I’m glad Boris Johnson is healthy again so I feel no remorse in criticising him and past Tory governments’ health policies. The NHS would not have needed a “human shield” or been “overwhelmed” (as per Pope Bojo’s Easter address) had it not been underfunded for a decade or been a political football kicked about during Brexit and elections. Our “greatest national asset” deserved treasuring and resourcing in the good times so that during the bad, the human shield could use it rather than be used by it!
We have 5x fewer hospital beds per capita than Japan and South Korea – some of the countries best handling Coronavirus, 3x fewer than Russia or Germany, 6x fewer ICU beds than Germany, 3x fewer ventilators than Russia.
We have the 4th highest bed occupancy rate of 41 nations, with typically less than 5-15% capacity left for crises. The NHS is overwhelmed.
“The number of hospital beds for general and acute care has fallen by 34 per cent since 1987/88, the bulk of this fall due to closures of beds for the long-term care of older people.” – King’s Fund Data
That’s the very group Covid-19 is affecting the most.
“In 2018/19, overnight general and acute bed occupancy averaged 90.2 per cent, and regularly exceeded 95 per cent in winter, well above the level many consider safe.” – King’s Fund Data
Out of 53 nations in the WHO greater European area, only Georgia and Andorra had fewer acute hospital beds per capita than the UK!
People shouldn’t be a human shield – and NHS staff should be properly shielded with decent PPE. A Human Shield is the language of terrorism. Underfunding the NHS is economic and political policy domestic terrorism! It’s an act of national vandalism and misguided austerity ideology. It’s not just hindsight saying this, doctors and nurses bodies, non-right wing parties, patient user groups, have been saying this for years. It’s too late to listen now.
Boris Johnson has used the rhetoric of Churchill and termed Covid a “national battle”. The language of warfare is about right, only the war is on our NHS. Stay Home, yes. Protect Our NHS, Save Lives, YES. But the latter should have been being done through Government policy the last decade. Invest in healthcare and its professionals, pay nurses, recruit doctors, appreciate foreign staff, build new hospitals, support mental health – that will Protect Our NHS and Save Lives, pandemic or not!
Well, the “meaningful” Brexitvote happened but didn’t seem to mean anything. The worst Government defeat in modern history by a margin of 230 votes and an unheard of stubborn clinging to power, despite a No Confidence vote. The previous worst was 95 years ago in 1924. On most occasions, resignations and lost elections followed. Momentous. Since Parliament cannot agree and only 25% of the population (admittedly, 52% of the electorate that voted) wanted it and even they are split on Deal/NoDeal, now is the time to delay or rescind Article 50.
“It’s a weird state of affairs. No-deal and People’s Vote are the two obvious options which hang over everything, but neither the prime minister nor the leader of the opposition are prepared to countenance either of them.” – Ian Dunt,Politics.co.uk
Theresa May and Andrea Leadsom are stubbornly standing their ground. Plan B = Plan A till you’re blue in the face. They knew the Brexit vote would fail yet wasted 5 weeks delaying it. They have no “political empathy” said one journalist. 70 days from disaster and we haven’t a clue. No deal and Remain are both political suicide for whoever makes that happen but history could record them later as a hero or a villain.
It’s astonishing that after the largest 230 seat Government defeat people retire to party political lines and this current leadership (if it can be called that) is shored up to go on and on with flogging the same dead horse deal. It’s almost national unity Government time. This Brexit political war must end.
“We’re going to have to chuck the party politics out, junk it, frankly and work together in the national interest to come to a solution.” – Chuka Umunna , Labour MP
Though I’m personally in favour of Remain still and actively want Article 50 abandoned or extended and Brexit cancelled, Labour can’t defeat the political maths of Tory+DUP, and so we drag on till exit EU day on 29 March because nobody will fall on their political sword for the sake of the UK bigger picture.
If a deal is impossible, and no one wants no deal, then who will finally have the courage to say what the only positive solution is?
Brexit may have won the first People’s Vote aka EU Referendum but no actual exit strategy commands a majority in Parliament or the country. Somebody needs to stand up and be honest about this, commit political hari-kari, and say it can’t be done.
We need to get past this Brexit hangover and get back to work, sorting out housing, homelessness, knife crime, Universal Credit, NHS and Care recruitment, police funding, trains, 5G, fibre to the premises for all. The cost of doing business within the EU is small change compared to Brexit’s waste of time & money.
Multiple economic forecasts say we will be worse off because of Brexit with much slower growth. The IMF, OBR, UK Gov, BoE, NIESR, BCC, Capital Economics, EY and more. The Bank of England’s Quantitative Easing (QE), consumer credit rise, and low-interest rates are currently insulating us from the Brexit effect. We are in Balance of Payment trade deficit despite the crashed Pound (at airports we are virtually on a par with the Euro now!). We net export in services, not goods.
This is the modern globalised world now, we are not a net industrial producer anymore, we don’t have the economies of scale or labour costs. Imagining that Brexit will make Britain productive again in traditional industries is like Donald Trump’s Make America Great Again. A recent report from Standard Chartered has Japan 9th, Germany 10th, and the UK outside of the top ten GDP nations by 2030. Only as a bloc will EU nations be able to trade on equal terms with India, Brazil, China etc.
It’s the issue of hundreds of Japanese companies invested in the UK, in part to access the EU market. There are 190,000 direct and another 650,000 indirect jobs in the UK dependant upon car manufacturing for instance.
“There is no Brexit dividend for our industry” – SMMT
We have a non-reproducing working population (replacement fertility rate of 1.8, required 2.1), we need sub £30k (the new immigration minimum) EU and international workers. We have labour shortages in the care sector, NHS etc. Who will pick fruit, wash dishes, wipe bums, change catheters, serve tables, hand wrap millions of pigs in blankets for Christmas? UK workers alone, or even at all?
“Inadequate” is such an insipid inadequate term to describe an abject failure to manage critical mental health services and to continue over 5-years to fail to improve.
Norfolk & Suffolk NHS Foundation Trust is the seventh largest mental health trust in the UK, running over 100 community
services across 50 sites and GP practices for 1.6 million people in an area of 3,500 square miles for £227m a year. In any one month they may have 25,000 patients being seen or served. No small feat.
I’ve had great NHS care and compassion, supported by superb individuals via NSFT, Wellbeing, CMHT, Therapy services within Norfolk Mental Health – indeed CQC scored it “Good” for caring. However, the waiting lists for many are criminally irresponsible. This isn’t even my usual rant about transgender waiting lists, although they form a part of mental health. The Government austerity cuts and CCG and NSFT financial and provision managers are presumably to blame as every other trust must be facing similar challenges. Mental Health services remain grossly underfunded and in crisis. Parity for mental health services with physical health and its 18-week guarantees are years away. NSFT tops the table in the worst possible way, making national news today. Norwich topping the football – great; NSFT topping the worst mental health care trust for 5 years – fail!
“NSFT doctors first raised concerns over cuts in January 2013, as more than 500 mental health jobs faced the axe in what was known as a radical redesign of services. Senior psychiatrists warned at the time that patient safety would be put at risk and said the trust was being “downright dishonest’’ for failing to state that the cuts would have detrimental effects on patient care.” – EDP
I had to fight for well over a year to get seen, assessed (I was “lost” in the system three times but with zero response to internal complaints raised), and keep my care – which I am losing in 3 months – apparently, long-term mental health symptoms can be in “recovery” (mine can be episodically), and bipolar and anxiety disorder be signed-off.
“36 people had waited five years to be seen and 2,732 were waiting for their first contact with services… 2,400 adult patients across the trust had not been allocated a care coordinator in community mental health services.” – EDP
This is the problem when capitalist market budgeting is applied to health, and recovery models applied to long-term ailments. I prefer a “discovery” model that supports but doesn’t focus on discharge until you yourself know you are ready. Instead, a benefits and unemployment model of punishing mental health as if it was an aspect of an alleged “work-shy” culture leads to shaming those in need of its services and a seemingly deliberate or incompetent policy of actually signposting ease of access to services resulting in many people never even finding the door, let alone making it through it. Whilst I am currently being “shown the door“, having had an exit strategy meeting, others are shown the door but not let in. As many friends of mine know all to well, just as with PIP applications and appeals, if you weren’t ill when you asked for help by the time you eventually get it the very wait will have made you ill, and certainly resulted in a deterioration of any conditions you have.
“The Care Quality Commission found patients desperately needing care were waiting so long for help they harmed themselves or took overdoses during delays – or were being turned away completely…Staff were covering up the length of waiting lists by allocating patients to staff or running several lists whilst agreeing that nothing would be offered until space was available. And some patients had been waiting five years for help.” – EDP
During a suicidal day, several years ago, I rang the 24hr acute line at Hellesdon on a Friday night and got a locum of some form who said: “I can’t help you, I can’t access your notes at a weekend” and was generally unintelligible and useless in several other ways. I never rang them again.
With a history of suicide, I’ve learned to stay alive by building my own care package and it includes my partner, friends, Wellbeing, CMHT – the “severe and enduring mental health needs” service (keeps getting renamed!), cats, honesty, whisky, and avoiding pills as an accessible suicide kit.
I have nothing but praise for 95% of the frontline staff who’ve helped me. I would not have survived continuing mental health challenges and rebuilt some of my life had it not been for my care team who have gone above and beyond their job descriptions to support my whole wellbeing and not just my mental health. That has included helping me with referrals to physio and general health, and applying for Housing Benefit, PIP and ESA for me, when I was in no state to do so. They are my heroes. The system of cuts and carelessness elsewhere that meant I needed them has probably meant that others have had less support or are still waiting.
“We want services which are provided for those who most need care. That may mean those who don’t have as much need wait a little longer.” – Antek Lejk, Chief Exec NSFT, EADT
Clearly, they are people that carry on caring despite the system and resources they are forced to work with. It is a wonder why so many keep working and don’t leave. Indeed, NSFT has 1-in-4 unfilled nursing posts.
“A perfect storm of cuts, incompetence and stigma has seen services unravel, with people struggling to access services, being discharged too soon, and staff under intolerable pressure with unmanageable caseloads. Following a savage real-terms budget cut, the number of doctors has been reduced by 51 (around 25pc) and the number of nurses by 163 (1 in 8) compared to when the trust was formed in 2012, while referrals have rocketed. The number of patients referred but still awaiting their first contact is 2,732 (as of October 12). That’s a lot of people in distress, without support.” Emma Corlett,EDP
When the CQC interviewed me for a previous report, I said that continuity (and accessibility) of care were critical as my care team kept getting changed or staff going off long-term sick themselves (probably stress at work based).
What happened? Three months later they shuffled the deck chairs (a “radical redesign” no doubt) and changed my care-co again, and I’ve had 3 more since. NSFT is that Titanic on which the deck-chairs get regularly rearranged rather than addressing the approaching iceberg of yet more service-users drowning in a cold heartless sea where the lifeboats are knocked-off the list of necessary equipment to save money.
“The key to keeping people safe is a trusting relationship. How can that be possible with repeated, persistent disruption. Worse of all, it’s deliberate disruption as like you describe, inept managers with a lack of a clue about what else to do opt to do another reorganisation, over the heads of staff and in some cases not even bothering to tell the service user.” – Emma Corlett, Nurse and Norfolk Councillor
This month saw World Mental Health Day. For the other 364 days of the year, we are forgotten. Austerity Britain has affected mental health services more than most. Despite promises to ringfence the NHS and bring parity between physical and mental health, this has not happened. Instead, beds have been cut, jobs have not kept pace with population growth, and my own trust, NSFT, has been placed back into special measures again, after being the first mental health trust in the country to be sanctioned in this way by the Care Quality Commission (CQC) in February 2015.
Mental health awareness and NHS service provision improvements are sorely needed as referrals have risen 20% in Norfolk and Suffolk, but staffing and beds have been cut. Complaints, locally, have risen from 430 to 592, 2013-16. The latest CQC report criticised inadequate staff and bed levels but praised staff the caring attitudes of staff as ‘good’.
2010-20 will be the most austere decade in NHS history
2010-17 UK population rose 5%, mental health staff up 0.87%
2011-14 33% rise in Police cases with mental health component
2010-13 56% rise in self-harm and suicide
Mental health at work costs UK economy up to £99bn
Entitlement to be seen <18 weeks applies to mental health too
A week ago, BBC Radio Norfolk ran a mental health week focus with Stephen Bumfrey featuring it each afternoon, and coming together with Nick Conrad, Sue Tebble and myself, on Friday 20th, for an hour-long special. (iPlayer episode – 2hr 32m in)
“overall if you look across the country there is a good record of actually being able to move trusts out of special measures” – Theresa May
This makes the failure to resolve the local NSFT crisis all the poorer. Patients, or the politically correct – ‘service users’, have complimented the staff but criticised the system, waits, and other failures. Patient deaths and out of hospital suicides have increased whilst beds and budgets have been cut. Hundreds of patients were sent out of county owing to the lack of beds, up to 225 miles away!
In 2012/13 the trust reported 53 unexpected deaths, 105 in 2013/14 and 14/15, 139 deaths, rising again in 15/16 to 158, and 140 in just 9 months of 16/17. When standardised for age it is above the average for England. The figures have risen across all regions during NHS austerity under this government, from 47 per 1,000 to 59 in England – up 25%, but from 44 to 66, a rise of 50% in Norfolk & Suffolk.
Jeremy Hunt, the Health Secretary, has boasted that provision for mental health has “got better” and that he has increased staffing by 30,000 posts. The reality of the lie, and statistics do indeed damn him, is that 4,100 mental health nurses, 4,596 mental health trust beds, have been cut, and just 692 extra staff employed – an increase of just 0.87% over seven years, despite population growth of 5% during that time – so, in other words, a cut!
“Although NHS funding is rising in real terms, current plans mean that 2009/10 to 2020/21 will be the most austere decade in NHS history. Total spending on the NHS in England increased by an average of 1.2% a year under the 2010-15 coalition government (0.9% for the UK), and is set to increase at the same rate under the current Conservative government. Between 2009/10 and 2015/16, spending increased from £109.1bn to £119.0bn and is planned to rise to £123.2bn in 2020/21. This growth rate of around 1% is below the historical average for the UK of 3.7% per year.” – The Health Foundation
Norfolk has a pioneering mental health within Police HQ service, but nationally, there has been a 33% increase in cases with a mental health component 2011-14. As much as 40% of Police time is spent dealing with mental health-related issues.
Eighteen Weeks, as if!
Under the NHS constitutional pledge, patients have a right to be treated within 18 weeks of referral, including mental health.
“the new waiting time standards will be as follows: 75% of people referred for talking therapies for treatment of common mental health problems like depression and anxiety will start their treatment within 6 weeks and 95% will start within 18 weeks.” Pledge of 2014 to be delivered by April 2016.
Yet, the wait for some treatments can be more like 18 months. Just try requesting something more complex than CBT or other less time-limited ‘quick-fix’ therapies. IAPT referrals seen within 6 weeks were apparently 93-96% in Norfolk and Suffolk.
My personal experience, and that of several friends, has been of much longer waits. Calling the acute care line at weekends can result in complete ignorance or lack of access to your medical records. Support lines have historically been cut. People fall between the cracks, and I know too many people no longer with us due to mental health funding and systemic failures.
Discovery or Recovery
Discharge centred mental health, is solution based, with as much an an economic imperative as a wellbeing focus.
“securing a minimum of 50 per cent recovery rate from treatment” – NHS
Mental health in Norfolk has a Recovery College, a course-based approach to improving wellbeing. I prefer to see it as a discovery-centric way of improving self-management with community support. Some mental health issues do not just resolve, yet the NHS insists on “developing a recovery culture” (p13) in mental health which fails those with long term or lifetime conditions.
74% of NSFT patients represented with mental illness symptoms within 6 months, compared to a national figure of 63% (2015 data).
IAPT (Improving Access to Psychological Therapies) approaches such as CBT serve best those with mild to moderate conditions, whereas moderate to severe need additional and more specialised help, as e.g., with OCD.
Between 2010-13, there was a 56% rise in self-harm and suicide across 52 NHS mental health trusts. It has been suggested that the over-capacity of up to 138% and staffing cuts has increased the risk of incidents.
I find the language, even if it has a clinical meaning, and the reality of response to people at risk of suicide, horrifying. The provision of “low level psychiatric support” was referenced in a Norfolk and Suffolk response it its higher than average suicide rate:
“There is a gap between the Wellbeing Service, the counsellors employed by GP practices and what is on offer via the mainstream mental health services. Suicide rate in Norfolk & Suffolk is high. GP referrals to MH are only accepted 20% of the time. GPs are left to manage risk the rest of the time.” – NSFT, pp11-12
The apparent aim is a “reduction in referrals to mainstream mental
health services by offering more low level psychiatric support in primary care.”
Care not Cuts
What worries me, is the low level of funding, of staff, of beds, and the cure rather than care attitude of the system. In contrast, the caring attitude of the staff is to be praised, and they need additional in-work support themselves to be able to deliver services under such tight austerity conditions.
2. Marching against multiculturalism (EDL & Britain First) and not getting the irony of bemoaning Halal ingredient sourcing in Tikka Masala – seeing curry as British and Christian!
Following a recital of the Lord’s prayer, Golding warned his audience about east London’s Brick Lane and its apparent “mobs”, telling supporters he was also finding it impossible to eat tikka masala now because of the preponderance of halal meat. Golding added: “We are the face of the future.” – The Guardian
5. Demanding the right for the UK to leave the EU but not for Scotland to leave the UK.
6. Wanting cheap food (Aldi and Lidl – German supermarkets), wine (usually French, Italian and Spanish) and clothes, yet not acknowledging the labour and sources that go into making them, whether in Lincolnshire fields at 5am, Eastern Europe, or further afield.
7. Loving foreign holidays in countries whose nationalities you spew at when back home, and expecting them to speak English in England, AND English when you visit them as a tourist abroad.
8. Wanting more money and jobs but not the endeavour, hours, productivity and wages that go into building a business. Immigrants are more likely to start self-employed businesses, contribute more to the economy, create employment than nationals.
9. Opposing immigration but not one’s own genes and forebears who are probably part Norman French, German Saxon, Norse Viking, Flemish-Dutch, Irish etc.
10. Add your own – the list could go on…
It’s an imperialistic (Great) Britain First attitude that takes what it wants from the world but does not give back or support the world from which it has taken. That, to me, is not Great Britain and the United Kingdom, but Lesser Britain and the Broken Kingdom.
We need to remember our roots, celebrate cooperation and community, discover disparate cultures and diverse expressions, and learn to share our resources with our European and global neighbours. Not to mention stamping out hate, xenophobia and bigotry wherever it rears its ugly head.
The West London Mental Health Trust (WLMHT) has issued a statement and then after mass trans patient panic (well a few of us!) has clarified it. The Gender Identity Clinic at Charing Cross Hospital (CX GIC) is not to close but to seek new NHS England oversight, preferably not under the auspices of mental health care. This is both unnerving for existing patients on the long waiting lists and potentially radical.
We are committed to running the Gender Identity Clinic until @NHSEngland find a new provider for the service. It will not close.
The Charing Cross Gender Identity Clinic is, in their own words, “the largest and oldest clinic of its kind dating back to 1966”. The same year that Harry Benjamin published “The Transsexual Phenomenon“.
UPDATE: It has been confirmed that from April 2017 the Tavistock and Portman NHS Foundation Trust will take over the management and funding of the Charing Cross GIC, without its location changing. The T&P NHS FT also run Tavistock GIDS, London (child and adolescent service).
NHS Hospital Cuts
All this comes the same day the NHS has announced further cuts in a spiralling financial crisis – the biggest in its history, requiring the euphemistically named “sustainability and transformation” plans, in other words, “cuts”.
“We are seeing more and more pressures on staff trying to run harder and harder. We are reaching breaking point.” – Chris Hopson,Chief Executive ofNHS Providers
West London Mental Health Trust statement
The Gender Identity Clinic at Charing Cross plays a leading role nationally and internationally in helping people experiencing gender dysphoria to feel more comfortable in their own bodies.
West London Mental Health Trust (WLMHT) is incredibly proud to have been at the forefront of developing gender identity services during a period in which societal attitudes and understanding of this issue has improved so vastly, and that the Charing Cross GIC and its staff have, since 1966, helped nearly 7500 people to lead happier, healthier lives.
Demand for gender identity services has risen sharply in recent years as society has grown more understanding and awareness of NHS services has developed. This has been challenging for the clinic and resulted in waiting times that are longer than we would like. However, the clinic’s staff have continued to invest huge amounts of energy and, working with NHS England, have made great strides in bringing these waiting times down while still providing a service which is rated highly by patients.
However, as WLMHT moves forward it is necessary to refocus the services that we provide. The Board has made a decision that the medium-term strategic focus for the Trust will be to develop mental health services, physical care and integration between the two.
As a result, the Trust has come to the conclusion that patients requiring gender identity services would be better served in the long term by another provider, and has therefore served notice on our contract to NHS England.
We know that many of the patients we see at the GIC are at difficult times in their lives and that this announcement may cause alarm; we would therefore like to offer the following reassurances:
This does not mean services are stopping now – we will continue to provide services as normal until such time as a new provider is able to take over; this is likely to be at least six months.
Patients from London and the South East will not be left without services or have to travel much further – NHS England as the commissioner for gender identity services will find a suitable alternative provider as quickly as possible.
Patients will not have to start their treatment all over again – continuity of care for our patients is the number one priority for clinic staff. GIC staff will work closely with NHS England and a new provider to ensure disruption to treatment is kept to an absolute minimum.
This does not mean we will let services deteriorate – WLMHT and the GIC will continue to deliver on plans we have developed with NHS England to improve access to and quality of services while it continues as the provider.
We will not reduce staffing levels – while we remain the provider of this service we have an obligation to ensure there are sufficient qualified staff to maintain and continue improvements in access and quality.
We will ensure a smooth handover to the new provider, working closely with our colleagues at the GIC and NHS England
Dr James Barrett, Lead Consultant at the Gender Identity Clinic (GIC), on behalf of GIC clinicians, later clarified:
“The gender identity clinic is not closing. To clarify, we clinicians have long felt that West London Mental Health Trust is not a good fit for the unique and specific service we provide (the vast majority of those we see are not mentally ill).
“Increasingly, we feel our patients would be better served by us if we worked somewhere better able to support and develop a more tailored approach to gender.
“There are a number of options in terms of alternative providers. We would not make any move unless confident that patient care would be markedly improved.
“Until that point, current arrangements will still apply. Our aim is for any change to be a positive one, and any transition to be as seamless as possible.”
CX GIC psychiatrist, Dr Stuart Lorimer, sought to reassure people:
Okay, so Charing Cross GIC is *not* closing. It’s about the gender clinic preferring to be hosted by a non mental health provider.
Waiting times for first appointments at the Charing Cross GIC are currently around 12 months from the initial referral but can often take 3-7 years in total, when you include surgery which only takes place after two psychiatric approvals and a pre-surgical assessment.
Referral times are not only a postcode lottery but constantly change – both up and down, according to staffing, and ever-increasing transgender service user demand. Norwich, alone, refers 50-60 adults a year not including the dozens of trans teens not yet in the adult system. It recently shifted its gender dysphoric population from Charing Cross to Nottingham GIC, having also, in the past, used Dr Richard Curtis’ TransHealth in London.
UK Trans Info has an excellent resource offering waiting times and estimated trans population surveys of all the GICs every three months. Last year Leeds were quoting 4 years for first appointments and Sheffield over 18 months! Nottingham’s 8 months has risen to 12 and now 18-19 months.
“Nottingham’s GIC saw the most marked growth, with a 2800% increase from 30 referrals in 2008 to 850 in 2015. More than 1000 are expected this year.” – Pink News
UK Trans Gender Identity Clinics
There are 7 adult and 1 adolescent-teen GICs in England, serving England and Wales – Wales has none of its own and London’s Charing Cross GIC also serves them. The Tavistock and Portman is the sole young person clinic in England, based in London, but with clinics in Exeter and Leeds.
Scotland has 4 adult and 1 adolescent clinic. Belfast Health and Social Care Trust runs an adult and separate “Knowing Our Identity” (KOI) service for children and teens.
For a full list and contact details see GenderAgenda’s UK GICs page.
More lies from Leave.EU and UKIP‘s ‘normal Nigel’ – I’m glad I’m not normal! Presumably, unlike Nigel Farage and his supporters, I’m not real, ordinary or decent, either! That said, he stood by his convictions, and was more down to earth than other EU or UK politicians, no wonder his message, however much I disagree with it, clicked with an increasing number of working class people. The worry – where do we go from here and what next for English and other nationalists? Democracy sucks when you’re on the losing side!
“We’ve got our country back” – Nigel Farage
“Dare to dream that dawn is breaking on an independent united kingdom…” – Nope, we are disunited and the Kingdom is likely to fracture and Vote Leave the UK next.
“a victory for real, ordinary, decent people” – What does that make Remainers?
“we have done it without having to fight, without a single bullet being fired” – Tell that to Jo Cox MP.
“let’s get rid of the flag, the anthem, Brussels and all that has gone wrong, let June 23rd go down in history as our Independence Day”
Destroying the EU and the UK?
“The E.U.’s failing. The E.U.’s dying. I hope we’ve knocked the first brick out of the wall.” – Nigel Farage
And so it begins. The BBC described the UK’s Brexit as “receiving a rapturous welcome from Europe’s far Right”, Donald Trump and Vladimir Putin. Worrying praise indeed.
Geert Wilders calls for E.U. Referendum in the Netherlands, “The Netherlands will be next”, he said. A Dutch television station Een Vandaag had a recent survey polling that a majority of the Dutch would vote ‘Out’ on a European Union referendum.
In France, Marine Le Pen said that “The French must now also have the chance to choose”.
Victoire de la liberté ! Comme je le demande depuis des années, il faut maintenant le même référendum en France et dans les pays de l’UE MLP
The last day of Women’s History Month, the day before April Fool’s, is the International Trans Day of Visibility (TDOV), 31 March. Since 2009, it has sought to celebrate transgender positivity in contrast to the Transgender Day of Remembrance (TDOR) events around 20 November that draw attention to the high levels of violence and murder that trans people suffer in some countries. Even where murder is less likely, bullying, harassment, and discrimination can be part of the transphobic package that can add to the likelihood of suicide, which some 40% of trans people attempt, and twice that number, consider.
TDOV is an opportunity to portray positive role models, to let the many trans just coming out know that “it gets better“. I’ve spent ten plus years ‘out’ and it’s been a rocky road, with the almost requisite marriage break-up, suicide attempts, looks in the street, and transphobic abuse online. But that need not be everyone’s experience and for many, it is getting easier, with better support and a more accepting society.
Ironically, many trans people don’t want to be visible, they’d rather not be noticed, hopefully passing as fellow human beings in a crowd. Inevitably, some of us stand out more than others, some by choice, some by fate. Don’t always assume a trans person wants to be recognised or feted as one, many would rather be seen as your common or garden variety man or woman. I’m of the louder and more visual variety, who’ll probably die still not conforming to gender stereotypes and expectations.
Non-Binary leads to inevitable visibility
I’ve found, indeed, that being non-binary is a better fit for me than the discrete categories of man or woman, male or female, boy or girl. I, personally, don’t mind whether anyone sees me as a “real woman” or not, I know basic biology, although mine is more complex and many people exist that makes one think again about binary sex default and gender constructs.
I am, however, also not a “real man”, that too is fine! Perhaps, as one of my godchildren once cheekily remarked to me upon opening the door, saying, “Half-ladies first”, I am a “Shim”, also his delightful invention. Other people should be respected, however they prefer to be addressed.
Whilst 2014 has been regarded as the “Transgender tipping point”, 2016-17 seems to be the year of Non-Binary Genderqueer and Genderfluid. In January, National Geographic ran a “Gender Revolution” special issue, and this March, TIME Magazine ran with “Beyond He or She”.
Half of young people now see gender as a spectrum and identify their own sexuality between gay and straight. Most now know someone who is trans and/or non-binary, and they are broadly accepting, the best it has ever been, teaching older adults the way to be around identity and expression. Whilst traditional feminists regard gender as a construct, it is young women who are most likely to see it as a spectrum, blurring the lines between gender and sex. Some 22% of young women identify as other than 100% female.
To be honest, I haven’t had it too hard, people have been accepting, and although gender dysphoric, at times I’ve been euphoric to finally be myself. Even with some trials and tribulations, it has been worth it.
My ten-year journey as Norfolk’s “most reluctant transsexual” – as my psychiatrist once called me, has recently closed one chapter and turned the page to another. After nearly 6 years on hormones my resistance towards surgery shattered and I went ahead with a version of GRS that suited my identity and needs. It has made me a happier, healthier person, with no regrets. Rather surprisingly, to myself at least, it has improved my other mental health condition, bipolar, for now at least, with just pockets of extreme downs, rarer hypomanic highs, and many more days of productivity and calm.
In going ahead with surgery I found my mind changed as much as my body. It really was life-changing, even saving, surgery. Whilst I had near constant doubts leading up to it, I’ve had none since that no-going-back day of 6 February 2016, and felt as much lighter between the ears as between the legs. I feel like a psycho-emotional brain tumour has been removed, I have more space in my head, in my thoughts and feelings, no longer obsessed and disturbed by gender identity. I feel no more female, just less encumbered and more myself. Oddly, I feel just as non-binary, non-conformist as ever, and, if anything, less gendered, though more comfortable in my body.
Prevalence of transgender people
I am but one of millions of trans people worldwide, more than a million in the USA alone, perhaps 300-600,000 in the UK or more. The NHS used to say that there were around 1-in-30,000 people born male (AMAB) transitioning to female (MTF) and 1-in-100,000 people born female (AFAB) transitioning to male (FTM). Those serious underestimates are reflected in the huge waiting lists of 1000s of people to access the handful of UK Gender Identity Clinics (GICs).
Given that the incidence of trans people seeking NHS help is now around 7,000 new referrals p.a., figures over an adult working lifetime would suggest a prevalence of 300,000-600,000 adults, around 0.5%-1% of the population, 1-in-200 or 1-in-100 people, perhaps more. In addition, For every trans person not seeking HRT or surgery there are four or five feeling and presenting as gender questioning or non-conforming. Recent surveys suggest 2.5% may identify as non-binary, 1.75% may be born intersex, and 2% may identify as trans or genderfluid. Overlap between these populations may suggest around 5% total, 1-in-20 people. This isn’t to conflate intersex with trans, just that some can be both, and it shows the degree of sex and/or gender atypicality in the population as a whole.
Visible Trans Persons
In the UK we have many visible trans already such as the comedian, actor and now marathon-addict, Eddie Izzard. Other trans comedians include Bethany Black and Andrew O’Neill. Then there’s the arts writer and ceramicist, Turner Prize winning artist, Grayson Perry. In the world of journalism, there’s LGBT Pink List-topping radio and print journalist Paris Lees, along with several contributors to the Guardian newspaper such as Jane Fae, Juliet Jacques, and Roz Kaveney. In the field of law and diversity, Professor of Equalities Law at Manchester – Stephen Whittle, Christine Burns, formerly of Press for Change, Rachel Reese of the University of Law, law partner Clare Fielding, and barrister, Caroline Harrison, QC.
In sport, there’s recently-out boxing promoter, Kellie Maloney, and MMA fighter Roxeanne/Alex Reid. In business, there is Kate Craig-Wood, an entrepreneur and founder of one of the UK’s largest IT groups. Musicians like CN Lester, Thomas Dolby’s son Harper, and a magician, Fay Presto. In politics, there are several trans people who have stood as councillors or for election, across the political spectrum. On television, there are actors and a spate of reality TV stars. Among people who came out in the 1960s and 70s, there’s models April Ashley and Caroline Cossey, and writer, Jan Morris – all well known British women with open transgender histories. I could go on as I know of hundreds of trans lawyers, doctors, activists in public life, here in the UK alone.
In the USA, Janet Mock, among others have blazed the way by being out and public in their defence of being themselves, creating a tipping point of trans visibility, perhaps leading to the timing of former Olympian Caitlyn Jenner’s coming out.
Also, recently, we’ve seen big names like Lana and Lilly Wachowski of the Matrix films, Chelsea Manning of Wikileaks fame, Cher’s son Chaz Bono, and Laura Jane Grace of Against Me. Actors like Alexis Arquette, Candis Cayne (“Dirty Sexy Money”), Laverne Cox (“Orange is the New Black”) and Calpernia Addams. Nor are “Gender Outlaw” author Kate Bornstein or Jennifer Boylan to be forgotten. Dr Marci Bowers, is an American gynaecologist and surgeon and actually carries out gender/sex-reassignment surgery. There’s the US biologist and author of “Evolution’s Rainbow” Joan Roughgarden.
The names above are just a sprinkling of the probably tens of millions of trans and gender-variant people million worldwide.
Saturday 30 May at midday saw several hundred people “depressed and angry about the election results” gather at the Norwich Haymarket who wanted “a more equal, fairer, kinder system…” standing together to find “a better way”. The growing local Norfolk People’s Assembly saw hundreds of local activists heed the call for a National day of Action from the UK People’s Assembly as a pre-cursor to a larger anti-government rally on 20 June in London. Some 475 joined the Facebook event and around 200-250 showed up at the Norwich Haymarket, nestled between McDonald’s, Top Shop, Next, Starbucks, and Primark. The statue of a pensive Sir Thomas Browne – the medic and author of “Vulgar Errors”, looked down upon the modern crowd, probably wondering why we hadn’t yet solved 17th century problems of inequality and poverty, more than 3 centuries later.
Different interest groups but a common message
Banners for Saving Mental Health Services in Norfolk and Suffolk (currently in special measures), the Norfolk People’s Assembly and DPAC Norfolk (Disabled People Against Cuts) were unfurled along with dozens of printed and home made anti-austerity signs held aloft by arms weary after 5 years of Coalition cuts and now faced with another 5 years of threatened welfare budget reductions under the recently elected Conservative Party.
Diverse people representing numerous special interest bodies such as Save the NHS or the Hewett School, students, unemployed, disabled groups, political parties, affiliations and none, all called in unison for an end to the cuts and austerity.
A lone young female heckler raised a sober voice saying that “you people on benefits already get too much”. Perhaps, influenced by the hardline Right wing and Ukip rhetoric in the East of England during the recent election campaign.
Passionate Political Speeches
If the personal is political then that rang true of speakers from across the board, less because it was about them, more because of the passion with which they spoke for and on behalf of others but from the depths of personal experience of austerity and cuts to their sectors or own lives.
Speakers from the rally organisers, included Jan McLachlan, representatives of the Green Party, and Mark Harrison of the disability charity Equal Lives who drew attention to the ongoing access issues at the Duke Street work capability assessments centre.
Recently elected local Labour MP for Norwich South – Clive Lewis, suggested that even illegal direct action may be necessary to oppose immoral laws and Government inaction. Lewis spoke in an impassioned way that would probably shame the current batch of Labour leadership hopefuls and their copycat “aspirations of hard working families” soundbites.
Media & Press Coverage
Norwich Evening Newsreported very briefly on the rally but unfortunately made the demonstration sound like it was organised by Clive Lewis, which was not the case. Great publicity for the LabourMP, whose support and speech were appreciated, however poor journalism and social media tweeting by the EDP‘s Evening News arm, neglecting to mention many speakers and making it sound like the excellent Norfolk People’s Assembly organisers joined Mr Lewis, rather than the other way around. Political fairness also dictates that other parties such as the Norwich Green Party were also represented there. After contacting ArchantI was assured that they would pass on “corrections you’ve pointed out to the reporter who wrote the story who will amend as appropriate”. Four days later, finally, an amendment to the online news story: “The rally, organised by the Norfolk People’s Assembly, was attended by Unison members, and pupils and parents from the Hewett School.” But still no response to the original and even more inaccurate tweet:
Education was well represented by Ian Anderson a spokesperson for the We’re backing Hewett campaign, UEA staff, and Postgraduate Education officer UEA Students Union Liam McCafferty.
Liam, depressingly depicted a dystopian future where people would not be able to afford higher education.
Local deputy head teacher, NUT Campaigns Coordinator, Norwich Pride Chair and social activist, Nick O’Brien mentioned the reportedly over 27,000 children in Norfolk now living in poverty, at increased risk of poor health and educational achievement, whilst more than half a dozen children of protesting parents were happy, beyond most young kids’ attention spans, to hold up placards drawing attention to the plight of people of all ages and abilities under the current cuts.
NPA Press Release
Norwich Radical writer and NPA Press Secretary, Jack Brindelli, issued this statement for the press:
We at the People’s Assembly are steadfastly opposed to the Tories vicious plans for Britain, and the implications they will have for the people of Norfolk. On David Cameron’s watch as Prime Minister, the country has become bitterly divided along the lines of wealth inequality. His government’s cuts have shamefully targeted society’s most vulnerable – from the disabled, to the unemployed, to the unborn.
Whilst the Conservatives have been selling off the NHS through the backdoor, Britain’s infant mortality rate has risen to become the highest in Western Europe. Since 2010, the Black Triangle campaign estimates more than 80 suicides have been directly linked to cuts to social security – as those who need help most have been driven to desperate decisions by the Tories’ savage austerity measures. Over the duration of the last Parliament, the government have also butchered our legal rights by cutting legal aid – and are currently poised to axe the Human Rights Act, which currently protects ordinary citizens of all races from torture and persecution.
They have dismantled the comprehensive education system with their failed Free Schools and Academies scheme, turning schools like Hewett into profit-driven production lines, and they have tripled tuition fees – essentially ending the chances of a generation to learn beyond a GCSE level.
We have a clear choice for the next 5 years then. If we want to live in a world without an NHS, without universal education, without opportunity, without hope, then we need only sit back and wait for 2020’s election to at best deliver us cuts from a different party. If however, we are intent on not only protecting the ideas of freedom, opportunity and the right to live with dignity, but also determined to literally save hundreds of lives, and to provide our children with a future worth living, then we must stand together now. Over the coming months, across the country from Glasgow to Newcastle, to Liverpool to London, the People’s Assembly plans to take action to stop David Cameron’s gang of market-extremists in their tracks, and build a better alternative. For us, the fightback starts here, in Norwich.
More photos of the Norfolk People’s Assembly Norwich rally here.
“Direct action is what works. It sends a loud and clear message that people aren’t happy. And it’s part of acknowledging that our current political resources aren’t enough. People don’t have enough resources in the current political system to make their voices heard and that’s why we resort to direct action.”
The language of austerity and recovery (the Tory version or Labour’s “austerity-light”) has all been about working to pay off the deficit, whereas the reality of much of it was about cutting public sector jobs and the benefits of those out of work. The language of Ukip has been about preventing others coming here to work, or labelling migrants as “benefit/health tourists”. According to many international bodies the UK has done well – economically, but socially we are falling apart. Socially and in microeconomics terms, rather than the surface macroeconomic recovery, the Coalition isn’t working, also “Labour Isn’t Working“, the political opposition has been ineffectual.
Measuring the Health of a Nation
In health service resources terms we are 28th out of 30 OECD nations, 19th in terms of our actual health. The health of society should not be measured in mere economic terms. Education, welfare, mental health, attitudes to those that are different, migrants, or asylum seekers, are often a better guide to how we are really doing as a society. When a million people are using foodbanks, something is clearly wrong.
The language of Labour and Conservatives this election has all been about “hard working families“, with Ukip adding British-only workers to that, but then even Labour wanted to push for British jobs first. On paper, the unemployment rate is almost back to its 5.3% pre-crisis figure along with a massive shift away from public sector towards the private sector. After 5 years of austerity certain types of jobs are growing (self-employment, small business, zero hours contracts – 700k/2.3% of workers), but those without are being left behind – something Cameron promised not to do.
“I want to, if I’m elected, take the whole country with me. I don’t want to leave anyone behind. The test of a good society is you look after the elderly, the frail, the vulnerable, the poorest in our society. And that test is even more important in difficult times, when difficult decisions have to be taken, than it is in better times.” – David Cameron on the Andrew Marr Show, just before the 2010 General Election
Whether disabled, unskilled, mentally ill, being a carer, or struggling with some other difficulty that makes the 9-5 “Arbeit macht frei” ethic not appropriate or possible for all, many are being abandoned, and forgotten. The very purpose of the modern state, the welfare state, even something once quoted but not fulfilled by David Cameron, is to care for the weakest and neediest in society – without scapegoating them as sick scroungers.
Ed Miliband and the #EdStone
Even Ed Miliband in his Cecil B. DeMille Mosaic stone Tablets announcement this weekend put the economy as the number #1 priority and “higher living standards for working families” as number #2, apeing UKIP and the Tories at number #4 is “Controls on Immigration“.
What no welfare?
Nowhere among Labour’s 6 priorities were people in need, on welfare, even mentioned. For welfare to remain a “dirty” word even with a so-called socialist party shows how times have swung and the extent to which a party will spin and abandon its principles in order to regain power.
“Cuts” has been the message of austerity and debt reduction. But those cuts have fallen on the neediest in society, those on disability or welfare, not those most able to pay, or indeed – such as the banks, most responsible for the economic collapse in the first place. In 2012 UK Uncut protested the March budget with a “queue” outside Downing Street and an “Austerity Isn’t Working” poster campaign mimicing the 1978/9 Saatchi poster done for Margaret Thatcher and the Tories.
The verdict of a successful government is not just something measured in economic terms but also in moral and social ones.
Is the economy the only measure of a successful country? If I starve my kids to pay off my overdraft am I a great parent? #BBCDebate
David Cameron’s Easter message interview with a Christian magazine summed up Christianity as about “hard work and responsibility“, not Christ’s work on the Cross, meaning that, soteriologically, everything was actually already done for mankind.
Jesus said that the “truth would set you free”, the truth seems to be the thing furthest from modern politicians, with all their spin and question-dodging. No wonder 35% of the electorate don’t vote.
Less about Economic Wealth what about Mental Health?
The real hard truth is that “Britain isn’t working”. Inequality is increasing. Our communities are fractured and our countryside fracked. Those not in work are being punitively capped and cut until they can take it no more.
The irony of a government forcing state-funded CBT onto the unemployed yet unable to deliver self-requested CBT via mental health services for those that want to work is clearly lost on the Big Brother worker state. Hundreds of therapists, counsellors, and mental health experts, have written to outline their fears about the emotional and psychological toxicity of austerity and how it is being carried out. Suicides have increased over the last 5 years, especially amongst men.
Big Society or Broken Society?
Is the Big Society broken? Does society even exist or matter? Thatcher’s “there’s no such thing as society” is falsely interpreted though under a Tory-LibDem watch has been almost a self-fulfilling prophecy.
“There is no such thing as society. There is living tapestry of men and women and people and the beauty of that tapestry and the quality of our lives will depend upon how much each of us is prepared to take responsibility for ourselves and each of us prepared to turn round and help by our own efforts those who are unfortunate.” – Margaret Thatcher, 1987
Saatchi and Saatchi designed the 1978 poster that helped Thatcher win the 1979 election with the tagline “Labour [Still] Isn’t Working“. The Labour Party has spoofed the self same poster nearly 4 decades later. It is time to think outside the box not just rattle and rebrand it.
The truth is society is more broken than 5 years ago even if the economy may be on the mend. Austerity has been toxic. Our health, transport, housing, and education sectors have declined after being starved of resources or sold off to the private sector. Now it is society that needs rebuilding, not the economy. That is the true measure of recovery.
With the Conservatives returned to power, not just coalition but a slim but workable majority, and achieving a rare (once in a century) feat of increasing their vote share, how much did their victory owe to spin and emphasis on the economy not those in need? Are the democratic majority simply selfish? The majority view does not mean it is the right view – ethically, morally, socially. In the meantime the 37 year-old poster image is still doing the rounds with Daily Telegraph cartoonist BOB re-posting “Labour isn’t working” with a queue of unemployed Labour MPs snaking back from the dole office.