Mark Brooks: This International Men’s Day, we must do more to promote men and boys’ wellbeing

19 Nov

Mark Brooks was the Conservative parliamentary candidate for Batley and Spen in 2019, and has an OBE for services to male victims of domestic abuse. These are his personal views.

It’s International Men’s Day today, which provides a real opportunity to focus on a whole range of issues that impact on men and boys. It also promotes the charities that support them, and allows for a positive conversation about the contribution they make to their families, society and their country.

There is also a House of Commons debate and I am hoping that our MPs urge the Government to start to hone in and tackle matters specific to men and boys’ wellbeing – which, in turn, affect women and girls, whom we share our lives and society with. If we want to create an inclusive Britain we should ask nothing less of our parliamentarians.

International Men’s Day is not an “establishment” promoted or endorsed event; in fact, to the contrary, it is often met with a wall of indifference as are a number of the issues that men and boys face. It is one that is created and led by the public, charities and organisations large and small across the UK.

It is very much in tune with a grassroots day because without any “establishment” promotion, it will be marked in over 150 ways. Big corporations have sponsored motivational conferences with well-known speakers (Colin Jackson and Nigel Owens) and the Civil Service will be running mental health events for its staff. There will also be the likes of Men’s Sheds Cymru’s Bring a Butty event, to fundraisers for Oxfordshire Mind. Twitter will be alive with the use of #InternationalMensDay.

It shows the public care about:
  • the alarming suicide rate with over 12 men per day taking their own lives;
  • 12,000 men per year are still dying from prostate cancer;
  • the fact that boys are behind girls at every education stage;
  • 60 per cent of the people dying from Covid-19 are men with little explanation of why this is;
  • 85 per cent of those sleeping rough on our streets are men;
  • 700,000 men are victims of domestic abuse per year;
  • 12,000 men are subjected to sexual violence per year; and
  • 75,000 men are in prison.

If the public care about these issues, we need to do too and be proactive about having policies that seek to address these both on broad terms but also look closely at how they affect men. What is it specifically that means more men take their own lives or are behind at school and less likely to go to university? However, because it is not a gender competition we should also be proactively looking at how these areas also affect women.

The Government should consider a range of policies including:
  • Men’s Health Strategy – A number of countries such as Ireland and Australia have a strategy looking at male cancers, mental health and promoting more accessible services. This is also advocated by the World Health Organisation Europe.
  • Male Suicide Prevention Action Plan – To focus in on the causes of male suicide with a plan to greatly reduce the rate.
  • To provide better support for those at risk or suffering from prostate and testicular cancer – As advocated by Prostate Cancer UK, every man with prostate cancer, or at risk of it, should have access to the same high-quality diagnosis, treatment and care, no matter where in the UK they live.
  • To introduce a parallel strategy to the Ending Violence Against Women and Girls (VAWG) titled Ending Intimate Violence Against Men and Boys – In policy terms, men who are victims of domestic abuse, sexual violence and force marriage are victims of “VAWG” crimes, as are sexually abused boys. As well as being factually incorrect, it makes them invisible.
  • To commission an official inquiry into the educational underachievement of boys – There is no agreement on what causes this 30-year problem, let alone how to resolve it. It is time this changed.

We need to do more to resolve men and boys wellbeing issues because to live in a mature and inclusive society, we need to both question why a number of these issues are affecting men and then take action.

More so, we need to act, because the public across the UK want action and are concerned. Why support international Men’s Day otherwise?

Just because it is not fashionable within the Westminster Bubble, in Medialand or in the broader Central London establishment, we still have a moral imperative to act. In fact, as was shown on the Brexit vote and the last year’s General Election win being unfashionable is very fashionable indeed with normal men and women across the UK. They care enough to act, so should we.

Happy International Men’s Day everyone!

David Davis: We are on course to be trapped in never-ending shutdowns with no exit route. Here is an alternative strategy.

1 Nov

David Davis is a former Secretary of State for Exiting the European Union, and is MP for Haltemprice and Howden.

The first question that Boris Johnson will face when he addresses the House of Commons tomorrow about his lockdown plans is: “what will you do on December 2 if the R number is greater than one”?

The probability, of course, is that it will still be greater than one on that date – and that the lockdown, whilst it may have mitigated the infection, will not have stopped it. And in that circumstance, the shutdown will continue.

That is what we, and many other countries, should have learned from the last general lockdown. The disease only really stopped with the onset of summer, and has restarted with the onset of winter.

When the Prime Minister announced the first lockdown on March 23, he was hoping for it all to be done in four weeks, and in practice it turned out to be four months. This time he is announcing a lockdown at the beginning of winter, and we may well be locked down for six months, until next summer.

Unfortunately, even the scientists admit that the evidence for the effectiveness of general lockdowns is quite weak. The evidence for the economic damage that they do, however, is so strong that it is obvious.

In truth, there is only one strategy that has worked in the other countries faced with this problem. This was a very early and draconian lockdown that brought the disease under control when it still only affected a small proportion of the population – followed by an extremely focused test, track, and isolate policy. At the moment, no element of this policy is fully operational in the UK.

The complete failure of Public Health England to deliver a functional testing system early in the pandemic crippled Tthe Government’s ability to deliver such an outcome. This is compounded by the worst decision in the whole crisis – on March 12, when we gave up our attempt to test all the suspected cases.

To be fair to Matt Hancock, he has driven the system to deliver a large testing capacity today, but that is too late. It is a little like having ten fire engines outside your house after it had burnt down.

What is needed from the testing system today is immediate availability for everybody with symptoms or exposure, and very rapid response so that action can be taken quickly to suppress the outbreak.

The Government is now talking about a 15 minute test, rather belatedly. Tests that deliver a very accurate result in less than an hour have been available in the United States since March. If there is any doubt at all about delivering the rapid test in the UK, the Government should licence existing foreign technology, and set about creating the capacity to deliver that domestically as soon as possible. The South Koreans achieved more in six weeks at the beginning of the crisis than we have in six months, and we should model our delivery policy on that.

The track and trace system is currently hopeless. It will only ever be useful if it delivers results within a few days of someone testing positive. Otherwise, it is too late to check the infection. It is long past time for the Government to read the riot act to the big companies that are making profits out of failure in this area. If they cannot deliver they should be replaced, ideally by a regional structure, which, as the Germans demonstrated, is much more likely to be effective.

Most important of all, however, is the isolate policy. We currently do not have one. Telling people to stay at home if they are ill simply means that they infect their families, and possibly the supermarket assistant when they do their shopping.

And of course, not everybody who is infected obeys even those rules, and the probability is that even more will flout them after a year of Covid fatigue. So self-isolation at home will be even less effective this winter than last.

Every successful strategy to date has properly isolated the infected, and often their closest contacts as well. In Wuhan, the Chinese government created a number of Nightingale-style hospitals, and used them to immediately isolate those who tested positive, and those closest contacts thought most likely to be infected. It worked, as did similar approaches in other East Asian countries.

We need more Nightingales, and we need to use them as the anterooms to the major hospitals, not as the (empty, unused) overspills. In a Nightingale, patients can be monitored properly, and receive treatment rapidly as they need it.

We should do the same with the private hospitals that we have sequestered. We should also have an explicit strategy to separate the conventional patients from the Covid patients – ideally in different hospitals. We should remember that this is an exercise in saving lives, not in hospital capacity management. Losing track of that aim leads to more excess deaths, rather than fewer. I fear that the slogan “Save our NHS” conflates and confuses those aims. It is said that a number of NHS managers were uneasy for exactly that reason.

During the first round of this crisis, there were four categories of unnecessary excess deaths.

First, there were those who were told to stay at home, unless they were very seriously ill. Many of those turned up in hospital too late to save

Second, there were those, mostly the elderly, that were triaged out of intensive care. The NHS denies this, but the numbers show that many elderly died untreated.

Third, tthere were those who were dispatched to care homes before they had recovered, leading to new rounds of infection amongst the most vulnerable.

Fouth, there were those who were displaced from hospital, leading to excess deaths both now and in the future from untreated non-Covid diseases, most obviously cancer. Much of this was avoidable with more focused management and a little bit of foresight.

Finally, when we do get the virus under control, we should rethink our “local” strategy. The successful countries interpret this at a really micro level, in some cases locking down one street or even one block of flats. It is possible to enforce lockdowns at that micro level.

When you lock down the Greater Manchester region, it is near certain that of its millions of residents, thousands, or even hundreds of thousands of people will break the rules. Such a strategy maximises economic harm and minimises lives saved. So when we return to local lockdowns, we should make them very local indeed.

Everybody wants to save lives, and ideally at minimum economic cost. A never-ending lockdown, without an explicit infection reduction strategy, and with it a lockdown exit strategy, offers little more than a winter of misery. The Australian and New Zealand governments initially tried a strategy like our current one, and very rapidly decided that the East Asian disease eradication model was a much better option. We should do the same – or this will be a very long winter indeed.

Pressure rises on Ministers to publish assessments of the impact of lockdowns, restrictions – and Covid itself

20 Oct

Last week, ConservativeHome called for the Government to broaden and deepen the national conversation about Covid-19 – or at least try to as best it can.

It is essential to see the disease in the round by understanding the consequences of lockdowns, restrictions and the virus itself on both lives and livelihoods.

For livelihoods, read what’s usually called the economy, a dry term, but is actually a human story of lost jobs, lower living standards, higher poverty, damaged schooling and vulnerable sectors, including hospitality and retail.

For lives, read healthcare outcomes other than Covid-related ones.  In other words, cancelled operations and fewer treatments, as well as (for example) worse heart disease, cancer, mental health and domestic abuse outcomes.

This is why we urged the Goverment to publish –

  • A regular Treasury report that calculates the economic cost of the lockdown.
  • A rolling Department of Health assessment of the human cost of the shutdown.
  • The creation of an economic counterweight to SAGE.

We also suggested that some think-tanks have the capacity to issue comprehensive reports.

This site originally urged this course during the spring, and is far from alone in having done so.  On which point, congratulations to the Daily Mail, which today publishes a four-page investigation into health outcomes. It finds –

  • 25,000 more people died at home during pandemic, since they didn’t go to hospital as it continued.
  • There is set to be a 20 per cent rise in cancer patient deaths because of treatment backlogs.
  • Organ transplant operations fell by two thirds while waiting list deaths doubled. More than 50,000 operations for children were cancelled.

It’s worth pointing out that some of these outcomes will have been a consequence of Covid-19 itself rather than restrictions – for example, people not going to A & E departments in order to reduce the risk of catching the virus.

The line Matt Hancock took yesterday in the Commons is that suppressing the virus is integral to better health outcomes, because the more NHS resources the virus demands the fewer there will be for other conditions.

But a question that obviously follows is whether or not the Government’s strategy, which is dependent at present on big lockdowns, is the best means of protecting the NHS.

It’s worth noting that a Department of Health analysis has said that “in the long-term, the health impacts of the two month lockdown and lockdown-induced recession are greater than those of the direct Covid-19 deaths”.

The Mail is not alone in trying to get its readers to look at the Coronavirus in a more full context.  Yesterday, the Daily Telegraph reported that the ‘Protect the NHS’ message led to 90 per cent drop in hospital admissions.

The Times last Friday urged the Government to be “more transparent about the economic and health costs – the same day that we took much the same view.

And a wide range of Conservative MPs are increasingly calling for the kind of action we have outlined.  Theresa May has called for more formal economic advice.  Steve Baker, writing on this site yesterday, urged Ministers to publish “serious analysis of the costs of the options they face”.

Downing Street will be reluctant to take this course, and thus indicate that the Government might change its strategy, while it is doubling down on the present one.

In political terms, that’s what our report yesterday about new LAMP and lateral flow tests signified.  Number Ten believes that these can deliver where track and trace has not (though it is not abandoning the latter).

So it is trying to persuade Tory backbenchers not to abandon the testing strategy, and transfer their support either to lockdowns and a permanent suppression plan, or to loosening and a more voluntarist approach.

We shall see whether this push pays off – and if this planned massive scaling-up of new tests works.  ConservativeHome’s understanding is that the Treasury hasn’t ruled out a big report on economic costs.

However, Government sources pointed out that much of the required data is already available (i.e: unemployment figures), and that it would be hard to disentangle the effects of restrictions from those of the virus more widely.

We also detect a concern about the consequences of publishing bad economic news: on the one hand, the Treasury has an interest in alerting voters to the scale of the economic challenge, but none in alarming them.

Karol Sikora: Millions of people are waiting for cancer services. That’s the second wave we should worry about.

3 Aug

Professor Karol Sikora is CMO of Rutherford Cancer Centres and Former Director of the WHO Cancer Programme.

Let me be clear, I have absolutely no interest in getting involved in politics. Despite being labelled a Government stooge on more than one occasion, one glance at my Twitter account will show that I have made my objections to Government policy clear, perhaps too frequently!

Before March I honestly had no idea how Twitter worked, I thought it was the sound birds made in the morning. The whole reason I signed up was to ensure cancer patients weren’t forgotten about in this Coronavirus whirlwind. To be honest, I failed.

We’ve tried everything; writing articles, doing media, lobbying ministers, online petitions. None of it has worked, there are still millions of people waiting for cancer services. Recent estimates put that number at 3,000,000 people, that is staggering. We’ve heard lots of words from Government, but not nearly enough action. Hopefully the message from this article may reach the right people.

Everyone reading this will have been touched by cancer in some way, we all know how relentless and insidious it is. It doesn’t stop for anything, never mind pandemics but we have given it far too much freedom to run riot over the last few months.

A delay of a few weeks in most cases will make no difference, and many cancer patients have had treatment delayed for appropriate clinical reasons, but lots have been delayed for operational reasons.

Sadly at the start of this pandemic I would always talk in hypotheticals about how many people could die from cancer delays. That is no longer the case; people have already lost their lives because the treatment they needed was not available.

We have far too often seen doomsday predictions thrown around by people who don’t fully understand the consequences. It is people of my age who are most petrified by this climate of fear and who are now unwilling to “trouble” the NHS. We’re the ones who need the help the most!

“Stay Home, Protect the NHS” was a brilliant slogan, but it was far too effective. People having heart attacks would refrain from ringing 999 and the numbers of people diagnosed with cancer this year has fallen off a cliff compared to the average. If anyone from the No 10 Behavioural Insights Team is reading this please understand you are playing long term with forces you don’t understand.

Oncologists have spent decades trying to get people to get persistent symptoms checked, so much of that progress has been undone in the last few months. I have neighbours who won’t even open their windows they’re so scared of catching the virus, if they find an unusual lump are they going to go and get a scan? I think not.

So what can we do? I’m acutely aware it’s all too easy to throw stones from the sidelines while offering no solutions. Isn’t that how politics works?

The approach has to be two-fold. First, we have to get cancer care prepared for the inevitable surge, but we also have to encourage that wave to come. If people won’t get checked at an early stage, sooner or later they will need treatment.

We need “COVID-secure” hubs to treat and diagnosis cancer. Weekly staff testing, temperature checks, ultra-caution within the building. We have to make cancer care as safe as possible to give people the confidence to come forward.

Embracing all available capacity seems obvious. My network, the Rutherford Cancer Centres, has increased our collaboration with the NHS during the pandemic and are willing to go further. There are other independent providers who have the capacity to help, it would be wrong to leave those machines empty whilst millions have cancer services delayed.

There is going to be a surge, we need to know exactly when that is coming to get ourselves prepared. I anticipate around September, so oncologists and our dedicated support staff should be getting ready for a very difficult autumn/winter.

What frustrates me the most is the fact that so many other countries have continued cancer treatment with not nearly as much disruption as us. An oncologist friend of mine has a Brazilian partner, even there they are dealing with cancer admirably in the face of a far worse situation than us.

The prospect of a second wave is one we have to take seriously and I have always said we are right to prepare for the worst, but we are already in this cancer crisis. In my mind, the second wave we have to worry about is the millions of neglected cancer, cardiac and other seriously affected patients who have been ignored.

History will not judge us kindly when the full damage of this disaster is visible. It isn’t too late to avert the worst of it, but we desperately need action, not more rhetoric and even worse dithering.