The UK was once a “world leader” in organ transplants, said the BBC’s “File on 4 Investigates”. But it has “fallen behind”.

In 2024, the number of heart transplants carried out per million people in the UK was lower than in most European countries, thanks to a lack of investment, resources and “outdated” technology. Waiting lists for organs are at a record high, while family consent rates for donation have fallen dramatically since the “opt-out” presumed consent system was implemented.

What’s going wrong?

“Organ donation is in crisis,” said Martha Gill in The Observer. Last year, the waiting list for an organ reached its highest on record, according to NHS Blood and Transplant: an 8% year-on-year increase. “As a consequence, many will die waiting for a phone call.”

There are only five heart and lung transplant centres in England, and one heart transplant centre in Glasgow. Anyone living in Wales or Northern Ireland must travel for a transplant, and there is significant regional variation in waiting times.

Half of the six main centres have also “lost their top surgeon in the past two years”, said the BBC. Others are leaving for jobs abroad: a “brain drain” of experts. Without experienced mentors, junior surgeons are increasingly “risk averse” and only using the healthiest donated organs, said Jorge Mascaro, Birmingham’s former director of cardiothoracic transplants (now based in the US). “It’s getting worse.”

The number of organs donated in the UK per head is equal to, or greater than, most of Europe. But the NHS transplants far fewer hearts and lungs than most countries, said the BBC. “Some countries make use of twice as many.” Surgeons say this is down to a lack of equipment and new technologies used abroad, such as machines that can scan organs to check if they are diseased. Ice boxes are often still used to transport organs between hospitals, which can harden them.

Operations are also regularly cancelled thanks to a lack of theatre space, hospital beds or staff. Post-transplant patient care is crucial to prevent complications, but the NHS “continues to struggle” to provide long-term support: the UK’s five-year survival rates “lag behind”.

Has the opt-out system failed?

When the “opt-out” system of presumed consent was implemented in England in 2020, “expectations were high”, said Gill. But the number of donors has been “crashing”. In the year to March 2025, there was a 7% decrease in the number of deceased organ donors, according to the Organ and Tissue Donation and Transplantation Activity Report. Life-saving transplants also decreased by 2%.

Most people support organ donation in theory, and nearly half the population have signed the Organ Donor Register, according to Organ Donation. But relatives have the final say; family consent rates have dropped from 69% to 61% over the past five years. Surveys suggest a “common reason: they didn’t know what their relative wanted”, said The Observer. The types of deaths that make donation possible – usually traumatic, sudden deaths of young healthy people – make it even harder for families to decide.

The presumed consent of the opt-out system acts as a “weaker signal of underlying preference” than the active consent of an opt-in system, said researchers at the Max Planck Institute for Human Development in a 2024 paper. This “uncertainty” means families are “more likely to refuse consent”. Evidence suggests an opt-out model alone doesn’t boost donations: it must be accompanied by a framework of logistics, psychological support and education.

What can be done?

The NHS and campaigners are calling for “better education in schools”, said The Mirror: for organ donation to be included in curriculums, and campaigns particularly targeted at ethnic minorities (among whom the family consent rate is significantly lower).

Evidence suggests an opt-out model alone doesn’t boost donations. Countries must invest in healthcare infrastructure, psychological support for families, and public awareness campaigns to encourage people to discuss their wishes. Family consent rates increase to almost 90% if the deceased has done so.

A government-commissioned review of heart and lung transplant services, published in 2024, made various recommendations, including better holistic care, a single-service model across the multiple centres, and “rapid-short term actions to improve organ acceptance decision-making”, said NHS England.

NHS England has since been abolished; responsibility for transplant services now lies with the Department of Health and Social Care. In a statement to the BBC, the department said the government had inherited a broken NHS, and that it recognised the “systemic issues” facing transplantation. The government said it would write to the NHS demanding that it “urgently implement” the recommendations, to make transplant services “fit for the future”.

US tech giant Palantir has wrapped its tentacles around the British state, securing major contracts with the Ministry of Defence and the NHS in the last three years. However, many are questioning the transparency and procurement process of such deals, and asking whether the company’s ties to Peter Mandelson, Israel and Ice could derail the UK.

The company was criticised this week by hedge fund manager Michael Burry, played by Christian Bale in the film “The Big Short”. He claimed that the tech firm had “systematically unreliable” third-party language models.

In a 10,000-word essay on Substack, he said that the company’s $300 billion valuation will fall by more than two thirds once others realise that “Emperor Palantir has no clothes”.

What is Palantir?

Founded in 2003, Palantir is a technology company that sells software that “processes large sets of data” to help clients, including governments, “find patterns and make operational decisions”, said The Times.

Since it launched its “artificial intelligence platform” in 2023, it has recorded a “surge in sales growth”. The platform has allowed the integration of large language models created by the likes of OpenAI and Anthropic into customers’ datasets.

Since this pivot three years ago, it has become a “stock market darling”, rising to a valuation of around $300 billion. Last year it “reported annual sales of $4.5 billion, up 56% year-on-year”.

What is its relationship with the UK?

In December, Palantir signed a contract with the MoD worth £240 million to continue its data analytics relationship. The contract is believed to be worth “three times more” than a previous MoD agreement signed in 2022, said the Financial Times. In 2023, Palantir, as leader of a consortium, also won a seven-year £330 million contract to help manage patient data across the NHS.

In briefings to Health Secretary Wes Streeting in June 2025, Department of Health and Social Care officials feared that Palantir’s associations with the Israeli military and Ice’s operations in the US would hinder the roll-out of the company’s Federated Data Platform in the NHS, according to documents seen by The Guardian. This would mean the contract would not offer value for money for the UK government.

This has arguably materialised. According to NHS data, the number of organisations within the health service using Palantir’s technology has increased from 118 to 151 since June last year. However, this is “well short of the target of 240 by the end of this year”.

Doctors are now being actively told “how to limit engagement with the NHS Federated Data Platform (FDP)” because of the “controversial” ties with Palantir, said the British Medical Journal. Given the US company’s “track record” with immigration enforcement and “risks to patient trust” and “data security”, there must be a “complete break” between Palantir technologies and the NHS, British Medical Association chair of council Tom Dolphin told the BMJ.

A spokesperson for Palantir said that its software is “helping to deliver better public services in the UK”, including “delivering 99,000 more NHS operations and reducing hospital discharge delays by 15%”.

What are the concerns?

This week, the government came under pressure to review the MoD contract, due to Peter Mandelson’s links to the company, said The Times.

Mandelson co-founded and held shares in the lobbying firm Global Counsel, which worked with Palantir. Mandelson, as the UK’s ambassador to the US at the time, helped arrange a visit by Keir Starmer to Palantir’s showroom while he was in Washington in February last year and accompanied the PM on the visit.

During the visit, Starmer met Palantir CEO Alex Karp and the company’s UK chief Louis Mosley. Conservative leader Kemi Badenoch told the FT that this should be “looked at very, very closely”, as the meetings “were not minuted” and she said that the MoD deal last year was a “direct grant of £240 milllion – not a tender, not a bid”.

Palantir has shown an interest in the British state in other ways, too. Last year it hired four ex-MoD officials, said openDemocracy, as part of its “revolving door” recruitment, where firms “appoint outgoing ministers, senior civil servants and special advisers to lobbying or advisory posts”. Mosley also joined the MoD’s Industrial Joint Council, which the government describes as its “main strategic mechanism for defence sector engagement”.

More broadly, the £240 million MoD contract has “renewed a debate about Britain’s dependence on American technology”, said Politico. Despite promises from the MoD that Palantir’s AI technology would accelerate decision-making and protection, the recent contracts raise “potential risks of technical dependence”, or “lock-in” with the US, especially at a time of “heightened trade and wider geopolitical tensions between the US and its traditional European allies”.

Cases of scabies are rising across the UK, with health experts struggling to account for the sudden increase.

In the second week of January, GPs reported just under 900 cases of scabies across England, which was nearly 20% higher than the same period the year before. And as doctors are only required to report cases of scabies in communal settings, like nursing homes, the total number of cases in England right now is likely to be much, much higher.

What is scabies?

When you hear scabies mentioned, you may think of a “Victorian-era” disease, symptomatic of “dirty conditions” and “bad housing”, said Clare Wilson in The i Paper. “If so, you’d be wrong”: firstly, it is thought to have been identified in Roman times, and secondly, scabies can affect anyone, irrespective of hygiene levels.

The itchy rash is caused by microscopic mites that burrow, live, and reproduce in the skin. Invisible to the human eye, they are around 0.4mm in diameter, and can burrow around 2.5cm – roughly the length of a fingertip – into your skin. The mites can also survive up to 36 hours outside the body. Only 10 females are needed to cause a significant outbreak, which can linger for months, and even years, if not treated correctly.

The itchy bumps, rash and discoloured “burrow” lines are an allergic reaction to the faeces of the mites, and “while not a serious condition, scabies can be very itchy and irritating”, said the BBC. This can exacerbate existing skin conditions like eczema, or cause secondary bacterial and skin infections.

Why is it spreading so quickly now?

The short answer is that there is no one, simple, cause for the spread. While there is “no definitive reason” behind the scabies rise, the back-to-school rush in September can kick-start transmission, as can the Christmas season, where “close contact in shared spaces is common”, Donald Grant, GP and senior clinical advisor at The Independent Pharmacy, told Women’s Health.

Scabies is often mistaken for an STI, as the groin area is “one of the most commonly affected” places, said The Guardian. Between 2023 and 2024, sexual health services registered a 44% increase in diagnoses of scabies – 4,872 up from 3,393. The mites are often transferred through “prolonged skin-to-skin contact”, so sexual partners are much more likely to be infected.

Numbers have kept creeping up since the Covid pandemic, which has left doctors “scratching their heads”. More and more contact, and fewer constraints on socialising, could have led to a “potential ‘ping-pong’ effect”, where “individuals are continuously reinfested within households or close groups of friends”. As symptoms can take “four to six weeks to develop”, and are most contagious before symptoms show, bugs can “lurk undetected while those affected are most contagious”.

Other factors in the spread include the “strain on NHS GP waiting lists”, and “lack of guidance and redirection to pharmacies”, Michael Marks, Professor of Medicine at the London School of Hygiene & Tropical Medicine, told the newspaper.

How to prevent and treat it?

The most common treatment is permethrin cream – also known as Lyclear – which “paralyses and kills the mites”, Hanna Yusuf, prescribing pharmacist at Chemist4U, told Cosmopolitan. The online pharmacy saw “year-on-year sales almost double” in January, “reflecting how many people are seeking treatment right now”. Available on prescription, the cream is applied all over the body from the neck down, and left for eight to 14 hours before being washed off. It often needs to be reapplied a week later, to kill off any eggs that have hatched into mites during that period.

Contaminated items that can’t be washed “should be sealed in a plastic bag for at least 72 hours”, and it is recommended to “vacuum mattresses, sofas and carpets” if there has been any contact.

To mitigate and prevent outbreaks, the NHS advises washing bedding and clothing at 60C or higher, followed by hot tumble drying if available, said The Guardian. If an outbreak has occurred, you should avoid close contact, and stop sharing bedding, towels or other material until the mites have been eradicated.

Cases of the new “subclade K” super-flu are “ballooning” in the UK, said NHS England. Its latest figures show that the number of flu patients admitted to hospital is up 50% on the same period last year, and an “incredible” 10 times higher than in 2023.

This “troublesome mutant” flu virus is a variant of influenza A H3N2, said London’s The Standard. And H3N2 generally tends to cause more severe illness and hospital admissions than influenza A H1N1, which has been more dominant in the UK in recent years. Subclade K of H3N2 is now the predominant flu virus in the UK and Japan, and samples taken in the US and Canada seem to show a similar trend.

What exactly is subclade K?

It’s part of the H3N2 flu virus “family” but it has undergone several mutations that have caused a distinct “genetic drift”. This means it’s “differentiated” from the reference strain of H3N2 chosen for use in this season’s flu vaccine – and could have “changed sufficiently to escape the immunity that has been built up from previous infections and vaccinations”, said Antonia Ho, a consultant in infectious diseases at the University of Glasgow, on VaccinesWork.

“The good news” is that, this subclade K variant “does not seem to be more virulent or cause more severe disease” than other H3N2 strains, said microbiologist Ignacio López-Goñi on The Conversation.

So why the rise in cases?

H3N2 flu waves are “always hotter and nastier” than those caused by other strains, said The Telegraph’s science correspondent Joe Pinkstone. H3N2 is “inherently more severe and infectious than other types of flu, owing to more potent genes and a bigger ‘R rate’ – the number of people one infected person will pass the virus on to, on average”.

And then, as subclade K of H3N2 is different from previous strains and from the strain in the flu vaccine, people may be more “susceptible” to it, Giuseppe Aragona, a GP and medical adviser for an online pharmacy, told The Independent. In other words, our herd immunity and the NHS vaccine may offer us less protection than usual against this new flu strain.

Other factors that have contributed to the spike in UK cases include the flu season starting earlier this year, giving the virus more time to spread, and the fact that “fewer people have been exposed to flu in recent years, especially children, which leaves more people vulnerable”.

What should you do?

NHS bosses, warning of “a tidal wave of flu” in the run-up to Christmas, are encouraging everyone who is eligible to get the free NHS flu vaccine – including children (who can take it in the form of a nasal spray). You can also pay to get the vaccine privately at most pharmacies.

Data published by the UK Health Security Agency shows that the current vaccine is 70%-75% effective at preventing hospital attendance in children aged two to 17 years, and 30%-40% in adults. However well-matched to subclave K of H3N2 or not, it’s still “the best form of defence”, said Thomas Waite, UKHSA deputy chief medical officer.

There are three times as many people hospitalised with flu in London than at this time last year, said NHS England – and yet fewer than half of Londoners who are eligible for the flu vaccine have taken it up.

“A woman gets to a certain age and all she wants is to be left alone,” said Viv Groskop in The Guardian. Well, no chance of that – because the “menopause gold rush” is in full flow.

Public awareness of menopause and perimenopause has improved in recent years but with that has come a “rapid expansion” of companies and individuals who “see menopause as a lucrative market”, said University College London researchers. The results of their survey of 1,596 women, published in Post Reproductive Health, suggests that women may be “vulnerable to financial exploitation” from the “marketing of unregulated menopause products”, and from menopause information on social media “that may not be grounded in evidence”.

Menopause has ‘hit prime time’

The menopause industry is now worth billions globally. Women are promised cures for some of the most debilitating symptoms – night sweats, hot flushes, fatigue, brain fog and anxiety – if they buy “specially branded supplements, teas and even pyjamas”, said Kirsty Wark in a BBC Panorama investigation last year.

Once something that women dealt with “in isolation”, menopause is now being experienced by a generation who are “less willing to suffer in silence” and more “proactive” about their health, said Courtney Rubin in Women’s Health. They engage openly with their symptoms. And when, all too often, their doctor dismisses their worries, they “ravenously” consume information online and demand “better solutions”.

“The slow-dawning realisation that women might be slightly underserved after centuries of demonising female ageing has unfortunately coincided with the high-water mark of aggressive capitalism”, said The Guardian’s Groskop. So the market is flooded with celebrity-endorsed menopause products, and treatments follow fads, rather than being rooted in science and tailored to a woman’s specific needs. "Menopause influencers” dominate Instagram timelines, the menopause “hits prime time” in special NFL Superbowl adverts, and Gwyneth Paltrow, Serena Williams and Drew Barrymore are all partnered with companies that sell menopause products.

The speed of change from taboo topic to something that’s constantly discussed can arguably make it harder to navigate the menopause. The streams of new opinion and “menopause management” products don’t make it easy to find accurate information or make helpful choices.

‘Happy medium’

Last week, the government announced that “menopause checks” would routinely be incorporated into the free NHS Health Checks for women, ensuring those “experiencing perimenopausal or menopausal symptoms get the right information and support”.

Perhaps, with this shift to make doctors actively address menopausal concerns that often go unrecognised, we can arrive at a “happy medium in the world of menopause, where it is a phenomenon that is neither constantly being marketed at us nor swept shamefully under the carpet”, said Groskop. As it is, “we have gone from a time when the word was barely spoken aloud to an era when it’s hard to find a podcast that is not discussing testosterone gel”.

Chronic staff shortages, low pay and demanding working conditions have long made it difficult to recruit care workers in Britain. For years, migrant workers have kept the sector afloat but now government immigration reforms could put further pressure on an already overstretched industry.

Social care providers will no longer be able to recruit staff from abroad on a Health and Care visa, under plans outlined in the government's immigration white paper. Instead, providers will have to employ domestic workers, immigrant care workers already here legally or immigrants on other visas. The government says these changes will reduce reliance on overseas workers, crack down on "rogue care providers" and cut immigration by 7,000 a year.

Care England, the body representing the adult social care sector, has described the plans as "a crushing blow to an already fragile sector."

How much do we rely on migrant care workers?

Migrant workers hold 32% of adult care worker roles in England, according to a 2024 Skills for Care report, with 26% coming from outside the EU and another 6% from an EU member state. Most foreign-born workers were recruited from Nigeria, India, Zimbabwe, Romania and Ghana.

In 2022, the Conservative government added care workers to the Health and Care visa list to allow overseas recruitment, following the twin shocks of Brexit and the Covid-19 pandemic. By 2023, more Health and Care visas were being granted than any other skilled worker visa – over 336,000 in total – but, last year, numbers fell to 27,174, after successful applicants were no longer allowed to bring dependants with them and the government cracked down on abuse of the scheme.

How did it get this way?

The problems facing social care are "deep-rooted" said The Bureau of Investigative Journalism. Austerity-era cuts from 2010 slashed council budgets, limiting funding for social care. And the challenges of the job – "stressful and sometimes exploitative conditions, a lack of career progression and high turnover" – have been cited in reports "as far back as 2015".

Health think tank The Nuffield Trust has also cited Brexit as "adding fuel to the fire of severe challenges" facing social care. "Shutting off the 'relief valve' of EU migration has put additional pressure" on staffing shortages in a system that "has relied heavily" on recruitment abroad and lacks an effective training and retention plan for British workers.

Yet workforce shortages aren't a recent problem, said the Centre for Health and the Public Interest. The NHS and the wider economy "have been dependent on migrant labour to fill job shortages for decades", with the root causes of staff shortages "deeply embedded into how we have chosen to run and organise" our healthcare sector.

Why do we struggle to recruit British carers?

Between 2022 and 2024, the number of British care sector employees dropped by 70,000. Even with over 100,000 immigrants filling care worker roles during that time, the sector's vacancy rate of 8.3% is still nearly three times higher than that in the wider economy, according to the Skills For Care report.

According to research published in Frontiers in Public Health, the sector struggles to recruit and retain workers for several reasons, including low pay, the prevalence of zero-hours contracts, limited opportunities for training and care progression, and the low social status of the work itself.

What does the future look like for the sector?

It's not a pretty picture, unless the government can solve the domestic recruitment crisis. Given Britain's ageing population, the demand for carers will only increase. Skills For Care estimates an additional 540,000 care jobs will be needed by 2040. But without urgent reform, including better pay, training and working conditions, few believe these roles will be filled domestically.

"International recruitment wasn't a silver bullet but it was a lifeline," said Care England's CEO Martin Green. "Taking it away now, with no warning, no funding and no alternative, is not just short-sighted; it's cruel."

The landmark assisted dying bill could be in jeopardy after the Royal College of Psychiatrists withdrew its support.

The college, which represents psychiatrists across the UK, cited "serious concerns" about the already limited capacity of NHS mental health services, as well as the role psychiatrists would play in assisted dying decisions.

MPs voted in favour of legalising assisted dying last year, but the Terminally Ill Adults (End of Life) Bill has generated "huge controversy" while progressing through Parliament, said Sky News. The bill will return to the House of Commons tomorrow, where MPs will vote once again, after first reviewing the 150 amendments that have been made to it.

But at least 15 MPs "who either abstained or supported the bill previously are now considering voting against it", said The Telegraph, leaving the bill's fate in the balance. "Interventions from medical bodies" like the royal college "have prompted more MPs to come forward with concerns about the bill".

What did the commentators say?

The Royal College of Psychiatrists' (RCPsych) move is a "major blow to the bill's credibility", said Dan Hitchens in The Spectator.

Originally, Kim Leadbeater, the Labour MP sponsoring the private member's bill, said a judge should approve each assisted dying case, but the Ministry of Justice dismissed the idea.

The "replacement" is a panel of experts made up of a lawyer, a psychiatrist and a social worker, but "remarkably, Leadbeater seems not to have consulted" RCPsych about the change, said Hitchens. "It seems she is dragging them into a process they regard as fundamentally flawed."

The group is apprehensive about the bill's "inadequate" conscientious objection clause – which gives professionals the option to opt out of participating in assisted dying procedures – as well as concerns regarding the duty of care psychiatrists have towards their patients.

The impact that assisted dying could have on the medical profession's "do no harm" principle could be "seismic", said Nadia Khan, a palliative medicine consultant and spokesperson for the British Islamic Medical Association, in The Yorkshire Post. Legislation that "compromises this moral safeguard" risks "disrupting the very nature of healthcare".

The British Medical Association, the union representing doctors in the UK, maintains a neutral stance on whether laws around assisted dying should change, but the bill still has a wide base of support among the medical profession.

One supportive GP, Susi Caesar, told the BBC she "will be at the front of the queue" to help terminally ill patients have the death they choose. "I think that's the core joy of my job – being with people to the very end of their health journey."

What next?

A final vote is "possible" when the bill returns to the House of Commons, but "MPs have put forward so many amendments to discuss that they are unlikely to get through them and progress to the next stage", said The Telegraph.

The "flurry of amendments" has brought more criticism from opponents of the bill, who worry lawmakers will not have enough time to review the proposals before Friday's debate. The next stage, a third reading, "is now expected next month" on either 13 June or 20 June.

Even if the bill does pass, it won't take effect until 2029. Initially, there was a "two-year 'backstop' between the legislation being passed and put into practice", but Leadbeater recently extended the period to four years, said Sky News.

The National Health Service is often held up as the defining achievement of the post-war British state. But more than 75 years on from its founding, the NHS is, according to the government, "broken" with a waiting list of nearly 7.5 million patients and public satisfaction at a record low of 21%.

For Health Secretary Wes Streeting, a focus on holistic health provision in individual neighbourhoods represents a pathway to repairing the NHS at the national level. And one such scheme in a deprived area of Birmingham – Washwood Heath – offers a potential blueprint for the rest of the country.

A 'blueprint' for the NHS

Washwood Heath Health & Wellbeing Centre presents Whitehall health policy professionals with a "living, working example" of what neighbourhood health provision might look like, said the BBC.

A community clinic set up in the east Birmingham suburb two years ago brings together hospital doctors, GPs, nurses, occupational therapists, physiotherapists, council social care teams, mental health professionals and charity staff, all under one roof.

Offering medical services, including ultrasound scans and X-rays, alongside non-medical interventions, the centre's staff work "collaboratively to ensure patients receive the care they need at the right place and time, significantly enhancing patient outcomes and experiences", said the National Health Executive (NHE).

"The target is the most frequent users of health services – and the aim is to keep them well and out of hospital," said the BBC. In practice, this means tackling social issues like access to housing or "arranging support for daily tasks such as washing and dressing", alongside medical treatment.

The result, said the Birmingham Mail, has been a reduction in waiting times and ambulance delays, and a significant drop in local GP calls and hospital A&E admittances.

On a visit to the centre in February, Richard Meddings, chair of NHS England, said, "there is a really good argument this is the model for the future".

The Washwood Heath clinic "combines data about the patients, it connects various parts of the health centre together to wrap care around the patient", he said, as well as helping the NHS "get more of our resources into primary and community" and collaborate more effectively with social care services.

Lorraine Galligan, chief of nursing for Birmingham Community Healthcare NHS Trust, said: "We see it as a blueprint for what the NHS could look like and should look like in the future."

A tough sell

Community-based care was a key part of Labour's election-winning manifesto and health ministers are "keen to see the soundbite being worked up into practical proposals", said Chris Naylor, senior policy fellow at health think-tank The King's Fund.

"Neighbourhood health is not a new 'thing' at all", said Anna Charles, also for The King's Fund, and "this could be one of its greatest strengths". Existing data on community-focused approaches show that improvement "isn't achieved through a single policy solution, but instead through the aggregation of many simultaneous changes to the way in which care is organised and delivered".

Yet there remain huge financial and political challenges ahead. While research suggests that every £100 spent on community care would save £131 in hospital care, "part of the problem with making the whole system buy into it is money", said the BBC.

Those in charge of managing local NHS funding are focussed on "making sure it goes on where they immediately need it," Ruth Rankine, an NHS Confederation primary care director, told the broadcaster.

The other issue is that the hospital sector has, in places, "been a bit cynical" she added. "The problem is that it takes time to get results – you need to invest in front and then it can be years before it has an impact."

A "perplexing" feature of our age is that the more our society spends on healthcare, the "gloomier the statistics around ill health" become, said James Le Fanu in Literary Review.

Funding for the NHS has grown sixfold in the past 50 years; and while there have been clear benefits – including better recovery rates from many life-threatening diseases – it's notable that the increase in investment has not made us less sick overall. Quite the contrary, in fact: since 2010, the "number of people labelled as having a long-term health condition – whether physical or mental – has leapt by six million". In her wide-ranging book, Suzanne O'Sullivan suggests that this glut of ill health has been driven by a culture of "overdiagnosis". Rather than actually "getting sicker", she writes, we are "attributing more to sickness", so that millions who once would have been considered healthy are now classed as unwell. The costs are considerable – to individuals and to society – and O'Sullivan's assessment of how this situation came about is "masterful" and "immensely persuasive".

As O'Sullivan sees it, overdiagnosis most often occurs in two forms, said Hannah Barnes in The New Statesman. First, there's "over-detection" – where improvements in our ability to identify signs of disease lead to unnecessarily early interventions (this has happened, she claims, with certain cancers). Secondly, there's "expanded disease definitions" – an ever-greater number of symptoms being classed as evidence of a condition. O'Sullivan believes the latter is chiefly responsible for the dramatic recent rise in diagnoses for conditions such as autism and ADHD. Historically, these may have been underdiagnosed, but now the opposite is true, and "almost nobody is denied a diagnosis". This, she argues, can do "more harm than good" – leading people to attribute all the problems in their life to their "condition", when the actual solutions may lie elsewhere.

Long Covid is another contentious illness that O'Sullivan considers, said Adam Rutherford in The Guardian. Here, uniquely, diagnosis has "been led by the public, often via social media". Exploring such areas is "incredibly difficult", and it would have been easy to be "sneering or dismissive". Thankfully, O'Sullivan is neither; her writing is "full of compassion, care and grace". The central argument of this excellent book is that diagnosis is a tool that should be "wielded with the utmost caution".

The UK's first legal drug consumption room opens in Glasgow today, following a decade-long legal battle between the city's council and Westminster.

The initiative "marks a significant, if contested, moment for British drugs policy after years of debate" about the best way to reduce overdose deaths and "take consumption off the streets", said The New York Times.

With Scotland recording the highest drug death rate in Europe, "all eyes are on Glasgow", Allan Casey, the city council's addictions convener told The Guardian, with "a huge amount of pressure to make sure we get it right".

How does it work?

The Safer Drugs Consumption Facility, to be known more informally as The Thistle, will offer some of the city's most vulnerable addicts a clean and safe environment in which to take their own drugs, under nurse supervision.

Open from 9am to 9pm, 365 days a year, The Thistle has eight open-plan injecting booths, as well as a lounge area, and shower and laundry facilities. Those wanting to use The Thistle do not have to give their full name at the reception desk but will be required to have a brief discussion with a member of staff about which drugs they are taking and how they plan to use them. Users will then be given access to clean syringes, needles and swabs.

Designed in consultation with a group of former addicts, the centre will "steer clear of what would often be found in conventional health services – which plenty of drug users have had traumatising experiences of", said the Big Issue. "A lived-experience team" helped decide things "like the way reception staff will greet people", as well as the choice of furniture and colour schemes (think lots of light wood, greens and turquoise)". Staff will not wear NHS uniforms.

The three-year pilot scheme will cost about £2 million a year to run, and has been funded by the Scottish government.

But aren't drugs illegal?

Drug legislation is reserved to Westminster, and the previous Conservative government repeatedly dismissed calls from Glasgow city council, backed by the Scottish government, for the legal powers to pilot such a scheme. The green light was finally given in 2023 after Scotland's most senior law office confirmed that the centre's users would not be prosecuted under the Misuse of Drugs Act 1971 for simple possession offences committed within the confines of the facility.

Clarifying the ruling ahead of The Thistle's opening, Lord Advocate Dorothy Bain KC said "it would not be in the public interest to prosecute people for simple possession offences when they are already in a place where help with their issues can be offered". This statement of prosecution policy "does not extend to people on their way to and from the facility, or anywhere else in Glasgow", said Scottish Legal News.

How will it help drug users?

There are now over 100 drug consumption rooms around the world, including in Europe, Canada, the US and Australia. Supporters of these facilities claim they "cut the risk of overdose and infection, reduce the costs of acute hospital admissions, and put users in touch with healthcare professionals who can offer drug addiction treatment", said The New York Times.

It is part of a "harm-reduction approach to problem drug use", said the Big Issue, which "means treating it as a public-health matter, rather than trying to shame or criminalise people into abstinence". Supervision at The Thistle is "deliberately light touch" said The Guardian, and it's hoped the centre will "engage drug users who have proved hardest to reach", given the "extra support for wider healthcare, housing and benefits also available". Staff "accept its reach will be limited but see it as a starting point", said Channel 4 News.

So is this the future of drugs policy?

The opening of the country's first legal drug consumption facility is a "potentially transformative moment in UK drugs policy", said The Guardian. Indeed, "such is the level of cross-UK interest" that Glasgow city council is working with other British cities to lobby Westminster "to allow further pilot schemes".

Not everyone is behind the initiative, however. Some local residents fear it could bring more drug dealing into the area, while "other critics worry that it will be counterproductive", said the New York Times. The addiction charity Faces & Voices of Recovery UK, for example, warned that there was "nothing kind" about offering "a place to continue destructive behaviours" that keep people "trapped in cycles of chaos, compulsion and despair".

The government has announced its first steps towards tackling the adult social care crisis in England. Health Secretary Wes Streeting said that an independent commission "will work to build a national consensus around a new National Care Service able to meet the needs of older and disabled people into the 21st century".

Baroness Louise Casey is to lead the commission, which will begin work on a two-stage report this spring, with the second phase slated for completion by 2028.

What did the commentators say?

Fixing social care will be "no-nonsense civil servant" Casey's "toughest challenge yet", said Andrew Gregory in The Guardian. "Leading voices in the sector" have already warned the government that social care provision is facing collapse, with high employment costs and lack of funding "threatening its overall sustainability".

Many care providers are "struggling to keep the lights on", said Steven Swinford and Poppy Koronka in The Times, and the industry is "chronically understaffed". A House of Lords report last September found that, in 2023 to 2024, there were more than 130,000 vacant posts. Services once "relied heavily on overseas workers" but the previous government's policies preventing carers from overseas bringing their families to the UK have made the problem worse. Pay is poor, and the widespread use of zero-hours contracts means there is little job security for people who are "expected to comfort our loved ones during some of their lowest moments in old age", said Daniel Keane in London's The Standard.

"Three things are needed" to get the sector back on track, said Sarah Woolnough, chief executive of The King's Fund policy think-tank, in the Financial Times. The government must first address the financial challenges, then "take forward long-term reforms" that address the current reality of "people with modest means" having to pay for care – "previous administrations have frozen in the face of this challenge". Thirdly, they should "get on with putting in place the building blocks" that will make these reforms possible. These could include Streeting's already-mooted NHS transition "from analogue to digital", and shift in focus "from sickness to prevention".

Streeting has already announced an extra £86 million for the Disabled Facilities Grant in this financial year, to help 7,800 more elderly or disabled people adapt their homes – widening doors or installing stairlifts, for example – to better fit their needs.

Care workers will also be given "guidance and support" to perform routine at-home health monitoring, such as blood-pressure checks, on the people they're looking after, to reduce strain on GP services. Confronting the problem of care-worker pay, however, will take time. "We need to get to a position where pay rises are possible," Streeting told ITV's Good Morning Britain. "The government's only been in for six months; give us a chance."

What next?

The first phase of the commission, which will identify the critical issues facing adult social care, begins in April and is due to report back with its recommendations in 2026. The second phase, reporting by 2028, will make longer-term recommendations for the transformation of adult social care. Opposition parties have been invited to take part in the commission.

Care bosses have criticised the length of time the recommendations will take."The people in care today cannot afford to wait any longer," Professor Martin Green, chief executive of Care England told Care Home Professional. "Their lives depend on action now."

But Streeting defended the timescale and said he would "go faster", if possible. "Louise Casey isn't known for being backwards in coming forwards," he told Good Morning Britain.

A new NHS call for blood donors to make – and keep – appointments in the run-up to Christmas has reignited the debate around how to increase rates of donation, including the use of financial incentives.

For many, the idea of paying for blood plasma "elicits concerns about the commodification of the human body", said Politico. For others, "paying donors a flat fee for their time and trouble should be part of the solution" to what is a growing global shortfall.

How often does the UK run low on blood?

The festive period is an annual crunch time for blood stocks "as cold weather, seasonal illnesses and busier diaries lead to more unfilled and missed appointments, while demand from hospitals can rise", according to the NHS Give Blood website. Last December, donations were 10% below the monthly average, with demand for the vital O-negative blood type – the universal type used to save lives in emergencies – exceeding collections.

It is not just a winter problem. This summer, the BBC reported that blood stocks had dropped to "unprecedentedly low" levels in England, following a "perfect storm" of no-show appointments as donors went on holiday, as well as increased demand following a cyber-attack which affected services in London. At the time, there was a 1.6-day supply of O-negative blood in England, well below the six-day target.

Which countries allow blood donors to be paid?

According to the World Health Organization (WHO) about 118.5 million blood donations were collected worldwide in 2023. Of these, 40% were drawn from high-income countries, home to just 16% of the world's population.

The US, Germany, Austria, Czech Republic and Hungary currently allow for a flat-fee payment for donating blood, and these five nations account for 80% of the global supply of plasma, the main component of blood, and a crucial ingredient in a range of medicines. In the US, the average payment per plasma donation is $80-$85 (£63-£67), said Matthew Hotchko of the Marketing Research Bureau, while blood and plasma donors in Austria receive an average of €30 (£25) per donation, with a maximum of 50 donations permitted per year.

Many other countries offer "non-monetary compensation like time off work or vouchers", said Politico.

Would paying donors boost donations in the UK?

Only around 7% of people in the UK donate blood on a regular basis, according to a YouGov poll from 2022, with most of these aged 45 or older. According to the survey, more than a third of Britons who do not currently donate blood said they would do so if they were paid.

Young people, in particular, are more likely to state they would donate blood if they were paid, with the number of potential donors rising to 47% of non-donors aged 18-24, and 46% of those aged 25-49 if money were involved.

What are the drawbacks?

Despite evidence suggesting paying donors could help solve global blood plasma shortages, the WHO wants to move towards "100% voluntary, non-paid blood donation in every country, as blood-borne infections are lowest among voluntary, unpaid blood donors", said The Independent.

Concern over safety is, however, not "well founded", said The Economist. In places such as Britain, scandals involving infected blood "loom large in the public consciousness". Yet there is "little evidence that plasma that is paid for is more likely to transmit disease than plasma from unpaid sources", said the magazine, "and even if it was, plasma can be heavily processed to ensure it is safe".

Another worry is that the privatisation of blood services leads to the exploitation of donors. The US made $37 billion (£29 billion) from exports of blood products last year, more than from coal or gold, and with a "large and growing population of people on the economic ropes", the business of Americans' blood plasma has become a "hugely profitable one", said The Guardian.

In Hungary's case, paid donations have led to "some troubling unintended consequences", reported Balkan Insight. Although by law donors can be paid only 7,500 forints (£15) in cash, there is no regulation on additional incentives, such as shopping vouchers and entry into prize draws and lotteries. In left-behind regions, home to the "most vulnerable, racialised and financially disadvantaged segments of societies", a "wild west" of private donation centres has turned plasma donation into a "regular, if dangerous, form of income".

If all the women waiting for NHS gynaecological appointments in the UK were to stand in line, they would stretch from London to Exeter.

That's according to a report by the Royal College of Obstetricians and Gynaecologists (RCOG), which found that about 750,000 women across the four nations are waiting for NHS appointments – a number that has more than doubled since February 2020, according to the BBC. And the real number "could be considerably more"; these are just the women who have already been referred onwards by a GP.

Women are waiting for treatment for conditions from "fibroids and endometriosis to incontinence and menopause care", but also for urgent appointments for suspected cancer. "Women are being let down," said Dr Ranee Thakar, president of the RCOG. Change is "urgently needed".

Why is the waiting list so long?

"Gynaecology is the only elective specialty that solely treats women," said Thakar. The disproportionately long waiting list reflects the "persistent lack of priority given to women and women's health".

The reasons for that are "complex and multi-faceted", she told the i news site. But the problem predates the Covid-19 pandemic. The growth of gynaecological waiting lists has been "outstripping other specialties since April 2018".

Women's health has long been "under-treated and under-researched", said the news site. Although one in three UK women suffer from a gynaecological health problem, less than 2.5% of publicly funded research is dedicated to reproductive health.

"There is apparently five times more research into erectile dysfunction, affecting 19% of men, than into premenstrual syndrome, which affects 90% of women."

This contributes to long diagnosis times and "poor treatment options", said Thakar, leaving women "struggling" with symptoms that impact their health and quality of life. Every month more patients are referred to gynaecology services than are seen, driving "a steady increase in waiting lists".

In fact, waiting times have tripled over the past decade, according to analysis by the Nuffield Trust and the Health Foundation. Between 2014 and 2024, the waiting list for gynaecological care rose by 223%: "faster than the overall NHS waiting list", said The Telegraph.

What is the impact?

One woman told The Times she suffered from "excruciating" non-stop pain and near-constant bleeding. She was diagnosed with endometriosis in 2020, and is still waiting for surgery.

More than three-quarters of women waiting for care reported worsening mental health, Thakar wrote in The Guardian. More than two-thirds said they were "unable to take part in daily activities", including work, socialising and caring responsibilities, due to severe pain or symptoms. Many experience exhaustion, dizziness, anaemia and infections because of "worsening conditions".

This "dire situation has repercussions for the whole NHS". A quarter of the women surveyed for the report had been to A&E, many needing "emergency interventions" – when they could have been treated as outpatients had they been seen earlier. This is "costing the country millions".

Women's absences from work due to health conditions like severe period pain and ovarian cysts cost the economy nearly £11 billion per year, according to a recent report by the NHS Confederation. Unemployment due to menopause symptoms also costs about £1.5 billion a year.

For every additional pound invested in gynaecology services per woman in England, there would be a return of about £11 for the economy, the report found. "That's an additional £319 million of gross value added across the whole economy," wrote Thakar, "just from prioritising women's health."

What can be done?

The NHS Confederation report recommended "allocating ringfenced funding" to women's health, to help close the "gender health gap at pace".

It also recommended additional funding throughout the country, improved education and training for doctors on women's health conditions, and an ambassador for women's health focused on improving outcomes for Black, Asian and minority women, which are significantly worse.

The RCOG is also calling on Labour to deliver "an urgent package of support for women" on the waiting list, said The Times.

"Too many women are facing unacceptable waits for gynaecology treatment," a Department of Health and Social Care spokesperson told the paper.

Labour is "overhauling women's healthcare". A 10-year plan backed by a £22.6 billion increase in day-to-day health spending will bring down waiting times, so women get "the support they need when they need it".

The King's Duchy of Lancaster estate makes £829,000 a year renting a warehouse to an NHS trust to keep ambulances.

That's just one of the findings from a joint investigation by The Sunday Times and Channel 4's "Dispatches" into how the monarchy's centuries-old property portfolios are used in lucrative contracts with public bodies and charities. The investigation also revealed how the royal duchies receive millions from the armed forces, schools, prisons and fire and ambulance services.

Adding to the royal family's woes, a separate investigation by The Mirror and "Dispatches" found "scores" of rental properties owned by Prince William as part of his Duchy of Cornwall estate are riddled with damp and mould and fail to meet the minimum legal energy efficiency standards for landlords.

What did the commentators say?

The royal family making millions of pounds a year in rent from the NHS and the armed forces is a "PR disaster" that could have serious consequences for the future of the monarchy, said Libby Purves in The Times.

The 185,000 acres that make up the Duchies of Lancaster and Cornwall have over time become "cash cows", raking in more than £50 million a year for King Charles and Prince William. That neither pay capital gains or corporation tax is already contentious, but the "real embarrassment" lies in the detail of their tenants – covering some of the most venerated public institutions in Britain.

For the modern monarchy, "perception is everything, and underpinning its popular support is the expectation that the royal family use their position for the public good", said Craig Prescott, a lecturer at Royal Holloway, University of London, also in The Times.

"Any suspicion that the monarchy is pursuing its public functions for private gain would be incendiary", something senior royals are "acutely aware" of.

While the Crown's vast land holdings are "no secret," said Zoë Grünewald on the i news site, "the scale of profit and hypocrisy is striking". The public outrage is "unsurprising" especially at a time of "widespread sacrifice for citizens" and when Labour is raising taxes on corporations and wealthy individuals.

There's nothing unusual about the royals' tax affairs, Ben Goldsmith, a British financier and environmentalist, told The Telegraph. "The Duchies of Cornwall and Lancaster are private assets which generate an income for members of the royal family, on which they pay full tax," he said. "The royal family owns stuff, like many families in this country. And?"

While there is no question of impropriety, it's "not a good look" for the monarch and heir to the throne, said The Express, "especially not making money from mining activities in Cornwall" given their much-touted green credentials.

What next?

The King is "under growing pressure" to refund the cash-strapped NHS, said the Daily Mail. But the revelations have "raised fresh questions" over the royal family's wider tax arrangements, said The Telegraph.

Their tax exemptions are, in fact, "outdated and indefensible" said Grünewald. It is time for Labour to "harness the public's frustration" and build on the momentum of its "redefining budget and the appetite for change" by ensuring the monarchy pays its share of corporation and capital gains taxes.

This would "benefit the Crown as well". By taking a lead in supporting national unity and public services, "the royals could redefine their role in modern Britain".

Keir Starmer's Cabinet ministers outlined their policy priorities this week, following Labour's landslide victory in the general election. 

The immediate focus appeared to be on economic growth, housebuilding and improving the NHS. In her first speech as Chancellor, Rachel Reeves promised to "get Britain building" by reinstating housebuilding targets for councils and reviewing green belt boundaries. However, she warned of "difficult choices" ahead as she ordered the Treasury to draw up an analysis of the state of the public finances. Separately, the Health Secretary, Wes Streeting, declared the NHS to be "broken" after 14 years of Tory rule, but said that he'd held "positive" talks with unions about a deal to end the junior doctors' strikes.

'Stability and expertise'

In his first days as PM, Starmer appointed a Cabinet that included record numbers of female and of state-educated ministers. He visited Scotland, Wales and Northern Ireland – vowing to "reset" relations with the devolved administrations – and hosted 12 regional mayors at No. 10. On Tuesday, he flew to the Nato summit in Washington. He reiterated his promise to raise defence spending to 2.5% of GDP, but did not say by when. In a call with Israeli PM Benjamin Netanyahu, he'd earlier stressed the "urgent need" for a ceasefire in Gaza.

Starmer promised change, said The Observer – and his initial decisions as PM suggest that he was serious. By giving most of his former shadow ministers their equivalent Cabinet posts, he has prioritised "expertise and stability" over "favours for allies". And he has made some "inspired" appointments from outside Parliament: James Timpson, the businessman known for employing ex-prisoners at his keycutting firm, was made Prisons Minister; Sir Patrick Vallance, the former chief scientific adviser, is the new Science Minister.

'Remarkable accomplishment'

 Britain has its first Labour PM in 14 years, and with a huge majority to boot. That's a "remarkable accomplishment" for Starmer, said The Times – and testament to the diligence with which he set about transforming his party after its defeat in 2019. But this was a "loveless landslide", said the Daily Mail. Labour won 63% of seats, on 34% of the vote – the lowest for an incoming PM since 1832. Yes, Labour won plenty of seats; but it didn't win voters' "hearts and minds".

The new Government faces formidable challenges, said The Daily Telegraph: Britain is mired in debt, the NHS is in "crisis", and growth has been sluggish for years. Starmer says that "actions not words" are needed to solve those problems and restore trust in politics; but his promise of "change" may soon "crash into a wall of economic reality".

The NHS can now offer patients with a rare blood disorder a "transformative" new treatment after the UK's medicines watchdog gave its funding the green light.

Around 200 people with haemophilia B will be eligible for the gene therapy, which helps their body produce blood-clotting factors and "frees" them from regular treatments, said Bloomberg.

What is haemophilia B? 

This genetic disorder is much rarer than haemophilia A, said Great Ormond Street Hospital (GOSH). Around 2,000 people in the UK have the condition. 

Due to a mutation in their DNA, patients with haemophilia B either can't produce enough of factor IX – a specific protein that makes blood clot – or lack it entirely. "Without this crucial clotting component, bleeds are bigger and longer," said the BBC. 

Treating haemophilia B requires constant care and monitoring. As a preventative course of treatment, people with the blood disorder receive weekly injections of factor IX to enable their blood to coagulate, said GOSH. On-demand injections are also administered if a patient injures themselves or undergoes surgery.  

How does this gene therapy work? 

The drug, Hemgenix, has been found to have long-term benefits for those with the condition. Clinical trials began in 2019, with 54 male patients from the US, EU and UK taking part. Then the gene therapy was "still just an experimental idea", said the BBC.

The therapy is administered as a "one-off infusion, lasting about an hour". Patients receive "engineered viruses" with "copies of the fully functional factor IX instructions". The viruses then "act like a fleet of microscopic postmen, delivering those blueprints to the liver". The organ is then able to follow the instructions to produce the clotting protein. 

What impact will the treatment have? 

NHS England's national medical director Professor Stephen Powis described the therapy as "transformative". Its impact, he said, could be "truly life-changing". 

Five years after being part of the clinical trial, Elliott Collins, 34, told the BBC: "I feel cured." Before, "I would have to think about it all the time". Now, "for it to completely disappear", it's changed me "mentally and physically". 

The therapy may not prove as effective for all patients, however. Of the 54 men who took part in the clinical trial, two continued to need factor IX injections. "And nobody knows how long it will last." Some research has suggested it could be more than 10 years. 

The therapy is also "not considered a true 'cure'", said the BBC, as it won't stop people with the disorder from passing it on genetically.

What's the price tag? 

The gene therapy comes at a hefty cost: £2.6 million, making it "one of the world's most expensive" treatments. "England's thrifty drug-cost regulator" (the National Institute for Health and Care Excellence, or Nice) has endorsed the investment for "a limited period" while the drug's efficacy "remains under scrutiny", said Bloomberg. 

The financial "deal" between the manufacturer CSL Behring, NHS England and Nice is "bound up in confidentiality agreements", said the BBC, but it is "essentially a performance-related pay for drugs", the "first such deal" that the health service has struck. 

Now that its funding has been approved, the therapy will be made available at centres in London, Manchester, Leeds, Bristol, Cambridge, Birmingham and Oxford.

The British state "knowingly exposed" about 30,000 people to disease via contaminated blood in what is widely regarded as the worst treatment disaster in NHS history.

Yesterday the Infected Blood Inquiry (set up in 2018) published a 2,000-page report accusing the government of "hiding the truth" over the scandal for decades. The victims had been failed "not once but repeatedly" by doctors, the NHS, the civil service and the government, the report concluded. Sir Brian Langstaff, who chaired the inquiry, said the scale of the scandal was "horrifying".

Between 1970 and 1991, about 30,000 patients were given blood infected with diseases like hepatitis and HIV. About 3,000 people have died, and thousands more are living with potentially lethal diseases. Prime Minister Rishi Sunak told the House of Commons yesterday that he was "truly sorry" for the "decades-long moral failure at the heart of our national life". He called it "a day of shame for the British state", and promised to pay "whatever it costs" in compensation. 

What did the commentators say?

"This is not some bland historical study," said Politico's "London Playbook" newsletter. "Those infected didn't just die. They endured years of stigma at a time when an Aids diagnosis inspired terror and smears. Their relatives fought for decades for justice."

The government has already made interim payouts of £100,000 each to about 4,000 survivors and bereaved partners. Today it has set out a £10 billion compensation package for victims and their families. Children were left without parents, while tens of thousands – perhaps hundreds of thousands – were infected with hepatitis (symptoms can take years to manifest). Money remains "the only currency in which recognition of fault can be paid", said The Independent, but ultimately any financial compensation will be "far too little, far too late".

The tragedy is also only one aspect of a wider scandal, said The Telegraph. The government's response to the "unfolding calamity" was not to halt the treatments, but to engage in a "large-scale cover-up". The inquiry found that there had been elements of "downright deception", including destroying documents. 

Former health secretary Ken Clarke was also "heavily criticised" by the report, said Sky News. In 1983, he said there was "no conclusive proof" that Aids was being transmitted in blood products, although the report found that there was such evidence by 1982.

In 1985, Clarke described infections as "unavoidable adverse effects" from medical procedures. This was "indefensible", the report concluded. It gave "false reassurance" and, by "not telling the whole truth", it did not "spell out the real risk". Victims are calling for Clarke to be stripped of the peerage he was awarded in 2020 by Boris Johnson. 

Overall, the report "highlights a culture of defensiveness" at the heart of the British state, said The Times, "a familiar theme" of scandals from the Hillsborough disaster to the two recent NHS maternity care catastrophes. 

The former health secretary and now Greater Manchester mayor Andy Burnham is calling for a "Hillsborough law" to impose a legal "duty of candour on public servants" to avoid future cover-ups. He said such a law would break the cycle that has led to "Whitehall cover-ups" such as the Post Office scandal and the Grenfell tragedy.

John Glen, the Cabinet Office minister dealing with the scandal, has also refused to rule out criminal proceedings for those involved. It is "welcome" that prosecutions may follow, said The Telegraph's assistant editor Sherelle Jacobs. "But it is likely that too many will go unpunished."

Delayed justice has become "a grim ritual", while a succession of public inquiries has revealed that the state's secrecy is "so prolific, so compulsive, so endemic that it threatens to effectively render Britain a failed democratic state".

Taken in isolation, national outrages like the infected blood disaster and the Post Office scandal "elicit an impotent shiver of revulsion" from a disillusioned nation, said Jacobs. "Taken together, they are dynamite."

What next?

There will be "some satisfaction" for survivors that organisations and individuals were criticised, said Sky News's science and technology editor Tom Clarke.

But they must "wait for another day" for prosecutions because the Inquiries Act prohibits public inquiries from finding criminal or civil liability. If prosecutions are to come, it will be through the courts.

And the NHS's "institutional defensiveness", which the report criticised, is still "all too evident", said The Telegraph. The ongoing "persecution of NHS whistleblowers" shows how "institutional malpractice can be allowed to fester".

The years-long inquiry also shows that there is still "no quick mechanism" for addressing institutional failures. "The next such scandal may already be unfolding; will we once again be too slow to avoid it?"

For many people, the arrival of spring heralds hefty doses of antihistamines, nasal sprays and eye drops to relieve hay fever symptoms.

Allergic reactions to pollen typically include a runny nose, itchy eyes and persistent sneezing, but for some, the symptoms can be debilitating and life-altering, and common remedies may have little effect. 

Hope is at hand, however, in the form of immunotherapy. The most acute hay fever sufferers are sometimes referred for the treatment, and now new research "highlighting its effectiveness" may lead to immunotherapy becoming "more widely available on the NHS", said the Daily Mail.

What is immunotherapy?

In essence, immunotherapy aims to "induce a shift in the immune response" of a patient, said Samuel J. White and Philippe B. Wilson from Nottingham Trent University on The Conversation. So instead of producing histamines that cause the classic symptoms of hay fever, the body produces "antibodies that can neutralise the allergen" and prevent an allergic reaction from occurring.

The process of immunotherapy trains the body to "avoid its overreaction" to a specific allergen, said Healthnews, and instead build a "tolerance" to it.

That usually begins with a three- to six-month "build-up phase", during which small doses of the allergen are administered to induce T-regulatory cells, which prevent the release of histamines. Doses are then gradually increased until the target dose is reached, at which point the "maintenance phase" begins, lasting for three to five years or longer.

Immunotherapy can be administered in two ways: under the skin via an injection (subcutaneous), or via the newer method of under the tongue using liquid drops or tablets (sublingual).

How effective is it?

Both types of immunotherapy treatment have demonstrated effectiveness in research. Subcutaneous has been used for much longer and so has a greater history of evidence showing it works. While it is considered safe, uncommon side effects include allergic reactions and a rash around the injection site.

The oral method has be shown to be "marginally less effective" than injections, said White and Wilson, but is considered "slightly safer".

The treatment usually begins a few months before the pollen season starts. Research has shown that treatment over three to five years can have longer-lasting benefits and is "effective in reducing symptoms and use of medications such as antihistamines". Sublingual treatment has been shown to be "particularly effective for hay fever caused by grass or tree pollens".

How do people access the treatment?

Despite the evidence of the effectiveness of immunotherapy in treating hay fever, it is currently "not available to the majority of people" with the condition in Britain, said The Sun.

Only 2,839 people in the UK out of the estimated 13 million hay fever sufferers are receiving three years of immunotherapy treatment, according to research by the British Society for Allergy & Clinical Immunology. The use of immunotherapy in the UK "severely lags behind the US and Europe", consultant paediatrician Dr Tom Dawson told the Daily Mail, despite the UK being "at the forefront of allergy research".

Most people need to demonstrate severe hay fever symptoms that can't be relieved with standard treatments before a GP may refer them for immunotherapy.

The treatment costs around £2,000 a year per patient, but supporters argue that in the long term, immunotherapy could save the NHS money, by resulting in fewer people succumbing to more severe conditions such as seasonal asthma.

Despite evidence of its efficacy, not all patients will experience a complete relief of symptoms through immunotherapy, and it "may not be a suitable option for everyone", said White and Wilson. It also requires a long-term commitment to regular treatment and can often take "several months or even years to see the full benefits". For many people, though, immunotherapy could prove a "valuable tool" in easing their hay fever symptoms.

Michael Sheen is "in his element" as the architect of the NHS, Aneurin Bevan, in Tim Price's "rousing" new play "Nye", said Dominic Cavendish in The Telegraph.

Sheen is "by turns down to earth and messianic, tender and full of clenched tenacity". And there is "no faulting the rest of the company either", Cavendish added.

Younger audience members "may know next to nothing about" Bevan, known as Nye, "the honourable member for Ebbw Vale, the left-wing orator who oversaw the creation of the National Health Service", said Clive Davis in The Times.

This production will "hopefully change that", said Rhiannon Lucy Cosslett in The Guardian. In 1948, when the NHS was founded, "almost everyone in Britain knew his name", and his death in 1960 "led to an outpouring of national mourning".

Like the former Labour MP and health minister, Sheen is "something of a Welsh folk hero, and his embodiment of the role astonishing", said Cosslett. Yes, the play "verges towards the sentimental at times", but it gets away with its slightly saccharine note "because it's also inventive, surreal and at times very funny".

There's some "skating over historical detail" as we follow him "from cradle to grave in a morphine-induced fever-dream amid Bevan's hospitalisation with terminal stomach cancer in 1960", said Cavendish. At one point, he sings a rendition of "Get Happy" in his pyjamas, with medical staff dancing around him.

Having an "ageing famous figure reliving his life in convenient vignettes" like this is a little "tired" as a format, said Alice Saville in The Independent, but director Rufus Norris "keeps things nimble and strange".

There are "poignant biographical insights". Initially, Sheen is "touchingly delighted to be treated by the public health system he helped dream into existence", but is soon "lost in post-operative hallucinations: the sadistic schoolteacher who beat him for his stammer, the black lung-afflicted miner father who – ironically – he couldn't or wouldn't help".

We also learn how Bevan's wife, Labour MP Jennie Lee, "sidelined her own ambitions to support her husband's career", said Cosslett in The Guardian. With the NHS currently crumbling, "the timeliness of the play, and some of its lines about Tory interests and ideology, were not lost on the audience".

National Theatre, London SE1 (020-3989 5455) until 11 May. Wales Millennium Centre, Cardiff, 18 May to 1 June. Screened live in cinemas via NT Live on 23 April. 

Hospitals in England will give families the right to an urgent second opinion on the condition of seriously ill patients under the new "Martha's Rule".

The rule will be adopted in 100 hospitals from April, with plans for a national roll-out, and allows a patient's family to access a review by other "doctors and nurses not involved in the medical team treating them", said The Guardian.

How did Martha's Rule come about?

The initiative is named after Martha Mills, the 13-year-old who died from sepsis after "catastrophic failings" by doctors at a south London hospital in 2021, said The Times. Doctors at King's College Hospital had failed to move her to "intensive care quickly enough to get treatment that would save her life".

Martha's parents, Merope Mills and Paul Laity, had concerns over Martha's "rapidly deteriorating" condition – which began after a holiday cycling accident injured her pancreas – but they were "brushed aside" by doctors. 

Mills wrote in The Guardian that clinicians had tried to placate her anxiety over Martha's condition and that she and her husband were "not told the full truth" about what doctors knew. Medical staff had established that Martha had contracted sepsis but they did not tell the couple, saying she had an "infection". 

"It's easy to feel cowed," Mills wrote, "but hold your ground". No matter how "indebted you feel to the NHS", it is right to "challenge decisions if you have good reason to".

A coroner ruled that Martha would "most likely have survived" if doctors had heeded warning signs and moved her to intensive care earlier, said The Telegraph. After years of campaigning, her parents said that the implementation of Martha's Rule meant their daughter had not died "completely in vain".

What will it change?

The key change that Martha's Rule will establish is that doctors and nurses will be "obliged to accept any request for a second opinion". They will also be told to note the observations of those closest to the patient, who spend the most time with them, and to "formally record daily insights and information", as well as "take account of changes in behaviour or condition".

The initiative will entitle patients' families to a "rapid review" from a critical-care team if the condition is worsening.

Amanda Pritchard, chief executive of the NHS, said the rule will "hopefully only be needed in a small number of cases", but had the "potential to save many lives in the future". It will also be advertised on leaflets and posters in hospitals to ensure awareness.

How will it be rolled out?

The implementation costs of a 24/7 escalation service will initially be funded by £10 million of government funding for the first 100 hospitals, which account for around "two-thirds" of those in England, said the BBC. After evaluation, further funding may be unlocked to expand the scheme across all hospitals with seriously ill patients.

Health Secretary Victoria Atkins told the BBC that while the initiative was something the government believes in "very strongly", it would be rolled out "step by step" to ensure that the "service is as we'd all expect it to be".

A successful first year could see Martha's Rule adapted for "community hospitals and mental-health trusts", the broadcaster reported.

What are the concerns?

There is a "background fear" from doctors that the rule could see them "overrun" with patients calling for a second opinion "all the time", Mills told The Guardian's "Today in Focus" podcast. But patients and families should not be "afraid to challenge decisions" by doctors, she said, adding that it is "not a way of casting blame" over patient care.

Evidence from similar schemes around the world, including in Australia, showed that doctors did not get "inundated with requests from patients or relatives for an urgent review", said the paper.

ITV's new Covid drama "Breathtaking" is "breathtakingly good". 

That was Carol Midgley's assessment in The Times. She said "it's the best I have seen" from the lead actor, Joanne Froggatt, because "her performance as the consultant Abbey Henderson was more powerful for being restrained".

This is a "tour de force, exposing political complacency and reminding us how, despite all the clapping, NHS staff, many of whom died in the line of duty, are still taken for granted".

'Unparalleled attention to detail'

"Rarely does television feel so visceral," said Rachael Sigee on the i news site. "The attention to detail is unparalleled," she added, "from the scuffs on the walls to the red imprints of mask outlines on faces", and "that authenticity carries into the performances".

Sigee added a "big caveat", though. "It might be essential viewing but it is equally essential to do so with care. It may make you want to scream, but it's more likely you will watch in stunned silence."

As a polemic it is "powerful", said Anita Singh in The Daily Telegraph. But it does at points become "so caught up in the fierceness of its message that it forgets the basics of hooking an audience".

Lucy Mangan, in The Guardian, had a similar take. "By the end, despite great performances from the whole cast, Breathtaking feels more like a cathartic rush for the writers, rather than something that deepens our understanding of what doctors and patients – and to some extent what we all – went through."

'Sad and authentic'

Ultimately, though, it is a "deeply sad and often triggering drama", said Sean O'Grady in The Independent. It is also a "highly authentic" one, based as it is on the book by Dr Rachel Clarke, who worked in hospitals during the pandemic.

"Without lapsing into heavy-handed propagandising, the drama has the voice of Boris Johnson in 'Mayor in Jaws' mode floating above the traumatic scenes, with the juxtaposition between lazy spin about 'sending the coronavirus packing', and the "frantic reality of people basically drowning, adding to the tragedy."

The contaminated blood scandal is widely regarded as the worst treatment disaster in the history of the NHS. From the 1970s until 1991, up to 30,000 people in the UK were given blood infected with HIV and hepatitis. 

At least 4,689 of those affected suffered from haemophilia, a rare genetic disorder in which the blood fails to clot, meaning that small injuries can result in dangerous blood loss. These patients were given contaminated blood-clotting agents. More than 3,000 people have died as a result, and thousands are still living with potentially lethal diseases. 

In terms of human life, it was a disaster much more costly than Grenfell or Hillsborough. Furthermore, the victims of this appalling scandal, and their relatives, have had to wait decades for justice. In 2018, a full public inquiry was launched. After many delays, its report is finally due to be published on 20 May.

How did the scandal come about?

Most people who suffer from haemophilia lack a protein, factor VIII, that enables their blood to clot. Until the 1940s, when transfusions of blood plasma were first administered, there were no effective treatments. But in the 1960s, Dr Judith Graham Pool, a US scientist, made an important discovery: plasma could be broken down to produce a concentrate of clotting factors. In time, factor VIII concentrate could be administered at home, by injection, to haemophiliacs. This changed their lives and was soon in high demand: by 1973, doctors were warning that the UK wasn't producing enough of it to meet patients' needs. That same year, Britain started importing factor VIII from the US – a step that was fraught with risk, and had terrible consequences.

Why was it risky?

Unlike in Britain, where blood was donated voluntarily, donors in the US were paid. Pool had warned as early as 1974 that this was a "dangerous" and "unethical" practice: prisoners, sex workers, drug addicts and alcoholics did it to make easy money, despite their high risk of carrying blood-borne diseases. Batches of blood were mixed; one could include blood from up to 40,000 donors; one disease-bearing donor could infect the whole batch.

In one Louisiana prison, the journalist Cara McGoogan was told, "people who had turned yellow" from hepatitis carried on donating, bribing the inmates who worked in the plasma centre with cigarettes. In 1975, a World in Action documentary revealed that the NHS was buying blood harvested from drug users and "vagabonds" causing a surge in hepatitis cases among haemophiliacs.

When were the first infections?

There was an outbreak of hepatitis B in British haemophiliacs in the 1970s, soon after US blood products were first used. In December 1983, a British haemophiliac tested positive for HIV as a result of blood products, dying 18 months later of Aids-related illnesses. By April 1984, a memo showed that the Department of Health "conclusively" knew that HIV was in blood products. The WHO and The Lancet had already sounded warnings to the same effect.

The true scale of the UK disaster, however, only became clear in 1985, when Dr Peter Jones, director of the Newcastle Haemophilia Reference Centre, tested 99 of his patients. All but one had received commercial factor VIII; 76 tested positive for HIV. By 1986, UK patients were receiving much safer treatment: donors were vetted, and blood products were heat-treated. (Today, synthetic clotting factors are available.)

Why did it take so long to act?

This is what the inquiry was set up to analyse. There were some legitimate reasons for the failures. Many doctors were aware of the risk of infections, but felt that the great benefits of factor VIII outweighed them. And it was not established that HIV was blood-borne until the first deaths of haemophiliacs in 1982. Nevertheless, a long series of warnings was ignored.

In 1975, the then Labour health minister, David Owen, promised Britain would become self-sufficient in blood products to reduce infections. It never happened. It seems that a combination of governmental indifference, professional malpractice and commercial greed was responsible: factor VIII was very profitable for companies such Baxter International and Bayer. Many doctors did not inform their patients of the risks.

How did the inquiry come about?

Victims and their families have campaigned tirelessly for justice over a 40-year period, but with limited success: some have received annual support payments, but no organisation or individual in Britain (unlike in other affected countries) has been held to account, and, until recently, no substantial formal compensation had been agreed. In Scotland, the Penrose Inquiry, which reported in 2015, made only one recommendation after seven years of work, and was widely dismissed as a "whitewash". In 2017, Theresa May finally bowed to intense pressure from campaigners to announce a full inquiry into the scandal.

What will it achieve?

It has already laid bare the scale of the scandal. At least 1,250 people in the UK contracted HIV from contaminated blood; about half of them died from Aids-related illnesses. About 30,000 more contracted hepatitis C; 2,050 of these died of liver failure or cancer. Perhaps most significantly, the inquiry has heard testimony from the victims and their relatives. Colin and Janet Smith told how they lost their son, Colin, at the age of seven in 1990, after he was treated with HIV-infected blood; the words "Aids-dead" were painted on their home.

They believe their son was knowingly used as a guinea pig by the haematologist Professor Arthur Bloom. In 2022, the inquiry's chair, Brian Langstaff, also took the unusual step of calling for interim compensation of £100,000. The total compensation bill is expected to exceed £20bn.

The mother of one of the Nottingham knife attack victims has said she was "foolish to trust the legal system", after the killer was sent to a high-security hospital rather than jailed for murder.

Barnaby Webber and Grace O'Malley-Kumar, both 19, and Ian Coates, 65, were stabbed to death on 13 June last year by Valdo Calocane, who then tried to mow down three other people with a van.

The 32-year-old, who had been diagnosed with paranoid schizophrenia, pleaded guilty to manslaughter on the basis of diminished responsibility and was last week handed an indefinite order to be detained in a high-security hospital. The government has today ordered a special review into Nottinghamshire Healthcare NHS Foundation Trust, where Calocane was treated.

Calocane 'got away with murder'

Calocane's crimes are "among the darkest in British history", said Leo McKinstry in The Sun, and his story is a "grim saga of negligence, incompetence and leniency which has denied justice to the families of his victims".

Speaking on the steps outside Nottingham Crown Court after the sentencing, victim Coates's son, James, suggested the killer had "made a mockery of the system and he has got away with murder". 

Webber's mother, Emma, told Sky News that, "with hindsight", she had been "foolish to just trust in our legal system". Her family had been "ill-prepared" to find out that the killer's manslaughter plea had been accepted, she added.

The ruling has left the bereaved families with "more questions than answers", wrote Sky News presenter Sarah-Jane Mee. "They were failed by a system meant to keep them and those living with mental illness safe," she continued. "In this horrendous case it did neither."

The "many missed opportunities" for interventions highlight a "stretched NHS mental health provision and police system that too often work against rather than with one another".

'Very probably' a life in high-security hospital

Sentencing Calocane, Mr Justice Turner said that after seeing detailed reports from "no fewer than five distinguished consultant psychiatrists", he was "very clear" that the ultimate conclusion with respect to diminished responsibility had been properly reached. 

Calocane would "very probably" be detained in a high-security hospital for the rest of his life, the judge said. However, under section 37 of the Mental Health Act 1983, an offender is entitled to a review of their mental health every three years, and "could become eligible for release if doctors assess that they have recovered and are of sound mind", reported The Telegraph.

Rishi Sunak has so far refused to order a public inquiry into Calocane's case, despite calls backed by Keir Starmer and Wayne Birkett, one of the people hit by a van during the attacks. Webber's parents told the BBC that they were "horrified" and "disgusted" that no inquiry was being planned.

A spokesperson for Attorney General Victoria Prentis did confirm that her office had received a submission arguing that the sentence handed down was "unduly lenient". She has 28 days from sentencing to review the request and decide whether to refer the case to the Court of Appeal, although her considerations are "unlikely to look at whether the correct charge was pursued in Calocane's case", said The Independent.

NHS England has said it is also planning to order a separate Independent Mental Health Homicide Review into Calocane's contact with mental health services, which is expected to take many months to complete.

King Charles is facing criticism for appointing as head of the royal medical household a doctor who has advocated for homeopathic remedies and claimed that Christian healers may be able to help the chronically ill.

Dr Michael Dixon, "a champion of faith healing and herbalism", has "quietly" held the senior position for the last year, revealed The Sunday Times.

While it is the first time the role has not included acting as the monarch's personal physician, duties include managing a team of doctors at Buckingham Palace, having overall responsibility for the health of the King and the wider royal family, "and even representing them in talks with government", said The Guardian.

'A less orthodox choice'

A "less orthodox choice" than his predecessors, Dixon is "one of the nation's most outspoken advocates of alternative medicine, including homeopathy", said The Sunday Times.

Dixon has long championed non-traditional treatments being made available on the NHS, including "thought field therapy", aromatherapy and reflexology, and has written papers arguing that Christian healers, however "unfashionable", may be able to help the chronically ill, reported the paper. He has also claimed the effects of homeopathy "may be real", citing a test tube experiment that suggested Indian herbal cures diluted with alcohol could kill breast cancer cells, added The Sunday Times.

While Dixon is yet to personally respond to the revelations, a Palace spokesperson denied that the doctor believes homeopathy can cure cancer. "His position is that complementary therapies can sit alongside conventional treatments, provided they are safe, appropriate and evidence based," they said. The Palace described him as a "practising GP" and fellow of the Royal College of GPs and Royal College of Physicians.

'Complementary medicine means precisely what it says'

Dixon and the King, who have known each other for decades, have "both been criticised for their support for homeopathy", said The Telegraph. 

Homeopathic remedies have not been available through the NHS since 2017, after its then chief executive Lord Stevens described them as "at best a placebo and a misuse of scarce NHS funds".

News of Dixon's appointment has therefore been described as "worrying and inappropriate by academics and campaigners", The Guardian reported. Michael Marshall, project director at the Good Thinking Society, which promotes scientific scepticism, told the paper the move "isn't appropriate" and suggested the King might still be supporting complementary medicine behind the scenes.

"The whole promotion of alternative medicine undermines the trust in real medicine," said Graham Smith, chief executive of the campaign group Republic. Putting Dixon in place is "really irresponsible" and "raises questions" about the King's judgement.

The Palace said the King's position on "complementary therapies, integrated health and patient choice" was well documented when he was Prince of Wales. "In his own words: 'Nor is it about rejecting conventional medicines in favour of other treatments: the term 'complementary' medicine means precisely what it says'."

Babylon Health, the UK tech start-up once valued at billions of dollars that collapsed in August, was only ever "smoke and mirrors", a former employee has said.

The rise and dramatic fall of the healthcare app, backed by senior politicians like the then health secretary Matt Hanock, who saw it as a panacea to cutting NHS waiting times, is more than a classic case of over-promising and underdelivering.

"The whole sorry and dangerous story is a symptom," said Sam Leith in The Spectator ,"of arts graduate politicians being idiotically dazzled by the idea of technological miracles and prepared to take any old rubbish on trust if the two letters 'AI' are involved."

What did Babylon aim to do?

Babylon Health was a London-based startup that aimed to "revolutionise healthcare" by putting an AI-powered "doctor in your pocket". Founded in 2013 by Ali Parsa, a British-Iranian banker, it was once hailed as the future of the NHS by Matt Hancock, the then health secretary. In 2018, Parsa claimed that its chatbot was better than a real doctor; that it had passed a medical exam with a score of 81%, when the average mark for human doctors at the time was 72%. The company raised hundreds of millions in funding, signed NHS deals on the back of overblown marketing claims, and soared on its New York stock market launch in October 2021 to a valuation of $4.2bn (£3.1bn) – before crashing into bankruptcy this summer.

What products did Babylon offer?

It had two main products. "GP at hand" was a telehealth service that would connect people to NHS doctors on videocalls. This was "helpful... but not exactly revolutionary", said Grace Browne in Wired; the service still exists today. The second, more game-changing offering was a symptom-checking bot, launched in 2017 – supposedly an easier, faster way of accessing medical care. 

By performing triage and assessing symptoms, the chatbot would reduce pressure on doctors' time, and help them make diagnoses, it claimed – thereby cutting waiting lists and slashing care costs. This was music to the ears of investors, healthcare officials and government ministers alike. According to Parsa, Babylon would "do with healthcare what Google did with information" – making it "accessible and affordable to every human being on Earth".

What happened next?

From its plush Knightsbridge offices, Babylon became one of the fastest-growing startups in healthcare history. Between 2013 and 2021, it raised $1.2bn (£876m) from investors, including Saudi Arabia's sovereign wealth fund and Demis Hassabis, the founder of DeepMind, Google's AI arm. In the past three years alone, it has received at least £22m from the NHS. Employees say Parsa was obsessed with "blitzscaling" – the "lightning-fast path" to building valuable companies popularised by LinkedIn's co-founder Reid Hoffman, in his book of the same name. The company went on wild hiring sprees; the sales team would bang a gong every time they made a sale. But it became clear to many insiders that all was not well at Babylon.

What went wrong?

The GP at hand service expanded fast to serve 100,000 patients, via deals with various NHS trusts. But its "ease of use", reported The Sunday Times, meant its patients asked "for far more appointments than is typical". Because the NHS pays GPs a flat fee per patient a year, of around £160, regardless of how much care they require, Babylon was soon losing money on every patient it saw. It needed the chatbot to save money by "automating away" consultations.

What happened to the chatbot?

It did not live up to expectations. One former employee, Hugh Harvey, a doctor, said that the company's "AI algorithm" was little more than a standard medical if/then "decision tree" set out in an Excel spreadsheet. He remembers thinking: "This isn't really artificial intelligence." Another critic, the oncologist David Watkins, pointed out that its supposedly all-seeing app failed to spot symptoms of a heart attack, and at times diagnosed an ingrown toenail as gout. In 2017, the Care Quality Commission raised concerns. In 2018, The Lancet concluded that there was no evidence that Babylon's chatbot worked better than a doctor, and there was "a possibility that it might perform significantly worse".

How did it all end?

Although Parsa's own fortune grew to an estimated £825m after the flotation, Babylon failed to make a profit and burned through hundreds of millions of dollars in funding. Eventually it had to withdraw from its loss-making NHS contracts; a move into the US market was even more disastrous. And there was a growing sense that the chatbot was a triumph of aggressive Silicon Valley-style marketing – or just old-fashioned smoke and mirrors – over substance. Within 18 months of floating, Babylon's shares had fallen by 99% – a situation described by Parsa as an "unmitigated disaster". Despite attempts to steady the ship, the company's accumulated deficit spiralled past $900m earlier this year, leading it to file for bankruptcy in the US in August, and in the UK soon afterwards. Its UK assets have since been sold off for £500,000.

What are the lessons of the story?

Babylon is not the first digital health startup "to struggle to move from hype to commercial success", said Wired: other examples include the blood-testing firm Theranos, and IBM's Watson Health, which, like Babylon, was sold for parts. "There's an inherent mismatch between the move-fast-break-things culture of tech startups and that of healthcare, where caring for patients requires thoughtfulness and context." Ultimately, it's hard to replace doctors with algorithms – though investors and politicians loved the idea of doing so.

What role did politicians play?

All along, Babylon's success was underpinned by close links with the Conservative Party. In 2018, Matt Hancock wrote approvingly about Babylon in an advertorial in the Evening Standard (then edited by former chancellor George Osborne), while Dominic Cummings, who served as Boris Johnson's chief adviser, was contracted briefly as a consultant. Such admiration was mutual: individuals and companies connected with Babylon donated more than £250,000 to the Conservatives – including £10,000 to Hancock's failed 2019 leadership bid. The saga of Babylon, at the very least, exposes the worrying lack of technical nous often prevalent among British politicians and civil servants.

A better understanding of statistics could help the NHS act more quickly to prevent a repeat of the Lucy Letby case, experts from the Royal Statistical Society have argued.

The neonatal nurse was sentenced to whole life imprisonment after being found guilty of murdering seven babies and attempting to kill six more at the Countess of Chester hospital between 2015 and 2016.

Following a public outcry centred around perceived failures within senior hospital management that allowed to Letby to carry on killing for so long, the government has announced a public inquiry to unpick the circumstances around her crimes and provide answers for the victims' families.

How could stats help in future cases?

In a letter to Lady Justice Thirwall, who is leading the public inquiry, Dr Andrew Garrett, president of the Royal Statistical Society (RSS), and its chief executive Sarah Cumbers, pointed to the importance of statistical evidence during the trial.

Chief among these was the duty roster spreadsheet showing staff shifts, through which the Crown Prosecution Service (CPS) was "able to show the jury that Letby was the one common denominator in the series of deaths and sudden collapses on the neonatal unit".

Although a 2022 RSS report entitled "Healthcare serial killer or coincidence?", setting out statistical issues in the investigation of suspected medical misconduct, was sent to both the defence and prosecution before the Letby trial, the letter suggests the judicial system could benefit from more guidance on the matter.

"Statistical evidence could prove helpful in providing evidence to NHS trusts of possible criminal activity," said the RSS in a press statement, and therefore it is "crucial that it is used appropriately". By doing so, "it is hoped that lessons from such cases in the past will be learnt".

To that end, the RSS has called for the inquiry to cover the use of statistical as well as medical evidence.

Does statistical evidence always add up?

While a better understanding of statistics and data "could help NHS trusts act more quickly in similar cases" said The Guardian, "there are potential pitfalls to avoid".

The RSS letter warned it is "far from straightforward to draw conclusions from suspicious clusters of deaths in a hospital setting – it is a statistical challenge to distinguish event clusters that arise from criminal acts from those that arise coincidentally from other factors, even if the data in question was collected with rigour".

Some have gone further, suggesting the way statistical data was presented in the Letby case was fundamentally flawed.

Statistician Richard Gill, who co-authored the RSS report, is one of those "backing a controversial claim that there are holes in Letby's case and it should be retried", The Daily Telegraph reported.

Speaking to the paper from his home in Holland, the emeritus professor of statistics at Leiden University said Letby's trial "would never have taken place if anybody had talked to a statistician”.

Referencing the duty roster spreadsheet that was central to the prosecution's case, Gill described the use of data as "very selective". "[It] only looked at events that happened when Lucy Letby was on duty,” he argued, adding that without a broader picture, it is mathematically impossible to draw a conclusion from the data.

Are there previous examples?

While any chance the Letby case could be retried on the basis of statistical misrepresentation may seem far fetched it is not without precedent.

In 2003 Dutch paediatric nurse Lucia de Berk was found guilty of four murders and three attempted murders and sentenced to life in prison. The case against her was based in large part on records that showed she had been present at a suspiciously high number of deaths and resuscitations. A total of 20 suspicious incidents occurred while she was on shift spread across four hospitals, with police claiming the probability of such a pattern happening by chance was one in 7 billion.

It was not until 2006, when Gill along with fellow statisticians and whistleblowers began examining the data, did it emerge that "tunnel vision, bad statistics, and poor human intuitions about coincidence had marred the investigation", Science reported in January.

De Berk was exonerated in 2010 and her case is "now considered one of the worst miscarriages of justice in the Netherlands", said the magazine.

There is no suggestion Letby's case carries such parallels and the CPS detailed other "key evidence in the prosecution case", such as "falsified" medical records, text messages and social media activity, and her handwritten notes and diaries.

Almost one in three women working in surgery have been sexually assaulted by a colleague at work, new research has found.

According to a study in the British Journal of Surgery, sexual misconduct in the profession is “rife” and appears to go unchecked. A “misogynistic culture” in hospitals poses a “significant risk to patient safety”, the authors warned.

Of more than 1,400 NHS staff quizzed, 63% of female surgeons reported being the target of sexual harassment ranging from “uninvited comments” about their body to being “threatened for refusing sexual favour”. And 30% reported assaults, including 11 instances of rape.

Insiders claim such assaults have long been “surgery’s open secret”, said the BBC. The research has exposed the largely “untold story” of women being “fondled inside their scrubs”, of male surgeons “wiping their brow on their breasts”, and men “rubbing erections against female staff”.  

A former breast cancer surgeon, Dr Liz O'Riordan, told the broadcaster earlier this year that she had experienced sexual harassment from colleagues on a regular basis in some of her jobs as a junior doctor.

The new study, commissioned by the independent Working Party on Sexual Misconduct in Surgery, found that 24% of male staff had also been sexually harassed. But the authors concluded that men and women surgeons are “living different realities”.

Surgery is facing its “MeToo moment”, said Tamzin Cuming, chair of the Women in Surgery Forum at the Royal College of Surgeons of England. The research report is “measured” and “its recommendations achievable”, she wrote in an opinion piece for The Times, “but this shouldn’t disguise the anger and frustration felt by many in our profession”. 

“Action is needed” to bring about a “profound change in the culture of healthcare”, Cuming concluded.

The crumbling concrete crisis has been described as the “tip of the iceberg” for the country’s schools.

Nearly 150 educational buildings were closed days before the start of the school term, but in The Times, Meg Hillier, chair of the Public Accounts Committee, said hundreds of thousands of pupils were being educated in generally “substandard buildings”.

Experts have warned that the reinforced autoclaved aerated concrete (RAAC) issue may extend beyond the education sector, while others have gone further in criticising the government neglect of public services, from healthcare waiting lists to transport delays and cuts in staff.

Yet amid all the gloom, many British public services continue to match or outperform their European and US counterparts, including aspects of the country’s healthcare, education, defence, and scientific and technological research.

Healthcare

The NHS is often praised for providing universal healthcare coverage to UK citizens, but the service also faces extensive challenges, including long waiting times, staff shortages, and ballooning bureaucracy and administrative costs.

Criticism of the service remains extremely high. Between 2020, as the Covid-19 pandemic struck, and 2021, the King’s Fund think tank measured the largest decline in the overall satisfaction rate with the NHS since the 1990s.

However, it continues to rank highly on global performance charts, producing notably better outcomes than many developed countries’ healthcare systems.

According to the latest report by the US-based foundation the Commonwealth Fund, which analyses the healthcare systems of 11 developed countries every few years, the UK ranked fourth out of 11, putting it behind only Norway, the Netherlands and Australia. Meanwhile, the US had an overall ranking of 11 out of the 11 countries included in the analysis.

Despite the strong performance the findings were “a blow to the NHS”, said The Guardian, given it had been “the top-rated system in the think tank’s two previous reports in 2017 and 2014”.

Education

In 2019, a tweet claiming the UK was the best country for education was shared by hundreds of people, including the then children and families minister Nadhim Zahawi and a British ambassador.

The data came from a survey conducted by media company US News & World Report, consultancy BAV Group, and the Wharton School of the University of Pennsylvania. However, as fact-checking website Full Fact noted the tweet was “based on data that measures public perception of different educational systems” which is “not good data for objectively ranking education systems”.

Nevertheless, while many experts say the UK’s education system is probably not the best in the world, it does perform strongly according to numerous measures. A Progress in International Reading Literacy Study (Pirls) published this year found that children in England were better at reading than anywhere else in Europe or the US.

The UK’s higher-education system also ranked third out of 50 countries assessed by researchers from the University of Melbourne, which took into account a number of measures including attainment, diversity, spending and employment among graduates.

Defence

In January, a senior US general privately told former defence secretary Ben Wallace that the British Army was no longer regarded as a top-level fighting force due to decades of cuts to save money.

Yet according to an analysis by Global Firepower, which ranks 145 countries’ military strength, the UK’s military remains the fifth most potent fighting force in the world.

Global Firepower weighs up a host of different factors including the sophistication of each country’s equipment, its finances, geography, and resources.

The site said the UK’s position was boosted by its strengths in manpower, air power, nuclear weaponry, and its strong financial position.

“It is also one of the few powers to operate more than one aircraft carrier,” the site added, noting that UK carriers, HMS Queen Elizabeth and HMS Prince of Wales, are among the newest in the world.

Science and technology

The government regularly boasts of being a “global leader” in science and technology with UK Research and Innovation, the national funding agency, crowing about the UK’s “global leadership in transformative technologies”.

According to science writer Anjana Ahuja, however, “the assertion that the UK is world-beating at science and technology is often repeated but rarely questioned.”

The truth is that “British science is undergoing a major reset, prompted by factors including Brexit and declining productivity”, Ahuja wrote in the Financial Times. But while the UK’s reputation is “inflated by historic successes”, we remain “good” in global terms, Ahuja concludes, just “not outstanding”.

The UK’s first womb transplant has been hailed as the “dawn of a new era” in fertility treatment.

Surgeons in Oxford spent eight hours removing the womb from the 40-year-old donor, then nine hours implanting it into her 34-year-old sister, who was in the operating theatre next door.

The chair of the British Fertility Society, Dr Raj Mathur, said the “remarkable achievement” is “the dawn of a new age” and “a new era in treating these patients”, noted Sky News.

What did the papers say?

The donor and recipient are said to be “over the moon” after recovering well from the procedure. The recipient plans to have IVF this autumn using embryos that she and her husband have in storage.

Prof Richard Smith, gynaecological surgeon, who led the organ retrieval team, told the BBC it was a “massive success”, adding that “the whole thing was emotional” and “we were all a bit tearful afterwards”.

The first birth following a womb transplant took place in Sweden in 2014, reported The Telegraph, when a boy called Vincent was born after his 36-year-old mother had a womb transplanted from a family friend.

Since then, more than 90 womb transplants have been carried out internationally, including in the US, Saudi Arabia, Turkey, China, Czech Republic, Brazil, Germany, Serbia and India. Most involved a “living donor”, said The Guardian, with “about 50 babies” born as a result.

UK surgeons were given permission to carry out the operation in 2015, but “institutional delays” and three years of disruption caused by the Covid pandemic meant a “much longer wait”, said the i news site.

Now that the first procedure has been successfully completed here, attention is turning to what this means for the future of fertility. The development will “change the fertility landscape here”, said the i news site. “You’ve got girls, maybe 14, who have not had periods, they go to the GP and a scan shows there is no uterus”, Prof Smith told the outlet.

This is an “absolute catastrophe” he added, and “up until now there’s been no solution for that, other than adoption or surrogacy.” However, “that’s not the case now”, he said, and “it’s really exciting.”

What next?

For now, the plan is to focus on “living donations” from a relative, with up to 30 transplants taking place a year, said Sky News, but there is potential for larger numbers, because many women have “come forward to offer their wombs”.

Isabel Quiroga, consultant at the Oxford Transplant Centre, and one of the surgeons, said young women have come forward to say: “I don’t want to have children, but I would love to help others have a child” or “I’ve already had my children; I would love other women to have that experience.”

A second UK womb transplant is due this autumn, with more patients in the preparation stages. Surgeons have approval for 10 operations involving brain-dead donors plus five using a living donor.

However, Womb Transplant UK currently has enough funds for only four of these operations and womb transplants on the NHS will not be available for “a long while”, said the i news site. For a permanent womb transplant programme to be funded on the health service, an evaluation would need to be carried out on operations to see if they have been successful.

Meanwhile, surgeons in the US said they believe it is “medically possible” to perform the procedure on trans women who were assigned male at birth but have had sex change surgery, reported the Daily Mail.

However, Prof Smith said transgender womb transplants are “many years off” because “there are an awful lot of steps” to go through. He said the pelvic anatomy, vascular anatomy and shape of the pelvis are different, and there are other issues to overcome, noted Yahoo News. “My suspicion is a minimum of 10 to 20 years,” he added.

While some would welcome such a development, it would be controversial. “Many would argue this Frankenstein procedure is not being performed in the interests of medical care,” wrote Alexandra Marshall in The Spectator Australia earlier this year, describing it as “stitching wombs into men in an attempt to create new types of humans that defy the natural order”.

However, Nicola Williams, who has been studying the ethical implications of human reproduction for several years at the University of Lancaster in the UK, told EuroNews that “there are definitely equality-based reasons for considering uterus transplants in transgender women.”

The NHS could roll out more virtual wards to treat flu and Covid patients this winter, after the treatments watchdog gave the green light to the plan.

Also known as “hospitals at home”, virtual wards could free up beds at a time of year when the NHS is under added pressure, and save millions of pounds in the process.

If it proves successful, it is a model that the NHS is likely to “pivot towards” in the future “as more emphasis is placed on preventing patients needing to attend hospital and stay for ongoing treatment”, said Sky News’s health correspondent Ashish Joshi.

How would it work?

In new draft guidance the National Institute for Health and Care Excellence (Nice) said tens of thousands of patients suffering from respiratory infections such as flu and Covid could be treated at home over the winter using digital technologies.

Patients on virtual wards will be given wearable devices to monitor vital statistics such as temperature, heart rate, breathing, blood pressure and oxygen. This data is then fed through an app or platform that connects them to their doctor, who will monitor them remotely. A telephone support line will also be available and patients will receive home visits where necessary from community nurses.

In January, NHS England set out plans for integrated care systems to expand their virtual capacity to 40-50 virtual beds per 100,000 people – around 24,000 in total – by December.

What are the benefits?

The expansion of virtual ward capacity has been “prioritised by NHS England as a way to relieve pressure on acute hospital services”, reported Nursing Times.

There are a record 7.6 million patients on the NHS waiting list and health leaders “are nervous about the coming winter, which could have a bad flu season amid continuing strikes by doctors” said Practice Business. Last winter around 300,000 people were admitted to hospital with either flu or Covid, and it is hoped virtual wards will relieve some of this strain.

The virtual wards could also “reduce pressure” on GPs and emergency departments, said The Telegraph, as “a significant proportion of people needing urgent care from their GPs or in hospital are because of these [respiratory] illnesses”.

It will also save money, with analysis by Nice finding virtual wards saved about £872 per person compared with inpatient care, and £115 per person compared with home care without the use of technology.

Crucially, evidence presented to Nice found that there were similar outcomes for patients treated in a hospital or at home.

Are there any obstacles?

“Home care is important, but it isn’t the answer to everything,” writes Brian Bostock, a registered nurse and independent healthcare management consultant, for The Guardian.

Virtual wards “can ease bed numbers, but not staffing issues”, he argued, while data remains “an imperfect way to gather feedback on a patient’s recovery”.

The success of this programme is “dependent on the recruitment and retention of trained staff”, agreed Joshi, citing an existing shortage of nurses and workforce crisis that extends across the NHS. It also “does not address the long-term crisis in social care which is driving the pressure on hospitals who are unable to discharge medically fit patients”, he added.

What do the public and NHS staff think?

In March 2023, the Health Foundation surveyed over 7,000 members of the public and over 1,200 NHS staff to find out what they thought about virtual wards and important factors for making sure they work well.

It concluded that the UK public is, overall, supportive of virtual wards (by 45% to 36%) with 19% unsure whether they are supportive or not. Nearly three-quarters of the public would be open to being treated in a virtual ward “under the right circumstances” suggesting that, “if implemented well, virtual wards should be acceptable to a large majority of service users”.

Support was highest among disabled people and those with a carer, while those from lower socioeconomic groups were far less supportive.

Two-thirds of NHS staff surveyed were supportive of virtual wards, provided people could be admitted to hospital quickly if their condition changed, and could talk to a health professional if they needed help.

A consultation on Nice’s recommendation is under way and will run until 1 September.

Lucy Letby has been jailed for life today, with no chance of parole, for the murder of seven newborns and attempting to kill another six, making her the most prolific baby killer in modern British history.

As shock at the scale of her horrific crimes continues to reverberate across the country, there is mounting anger at how the now 33-year-old nurse was allowed to get away with it for so long.

One father, whose twin boys survived Letby’s attempts to kill them, told The Sun simply: “I’m blaming the hospital.”

What did the papers say?

The health service is facing calls for a public inquiry, said The Spectator’s Isabel Hardman, over claims that managers at the Countess of Chester Hospital did not respond to concerns about Letby’s presence at the mulitple deaths and collapses of babies between 2015 and 2016.

The whole saga is, “to put it politely, messy”, said Politico’s London Playbook, adding that Letby’s conviction has “opened the floodgates to a slew of reports about the way hospital managers handled consultants’ fears about the nurse”.

Staff reported being “fobbed off”, said Hardman, when they raised concerns about the nurse, and even after she was removed from frontline ward duties in 2016, managers “reportedly pushed for her to be reinstated”.

Perhaps most alarming are reports that senior paediatricians were told to apologise to Letby for suggesting she was somehow connected to the rise in unexplained infant deaths.

An external review into the hospital, which has yet to be published, is expected to reveal multiple failures by the Countess of Chester NHS Trust’s leadership to act on warnings, The Independent understands.

The news site claimed Letby “was free to target babies for nearly a year after she murdered her first patient as hospital leaders repeatedly ignored concerns raised by whistleblowers”.

“On up to ten occasions, suspicions were raised or events happened that linked her to the spike in deaths or collapses,” said the Daily Mail. But “hospital bosses refused to believe she was to blame” and were “desperate to protect the reputation of the trust”. The paper estimated as many as nine babies might have been saved or escaped harm had hospital managers and doctors not missed vital opportunities to stop her.

The problem, said The Times, is that many of the bosses who could have acted sooner to stop Letby have since “retired with big pensions or moved to lucrative new NHS jobs”.

Among these is the chief executive at the time, Tony Chambers, a former nurse who stepped down from the £160,000-a-year job shortly after Letby’s arrest in 2018. Medical director Ian Harvey, who also retired weeks after Letby’s arrest and now lives in France, is “accused of delaying calling in the police to investigate unexplained deaths on the neonatal ward”, said The Times. While Karen Rees, head of nursing for urgent care and one of Letby’s line managers, allegedly refused to remove her from duty after two babies died within 24 hours.

Chambers issued a statement after the guilty verdict saying he would cooperate fully with any inquiry and that “his focus was on the safety of the baby unit and the wellbeing of patients and staff”. Harvey also welcomed a forthcoming inquiry and said that he had been “determined to keep the baby unit safe and support our staff” when he was medical director.

“We never had hard evidence, but we had reached a point where we had explored every other cause. However, the consultant paediatricians didn’t feel there was any further work or investigation – short of a police investigation – that could be done that would satisfy them that some of the deaths weren’t due to natural causes,” he told ITV News.

Rees told Sky News she wasn’t given enough information to justify removing Letby from her duties and that she was “currently taking legal advice about the untrue allegations” made against her.

Police investigating Letby, who was today handed 14 whole-life orders, suggested chances might have been missed because the scale of what was going on was beyond the comprehension of many of her colleagues and those in senior positions at the hospital.

“It was the inability of those around Letby to imagine that a nurse would be deliberately killing babies that allowed her to cause harm for so long, even when it was happening right in front of them,” said the i news site.

Detective Chief Inspector Nicola Evans, who co-led the investigation into Letby, put it more bluntly: “Nobody was looking, because why would they? Why would they expect that this would occur?”

What next?

There are growing calls for the government’s inquiry into the scandal – which was announced on Friday following Letby’s conviction – to be beefed up.

Health Secretary Steve Barclay said a non-statutory inquiry would allow lessons to be learned in the quickest way possible. But over the weekend, the former justice secretary Robert Buckland, health committee chair Steve Brine and crossbench peer and former General Medical Council member Alex Carlile joined calls from grieving parents for it to be put on a statutory footing. This would see it led by a judge and have more powers, including being able to force witnesses to appear.

As with inquiries into previous healthcare killers like Harold Shipman, the Letby case could lead to “big changes in the way NHS staff are vetted and scrutinised”, said Hardman.

For other workers, she concluded, “it has damaged the bond of trust they have with their ward colleagues in high pressure situations – and the trust that parents put in the people they leave their tiny, desperately vulnerable babies with”.

The National Health Service celebrates its 75th birthday today – but as it reaches its landmark anniversary it faces an uncertain future.

Founded in 1948 under Clement Attlee’s Labour government, the NHS was the first universal health system in the world to be available to all and free at the point of delivery.

But an ageing population, staff shortages and huge waiting-list backlogs – to name just a few of its seemingly intractable problems – have left many wondering whether the healthcare system will survive to its centenary.

What challenges is the NHS facing?

There is little doubt that the NHS is “profoundly cherished” in the United Kingdom for the “still astonishing cradle-to-grave” principle of care that underpins it, but there is “no question” that it is “very sick”, said Esther Addley in The Guardian’s First Edition newsletter.

There has been a spike in the number of people dying as they wait for ambulances, waiting times for treatments have “almost tripled” since 2020, while GP surgeries and mental health services are “at breaking point”. Meanwhile, staff are “leaving in droves”, and junior doctors, nurses – and most shockingly – even consultants are going on strike over pay and patient safety concerns.

One of the main challenges facing the NHS is the shift from providing short-term care – its “main focus” when it was created – to providing long-term care for the chronic health problems found in an ageing population, said the BBC. People aged over 65 will have at least two chronic conditions. It is estimated that about £7 out of every £10 spent in the NHS goes on people with these conditions. And as the UK’s population continues to age, “the situation is only going to worsen”.

The amount of public money spent on the NHS has steadily increased since it began. More than 40p out of every £1 spent on day-to-day public services is now spent on the health service, leaving many wondering “whether such spending is sustainable”.

How does it compare to other countries?

While the UK was not the only country that needed to “catch up with routine care after the pandemic”, other countries have fared much better with that task, said The Times. A recent King’s Fund report compared the NHS with 18 other international health systems, and found that countries such as Germany and Singapore are now able to “speak about their backlogs in the past tense” as – unlike the UK – they had spare capacity within their healthcare systems they could use to catch up.

The report gave the NHS a mixed bill of health, with the UK doing “better than comparable countries in some areas, and worse in others”, adding that there was “little evidence that one individual country or model of healthcare system performs better than another across the board”. It suggested that reforming a country’s existing model of healthcare, rather than adopting entirely new alternatives, appeared to be the most effective way at improving the health of a nation.

But in some areas, the NHS is doing particularly badly. For example, the UK has fewer doctors and fewer nurses per 1,000 people than the average. According to the report, “while some countries do, for example, have fewer nurses, many counterbalance that by having more doctors”. But the UK “is remarkable as it scores low on both”. The UK also has the fewest CT scanners and MRI machines of any comparative country.

How can these problems be solved?

In a policy paper, former Labour leader Tony Blair has argued that making much more use of private healthcare providers is key to cutting waiting times, including embracing “co-payment options” which would allow patients to pay for faster treatment, or to “co-pay” towards services that the NHS would not otherwise fund.

Three of the UK’s leading healthcare think tanks have written to the leaders of the country’s three main political parties warning that the NHS is unlikely to reach its centenary if they persist with short-term policy decisions and promises of “unachievable, unrealistically fast improvements”.

In a joint letter, the Chief Executives of the Health Foundation, Nuffield Trust, and The King’s Fund have emphasised the need for long-term plans, investment in physical resources, reform of adult social care, improvement of social and economic conditions, and sustained commitment to the government’s recently published NHS long-term workforce plan.

Can the NHS survive in its current form?

Support for the NHS is still very strong, said The Guardian. And while the lack of healthcare before the NHS is “still a part of living memory”, support for the service is not strong simply because “people dread a return to the 1930s, but because they can see the alternatives that exist right now”. Few want their health “placed in the hands of profit-seeking businesses”, argued the paper.

The NHS has little to celebrate, said The Telegraph, with millions of people on waiting lists, overcrowded A&E departments and a “broken” primary care system. “How can this be considered a success story by any measure, let alone ‘the envy of the world’?”. In order to hold on to the NHS’s founding doctrine – that healthcare should be universally accessible and free at the point of delivery – we appear “prepared as a nation to put up with poor care, provided it is easily accessible”. It is an “egalitarian fetish that is literally costing people their lives”.

The creation of the NHS is a “cause for celebration” said The Times in its leader today. “Free healthcare for those who cannot afford to pay for treatment is the bedrock of a civilised society,” continued the paper. But if the NHS is to reach its 100th birthday in “good health” it requires “less worship, less politics and more unsentimental inquiry into what works”.

The Captain Tom Foundation is no longer accepting donations after the daughter of the late NHS fundraiser was ordered to demolish an unauthorised home spa allegedly built “using the hero’s name”.

Hannah Ingram-Moore and her husband, Colin, applied in 2021 for permission to build an office in the grounds of their £1.2 million home in Marston Moretaine, Bedfordshire, that was to be used partly “in connection with the Captain Tom Foundation and its charitable objectives”. The annex “was given the all-clear”, said The Sun, but they then added a building containing a 50ft by 20ft pool and applied for retrospective permission.

After refusing the application, Bedforshire Council has ordered that the “now-unauthorised building” be demolished. A council spokesperson said the decision was being appealed by the Ingram-Moores.

A local resident told The Sun that “it feels like they thought their goodwill gave them cover to do whatever they wanted”.

The charity trustees were reportedly “left in the dark” about the spa complex. The foundation told the paper that “had they been aware of any applications, the independent trustees would not have authorised them”.

The foundation “was already in crisis”, said the Daily Mail, after the Charity Commission launched an investigation last year into decisions that “may have generated significant profit” for a private company run by the Ingram-Moores. The probe began with “a series of discussions with the foundation amid concerns about the way it was governed”, said The Guardian, and “escalated into a full inquiry after fresh evidence emerged of potentially serious misconduct”.

The charity said yesterday that it had “taken the decision to close all payment channels while the statutory inquiry remains open”.

The Captain Tom Foundation was set up in June 2020 after its namesake raised £38.9m for the NHS by walking laps of his Bedfordshire garden during the UK first Covid-19 lockdown. He died at the age of 100 in February 2021.

The National Health Service today celebrates its 75th birthday, but many are worried about its future, despite its illustrious past.

Under the 1948 National Health Service Act, the NHS as Britain knows it was first born, bringing together a wide range of medical professionals under one service.

Before its creation, many people relied upon “voluntary organisations and charities and insurance schemes”, said the i news site. “Quality healthcare”, therefore, was inaccessible for millions, the website added.

Since then, the NHS has come on leaps and bounds, while sticking to its original pledge to provide a “cradle-to-grave” service.

“Like any 75-year-old, over its lifetime our health service has grown and matured, adapting to the changing world around it”, said Nursing Times. However, the “signs of wear and tear” are becoming increasingly noticeable.

Experts remain concerned about how the service will tackle the increased burden it has faced in recent years. The NHS is “mired in backlogs after a tsunami of health issues”, The Times reported, with a “record 7.4 million people on waiting lists for hospital care”.

Despite strains, the public “remains passionately in support of the principles of the NHS,” said The Guardian’s Polly Toynbee, “however glum about its current state”. The health service is a “national religion”, which many continue to celebrate, she added.

The Week takes a look at some of the key moments in its history.

The government is promising “the biggest ever expansion in workforce training in the NHS’s history” as it announces “historic” plans to boost doctor numbers.

In what he described as “one of the most significant commitments I will make as prime minister”, Rishi Sunak pledged £2.4 billion over five years to train and hire more staff. More than 300,000 extra nurses, doctors and other health workers will be employed under the plans.

The prime minister answered questions about the new NHS Long Term Workforce Plan in a “Covid-style Downing Street press conference”, said The Times, but opposition politicians are already on the attack, with Labour accusing the government of copying its proposals.

This is what we know so far.

Double medical school places

Officials said the plan will double medical school training places to 15,000 by 2031, with more places in areas with the greatest shortages of doctors, said The Independent.

The document will set out to increase the number of GP training places by 50% to 6,000 by 2031 and “almost double the number of adult nurse training places by 2031”.

This, it is hoped, will “banish the service’s chronic lack of frontline personnel, its heavy use of agency staff and the increasing reliance on foreign workers”, said The Guardian.

The proposals come as officials “warned that, without action, there could be 360,000 vacancies in the health service by 2037”, said Metro.

Ramped up apprenticeships

The plan sets out to “ramp up apprenticeships”, said The Independent, so students can “earn while they learn”. It is estimated that one in six of all training for clinical staff, including doctors, nurses and other health professionals, will be offered through degree apprenticeships by 2028, including 850 doctor apprenticeships.

“We believe apprenticeships will provide a particular boost in areas where it’s harder to recruit staff and reduce barriers to entry for more disadvantaged people looking to start a career in medicine,” said Matthew Taylor, chief executive of the NHS Confederation. A new apprenticeship for doctors will be launched next year, reported Personnel Today.

Retaining staff

As well as bringing new staff in, the plan is aimed at keeping hold of those already working in the health service. Officials said the document will also have a “renewed focus on retention” – with more flexible working options and better career development.

It is “hoped these plans”, together with “reforms to pension schemes”, could mean that up to 130,000 staff stay working in NHS for longer, said The Independent.

Bot booking

The government hopes to bring more technology into the health service, said The Telegraph. It is calling for the use of “robotic process automation” to schedule appointments and operations alongside the use of AI software such as ChatGPT to transcribe doctors’ notes.

It is hoped that bots will automate booking processes up to 10 times faster than a human, while saving up to 30% in administrative costs. Sunak said this would “ensure that the NHS is fit for the future” and “modernise the NHS for the long term”.

Too late?

However, the workforce plan has not been universally praised. It has apparently been copied from Labour, said Wes Streeting. “To be fair to the government, it looks like they’re about to adopt our plan,” the shadow health secretary told Times Radio.

However, he added that the government “should have done this a decade ago – then the NHS would have enough staff today”. Liberal Democrat health spokesperson Daisy Cooper agreed that the plan “will come too late for the millions of people who have suffered in pain or died in hospital corridors waiting for treatment because the government refused to act”.

Meanwhile, the union Unison warned yesterday that ministers must not ignore “support roles”, including porters, cleaners and 999 call handlers, in its NHS workforce strategy, said the i news site.

The former neonatal nurse accused of murdering infants in her care has told a jury she is being targeted by a “gang of four” consultants and that she has “not attacked any children”.

Lucy Letby is on trial for the alleged murder of seven babies, and the attempted murder of a further ten, between June 2015 and June 2016 while working at the neonatal unit at the Countess of Chester Hospital. She denies all charges.

The trial began at Manchester Crown Court last October and Letby is being cross-examined by the prosecution for the first time.

What has Letby said so far?

The 33-year-old former nurse “always wanted to work with children” and told the jury she had been “traumatised by her arrest” when in the witness box for the first time on 2 May, the BBC reported. She added the allegations against her were “sickening”.

Letby “broke down in tears” when recalling the moment she was arrested in July 2018. She said she was “led away in her pyjamas” before she was then told of the charges.

The prosecution had previously shown the jury notes that were found at Letby’s home, which read “I am evil” and “I killed him on purpose because I’m not good enough”.

When asked why she wrote “not good enough”, Letby told the jury this was “the overwhelming thought and feeling I had about myself at that point”. She added she felt she “somehow had been incompetent and done something wrong, which affected those babies”.

Letby told the jury “she had probably cared for hundreds of babies at the hospital”, said Sky News, and that she “only did my best to care for them”. She added the allegations were “completely against everything that being a nurse is”.

How has she responded to cross-examination?

When Nick Johnson KC, who leads the prosecution, first began questioning Letby, she was “crying in the witness box”, said the BBC, prompting Johnson to ask why “she cries when talking about herself but not about the babies”. She denied this, adding “she has cried whilst talking about the babies”.

Concerned by a “coincidence between unexplained deaths, serious collapses and the presence of Lucy Letby”, consultant Ravi Jayaram told the court he walked in on Letby “as she allegedly attempted to kill a newborn baby girl” in February 2016, ITV News reported in October last year. He “found child K’s breathing tube had been dislodged”, he said.

Johnson asked Letby “why some of her colleagues on the neonatal unit suspected her of murder”, The Guardian added.

Letby said the incident “never happened” and agreed when Johnson proposed whether there was “some sort of agreement between medical staff to get you”. She continued to say they “apportioned blame on to me” to “cover failings at the hospital”.

When police searched Letby’s home, they found 257 handover sheets relating to babies on the neonatal unit. Johnson accused her of lying when she previously remarked “she didn’t keep them on purpose”. She also denied that she “fished anything out of the confidential bin”, in reference to Baby M’s blood gas reading, the Daily Mail reported, also denying “it was for [her] little collection”, as the prosecution put it to her.

What has Letby said about the victims?

Letby’s defence, led by Ben Myers KC, “outlined its arguments with regard to each baby involved in the case, one by one”, the BBC reported.

When asked about Child H, who suffered a severe collapse on 26 September 2015, Letby “denied having any knowledge of why the incident occurred”, said the i news site. She also asked bosses for help “because of the complex level of care required” and said that “the unit was struggling with a lack of staff”, she told the jury.

She added that Child F and L were “deliberately poisoned with insulin”, said The Guardian, “but not by her”.

Johnson also suggested that Letby is the “only common feature” in the collapse of the 17 victims, said the Mail, and the “shift pattern gives us the answer” if the jury agrees a certain combination of babies was harmed. “Just because I was on shift doesn’t mean I have done anything,” Letby replied.

A BBC Panorama investigation has sparked debate for suggesting that ADHD assessments undertaken at private clinics are “rushed” and unreliable”.

An undercover reporter working for the BBC underwent assessments at three private clinics, each of which diagnosed him with attention deficit hyperactivity disorder, a neurodevelopmental condition commonly referred to as ADHD.

But he was found not to have the condition after undergoing a “more detailed, in-person NHS assessment”, reported the BBC.

The investigation found that the private assessment clinics were carrying out “only limited mental health assessments of patients” and that “powerful drugs were prescribed for long-term use, without advice on possible serious side effects or proper consideration of patients’ medical history”.

The findings of the investigation have sparked debate online, with some questioning the reporting methods used in the investigation, while others feared this could add further stigma to those seeking assessment or treatment for neurodiverse conditions and disorders.

Are ADHD diagnoses on the rise?

NHS Business Services Authority data shows that 646,000 ADHD-medication prescriptions were issued between October and December 2022, a 69% increase since 2017/18, said Pulse. The health professionals magazine quoted one GP who “said the figures matched what they were seeing in practice”.

But prescription totals do not include people with ADHD who don’t use medication, said Dr Tony Lloyd, the chief executive of the ADHD Foundation. He told The Guardian that his charity’s own figures suggested a 400% increase in adults seeking a diagnosis since 2020.

Content about ADHD symptoms and criteria are hugely popular on social media sites at the moment, with posts made using the hashtag ADHD garnering almost 25 billion views on TikTok, while celebrities such as Johnny Vegas and Sue Perkins, both diagnosed as having ADHD, have also raised awareness.

Medical journal The Lancet said the average global prevalence of ADHD is around 5% – meaning that some 2.6 million people in the UK could have the condition, including 1.9 million adults.

But according to Lloyd, “ADHD remains significantly under-diagnosed and under-treated in the UK – at great cost to public services and to the individual and the workforce.”

How long does it take to get a diagnosis on the NHS?

ADHD services on the NHS have been “swamped” as more people seek a diagnosis, experts told The Guardian in January, with clinicians worried that long waiting times and a “dearth of clinical awareness” could be leaving those awaiting a diagnosis in a “perilous position”.

“I think it’s probably as big a year as we’ve ever had. We are seeing a lot more people from all walks of life seeking a diagnosis later in life, particularly women,” Dr Max Davie, a consultant paediatrician and co-founder of ADHD UK, told the paper. “At the same time waiting lists have gone through the roof. NHS services have been swamped for a while and private providers are also closing their lists – there are wildly inadequate services for ADHD diagnosis, particularly for adults.”

Knowing exactly how long people are waiting in the UK for an ADHD diagnosis is “difficult to establish”, added the paper, partly because current clinical guidelines do not recommend a maximum waiting time, and because data on the number of people waiting for a diagnosis is not collected nationally.

New analysis suggests that “800,000 people with undiagnosed ADHD may be left waiting more than a year for a diagnosis”, said Sky News.

Charlotte Colombo, a journalist writing for Stylist magazine, was told by her GP she could be left waiting five years for an assessment.

How is ADHD diagnosed?

While a set of “strict criteria” is used to diagnose ADHD in children, the condition can be more difficult to diagnose in adults as there is “some disagreement about whether the list of symptoms used to diagnose children and teenagers also applies to adults”, according to the NHS.

But in some cases, adults will be diagnosed with ADHD if they have five or more symptoms of inattentiveness, or five or more of hyperactivity and impulsiveness, listed in the diagnostic criteria for children with ADHD.

Why was the BBC investigation controversial?

It is exactly because of these “extraordinarily long NHS waiting times” that many in the UK have had to “go private for ADHD assessments”, wrote James Bloodworth in The Times. The Panorama investigation “provides important scrutiny” of the growing private healthcare industry in the UK, he added.

In some states of the US, for example, “nearly 20% of children have been diagnosed with ADHD”, continued Bloodworth, offering a “cautionary tale as to how profit-based healthcare can incentivise the over-medicalisation of society”.

The Guardian’s Robyn Vinter wrote on social media that she was “surprised by the criticism” of the investigation as “patients deserve a thorough assessment with a clinical psychologist that rules out other neurological conditions and mental health problems as the cause of their symptoms..

Journalist Diyora Shadijanova, however, argued that the investigation had failed to adequately grapple with the “core issue”, namely that the “chronic underfunding of the NHS” meant that the wait for an ADHD assessment was now years long.

And former BBC journalist Sophia Smith Galer suggested the investigation would have done better to focus on the “lengths families have had to go to fund private diagnoses & treatment for *real* experiences of ADHD because of lengthy waiting lists”.

Many online also questioned the journalistic methods used to report on the private assessments, noting that the conditions the undercover reporter was assessed under “were different for the private clinics compared to the NHS”, said HuffPost.

A BBC spokesperson speaking to the news site said the Panorama investigation “makes clear that ADHD is a recognised condition affecting many adults and it highlights the long waits for assessment and treatment on the NHS in some areas.

They added: “It is an investigation into the way some private clinics diagnose and prescribe ADHD medication following assessments conducted over online video calls. Panorama’s research has uncovered serious failings by some clinics and we think there is a clear public interest in broadcasting the findings.

“We will be reflecting serious concerns that have been raised by clinicians specialising in this field as well as individuals who have been diagnosed with ADHD.”

Racial disparities in maternal death rates in Britain have been condemned as as “nothing short of a scandal”, after an MPs’ report warned that black women are nearly four times more likely to die in pregnancy and childbirth than white women.

A scandal undoubtedly, said Candice Brathwaite in The Guardian, yet “I wish I could still feel shocked”. A 2018 report revealed that black women were five times more likely to die than white women. “Five years on, the data hasn’t changed much.”

What’s the current situation?

Between 2018 and 2020, just over two million women gave birth in the UK, according to the newly published report by the Women and Equalities Committee. During this period, 229 women died during or up to the six weeks after the end of pregnancy from causes associated with their pregnancy.

Black women were 3.7 times more likely to die than white women, and Asian women were 1.8 times more likely to die than white women.

Black and Asian women are dying from the same causes as other women “but more frequently”, said BBC health reporter Philippa Roxby. Cardiac disease is the largest single cause of indirect maternal deaths, followed by epilepsy and stroke. Deep vein thrombosis remains the leading cause of direct maternal death during or up to the six weeks after the end of pregnancy.

Experts told the committee that the vast majority of women who die, across all ethnicities, have multiple and complex health problems – but that “their risks were not always communicated to relevant staff”, Roxby reported.

The lawmakers’ report noted that women from the poorest areas of the country, where a higher proportion of babies belonging to ethnic minorities are born, are two and a half times more likely to die than those from the richest.

What is the biggest problem?

The reasons for ethnic disparities in mortality are not fully understood.

However, a shortage of staff in maternity care has been cited as a core issue, with greater investment in maternity services desperately needed.

As the cost of living continues to rise, “it is becoming unaffordable to live on a public sector salary”, which is driving away “many great women dedicated to anti-racism who want to be midwives”, said Brathwaite in The Guardian.

The Royal College of Midwives (RCM) estimates that the NHS in England is short of the equivalent of around 2,500 full-time midwives. The orgaisation’s head of policy, Sean O’Sullivan, told the Daily Mirror that with fewer staff in place, there was also more pressure on those who remain.

“It’s a vicious circle so the more that leave, the more pressure is on those who remain and that tends to be breeding ground for toxic cultures for bullying and discrimination,” he said.

To what extent is racism a factor?

There is also a “clear racial barrier” between suitable healthcare and black women, said Open Access Government, with black women frequently overlooked or ignored.

The first step to eliminating disparities “has to be recognising the role that racism plays and how it infects institutions, systems, policies and attitudes”, said Janaki Mahadevan and Shanthi Gunesekera, CEOs of the Brithrights charity, in The New Statesman.

The charity has heard accounts of “racial microaggressions and stereotyping, failure to identify serious medical conditions due to skin colour, lack of respect for culture and religion, breaches of consent, and trauma”, the duo wrote. And that black maternal death rates have “changed little in the two decades since the data started being published is nothing short of a scandal”.

There have been numerous reports of black women being ignored or told they were overreacting when complaining of pain. Tinuke Awe, who co-founded an organisation called Five X More after the traumatic birth of her son, told BBC Radio Four's Today programme that her her pain was “actively dismissed”.

“There is a stereotype of black women not feeling pain and being quite aggressive and loud, very strong, so we're able to take more pain,” she said.

Brathwaite agreed in The Guardian that “tropes still abound about black skin being thicker than white; that black people don’t need as much pain relief as our white counterparts”.

A 2016 study of white medical students in the US found that nearly half of those quizzed held false beliefs about biological differences in black patients, including thicker skin and less sensitive nerve endings.

What needs to change?

According to a Department of Health and Social Care spokesperson, the UK government has invested £165m since 2021 “to grow the maternity workforce” and is “promoting careers in midwifery”, with an extra 3,650 training places per year.

But campaigners and some politicians say more needs to be done to reduce the number of non-white women dying in childbirth.

The government has set targets for halving the total number of stillbirths and neonatal deaths by 2025 compared to 2010 levels. But targets are also needed specifically for reducing deaths among black women, Janet Fyle of the RCM told the Mirror.

“Targets allow you to adjust what you’re doing. Unless they have targets, they’ll never know what does or doesn’t make a difference”, she said.

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.

Olly Mann and The Week delve behind the headlines and debate what really matters from the past seven days. With Leaf Arbuthnot, Holden Frith and Abdulwahab Tahhan.

You can subscribe to The Week Unwrapped wherever you get your podcasts:

• Spotify
• Apple Podcasts
• Global Player

In this week’s episode, we discuss:

Women’s healthcare

A global survey revealed this week that women in the UK are increasingly dissatisfied with the healthcare they’re receiving, and suggested that the care provided here is as bad as Kosovo and Kazakhstan’s and worse than China’s. Less surprisingly, the UK ranked below the US, Australia, New Zealand, France and Germany. Analysts said the UK’s poor score was due to difficulties accessing to preventative care and slow diagnoses for chronic pain. Can the NHS do better?

The Earth’s inner core

Research carried out at Peking University in Beijing, and published on Monday in Nature Geoscience, suggests that the inner core of the Earth is now rotating at the same speed as the rest of the planet. This is a recent development: until about a decade ago, it was rotating faster than the rest of the Earth. What consequences will this have? And why do we know so little about the Moon-sized planet within a planet that lies deep beneath our feet?

Lunar new year

This week was the first of the new year in the lunar calendar, observed in China and parts of Southeast Asia. Meanwhile, in the Muslim world, we’re in the year 1444 – or 2973 in some parts of North Africa. Does it matter how we count the months and year? And what do our date systems tell us about our culture?

Patients should be allowed to bypass their family doctor to make self-referrals to specialists, said Keir Starmer.

Speaking to the BBC, the Labour leader said he wanted to “lift the burden” on the NHS by allowing more patients to contact specialists directly, “so that individuals don’t have to go to a doctor, use up a doctor’s time in order to get referred to specialist help.

“If you’ve got back pain and you want to see a physio it should be possible, I think, to self-refer,” he added. “If you’ve got internal bleeding and you just want a test, there ought to be a way that doesn’t involve going to see a GP.”

Speaking on LBC, Starmer clarified that self-referral for bleeding “would only apply for people seeing blood in their stool and needing a test for which GPs routinely referred them”, said The Times. He said getting the test without seeing a GP first was “an example” and “all of this will be subject to discussion with the professionals of course as to what would work”.

But he insisted: “We’ve got so many examples of going to a GP and then being referred elsewhere and there are examples where we think we can cut that down.”

The interview has caused a stir in political and medical circles. Here are the arguments for and against self-referral.

1. Pro: faster treatment

Self-referral “cuts waiting times” and faster access to specialist care “helps prevent acute problems from becoming chronic and reduces long term pain and disability”, wrote Karen Middleton for Health Service Journal.

During a trial in Torbay, a self-referral mode saw waiting times cut from ten weeks to less than three days for more than 90% of patients, she said.

Middleton, chief executive of the Chartered Society of Physiotherapy, felt that the pressure on the health service make these advantages ever more timely. “When GPs are under such enormous pressure, when patients are waiting longer for an appointment, when budgets are becoming ever tighter, the time for self-referral is surely now,” she said.

2. Con: potential dangers

Starmer’s example of someone with internal bleeding has raised wider concerns about the safety of self-referral. “Hopefully, we don’t need to state the bleeding obvious (pun very much intended) as to why this is utter nonsense,” said indy100.

Experts have also criticised the proposal. “As a health professional, if you’ve got or think you have internal bleeding bypass your GP and phone an ambulance,” tweeted Jon Squires, a nurse specialist in palliative care.

“For Keir Starmer to advocate self-referrals for internal bleeding is a recipe for disaster that will waste resources and cost lives,” the Socialist Health Association, Labour’s affiliated socialist society for healthcare and medical professionals, told The Guardian.

3. Pro: mental health support

Self-referral can be beneficial for those seeking help for mental health problems, according to a study.

People “may feel embarrassed” about discussing their problems with the family doctor, or “fear that they will be seen as weak and/or unable to cope”. They “may also have concerns that there is insufficient time to talk about problems”, found a study published in the British Journal of General Practice.

Also, the researchers concluded, many people “believe that their GP would not be able to offer treatments other than antidepressant medication, which is commonly regarded with suspicion”.

4. Con: encourages ‘Dr Google’

After Starmer’s interview, concerns were raised that the move could encourage people to self-diagnose online. “There is a real danger people would turn to Dr Google and inundate specialists with referrals for illnesses they don’t have,” Dennis Reed, from Silver Voices, which campaigns for elderly patients, told the Daily Mail.

Writing for the BMJ, Helen Salisbury, a GP, cited Starmer’s example of having a lump on the back of his head and needing to see a dermatologist. “How did he know that he needed a dermatologist, rather than an oncologist or an ENT specialist,” she asked, “or maybe some blood tests, an ultrasound scan, antibiotics, or just reassurance?”

5. Pro: saves money

Self-referral could free up more time for GPs, which saves funds. Up to 30% of patients seeking a GP consultation do so with a musculoskeletal complaint, such as back or neck pain, wrote Middleton, meaning more than 100 million appointments could be freed up in England alone if patients were given the choice of a physiotherapist as their first contact.

With that additional capacity comes “significant savings”, she added, and “health economist modelling” showed it “cut costs by £33 per patient, which equates to a saving of up to a quarter”.

6. Con: bad for GP morale

There is concern that self-referrals could undermine the standing and morale of GPs. Advocates for self-referral misunderstand “the role of the GP”, wrote Jaimie Kaffash, editor of Pulse.

Describing the GP as “the gatekeeper”, he said “their role is to manage undifferentiated symptoms; it is telling the difference between the harmless and the harmful rash”.

Dr Rachel Clarke, a doctor and writer on the NHS, dismissed the proposal as “monumentally stupid (& insulting) on multiple levels”, reported GB News. The “dismissal of the role of GP as a bureaucratic waste of time” betrays “spectacular ignorance of how healthcare works”, she tweeted.

“In the 106-year history of the Royal College of Nursing (RCN) there has never been a national strike,” said Andrew Fisher in the i news site. That looks set to change this winter: in a ballot earlier this month, nurses working for hospitals and other NHS services across most of the UK voted to strike (although around half of hospitals in England will be unaffected, because turnout did not meet the 50% threshold).

Their demand is simple: “fair pay for nursing”, after years of real-terms pay cuts (of about 20% since 2010). And it is in the interests of both nurses and patients that their demands are met. Nursing is in crisis. One in nine nurses left the profession last year alone: more than 40,000 in total.

This exodus “reflects terrible morale and low pay”. Nursing is “tough”; work-life balance is now the most common reason for leaving, except for retirement. And the exodus makes the job still harder. There are more than 46,000 vacancies in NHS England. Nurses can count on public support, said Polly Toynbee in The Guardian. A recent YouGov poll found that 65% were in favour of the strike, and only 27% were against.

‘Justified admiration’

“There is plenty of justified admiration for nurses,” said Ross Clark in The Daily Telegraph. We haven’t forgotten the pandemic. And unlike, say, train drivers, they are not overpaid: pay starts at £27,000 for newly qualified nurses.

But the RCN – “and that’s a trade union, lest anyone be confused, not a real college” – seems to have calculated that this means they can ask for whatever they like: in this case, a pay rise of 17.6%, more than five percentage points above inflation, though other public sector workers are reportedly having pay capped at 2%. This would cost the Treasury some £9bn.

‘Goes against nursing’

Striking also goes against a fundamental tenet of what it means to be a nurse, said Carmelah Jacobs in the Daily Mail: “that the patient always comes first”. The RCN has insisted that emergency care will be unaffected. But even so, thousands of operations, and chemotherapy and dialysis appointments, will be cancelled, at a time when the NHS is already under great strain.

“It is not too late for both sides to compromise,” said The Times. Steve Barclay, the Health Secretary, should reflect seriously on this “unprecedented action”. He won’t be able to meet their demand, but he should make a “fair pay offer” – above the current one, of around 4%.

Equally important, though, is a proper strategy “to solve the staff shortages that leave so many nurses overworked and hospitals overstretched”. Failing to reach a deal would be disastrous, “for nurses as well as patients”.

The UK is bracing itself for the largest coordinated public sector strike in years on Wednesday as teachers, rail workers and civil servants walk out over pay and conditions disputes.

“Coordination between unions in their battles against under-inflation pay settlements is becoming evident,” said Personnel Today. Wednesday 1 February has emerged “as a prime target”, with unions timing their strikes to coincide with the Trades Union Congress (TUC) national “protect the right to strike” action, protesting against the government’s anti-strike legislation.

Industrial action has “only increased in frequency and spread across more parts of the public sector” since the so-called Strikes Bill was announced, said Politico’s London Playbook. After the bill passed through the Commons unamended last night, Business Secretary Grant Shapps told Playbook that while the ability to strike was “rightly protected by law... people don’t choose when they need an ambulance or the fire brigade”. He added: “We need to maintain a reasonable balance between the ability of workers to strike with the rights and safety of the British public.”

But as it stands, the new legislation would allow employers to give a “work notice” that would identify people required to continue work during strike dates – and workers could be fired if they fail to comply. Writing for the London School of Economics Politics and Policy blog, employment law specialist Ewan McGaughey said the bill amounts to “forced labour” and is “a gross violation of international law”. Paul Nowak, the new general secretary of the TUC, called it “undemocratic, unworkable and almost certainly illegal” and said “it will likely poison industrial relations and exacerbate disputes, rather than help resolve them”.

As disputes continue, here’s a rundown of which workers are striking tomorrow and in the coming weeks.

Medical staff

Members of the Royal College of Nursing in England are not due to walk out this week although further action has been announced on 6 and 7 February. Ambulance staff in England and Wales are also taking part in industrial action on 6 and 20 February, with as many as 4,200 NHS physiotherapy staff in England due to strike on 9 February. GP practices will continue to operate as normal.

It comes after new figures from the British Medical Association (BMA) revealed strike action by nurses and ambulance staff in January forced hospitals in England to cancel 88,000 appointments.

Junior doctors are also being balloted by the BMA, and will walk out for 72 hours in March if the majority of union members vote to strike with at least a 50% turnout.

Members of the Royal College of Midwives in Wales backed strike action in December; dates are yet to be announced.

Rail and transport workers

Train drivers who are members of the National Union of Rail, Maritime and Transport Workers (RMT) and the Aslef union will strike on 1 and 3 February, with more strike dates next month to be announced.

Around 1,900 Unite members working on Abellio bus services in south and west London are also striking on 1, 2 and 3 February. Transport for London has warned that there is likely to be disruption across the capital on those dates.

Education

Wednesday marks the first day of action by the National Education Union, which represents almost half the teaching workforce. The NEU membership has voted to stage seven days of walkouts in England and Wales. The national strikes will take place on 1 February and 15 and 16 March, with regional dates also scheduled:

• 14 February: Wales
• 28 February: Northern, North West, and Yorkshire & the Humber regions of England
• 1 March: the East Midlands, West Midlands and Eastern regions
• 2 March: London, South East and South West region

The action will affect the “vast majority of schools in England and Wales”, said the Financial Times, “with the NAHT headteachers’ union warning that many would close their doors rather than compromise pupils’ safety”.

Teachers who are members of the Educational Institute Scotland are due to continue their on/off three week walkout until 6 February.

University and College Union members are also due to take 18 days of industrial action in February and March, starting with a staff walkout on Wednesday 1 February. It is estimated that more than 70,000 staff at 150 universities across the UK will walk out in disputes over pay, conditions and pensions. University staff are also taking action over “the casualisation of employment contracts” and pensions, said Personnel Today.

A full list of university strike dates is 1, 9, 10, 14, 15, 16, 21, 22, 23, 27 and 28 February, and 1, 2, 16, 17, 20, 21 and 22 March.

Civil servants

Around 100,000 civil servants are expected to strike on 1 February, “in a major escalation” of pay and working condition disputes, said The Mirror.

Members of the Public and Commercial Service Union at 124 government departments are likely to walk out, “disrupting airports and public services including benefits, passports and driving licences”.

Firefighters

The Fire Brigades Union (FBU) voted overwhelming for strike action in a ballot that closed on Monday. The union said while it had a mandate to take its members out on strike, it would not announce any dates until after it met employers – scheduled for 8 February – where the FBU said it hoped to receive a revised pay offer.

The BBC said the earliest likely date for any action would be 23 February, and if it went ahead it would be the first nationwide walkout over pay in 20 years.

Postal Workers

There are currently no strike dates announced for postal workers. However, the dispute between Royal Mail and the Communication Workers Union “shows little sign of reaching a conclusion, meaning further action is likely at this stage”, said the i news site.

Nurses across the UK will stage mass walkouts within weeks after voting to take strike action over pay and working standards.

The strikes will affect “more than half of hospitals and community teams” nationwide, the BBC reported, with nursing staff at 176 out of a total 311 NHS organisations backing walkouts after clearing a 50% turnout threshold required to hold ballots. The Royal College of Nurses (RCN) said the “strong and clear” result of the members’ ballots – the first in favour of nationwide strikes in the union’s 106-year history – showed that “enough is enough”.

Nurses will “no longer tolerate a financial knife-edge at home and a raw deal at work”, said the union’s general secretary, Pat Cullen. The RCN is seeking a 5% pay rise for its members above the Retail Price Index (RPI) inflation, currently at 12.6%. Cullen said the strikes were also aimed at raising healthcare standards that are “falling too low”, adding: “This action will be as much for patients as it is for nurses.”

The strike action is expected to begin next month and “could last until spring and affect hundreds of thousands of patients”, said The Times.

The Telegraph reported that according to a “senior health source”, the RCN “will commit to delivering a bank holiday, or Christmas Day, level of service” during walkouts, “with some chemotherapy, dialysis and planned surgery cancelled”. Under a “life-preserving care model”, nurses in A&E and in intensive care will be “exempt” from the strikes, the paper said.

Health Secretary Steve Barclay described the vote result as “disappointing” and argued that the union’s demands “simply aren’t reasonable or affordable”.

A senior hospital staff nurse told the BBC that she felt she had “no choice” but to take strike action. Jodie Elliott said that her pay had “not kept up with inflation for ten years” and that low staffing levels meant “care is becoming unsafe”.

The “unprecedented move” by the RCN comes as “other health care unions Unite, Unison and GMB are also balloting members” over potential walkouts, said The Independent.

Laboratory-grown red blood cells have been transfused into people in a world-first clinical trial.

In a development that “could significantly improve treatment for people with blood disorders and rare blood types”, small amounts of lab-grown red blood cells were tested to see how they perform inside the body, said CNBC.

The two people transfused with the lab-grown red cells were closely monitored and remain “well and healthy” and have suffered no side effects, said the University of Cambridge. This is the first time that red blood cells grown in a laboratory have been given to another person as part of a trial into blood transfusion.

How is blood grown in a lab?

The three-week process begins when scientists take a normal donation of a pint of blood and use magnetic beads to “fish out” flexible stem cells that are capable of becoming a red blood cell, said the BBC.

These stem cells were encouraged to grow in large numbers in the lab and are guided to become red blood cells. They were transfused in quantities of around 5-10ml – about one to two teaspoons – into the volunteers.

What are the benefits?

The aim of the trial is to manufacture vital, but ultra-rare, blood groups that are hard to get hold of. The University of Bristol’s Prof Ashley Toye said some blood groups were “really, really rare” and there “might only be 10 people in the country” able to donate these.

However, if they were produced in bulk in labs, red blood cells can be “tuned to have whichever blood type is needed”, said New Atlas. This addresses the two challenges the blood donation system faces: that demand “far outstrips supply” and the “extra hassle” of “matching blood types”.

Therefore, the development “could be an absolute game changer for increasing supplies of previously ultra-rare blood types”, agreed Popular Science, “and may even one day enable smaller and less frequent transfusions”.

If the manufactured cells prove to last longer in the body and patients require less transfusion, it would bring down the iron overload from frequent blood transfusions, which can lead to “serious complications”, said The Independent.

What are the challenges?

Harvested stem cells “eventually exhaust themselves”, said the BBC, which limits the amount of blood that can be grown. Therefore, “it will take more research to produce the volumes that would be needed clinically,” the broadcaster added.

Then there is the question of cost. While the average blood donation costs the NHS around £130, growing blood will cost significantly more. However, a spokesperson from NHS Blood and Transplant told CNBC, “if the trial is successful and the research works, then it could be introduced at scale in future years, meaning that costs would fall”.

What do experts say?

John James OBE, Chief Executive of the Sickle Cell Society, said the research “offers real hope for those difficult to transfuse sickle cell patients who have developed antibodies against most donor blood types” but added that “the NHS still needs 250 blood donations every day to treat people with sickle cell and the figure is rising”.

Dr Farrukh Shah, Medical Director of Transfusion for NHS Blood and Transplant, agreed that “the need for normal blood donations to provide the vast majority of blood will remain” but added that “the potential for this work to benefit hard-to-transfuse patients is very significant”.

The NHS is using maggots to clean wounds and help combat antibiotic resistance. The maggots are put into teabags that are placed on wounds, where they feast on the dead tissue, all the while oozing antimicrobial molecules to destroy bacteria. The larvae’s “healing abilities” were discovered during the First World War, said The Times, when surgeons realised that troops whose wounds became infested with maggots healed faster than others.

University ponders how to chat with aliens

A team at the University of St Andrews is researching how we could interpret alien messages. “One of the big debates is, if we get a signal do we respond?” said Dr John Elliott, co-ordinator of the team. While some scientists think we should be friendly, others feel that replying would just tell wicked aliens where to come to colonise us. “This isn’t resolved at all,” Elliott said. “Something like this would be very, very high impact,” he added.

‘Crude’ Rembrandt imitation turns out to be genuine

An oil sketch dismissed as a “crude imitation” by Rembrandt has been revealed to be the real deal, said The Guardian. Although the Raising of the Cross, from the 1640s, was long thought to have been the work of a follower of Rembrandt, the Bredius museum in The Hague, where the sketch is on display, has concluded that it was in fact painted by the Dutch master. “I am convinced that this is a Rembrandt,” said Johanneke Verhave, who restored the work.

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The NHS is meant to provide basic dentistry to all, although since 1951, adults who are not on low incomes have paid contributions for each treatment (currently, an emergency appointment costs £23.80). However, finding NHS appointments has become increasingly difficult.

A comprehensive BBC investigation published in August revealed that nine in ten NHS dental practices across the UK aren’t accepting new adult patients; and eight in ten aren’t taking on children, although children are theoretically entitled to free care on the NHS. In a third of the 200 or so UK council areas, no dentists at all are taking on adult patients; and a tenth of local authorities don’t have any practices taking on under-16s for NHS treatment. Most dental surgeries don’t even have waiting lists.

What are the consequences of this?

Most obviously, people are going to the dentist less. By early this year, only 34% of adults in England had seen a dentist in the preceding two years. In Thurrock, Essex, just 26.1% of adults had seen a dentist in the past two years (and 30.7% of children in the past year). Tooth extraction is now the most common cause of children being admitted to hospital, costing the NHS over £20m a year.

Wealthier people are going private: some 21% of people in the southeast have a private dentist. But those who can’t afford private care are resorting to “DIY dentistry”, or “dental tourism”, travelling to places such as Hungary, Turkey, Nepal for treatments as basic as fillings. Some areas of the UK, such as Lincolnshire and Norfolk, have been called “dental deserts” owing to the dearth of NHS dentists. Ashfield in Nottinghamshire has the lowest number, with just one dentist per 16,129 people.

Why is this happening?

As with the rest of the NHS, staff shortages are a critical issue. Over 2,000 out of just under 24,000 dentists providing NHS care in England quit the health service last year, according to NHS figures; 951 left the year before that. Each of those dentists would have had a caseload of about 2,000 patients, leaving perhaps four million people without access to NHS care.

So why the exodus? Some dental practices say that their staffing levels have taken a hit since Brexit, which affected recruitment of staff from Europe. Others cite the pandemic, when many foreign staff at dental practices returned home, or dentists simply reassessed their working lives. Yet many agree that the problems in their sector date back to long before Covid, and have their roots in a new contract system for NHS work, brought in 16 years ago.

What changed in 2006?

About 90% of UK dentistry is provided by independent high street dental practices, which are contracted to deliver NHS services; the government pays about 70% of the cost, patients 30%. Before 2006, dentists were paid for each piece of work they did. But the reforms of that year mean that dentists in England now receive a “block contract” from their primary care trust, committing them to perform a certain number of “units of dental activity” for a negotiated fee, paid for by the NHS.

If they don’t complete 96% of that work, they must pay back some of the money paid to them; but the amount of work they do is also capped, which is why patients are often told by practices that they cannot be accommodated. The trade body, the British Dental Association, describes this as a “broken contract” because funding is insufficient, and because the system is structured unfairly: for instance, they don’t get paid for the time and multiple appointments involved in complex cases.

Is that a fair criticism?

There’s no doubt that dentists are being driven away from NHS work. The British Dental Association says that “dentists are simply not seeing a future in the NHS”, and that if they want to do NHS dentistry, they have to cross-subsidise it with their private work. Many experts would agree.

Ian Mills, an associate professor of primary care dentistry at the University of Plymouth, estimates that the current level of funding is only sufficient to provide care for 50% of the population, because funding has reduced heavily in real terms since the contract was introduced in 2006. The problem is particularly acute now, owing to the rising costs of wages, materials, consumables, laboratory items, and to the effects of the pandemic, when as many as one in five practices reported that they were on the brink of collapse.

What does the government say?

Successive governments have recognised that the current situation is inadequate. In May, Boris Johnson’s government said it was “working closely with the NHS to reform the dental system”, and negotiating improvements to the contract with the British Dental Association.

The Department of Health and Social Care said at the time that it had made £50m available to the NHS to fund up to 350,000 extra dental appointments. The new Health Secretary, Thérèse Coffey, has included dentistry on her “ABCD” list of priorities – ambulances, backlogs, care, doctors and dentists – promising to improve contracts and “support the dental workforce”.

Are there grounds for optimism?

In the short term, not really. The British Dental Association says an immediate funding injection of about £880m is needed to stabilise the situation. But the NHS – like many public services – is currently beset by urgent funding problems, and dentistry has tended to be a relatively low priority.

That may represent a false saving: if not treated, dental problems tend to get worse, and more expensive to treat. The situation remains profoundly difficult. The UK has one of the lowest per capita ratios of dentists in Europe: 54 per 100,000 people, according to a 2020 study, compared with 65 in France and 82 in Germany. Without reform and considerable investment, the current problems will only get worse.

The NHS “horror stories” keep coming, said Rachael Bletchly in the Daily Mirror: the 62-year-old Shropshire woman who spent ten hours on a path with a broken leg waiting for an ambulance; the family in Cornwall who had to build a makeshift shelter for their injured 87-year-old father as he lay outside for 15 hours waiting for paramedics. These are just two of many such tales illustrating the dire state of the health service.

There are currently some 6.7 million people waiting for NHS treatment. Hospitals, meanwhile, are full of patients who can’t be discharged owing to a lack of care-home beds or community services to support them. This means that there’s no space on wards to transfer patients out of A&E, which in turn means that ambulances are queuing outside hospitals for hours, unable to offload patients and attend the next emergency. The whole system is “on its knees”.

“For much of its 74-year history, the NHS has stumbled from crisis to crisis,” said Ian Birrell in The i Paper. But this one feels “different, more existential”. The Covid pandemic has brutally exposed long-standing problems with the service, driving it to “breaking point” and prompting a dramatic loss of public confidence.

We’re past the stage of sticking-plaster solutions, said Nora Colton in The Sunday Times. Rishi Sunak has proposed fining people £10 for missing appointments, but that’s not going to cut it. We need much bolder reforms. Whatever happens, we’ll likely have to spend more on health, as many EU countries do.

‘Less about funding’

The NHS’s problems have less to do with funding than with how that money is spent, said Labour’s former health secretary, Alan Milburn, in The Telegraph. About 70% of health spending goes on dealing with an “ever-growing tsunami of chronic diseases like diabetes, arthritis and dementia” that the NHS is poorly set up to deal with. Hospitals are absorbing most of the cash, “when what is needed is a system geared to help keep patients healthy and out of hospital”.

With early diagnosis and treatment, many patients could be kept off wards, and many emergency admissions could be prevented. The NHS must harness new technology to aid this approach, while at the same time seeking to give patients more choice and control.

“Every NHS patient on a waiting list should be able to choose faster treatment – paid for by the NHS – at those hospitals, public or private, with the shortest wait times.” The system also needs to be made more transparent. One thing’s for sure: “doing more of the same will not turn the situation around”.

Surviving victims of the infected blood scandal will be awarded interim compensation of £100,000, the government has announced.

By the end of October, the survivors, a group of around 4,000 people, will receive compensation for having been mistakenly infected with blood-borne viruses like HIV and hepatitis C. The partners of deceased victims will also receive the payout, however, the parents and children of victims will currently receive nothing.

Family members of victims have accused the government of “perpetuating the scandal” by not recognising them, The Guardian said, after a “40-year battle” to win compensation for those affected by the mix-up.

The “urgency of the need” to make the payments was recognised by ministers, with survivors “dying at the rate of one every four days”.

The interim compensation was awarded on the recommendation of an inquiry which began in 2019 and is set to produce its final report in mid-2023.

What happened?

The infected blood scandal is potentially the “worst treatment disaster in the history of the NHS”, said Nick Triggle, a health correspondent at the BBC.

In the 1970s and 1980s, thousands of NHS patients suffering from blood disorders, such as haemophilia, were given contaminated samples of the clotting treatment called Factor VIII, leading to HIV and hepatitis C infections. The treatment was used to enable patients’ blood to clot quicker, avoiding “lengthy stays in hospital to have transfusions”, said the BBC. The contaminated blood products were also administered to people requiring transfusions for operations or childbirth.

The Factor VIII treatment was imported from America and involved pooling together the plasma samples of thousands of different donors, “including some in high-risk groups” for infection with blood-borne viruses “such as prisoners”.

Up to 6,000 people are known to have been infected after being treated with contaminated blood products, and around 2,400 people have died.

When was the inquiry launched?

The inquiry into the scandal was launched after years of campaigning by victims and their families in 2018 and has been led by former judge Brian Longstaff. Victims called for the inquiry after claiming that “the risks were never explained and the scandal was covered up”.

In July, the inquiry recommended the government issue interim payments “without delay” to the surviving victims before deciding on final compensation when the report concludes. An open letter by campaigners was then delivered to Boris Johnson, urging payments to be made as quickly as possible with over 400 victims dying since 2017.

The delay between the inquiry’s recommendation and the government’s announcement was because ministers had been “looking very closely at how best to right this historic wrong”, a government source told The Telegraph.

The government said in its announcement this week that the payments would be “tax-free and will not affect any financial benefits support an individual is receiving”.

What has the reaction been?

Johnson said making the interim payments was the government “taking action to do right by victims” but added that “nothing can make up for the pain and suffering endured” by victims.

The compensation was a “significant milestone” after decades of campaigning, Kate Burt, chief executive of the Haemophilia Society, told BBC Breakfast, adding that there should be “no further delay in looking into a full infrastructure for compensation” by the government.

Victim Richard Warwick told The Guardian that the interim payment was just the start of “meaningful compensation” and that it was “shameful” that it had “taken the government so long” to admit fault in the scandal. He accused the government of delaying payments because “the more people die the less they will have to pay”.

Parents and children of victims who have died will “continue to fight” for recognition and compensation. Campaigner Sue Threakall, whose husband died in 1991 after being treated with contaminated blood, told the BBC it is “not just about money” for bereaved family members, but “recognition of people whose lives have been destroyed”, including parents who lost children in the scandal and children who grew up without parents.

Lauren Palmer, whose parents both died of Aids as a result of the scandal, told Sky News that she had been unable “to lead a normal life”, questioning how the government had established “this hierarchy between bereaved families”.

Pharmacists have warned that a shortage of some medicines is putting patients at risk.

A survey of 1,562 UK pharmacists for The Pharmaceutical Journal found that 54% believed patients had been put at risk in the past six months due to shortages.

One pharmacist working in a GP practice in England told the publication that they were “always firefighting”.

“Presently, hardly a week goes by without at least one pharmacy asking us to give an alternative,” they said, adding that this can be “quite dangerous” and “creates a lot of stress to both patients and professionals alike”.

Sky News said that the government has issued a number of “medicine supply notifications”, highlighting shortages of certain drugs, including one used by prostate cancer patients, an antipsychotic drug used among bipolar disorder and schizophrenia patients, and a certain brand of insulin.

The NHS is also said to be facing a shortage of epidural kits, a key form of pain relief during childbirth, as well as Remifentanil, a painkiller that women are offered as an alternative.

Supplies of both are so low that some hospitals are no longer able to offer pregnant women the standard right to choose which one they want to reduce labour pains, said The Guardian.

Anaesthetists told the paper that this has led to “difficult discussions” with women who had been told they would be given a choice.

A Department of Health and Social Care spokesperson said it works “closely with industry, the NHS and others to prevent shortages and resolve any issues as soon as possible”.

There have also been shortages overseas. The European Medicines Agency has experienced low supplies of a drug that is used frequently in IVF procedures, said Endpoints News.

Meanwhile, Australia faces “dire” medicine shortages, with more than 300 drugs in short supply, said The Guardian.