worker.

Her comments come days after the country's health minister warned that the disease was a threat to the nation's existence.

Crowe, who just returned from Liberia, said the country is involved in a war against "an unseen enemy without foot soldiers", according to the BBC.

"Ebola has turned survivors into human booby traps, unexploded ordinance - touch and you die. Ebola psychosis is paralysing."

Ebola: 'plague' threatens Liberia's existence

10 September

Liberia's health minister has said his country is facing "a serious threat to its existence" and has appealed to the international community for urgent support.

Brownie Samukai told the UN Security Council that the disease was beyond the country's control and was "devouring everything in its path", the BBC reports.

More than 2,200 people have now died from the disease across Liberia, Guinea and Sierra Leone. Liberia has been the worst affected nation by far, with over a 1,000 of the total deaths. Doctors warn that Ebola is spreading at an exponential rate, with half of all cases in West Africa occurring in just three weeks.

Karin Landgren, the UN Secretary-General's special representative for Liberia, described the outbreak as a "latter-day plague" saying that "Liberians are facing the greatest threat since their war".

The blame has been placed on traditional burial practices as well as the country's crumbling infrastructure which was damaged by two civil wars in as many decades. The UN has said at least 160 health workers in the country have contracted the disease as they do not have adequate protective clothing. Hospitals are severely understaffed and there are not enough beds, with many patients being told to go home.

The World Health Organization (WHO) has called on the international community to scale-up their response to the outbreak.

UN Secretary General Ban Ki-moon says a meeting on the international response to the outbreak will be held at this month's General Assembly.

"I don't think anyone can say right now that the international response to the Ebola outbreak is sufficient," said US ambassador to the UN Samantha Power.

Ebola vaccine: human trials after monkey test a success

08 September

Human trials of an experimental Ebola vaccine have begun in the US after it proved successful in protecting monkeys from the virus.

The World Health Organization is working to fast-track experimental vaccines and treatments for Ebola to combat the outbreak in West Africa, and says that if the latest vaccine turns out to be safe it could be used in West Africa as early as November.

The tests, conducted by the US National Institutes of Health, showed that 100 per cent of the macaque monkeys survived after being vaccinated and then infected with the disease. However, a booster injection is needed to extend its effectiveness.

"The good part of this vaccine is that at five weeks or earlier you get full protection," Dr Anthony Fauci, the director of the US National Institute of Allergy and Infectious Diseases, told the BBC. "The sobering news is the durability isn't great, but if you give a boost, a second shot, you make it really durable."

Professor Jonathan Ball, a virologist at the University of Nottingham described it as "really encouraging data".

The vaccine contains a genetically modified combination of two different strains of Ebola. Scientists hope that patients will react to the small amount of the virus and develop immunity against it.

Safety trials in humans have already begun in the US and are expected to be extended to the UK and Africa.

Over 2,100 people have now died from the disease that continues to spread across West Africa. There is currently no proven cure or vaccine against the disease, but several are in development across the world.

In other developments:

• The government in Sierra Leone has ordered a three day lock-down of the entire country. Between 19 to 21 September people will not be allowed to leave their homes in order to enable healthcare workers to locate and isolate those who are infected.
• Barack Obama has said the US must lead the international community in containing the spread of Ebola in Africa. He said he was prepared to deploy the US military to set up isolation centres and provide security for international health care workers.
• American healthcare worker Dr Rick Sacra, who was infected with the disease while working in Liberia, has been flown to Nebraska for treatment and is said to be improving.

Ebola: British nurse makes 'full recovery' and leaves hospital

03 September

William Pooley, the first Briton to be infected with the deadly Ebola virus, has made a full recovery according to his doctors.

The 29-year old nurse from Suffolk was being treated in a specialist isolation centre in west London's Royal Free Hospital. His doctors say he is no longer infectious and poses "no risk to the wider community in any way".

He caught the virus while working as a volunteer nurse at the centre of the current Ebola outbreak in Sierra Leone. "I was worried that I was going to die, I was worried about my family and I was scared," he said.

He was flown back to the UK and received the experimental drug zMapp, but doctors are still unable to determine whether it was directly responsible for his recovery, as patients can get better naturally. However, "levels of the virus in his bloodstream did fall significantly" following the treatment, reports the BBC's health editor James Gallagher.

Pooley said he was very lucky in to receive such high quality care, saying treatment in the UK was a "world apart" from what people were receiving in the worst affected countries in West Africa.

He also said that despite experiencing some unpleasant symptoms, they never progressed to the "worst stage of the disease", adding: "I've seen people dying horrible deaths."

He praised healthcare workers that are still operating in the region. "In the face of quite likely a horrible death, they're continuing to work all day, every day helping sick people, it's amazing."

Meanwhile, the charity Medecins Sans Frontieres has criticised the international response to the outbreak in West Africa as "lethally inadequate".

Over 3,000 people are infected and more than half have died across Sierra Leone, Liberia, Nigeria, Guinea and Senegal, with a separate outbreak in the Democratic Republic of Congo.

Ebola virus outbreak: the economic cost

02 Septmber

The introduction of travel bans and quarantines in order to combat the outbreak of Ebola virus are having a devastating economic impact on several African countries, warns the UN.

The UN Food and Agriculture Organization (FOA) has issued a high-level food security alert for Liberia, Sierra Leone and Guinea, warning that the food crisis is expected to intensify in coming months, according to Reuters.

Food supplies

"With the main harvest now at risk and trade and movements of goods severely restricted, food insecurity is poised to intensify in the weeks and months to come," the FAO's Bukar Tijani told Deutsche Welle.

Production of vital crops such as rice, maize, and palm oil is being scaled back due to a shortage of labour. This in turn is leading to sharp price hikes. For example, the price of Cassava, a staple carbohydrate in the region, has risen by 150 per cent in just two weeks.

Even before the outbreak, many households were forced to spend as much as 80 per cent of their income on food, said Vincent Martin, also from FOA. "Now these latest price spikes are effectively putting food completely out of their reach".

The UN World Food Programme has launched an emergency response to the situation in West Africa and is sending 65,000 tonnes of food to 1.3 million people in the worst affected areas.

Tourism

Tourism is "one of the first casualties of any epidemic", according to the Economist. Airlines have suspended flights to Sierra Leone, Guinea and Liberia and various governments have issued travel warnings. This comes despite advice from the World Health Organisation not to issue travel and trade bans as they are counterproductive.

The fears surrounding Ebola are even affecting popular tourist destinations in South Africa and Kenya – thousands of miles away from the affected area. Hannes Boshoff, managing director at Johannesburg-based ERM Tours, told Reuters that 80 per cent of his Asian customers had cancelled booked trips over fears of Ebola. A lot of tourists just see Africa "as one country", Boshoff said. "I try and tell people that Europe and America are closer to the Ebola outbreak than South Africa."

Mining

Several foreign mining companies including London Mining began evacuating staff based in West Africa in June, when the outbreak was still in its early stages. Since then, many more have followed suit. China Union has threatened to shut down its entire operation in Liberia if the outbreak continues to spread. Sierra Leone will miss its goal of producing $200 million worth of diamonds as miners are frightened to go down the diamond pits to work.

Despite fears of a looming food crisis, the UN says that "preventing further loss of human life and stopping the spread of the virus" remains their primary objective.

Ebola: healthcare workers go on strike over safety fears

01 September

Healthcare workers at a large state-run hospital at the centre of the Ebola outbreak in Sierra Leone have gone on strike over pay and hazardous working conditions.

They say they are not being provided with adequate protection against the disease after more than 20 health care workers died from the disease, ITV reports.

"The workers decided to stop working because we have not been paid our allowances and we lack some tools," adds Ishmael Mehemoh, chief supervisor at the clinic in the city of Kenema in the east of the country.

The deadliest Ebola outbreak on record has now infected over 3,000 people and killed more than 1,500. The World Health Organization (WHO) has said that it is concerned about the "unprecedented" number of doctors and nurses who have been affected. So far 240 have been infected and 120 have died.

Separately, the British Red Cross is appealing for doctors and nurses with experience of "acute-care and working in a resource-poor setting" to join their team of healthcare workers battling Ebola in the same Sierra Leonean city.

In other developments:

• In extensive animal tests, the experimental drug zMapp was proven to be "100 per cent effective" in treating the disease. It has yet to be clinically tested on humans but has been given to a handful of health workers.
• Two Liberian doctors have been released from hospital and no longer test positive for the disease after receiving the experimental drug zMapp. Dr Senga Omeonga and Kynda Kobbah were infected while treating patients but have now made a full recovery, CNN reports.
• In Sweden, a man returning from West Africa thought to have the disease has tested negative.
• Ivory Coast is being threatened with expulsion from the Africa cup of Nations for refusing to play against Sierra Leone "because of fears over Ebola", BBC sport reports.

Ebola virus outbreak spreads to Senegal

29 August

The first case of Ebola has been confirmed in Senegal, making it the fifth country in West Africa to be affected by the outbreak of the virus, according to Reuters.

The country's Health Minister Awa Marie Coll Seck said the victim had arrived in Senegal from neighbouring Guinea, where the deadly outbreak began in March.

The young man was immediately quarantined and health officials are working to find people he may have come into contact with.

Senegal had previously shut its borders with Guinea, but has not been able to stop people travelling to its cities, which are major trade and transport hubs.

At least 3,000 people have now been infected with the disease across West Africa and over 1,500 have died. The World Health Organisation has warned that outbreak could accelerate, ultimately infecting upto 20,000 people.

Ebola cases could rise to 20,000, warns WHO

28 August

Cases of the Ebola virus could exceed 20,000 as the disease continues to spread at an "alarming" rate across West Africa, the World Health Organization has warned.

The view was echoed by US health officials. "The cases are increasing. I wish I did not have to say this, but it is going to get worse before it gets better," Tom Frieden, the director of the Centres for Disease Control and Prevention told Al Jazeera in Liberia.

Over 1,500 people are known to have died in the deadliest Ebola outbreak in history and over 3,000 people have been infected, with 40 per cent of those cases occurring in just the last few weeks. The fatalities already include 120 health workers.

The news comes as health ministers from across the region meet in Ghana for the second time in the last few months to co-ordinate a response to the crisis.

In other developments:

• Human safety trials for a new Ebola vaccine developed by GlaxoSmithKline are set to begin next week.
• The British nurse Will Pooely who is being treated at a London hospital has been given the same experimental drug zMapp used to treat two American health care workers. It is yet unclear whether the medication contributed to their recovery.
• In Nigeria the disease has spread to the oil hub of Port Harcourt, the first recorded case outside of Lagos. The country has closed all of its school until mid-October in an effort to contain the outbreak.
• Several more airlines have suspended flights to the region, with Royal Air Morocco now said to be the only carrier still offering flights from the Liberian and Sierra Leonean capitals. This is despite the WHO's advice that travel and trade bans are not necessary.

Ebola: WHO calls for screening at borders in West Africa

19 Aug

Countries affected by the Ebola outbreak have been asked to introduce exit screenings at all international airports, seaports and major land crossings in order to stop the spread of the disease in West Africa.

The recommendation comes from the World Health Organization [WHO], which has set up a task force to monitor and contain the outbreak, reports Time magazine. The task force will also be responsible for providing information to governments and transport companies, but it has not so far not called for general travel bans.

"Any person with an illness consistent with [the Ebola virus] should not be allowed to travel unless the travel is part of an appropriate medical evacuation", the UN health agency said. It added that non–affected countries in the region "need to strengthen the capacity to detect and immediately contain new cases".

Separately, it has now been confirmed that 17 patients who were freed from a quarantine centre in Liberia last week are indeed missing, the BBC reports. This is despite claims from some health care workers that they had been moved to another facility. The attack on the centre was described as Liberia's "greatest setback" during the current Ebola outbreak by the country's information minister.

"Assaults on health workers and facilities seriously affect access to health care, depriving patients of treatment and interrupting measures to prevent and control contagious diseases", said the WHO's Dr Richard Brennan.

The death toll has now risen to 1,229 with 2,240 confirmed cases across Sierra Leone, Guinea, Liberia and Nigeria. Sierra Leone is currently the worst affected nation with 810 cases of Ebola across 12 of the country's 13 districts.

Ebola: infected patients 'freed' after raid in Liberia

18 Aug

Hundreds of people have reportedly raided an Ebola quarantine centre in the Liberian capital of Monrovia and released infected patients, AFP reports.

An "angry mob" of several hundred people attacked a health centre in city's West Point township on Saturday, but there are conflicting reports about what has happened to the patients.

Some health officials told the BBC that the patients, who have all tested positive for Ebola, had been transferred to another medical facility. But witnesses and the head of the country's health workers association, George Williams, have claimed that 17 escaped and three were taken away by their families.

Those responsible for the raid were heard chanting "there is no Ebola" amid claims from locals that the disease was a hoax. Residents had opposed the centre, saying "we told them not to (build) their camp here. They didn't listen to us."

Blood-stained mattresses, bedding and medical equipment were looted from the health centre, a senior police officer told the BBC. These pose a significant health hazard as the disease is spread by contact with infected bodily fluids.

"This is one of the stupidest things I have ever seen in my life," the police source said.

If the patients have escaped, there are fears that the outbreak will spread to nearby densely populated slums in West Point, where up to 50,000 people live.

The deadly outbreak has so far killed at least 1,145 people in West Africa, including 413 in Liberia where health officials are struggling to contain the outbreak due to widespread misinformation and fear of the disease.

In a separate development, Kenya has closed its borders to all incoming travel from Sierra Leone, Guinea, and Liberia. Kenya Airways has also suspended flights to the region, despite advice from the World Health Organization (WHO) not to issue travel bans as the risk remains low. Several other airlines including British Airways and Emirates have already cancelled suspended flights to the region.

Ebola: scale of outbreak has been 'vastly underestimated'

15 Aug

The magnitude of the Ebola outbreak in West Africa has been "vastly underestimated", according to the World Health Organization (WHO).

The WHO said it would be coordinating a "massive" scaling up of the international response after it discovered that the number of reported cases and deaths did not reflect the severity of the outbreak.

Almost 2,000 people are reported to have been infected and the latest death toll stands at 1,069 across Sierra Leone, Guinea, Liberia, Nigeria and Spain, where a priest infected in Liberia died earlier this week.

The WHO did not say what it thought the actual number of cases was, but it said it expected the outbreak to continue "for some time", with its response plan extending to several months.

It said "extraordinary measures" were now needed to contain the outbreak affecting countries that are dealing with "extreme poverty, dysfunctional health systems, a severe shortage of doctors, and rampant fear".

However, the organisation reiterated that the risk of transmission via air travel remains low. It has advised against travel or trade bans, instead advising countries to provide citizens travelling to the region with accurate information on how to reduce their risk of infection.

"Unlike infections such as influenza or tuberculosis, Ebola is not airborne," Dr Isabelle Nuttall, Director of WHO Global Capacity Alert and Response said in a statement. “It can only be transmitted by direct contact with the body fluids of a person who is sick with the disease.”

In a separate development, two people in Nigeria have died after drinking salt water, rumoured to prevent the disease, according the BBC. Ministers warned the public not believe information from social media that had not been issued by the government or health officials, as fear of the disease spreads across the region.

Ebola: Canada sends untested vaccine to West Africa

13 Aug

Canada has announced that it will donate an experimental Ebola vaccine to the World Health Organization (WHO) to be used in West Africa.

It said it would be donating between 800 and 1,000 doses of the vaccine but experts have warned that supplies of the drug are limited as it takes months to produce.

Dr Gregory Taylor, deputy head of Canada's Public Health Agency told Reuters that he believed the drug was a "global resource" to be shared.

The vaccine has never been tested on humans and Taylor admitted that they have no idea how safe the vaccine is or what the side effects will be, "but in this extraordinary circumstance in Africa right now, we're trying to do everything we can to assist."

This follows yesterday's decision by the WHO to allow untested and unlicensed drugs to be used in response to the epidemic. It decided that, with West Africa in the grip of the worst-ever Ebola outbreak, it would be ethical to use extend the use of experimental treatments.

There is currently no proven Ebola vaccine or cure, but several pharmaceutical companies are developing different methods of treating and preventing the disease.

Treatments

• zMapp, a cocktail of antibodies harvested from an infected animal's blood and grown in specially-modified tobacco leaves, works by stopping the virus from entering and infecting new cells. It has been used to treat three Western health care workers, including a Spanish priest who died yesterday, and is being sent to doctors in Liberia.
• Blood serum is another treatment being considered by the WHO. Serum is part of blood plasma taken from a patient who has recovered from Ebola and is used to treat others as it contains essential antibodies against the disease. It has proven effective in previous outbreaks but the WHO wants stricter safety controls to be introduced.
• The drug TKM-Ebola, developed by a Canadian pharmaceutical company, works by interfering with the virus's genetic code and stopping it from producing disease-causing proteins, the BBC reports. Human trials were halted earlier this year over safety concerns, but the company announced that the US Food and Drug Administration (FDA) had partially lifted the ban, raising hopes that the drug could be made available to combat the current outbreak.

Vaccines

Other vaccines, in addition to the one developed by the Canadian government, are currently in the pipeline. According to the WHO and FDA some clinical trials are being fast-tracked and new vaccines could be made available by 2016.

Ebola: infected British nurse poses 'little risk' to public

26 August

Britain's first confirmed Ebola patient is being treated at a London hospital and is receiving "excellent care", as health officials insist the public risk from the disease remains "very low".

William Pooley, a 29-year old volunteer nurse from Suffolk became infected while treating patients with the deadly disease at the centre of the Ebola outbreak in Sierra Leone.

He arrived at London's Royal Free hospital after being flown into RAF Northolt in West London on Sunday night in a specially modified military aircraft, according to the BBC.

Pooley is being treated at a high-level isolation unit, with a specially designed tent surrounding his hospital bed to contain the disease. The specialist equipment allows doctors to treat Pooley without coming into direct contact with him, Channel 4 reports.

The UK Department of Health has said that Pooley is not currently "seriously unwell". There is no known cure for Ebola and the treatment is said to involve rehydration, pain relief and other palliative care.

It is yet unclear whether Pooley will receive any experimental treatment for the disease. The untested drug zMapp was given to two infected American health care workers who recovered and were released from hospital last week, but the pharmaceutical company that produces it has said stocks of the drug had been depleted and will take months to replenish.

Health experts insist the public risk from Ebola in the UK remains "very low". Professor John Watson, deputy chief medical officer described the NHS systems for dealing with unusual infectious diseases as "robust, well-developed and well-tested".

"UK hospitals have a proven record of dealing with imported infectious diseases and this patient will be isolated and will receive the best care possible," he said.

Pooley's co-worker Dr Oliver Johnson told Channel Four that he was a "remarkable man" who had been working tirelessly at "ground-zero" of the outbreak.

"We consider him a hero," said Gabriel Madiye, the executive director of The Shepherd's Hospice, where he was working. "Somebody who is sacrificing to provide care in very difficult circumstances - when our own health workers are running away."

In other developments:

• The Democratic Republic of Congo has reported cases of the disease, the first outside of West Africa. The current outbreak had previously been confined to Sierra Leone, Liberia and Guinea, with a few isolated cases in Nigeria.
• One of the Liberian doctors who was given zMapp has died, despite initially showing signs of recovery.
• Japan has said it is willing to offer its influenza drug favipiravir, or T-705, as an experimental Ebola drug if requested.

Ebola: did zMapp cure American healthcare workers?

22 August

Two missionary healthcare workers have been released from hospital in Atlanta and cleared of the Ebola virus after receiving the experimental zMapp drug.

After three weeks in an isolation centre, doctors confirmed that Dr Kent Brantly and Nancy Writebol were now free of the disease and pose no health risk to the public.

"I am thrilled to be alive, to be well and to be reunited with my family," said Brantly after his release, calling his recovery "miraculous".

Brantly thanked the medical staff who treated him at Emory University Hospital and credited zMapp for the improvement in his condition. He also said his survival was a "direct answer to thousands and thousands of prayers".

However, doctors are reluctant to directly attribute the patients' recovery to the drug. "We're all very happy Brantly and Writebol have gotten better", Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told the New York Daily News. "But I think it would be a misperception to say that the drug is the thing that made them well.

"We don't have any idea whether this helped them get better, had no impact or even, unlikely, made their recovery delayed," he said.

While Ebola has an extremely low survival rate, ten per cent of people do recover from the disease and Writebol and Brantly could have simply gotten better naturally.

Dr Bruce Ribner, who runs the infectious disease unit at Emory University Hospital, reminded the public that the drugs were still in an experimental phase and much more research was needed before any conclusions on its effectiveness could be made.

Stocks of the drug have now been depleted and scientists warn it could take months to produce more.

What is 'zMapp'?

Developed by an American biopharmaceutical company, zMapp is a "cocktail" of antibodies harvested from an infected animal's blood and grown in specially-modified tobacco leaves. It works by stopping the virus from entering and infecting healthy cells. This type of drug has already been used in the treatment of some forms of cancer, but takes a long time to produce.

However, according to previous trials, the treatment is only effective within a limited time frame after infection, with optimum results reported when administered within 24-hours.

Who has it been given to?

• The two American aid workers would have been among the first humans to take the medication, before them, the drug had only been tested on monkeys.
• A 75-year-old Spanish priest who was infected in Liberia was given the drug, but he later died in Madrid.
• zMapp has also been given to three Liberian healthcare workers who are reportedly showing signs of improvement.

Why was it given if it hadn't been approved?

The US Food and Drug Administration (FDA) allows drugs to be administered without testing under what it calls compassionate use. This "expanded access" is what many suspect happened in this case, as it can only be extended to individuals who are facing an immediately life-threatening condition where no other treatment is possible.

The World Health Organization has also decided that the use of untested drugs to treat the deadly outbreak is ethical.

Ebola: police open fire to enforce Liberia quarantine

21 August

Police in Liberia respond with force as slum residents attempt to break Ebola quarantine to get food and water

Liberian police have fired live rounds and teargas at residents who attempted to leave a government-imposed Ebola quarantine zone in the country's capital, Monrovia.

Officials sealed off the city's West Point slum, home to up to 75,000 people, in order to stop the spread of the Ebola virus. But the introduction of curfews and quarantines has angered residents who say they were given no advance warning of the measures which have stopped them from buying food and water.

Some began throwing rocks at police who were enforcing the quarantine, according to Reuters. The police responded with live rounds, tear gas and beatings. Several serious injuries were reported but no-one is known to have died during the clashes.

The country's president, Ellen Johnson Sirleaf, defended the quarantines, which have been established in areas around the country, saying they were essential to control the spread of the disease. She said that Ebola had continued to spread because of "continued denials, cultural varying practices, disregard for the advice of health workers and disrespect for the warnings by the government".

There are fears that such large scale isolations could lead to widespread unrest as the movement of essential goods is cut off. "I don't have any food and we're scared," said Alpha Barry, a West Point resident.

The World Health Organization has begun working with local authorities to deliver emergency food aid into quarantined regions in an attempt to reduce rising tensions.

In a separate development, a multi-million pound research package has been announced by the UK's Department for International Development and the Wellcome Trust charity. £6.5m in funding will be given to researchers working on ways to tackle the disease.

Welcome Trust Director Dr Jeremy Farrar said the severity of the outbreak demanded an immediate international response.

Ebola: world 'failing to help' as Africa faces 'emergency'

20 Aug

The head of an international medical charity has accused world leaders of doing "almost zero" to help countries affected by the worst outbreak of the Ebola virus in history.

"Leaders in the West are talking about their own safety and doing things like closing airlines –and not helping anyone else," Brice de la Vigne, the operations director of Medecins Sans Frontieres told The Guardian.

He argues that containing Ebola is not a complicated task, but requires international intervention. He accused leaders of lacking the political will to take action. "Time is running against us", he warned.

Other healthcare workers have echoed De la Vigne's comments. "We are gone beyond the stage of a health crisis", said Sinead Walsh, head of Irish Aid working in Sierra Leonia's capital. "This is a humanitarian emergency now".

In other developments, the Liberian government has imposed a curfew across the country in order to try and control the spread of the Ebola virus. Health officials have also managed to locate the missing patients who were freed from a quarantine centre last week, the BBC reports.

Separately, the infected health care workers who have been treated with the experimental zMapp drug in Liberia are reportedly recovering, but it is yet unclear if their improving conditions are directly related to the drug.

Ebola: Liberian doctors receive 'last' of untested zMapp drug

12 Aug

Two Liberian doctors will be the first African patients to receive the experimental zMapp drug to treat Ebola, The Guardian reports.

The drug was provided to the West African country "at no cost in all cases", according to the producer Mapp Biopharmaceutical, but it warned that its current supply of the drug had now been exhausted. More of the drug is being produced, but scientists say that it could take several months.

It follows a direct appeal by the Liberian president, Ellen Johnson Sirleaf, to the US government. The country's information minister Lewis Brown told the BBC that the alternative to taking the untested drug was almost certain death.

There has been growing anger in the region as the only patients to have received the potentially life-saving treatment are Westerners. Two US health care volunteers who were given zMapp are reportedly recovering, but it is yet unclear if their improving condition is directly related to the drug. However, a Spanish priest who was also given the drug has now died in Madrid, the BBC reports.

The death toll in the world's deadliest outbreak of Ebola has now exceeded 1,000 in four West African countries.

The BBC's Will Ross warns that the untested use of drugs in Africa can become very controversial, citing the deadly Nigerian meningitis outbreak in 1996. The US drug company Pfizer gave 100 children an experimental antibiotic, but was later sued by the families as well as the government after 12 children died and many more were left with permanent disabilities including brain damage.

The company denied responsibility, saying the outcome was a result of the disease, not the drug, but was forced to pay a multi-million dollar settlement. Ross says that the result contributed to a suspicion of Western medicine in the region.

The World Health Organization is expected to announce the results of its emergency ethics meeting on using untested drugs to try and contain the outbreak.

Ebola: WHO debates ethics of giving untested drug to Africans

11 Aug

A group of specialists are meeting at the World Health Organization (WHO) today to discuss the ethical dilemma of whether or not to make experimental Ebola drugs available to infected patients across West Africa.

The ethics group will include doctors, medical historians, anthropologists, clinicians, epidemiologists, logisticians and other specialists, says the BBC. The diverse group will allow for "a nuanced appreciation of the likely risks and benefits" to be determined.

The deadliest Ebola outbreak ever recorded has so far killed almost 1,000 people in West Africa. Two infected US volunteers were given the untested drug zMapp earlier this month and experts have called for its use to be extended to patients across the region and not just to Western health care workers.

The pharmaceutical company GlaxoSmithKline has said that it will begin trials of a separate vaccine for the disease later this year, Reuters reports. However, even if it is fast-tracked and proven to be safe and effective it is unlikely to be released until 2015.

In other developments:

• Doctors believe they have traced the outbreak to a two-year old boy in Guinea. 'Patient Zero' went on to infect his mother, sister, and grandmother in a village bordering Sierra Leone and Liberia, the New York Times reports.
• Guinea has become the latest country to close its borders in order to contain the virus.
• Health care workers in Liberia have admitted that the "overwhelmed" public health system was responsible for the spread of the disease within the country. Medecins Sans Frontieres told the BBC that the country's health care system was "falling apart".

Ebola declared an 'international health emergency'

08 Aug

The Ebola outbreak which has resulted in over 930 deaths in West Africa has officially been declared a global health emergency by the World Health Organisation.

The outbreak has been placed in the category of "public health emergencies of international concern" at an emergency meeting in Geneva.

WHO officials called the spread of the disease an "extraordinary event" and said the possible global consequences were "particularly serious", the BBC reports.

The announcement will trigger a "coordinated international response" which will aim to contain and control the deadly outbreak. However, action would stop short of a widespread ban on travel or trade.

Containment of the disease is becoming "impossible for these governments to handle themselves", Stephen Morrison, the director of the Global Health Policy Centre at the Centre for Strategic and International Studies told Newsweek.

While health officials at the WHO said the threat was serious, they also said "it is an infection which can be controlled". Much of the blame of the spread of the disease has been placed on the region's poor public health infrastructure.

Ebola: give Africans new experimental drug, say experts

07 August

The World Health Organization (WHO) should extend the use of experimental new treatments for Ebola to patients in West Africa, say the world's leading experts on infectious diseases.

The death toll from the outbreak in West Africa has now reached 932, with Liberia now the second country to officially declare a state of emergency due to the virus.

Three leading Ebola experts, including Dr Peter Piot who co-discovered the disease in 1976, are calling for the experimental new drug zMapp to be used to treat patients across Sierra Leone, Guinea, Liberia and Nigeria , Al Jazeera reports. This comes as doctors report that the two US health workers being treated with the untested drug in Atlanta are continuing to show signs of recovery.

Piot, David Heymann, of Chatham House, and Wellcome Trust director Jeremy Farrar, issued a joint statement saying that African governments should be "allowed to make informed decisions" on whether or not to use the drugs.

They said that people suffering in West Africa were not being afforded the same chance of survival as Westerners, arguing that if Ebola was spreading through the US or the UK "rapid decisions" would be made about extending the use of this potentially life-saving treatment.

The three professors called on the WHO to take on a "greater leadership role" in this crisis, adding, "These dire circumstances call for a more robust international response".

The pharmaceutical company that created the drug has warned that production is in its early stages and very little of it currently exists, but it said it would be working to increase production.

President Obama said the use of an untested drug to treat Ebola would be "premature", Al Jazeera reports. "We've got to let the science guide us and I don't think all the information is in on whether this drug is helpful", he said. He placed the blame of the outbreak on the overwhelmed public health infrastructure in the affected countries.

The WHO has said that it will meet next week to discuss the merits of extending the use of experimental drugs in West Africa.

In other developments:

• Nigeria's health minister says the country is facing a national health emergency after a second person died from the disease in the region's most populous country.
• A Spanish priest suffering from the disease is to be flown back to Spain this week, the first confirmed case of Ebola to be treated in Europe.
• The WHO is holding a second day of talks in Geneva to decide whether to declare a global health emergency.

Ebola outbreak: BA cancels flights as disease spreads

06 Aug

British Airways has suspended flights on some West African routes as concern grows that Ebola has spread to Nigeria.

Health care workers in the country have confirmed that eight people are showing signs of the deadly disease, increasing fears that the it has now spread to a fourth country, Reuters reports.

All of the patients came into contact with infected doctor Patrick Sawyer, who flew from Liberia to Nigeria and later died in Lagos.

In a seperate development, a businessman believed to have contracted Ebola after travelling to Sierra Leone has died in Saudi Arabia. If confirmed, it would be the first time anyone outside of Africa has died of the disease.

The World Health Organisation (WHO) is currently meeting in Geneva to discuss whether to declare the outbreak a global health emergency, the BBC reports.

The world's largest Ebola outbreak has now killed almost 900 people across Sierra Leone, Guinea, Liberia and Nigeria.

Hundreds of troops have been deployed in Sierra Leone and Liberia to help contain the disease. The plan, known as Operation Octopus, is the latest attempt to enforce stricter quarantines across the worst affected areas.

"We hope it will not require excessive force, but we have to do whatever we can to restrict the movement of people out of affected areas," said Liberia's information minister, Lewis Brown.

Germany has now joined France and the US in issuing official travel warnings to West Africa.

British Airways announced this morning that is had cancelled flights to Liberia and Sierra Leone due to a "deteriorating public health situation". The suspension is expected to last until the end of August, but will be reviewed over the coming weeks.

In a statement it said "the safety of our customers, crew and ground teams is always our top priority".

The move by BA follows similar decision by Emirates and smaller regional airlines earlier this week.

Ebola: 'miraculous' zMapp drug saved lives of workers

05 Aug

An experimental drug to treat Ebola was given to two American medical volunteers and probably "saved their lives", claims CNN.

Frozen vials of the drug called 'zMapp' were reportedly flown to West Africa last week and given to Dr Kent Brantly and Nancy Writebol, aid workers who had been infected after treating patients in Liberia. Their conditions improved after taking the drug and they have now been flown back to the US for further treatment.

"Within an hour of receiving the medication, Brantly's condition was nearly reversed", says CNN's chief medical correspondent, Dr Sanjay Gupta. He said one of the doctors described the turnaround as "miraculous", which is "not a term we scientists like to throw around".

But what is this new drug and if it is so effective, why wasn't it administered to the hundreds of patients who have died of the disease across West Africa?

What is 'zMapp'?

Developed by an American biopharmaceutical company, zMapp is a "cocktail" of antibodies harvested from an infected animal's blood and grown in specially-modified tabacco leaves. "It works by preventing the virus from entering and infecting new cells", says Gupta. This type of drug has already been used in the treatment of some forms of cancer, but takes a long time to produce.

However, according to recent trials, the treatment is only effective within a limited time frame after infection, with optimum results reported when administered within 24-hours.

Has it been tested on humans?

Not properly. The two American aid workers would have been among the first humans to take the medication and would have been made aware of the risks and been required to give "informed consent".

The drug is still in early stages of testing and had only been tested on monkeys, with scientists reporting "promising" results.

Why was it given if it hadn't been approved?

The US Food and Drug Administration (FDA) allows drugs to be administered without testing under what it calls compassionate use. This "expanded access" is what many suspect happened in this case, as it can only be extended to individuals who are facing an immediately life-threatening condition where no other treatment is possible.

So, why hasn't it been given to other dying patients?

The FDA only grants compassionate use on a case-by-case basis for individual patients or "intermediate-size" groups of patients. It could only allow the use to be broadened if there was sufficient evidence on the safety and effectiveness of the drug.

When is it likely to be readily available?

Scientists from the National Institute of Health in the US have announced that they expect to begin testing a possible vaccine for the disease in September. Despite these developments, health professionals warn that it doesn't mean a cure is close. Clinical trials are not quick and doctors suggest that it is unlikely either a cure or a vaccine will be delivered before the end of 2015.

What has the response been?

While many were quick to celebrate the positive effects of the drug, others warned of the ethical, legal and medical dilemmas of using untested drugs. The World Health Organization (WHO) has said that health authorities "cannot start using untested drugs in the middle of an outbreak". Doctors without Borders warned that using drugs in their early stages of development would have a "series of scientific and ethical implications".

Ebola scare at Gatwick: disease 'has not spread to UK'

04 Aug

Tests carried out on an elderly woman who died shortly after arriving at Gatwick airport from the Gambia have come back negative for Ebola, the Department of Health has said.

A woman, believed to be in her early 70s, collapsed at the airport shortly after landing and was later pronounced dead in hospital.

Dr Brian McCloskey, director of global public health at Public Health England, confirmed that "there was no health risk to other passengers or crew". He told the BBC that it was considered "very unlikely" that the woman was carrying Ebola, but tests were carried out as a precaution.

"The correct procedures were followed to confirm there was no reason to quarantine the airplane, the passenger or staff," he said.

The disease, currently only known to have spread in Liberia, Sierra Leone and Guinea, has resulted in at least 826 suspected deaths, according to the figures released by the World Health Organization (WHO). The organisation said the disease was "moving faster than our efforts to control it".

The second UK scare comes as two infected American medical volunteers were flown to a US hospital for treatment. Dr Kent Brantly and Nancy Writebol were infected while treating patients in Liberia, The Guardian reports. Doctors working to treat the pair allayed fears that the disease could spread in the US, saying that strict isolation procedures are in place to prevent an outbreak.

Emirates has become the first major airline to suspend flights in response to the outbreak. "The safety of our passengers and crew is of the highest priority and will not be compromised," it said, according to Al Jazeera.

Meanwhile, a leading British doctor has blamed Western pharmaceutical companies for delaying the development of a vaccine for the disease as it "only affects Africans".

In cases of Ebola, like HIV/Aids, "the involvement of powerless minority groups has contributed to a tardiness of response and a failure to mobilise an adequately resourced international medical response", Professor John Ashton, president of the UK Faculty of Public Health wrote in the Sunday Independent.

Ebola: Commonwealth games athlete cleared of disease

01 Aug

The death toll of the worst-ever Ebola outbreak has risen to 729, as global efforts to test for, treat and contain the disease intensify.

A cyclist from Sierra Leone taking part in the Commonwealth games in Glasgow was tested for the disease after he fell ill and was hospitalised last week, according to the BBC. Moses Sesay has been cleared of the virus and has since returned to the competition.

"There is no Ebola in the Athletes' Village," a spokesperson confirmed, and "no one has tested positive for Ebola in Scotland".

Across the Atlantic, a US aid worker infected with the disease in West Africa is to be flown to Atlanta for treatment in the next few days in an unprecedented move. The unnamed patient will be placed in a high-security isolation unit at Emory University hospital, the BBC reports.

The US Centre for Disease Control (CDC) yesterday issued a travel warning for parts of West Africa that have been worst affected by the disease. It has advised against all non-essential travel to Sierra Leone, Guinea and Liberia. The CDC will also be sending 50 disease control specialists to the region to work alongside World Health Organization (WHO) and local officials, Time reports.

A state of emergency has been now declared in Sierra Leone by President Ernest Bai Koroma. He said tighter quarantine restrictions would be put in place and that the army and police would work together to restrict the movement of people in affected areas in the country.

The WHO and leaders from West Africa are expected to announce a $100m response plan later today to better equip health workers in their fight against Ebola.

Meanwhile, scientists from the National Institutes of Health in the US have announced that they expect to begin testing a possible vaccine for the disease in September.

Ebola virus: UK 'not ready' to deal with outbreak

31 July

The Ebola outbreak in West Africa, described yesterday by the Foreign Secretary as a threat to the UK, could catch UK Border staff unprepared, a union official has said.

Lucy Moreton, general secretary of the Immigration Service Union, said border, immigration and customs staff are "very concerned" about the risk of Ebola reaching the UK.

She said her members told her they felt unprepared to deal with people entering the UK with suspected cases of the deadly virus, and that staff who are serving on the "front line" need further training and guidance to deal with the threat.

"There is no health facility at the border, there is no containment facility, and until extremely recently there has been no guidance issued to staff at all as to what they should do," She told the BBC Radio 4's The World Tonight. "They are phoning us up and asking 'what are we supposed to do, how do we spot this, how do we protect ourselves?', and we can't answer that for them just now."

Yesterday Philip Hammond, the Foreign Secretary chaired an emergency meeting of the Cobra committee to discuss ways of managing the risk. He had earlier said that Ebola posed a threat to the UK.

The deadliest Ebola outbreak on record has so far killed more than 670 people in Sierra Leone, Guinea, Liberia and Nigeria and there are fears of a global epidemic.

However, Hammond said that he was "fairly confident" that no Britons had been infected so far and added that the disease had not been detected in the UK. He said the government was "absolutely focused" on dealing with the risk and was planning to look at "whether there are precautions we need to take either in the UK or to protect our nationals".

An alert has been issued by Public Health England for doctors across the UK to be aware of symptoms of the disease. One man in Birmingham was tested for the disease but results came back negative, the BBC reports.

Several airlines have followed the lead of Nigerian carrier Arik Air, which has suspended flights to the affected areas of West Africa in order to contain the disease.

The government's chief scientific adviser Sir Mark Walport told the Daily Telegraph that by living in such an interconnected world "disruptions in countries far away will have major impacts" across the globe.

"We were lucky with Sars. But we have to do the best horizon scanning", he said. "We have to think about risk and managing risk appropriately."

Ebola: flights suspended as virus spreads to Nigeria

29 July

Extraordinary measures are being taken across West Africa to contain the deadliest ever outbreak of Ebola, which has killed at least 672 people in the past seven months.

Flights across the region have been cancelled, a Nigerian hospital has been shut down and armed police are patrolling hospitals in Sierra Leone, The Guardian reports. The new measures follow Liberia's decision to shut most of its borders yesterday in an attempt to contain the highly infectious disease.

Last week, a Liberian man died of the disease after flying into Lagos despite feeling unwell. Before then, there had been no reported cases of the disease in Nigeria. Liberian president Ellen Johnson Sirleaf criticised the man for not following medical advice, saying the victim put others at serious risk due to "disrespect for the advice which had been given by health workers".

Anyone who was seated near the infected man could be in "serious danger", Derek Gatherer, a virologist at the University of Lancaster told The Guardian. The hospital where he died has been closed and quarantined, and the World Health Organisation is working to trace all the passengers on board the flight.

One of the largest airlines in the region, Arik Air has suspended flights between Nigeria, Liberia and Sierra Leone, Reuters reports.

As public fear continues to grow, armed police have been called in to guard a hospital in Sierra Leone, which houses several confirmed cases of the disease. Local residents had threatened to burn the centre down because of popular misconceptions surrounding the disease, according to Reuters.

Ebola outbreak forces Liberia to close most of its borders

28 July

The Liberian government has closed its borders in a bid to stop the deadly Ebola virus from spreading further across the continent.

More than 670 people have died from Ebola across West Africa, including one of Liberia's most high-profile doctors, Dr Samuel Brisbane.

An American physician, Dr Kent Brantly, is currently being treated for the deadly virus, as well as a US missionary, Nancy Writebol, who was working in the capital city, Monrovia.

Brantly, who had been wearing protective coveralls from head to toe while treating patients, was lucky to notice the signs early but he is "not out of the woods yet", said aid workers.

Yesterday, Liberia's president, Ellen Johnson Sirleaf, said: "All borders of Liberia will be closed with the exception of major entry points. At these entry points, preventive and testing centres will be established, and stringent preventive measures to be announced will be scrupulously adhered to."

Public gatherings such as marches and demonstrations have also been restricted.

The virus, which is highly contagious, is transmitted by direct contact with the blood, body fluids and tissues of infected animals or people. It also has no known cure, making it one of the deadliest in the world. It begins with symptoms such as a fever and sore throat and escalates to vomiting, diarrhoea and internal and external bleeding.

At least 1,201 people have been infected in Liberia, Sierra Leone and Guinea, according to the World Health Organisation. Ebola can kill up to 90 per cent of those who catch it, although the fatality rate of the current outbreak is around 60 per cent.

On Friday, Nigerian officials said that a Liberian man had died of Ebola in Lagos. "An outbreak in Lagos, a megacity where many live in cramped conditions, could be a major public health disaster," says the Washington Post.

Experts believe the outbreak in Africa might have begun in January in south-east Guinea, though the first cases were not confirmed until March.

Ebola: chief doctor fighting outbreak infected with virus

24 July

The head doctor fighting an outbreak of Ebola in Sierra Leone has himself been infected with the disease, the president’s office has announced.

Sheik Umar Khan, a 39-year-old virologist who has treated more than 100 people infected with the deadly Ebola virus, has now been admitted to a treatment ward in Kailahun, the epicentre of the latest outbreak.

More than 630 people have died in Sierra Leone, Liberia and Guinea since the outbreak began in February, according to the latest data from the World Health Organisation.

The outbreak in the three West African states is the deadliest to date. There is no known vaccination, cure or treatment for Ebola, beyond the relief of symptoms. The disease kills 90 per cent of those it infects.

Health minister Miatta Kargbo said the news about Dr Khan reduced her to tears. She described him as a "national hero" and said she would do "anything and everything in my power to ensure he survives," The Independent reports.

Medical charity Medecins Sans Frontieres described the latest outbreak as "out of control".

Nurses in the government hospital in Kenema town in Sierra Leone went on strike on Monday following the death of three of their colleagues of suspected Ebola, the BBC reports. The strike was suspended after the government promised to investigate their demands, which included the relocation of the Ebola ward from the hospital to a separate facility administered by Medecins Sans Frontieres.

It is not known how Dr Khan contracted the illness. Ebola is spread through bodily fluids such as sweat and saliva – but according to Reuters, the doctor was "always meticulous with protection, wearing overalls, mask, gloves and special footwear".

Nevertheless, Khan said he feared Ebola. "I am afraid for my life, I must say, because I cherish my life," he said. "Health workers are prone to the disease because we are the first port of call for somebody who is sickened by disease. Even with the full protective clothing you put on, you are at risk."

Ebola outbreak: why the disease is 'out of control'

11 July

The Ebola virus is "out of control" and continuing its rapid spread across Guinea, Liberia and Sierra Leone, with the World Health Organisation recording 44 new infections and 21 deaths in just two days, Al Jazeera reports.

This comes despite agreement between West African nations about how to tackle the deadly disease at crisis talks held in Ghana.

We examine why governments and health workers are having such difficulty controlling the spread of the disease, and how humans are making it worse.

Where did the virus originate?

The Ebola virus was first identified in the Democratic Republic of Congo in 1976. It gets its name from the Ebola River, which is situated near the village where it was discovered.

Ebola is a "zoonotic" disease, meaning that the virus can spread easily between animals and humans, according to the WHO. Scientists believe it was initially present in wild animals living in tropical rainforests in equatorial Africa. Fruit bats have been identified as one of the main hosts as they can transmit the disease while remaining unaffected by it.

The disease spread to humans when they came into contact with blood or other bodily fluids from infected animals through hunting.

Why is it so difficult to control?

Ebola is highly infectious. It can be transmitted through bodily fluids, skin and other organs or through indirect contact with environments contaminated by the disease.

The disease can also have a long incubation period, lasting up to three weeks, which allows it to spread rapidly before diagnosis and quarantine can take place. Men who have been infected with the disease and recovered can still pass it on through sexual contact for up to seven weeks.

High population densities in the affected West African cities and the difficulty in regulating the movement of people across the region further compounds the problem.

How are humans making it worse?

The consumption of bush meat is a significant contributing factor in West Africa, Mother Jones reports. Bush meat is often sold from roadside grills, and despite being banned in the Ivory Coast in an attempt to stop the spread of the disease, people continue to sell and consume it.

Traditional burial rituals, such as embalming, commonly practised in West African countries, involves direct contact with the body. Even where such customs have been banned or discouraged, relatives have risked transmitting the disease further by insisting on traditional burials.

Human activity in the region, particularly deforestation, mining and conflict all contribute to the destruction of rainforest and animal habitats and causes "people and animals to have more contact" than usual", says epidemiologist and Ebola expert Dr Jonathan Epstein.

In this way, "human activity is driving [infected] bats to find new habitats amongst human populations".

West Africa faces deadliest Ebola outbreak in history

3 July

Health ministers from across West Africa are meeting in Ghana to form a regional response to the Ebola outbreak that has killed almost 500 people.

The World Health Organisation has confirmed that this outbreak, which affects Sierra Leone, Liberia and Guinea, is the deadliest and most aggressive in history.

The organisation says "drastic" action is needed to contain the spread of the virus.

"We’re hoping to take decisions about how to enhance collaboration and responses [of these countries] so we can get a grip and halt this outbreak," WHO spokesman Daniel Epstein told the BBC.

The disease is described as "a severe acute viral illness". It kills up to 90 per cent of those infected and is highly contagious, with no known vaccine or cure.

There are various challenges facing the containment of the disease. "In Liberia, our biggest challenge is denial, fear and panic. Our people are very much afraid of the disease," Bernice Dahn, Liberia’s deputy health minister, told Reuters at the meeting in Ghana.

Sierra Leone’s health minister says more money is needed to pay for drugs, medical staff, protective clothing and isolation centres to halt the spread of the disease.

The WHO sites three main reasons it has been so difficult to contain the spread of the disease: high population densities in the major cities affected, the difficulty in regulating the movement of people across the region and families insisting on traditional burials of victims which risk spreading the disease.

Medical charities in the region are also reporting attacks on foreigner aid workers, who some blame for the disease. "We are seeing an increasing level of hostility borne out of fear in some communities," said Dr Bart Janssens, director of operations for Médecins Sans Frontières.

Ebola outbreak: London Mining staff leave Sierra Leone

3 June

A number of staff from a British mining firm have left Sierra Leone following an outbreak of the deadly Ebola virus.

London Mining said it was not aware of any incidences of the disease among its own workforce, but said it was monitoring the health of all of its employees and has imposed restrictions on travel in the region – which prompted "non-essential" staff to return home.

The BBC says London Mining is the first company to go public on an "evacuation" since 50 suspected cases of the incurable and highly contagious disease emerged in the west African country. Five people have died in Sierra Leone, while more than 100 people have died in neighbouring Guinea where the outbreak started. Cases have also been reported in Liberia.

Symptoms of Ebola, which first emerged in central Africa 20 years ago, include internal and external bleeding, diarrhoea and vomiting. The disease kills between 25 and 90 per cent of its victims.

It emerged last month that relatives of Ebola patients in Sierra Leone had been removing their loved ones from community health centres despite protests from medical staff.

The family of one woman said they had removed her from a clinic because they did not trust the medical system and feared she would die if a planned transfer to a general hospital went ahead.

BBC international development correspondent Mark Doyle said some families apparently wanted to have their loved ones treated by traditional African healers.

Amara Jambai, the Health Ministry's director of disease prevention and control, warned that those patients now risk infecting their family members and others in the community.

London Mining said in a statement: "A number of non-essential personnel have left the country due to voluntary restrictions on non-essential travel."

It said it has established "proactive health monitoring" of the workforce, including screening all staff and visitors entering its sites and ensuring its facility has the appropriate medication and equipment to manage any potential occurrences of the disease. It added that production at its Marampa mine is "not currently affected".

Ebola death toll passes 100 as disease spreads from Guinea

9 April

THE DEADLY Ebola outbreak in West Africa is one of the "most challenging" seen since the virus emerged four decades ago, the UN World Health Organisation (WHO) says.

More than 100 people have now died from the disease in Guinea, Liberia and Mali, and experts say that it may take up to four months to contain.

Guinea now has 157 suspected and confirmed cases of Ebola and 101 deaths. The virus has also spread across the border to Liberia where there are another 21 suspected and confirmed cases and 10 deaths.

So why is this outbreak so challenging? The BBC's global health reporter Tulip Mazumdar says that the virus's broad geographical spread is to blame.

Previously, much smaller areas have been affected. The last significant outbreaks in the Democratic Republic of Congo and Uganda in 2012 led to 60 deaths in total. Health officials were able to contain the spread of the virus in both cases because the outbreaks occurred in remote locations.

By comparison, the recent outbreak in Guinea has now spread to the capital of Conakry, which has a population of two million people, and across the border to Mali and Liberia.

"We fully expect to be engaged in this outbreak the next two to three to four months before we are comfortable that we are through it," Keiji Fukuda, assistant director-general of the World Health Organisation, said at a briefing in Geneva.

Saudi Arabia has suspended visas for Muslim pilgrims from Guinea and Liberia hoping to take part in the Hajj in October. Mali has also promised to tighten border controls.

The WHO describes Ebola as "a severe acute viral illness". Early symptoms include the sudden onset of fever, intense weakness, muscle pain, headache and sore throat, it adds. There is no known cure or vaccine for the virus. Medecins Sans Frontiers said that the current Zaire strain of Ebola was the most aggressive and most deadly it had ever seen, killing nine out of ten patients.

Ebola virus: 'unprecedented' outbreak kills 78 in Guinea

1 April

SEVENTY-EIGHT people have died in an outbreak of the Ebola virus across Guinea that a medical charity describes as "unprecedented".

Medecins Sans Frontiers (MSF) said that the Zaire strain of the Ebola virus was the most aggressive and most deadly it had ever seen, killing nine out of ten patients, Al Jazeera reports.

"We are facing an epidemic of a magnitude never before seen in terms of the distribution of cases in the country: Gueckedou, Macenta Kissidougou, Nzerekore, and now Conakry," said Mariano Lugli, who is coordinating MSF's project in Conakry, the capital of Guinea.

Guinean health authorities report that to date there have been 78 deaths and 122 suspected patients. The virus is also believed to have spread to Liberia and Sierra Leone, but so far no cases have been confirmed in either country.

On Saturday, Senegal announced that its border crossings to Guinea would be closed "until further notice".

Liberia's Health Minister Walter Gwenigale advised people to stop having sex, as the virus can be spread through bodily fluids, the BBC reports. People have also been recommended to stop kissing and shaking hands.

The WHO describes Ebola as "a severe acute viral illness". Early symptoms include the sudden onset of fever, intense weakness, muscle pain, headache and sore throat, it adds.

"This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes." The virus is said to have a fatality rate of up to 90 per cent.

Senegalese singer Youssou N'Dour cancelled his concert in Guinea over concerns that bringing large groups of people together could help the virus spread.

This is the first outbreak of Ebola in west Africa in two decades. Since it was discovered in Zaire, now the Democratic Republic of Congo, in 1976, the virus has killed an estimated 1,500 people.

THE "shocking underperformance" of health services causes tens of thousands of people to die needlessly each year, the Health Secretary was due to tell the Commons today.

Jeremy Hunt will "issue a warning" that England’s failure to match the best health care in other European countries means that 30,000 people a year die too early, The Times reports.

His speech comes as a study published in The Lancet shows that Britons enjoy fewer years of good health before they die than people in other wealthy nations, reports The Guardian.

The study, which analysed data collected by the Institute for Health Metrics and Evaluation in Seattle, ranked the UK 14th out of 19 countries of similar affluence in 2010 in terms of premature deaths. Britain has slipped from 10th position in 1990, despite "big increases in funding" for the NHS in recent years, and many reform initiatives, the study says.

Higher incidences of Alzheimer's disease, cirrhosis of the liver and drug use disorders have been blamed for the UK's worsening position.

Hunt will tell the Commons today that all middle-aged people should be offered regular health checks to spot emerging problems and he is expected to call on the NHS to focus on "the five biggest killer diseases". He will say: "Despite real progress in cutting deaths we remain a poor relative to our global cousins on many measures of health, something I want to change. For too long we have been lagging behind and I want the reformed health system to take up this challenge and turn this shocking underperformance around."

The Health Secretary believes that too many deaths occur because the NHS is "not good enough" at preventing sickness and its treatment of patients often fails to match "the best on offer". Hunt will also urge the public to do more to look after their own health and that of others, the Times says.

One of the study’s authors, Professor John Newton, chief knowledge officer of Public Health England, agreed that hospital care was only part of the equation. He told the Guardian that "the way we live – our diet, our drinking and continuing smoking habits" all play a part in the nation’s poor health ranking.

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