Sally-Ann Hart: ‘DIY’ home abortion puts women and babies at risk, and ministers should end it

29 Jan

Sally-Ann Hart is the MP for Hastings and Rye and was a councillor in Rother.

The Department of Health and Social Care (DHSC) recently launched its public consultation on whether to make home use of both abortion pills a permanent measure in the UK.

‘At-home’ abortions – which the media and critics have termed ‘DIY’, or ‘do-it-yourself’ abortions – were introduced on 30th March 2020 in the most radical change to abortion law since 1967. After a phone call with an abortion provider, women can now be sent Mifepristone and Misoprostol pills to take at home without direct medical supervision in order to end their pregnancies.

Originally sanctioned as a temporary measure to reduce transmission of Covid-19 during the pandemic, abortion campaigners and providers are pushing to make ‘at-home’ abortions permanent.

But given the risk of serious complications, coercion from abusive partners, and inability to verify gestational age over the phone, the Government should immediately withdraw the temporary order. Should it and the consultation continue, however, I can only hope we see the concerns of those responding to the consultation taken seriously by our Government.

Before reviewing the serious complications that have occurred in relation to ‘DIY’ home abortion, it is prudent to refute recent claims in the New Statesman of a relative lack of medical complications for ‘DIY’ home abortion. Indeed, this article rather serves to highlight the serious problem of systemic underreporting of such issues.

DHSC data show only one complication following ‘DIY’ home abortion from April to June this year for the whole of England and Wales. Unbelievably, this would mean that the average rate of complication for medical abortions at a similar gestation over the past five years was over seventeen times higher than the complication rate for ‘DIY’ home abortions earlier this year. This is not only highly unlikely – that complications would radically reduce in a home setting versus a medical setting – but, some may say, ridiculous.

Indeed, evidence from a Freedom of Information (FOI) request demonstrates clearly the current issues related to reporting complications when abortions take place outside a clinical setting. The data from the FOI request shows seven women were admitted to University Hospital Lewisham alone for complications following medical abortion between the end of March and the beginning of September this year.

If both Departmental and hospital records were true, this is a shocking leap from just one complication nationwide in the three months from April to June to a further six complications in the same locality in the two months from July to September. There is either a serious problem with sharply rising complications in Lewisham since the end of June, or a substantial issue with the overall quality of reporting and recording the real impact of medical abortion on women’s health when abortions take place at home.

Serious complications can certainly arise when abortion is removed from a clinical environment. One Swedish study from 2018 of almost 5,000 induced abortions over eight years (from 2008 to 2015 inclusive) found that the complication rate for medical abortions before 12 weeks’ gestation almost doubled from 4.2 per cent in 2008 to 8.2 per cent in 2015, concluding that the significant surge in complications “may be associated with a shift from hospital to home medical abortions.”

Requiring the first pill to be administered in a clinic provided essential safeguards for women, not least as it allowed for an in-person examination or ultrasound to verify whether a woman was too far along in her pregnancy to be prescibed a medical abortion.

Tragically, we have already begun to see the effects of the absence of such safeguards. Police have been investigating the death of an unborn child who was aborted at 28 weeks – four weeks past the legal limit for surgical abortion and a shocking 18 weeks past the limit for abortions at home. Notably, abortion provider BPAS stated they were investigating the case along with eight other known incidents of babies who were aborted past the 10 week legal limit for ‘at-home’ abortions.

Only this year, a study (funded by NICE) found that for later gestational dates, greater dosage of misoprostol may be required to achieve a complete abortion. As such, there ‘may be more pain or bleeding associated with the expulsion of a larger/later pregnancy’. This clearly highlights a need for accuracy in determining gestational age, particularly if the woman expels the pregnancy at home.

Further concerns are highlighted by a leaked NHS email from a Regional Chief Midwife on the ‘escalating risk’ around the ‘pills by post’ service in May 2020, which revealed that a woman received abortion pills at 32 weeks of pregnancy. The email goes on to note that there were 13 incidents under investigation linked to ‘at-home’ abortions, and “3 police investigations”, one of which “is currently a murder investigation as there is a concern that the baby was live born.”

If such troubling incidents occurred within weeks of the ‘DIY’ home abortion ruling, making it a permanent feature of our healthcare system would clearly be a disservice to women in the UK.

In addition, many women in domestic abuse situations may be coerced by their partner into having an abortion. If we remove the requirement of a face-to-face consultation, there is no guarantee that a patient can speak freely without the coercive party listening in. Indeed, Health Minister Lord Bethell iterated these concerns on behalf of the Government when the Coronavirus Bill was brought to the House of Lords on 25 March, recognising that:

“If there is an abusive relationship and no legal requirement for a doctor’s involvement, it is far more likely that a vulnerable woman could be pressured into having an abortion by an abusive partner.”

Furthermore, if a woman is in a domestic abuse situation, leaving her to perform her own abortion at home only helps her abuser by enabling her to remain in an abusive situation.

Accounts from women of their experience of the ‘pills by post’ system should further compel the Government to immediately suspend this temporary order. For example, a nurse who suffered extreme complications from ‘DIY’ home abortion that left her needing life-changing surgery disclosed that she experienced ‘excruciating pain’, and heavy bleeding that continued for ten days after the abortion. Claiming Marie Stopes failed to provide follow up care, she also shares: “I’m actually quite shocked that the UK, with all of our research and expertise would approve this”.

In addition to physical complications, other women have expressed concern at the ease and speed with which they were able to acquire these life-changing pills. One woman describing her experience stated: “I wasn’t ready. It all seemed so fast. I was expecting to speak to lots of people, to be offered counselling.” Yet ‘greater capacity’ and ‘shorter waiting times’ have been lauded by proponents of ‘at-home’ abortion as prime reasons for extending the scheme, perhaps due to the notion that telemedical abortions free up NHS resources.

This is the kind of language used to discuss routine health appointments and hip replacements; that this narrative is currently being used to frame the life-changing decision to abort a child – the termination of a human life – is truly disturbing. Tragically, this same language is replicated in the newly launched UK public consultation, where participants are encouraged to reflect on ‘at-home’ abortion services in the context of ‘workforce flexibility, efficiency of service delivery’ and ‘value for money’.

Opposition to ‘DIY’ abortion schemes is widespread across the UK. Hundreds of healthcare professionals recently signed an open letter to the Health Minister of Northern Ireland to highlight the dangers of removing essential safeguards around abortion. Additionally following the launch of the Scottish Government consultation on ‘at-home’ abortion in October, Chairman of the Scottish Council on Bioethics Dr Antony Latham highlighted the increased health risk if ‘DIY’ home abortions are introduced on a permanent basis, stating ‘significant bleeding and sepsis are not uncommon.’ He further notes that the removal of in-person consultation opens the door for abortion coercion.

Finally, polling suggests that in-person assessment during the abortion process is highly valued by women in the UK; in one poll 77 per cent of women agreed that doctors should be legally required to verify in person that a patient seeking abortion is not being coerced, while another poll showed that 92 per cent of women agreed that a woman seeking an abortion should always be seen in person by a qualified doctor.

‘At-home’ abortions are not safe, and must not be euphemised as abortion ‘care’. Contrary to representation from abortion activists and providers, extending the ‘at-home’ abortion policy is not a given, and the public consultation has been launched with the option to ‘end immediately’.

Safe and effective healthcare is central to our British values: this irresponsible policy must be revoked before more lives are put at risk. I encourage all reading this to respond to the consultation – and select ‘end immediately.’

Julian Brazier: A single allowance rate for Inheritance Tax – and five other proposals for making social care more resilient

23 Jan

Sir Julian Brazier is a former Defence Minister, and was MP for Canterbury from 1987-2017.

A great deal is currently being written about resilience – normally an underrated subject in politics. Building resilience should not just be about considering major national or global crises, but also involve asking questions about the likelihood of – and the solutions to – more frequent and more local crises. These range from NHS winter pressures to power cuts to cyber and terrorist attacks.

At the same time, there is an overwhelming view today that social care needs urgent reform and greater intervention from government. Yet there seems to be little appetite for considering these two great issues together:  the care of the elderly and its implications for national and local resilience.

This article seeks to show that incentives in current provision, for social care, benefits and tax, are reducing resilience. Some of the current proposals for social care ‘reform’ would worsen this.

The largest category of vulnerable people are those elderly people who cannot live without supporting care. Their domestic circumstances can be divided into four broad categories, listed in descending order of independence:

  • Those still in their original homes (whether owned or rented) with visiting carers,
  • the growing category of those in specially adapted sheltered accommodation
  • those living with family, in so called ‘inter-generational’ arrangements and, finally,
  • those in residential care.

How do these categories measure up for resilience?

At first sight, the least resilient group are those people living in their own, unmodified homes; they are reliant on visiting carers, who may not be able – or willing – to come in a crisis. They are also more likely to fall over or have an episode isolated in surroundings which have not been adapted, are most vulnerable in power cuts, for the same reason, and – crucially – they are often difficult to discharge from hospital.

But there are serious problems with the fourth category too. We have seen the problems with care homes in a pandemic. With their communal eating and recreation facilities, such homes have proved principal vectors of disease.

Equally, they have become a major cause of bed blocking, once the dangers of releasing patients to them was recognised. Britain’s higher-than-European-average concentration of people in residential homes has worsened our death rates and increased pressures on the NHS.

As Conservatives, we should also be concerned that residential care is not only the most expensive arrangement (whoever is picking up the bill). It also, for those fit enough to choose, offers the least independence.

This brings us to the two middle categories above.

Dwelling in adapted accommodation and living with younger family members are both comparatively resilient arrangements, and both are much less expensive than residential care.

They also have other features most Conservatives approve of. They offer a degree of independence absent in residential homes. There is also the potential for free childcare in inter-generational arrangements, or where nearby retirement accommodation has been chosen. Both categories offer an antidote to the loneliness of those still stranded with limited mobility in their original homes.

Any new system which aims to promote resilience should direct incentives towards rewarding, rather than penalising, these two middle categories: those who step down to retirement accommodation and those cared for by their descendants. That is how resilience is maximised.

Yet this is far from the case at present. Our commitment to ring-fencing the principal home for tax and benefit calculation purposes is a great policy, but one which has perverse unintended consequences when applied to transfers between generations. The state ends up penalising the heirs of those who aim for resilience, and rewarding many of those whose parents become most dependent.

For example, if an elderly person struggles on in their own home without much money, the state picks up the bill for their carers, and the potential strain on the NHS is maximised. Yet, if they own that home, their heirs will maximise the windfall when they die, compared to the alternatives. This has been exacerbated by the George Osborne tax break on Inheritance Tax, which greatly increases the exempt allowance, if and only if the inheritance is tied up in bricks and mortar.

On the other hand, suppose the same old person were to sell and move into purpose-built sheltered accommodation. They are less likely to have accidents where design has the frail in mind – and easier to release from hospital especially if there is warden assistance or such accommodation was selected to be close to relatives. Such people are also much less at risk in times of crisis – overall, a resilient arrangement.

Yet, from the point of view of their heirs, their estate diminishes, as the cash released from sale of the home is used to pay carers and service fees. If the original home was worth more than half a million pounds, thanks to the Osborne inheritance tax break, the heirs also face paying more tax than if the parent had soldiered on in the original house.

Similar points can be made about the position of families who look after elderly relatives at home, who have sold or moved out of their own houses. The one incentive such families currently get from the system for providing their loving care (and potentially relieving the state) is the carers’ allowance. Yet it is rumoured that there is a plan afoot to means test that. So, if the arriving parent or relative owns the proceeds of selling a property, that allowance would be lost.

It is time we built the promotion of resilience into our design of social care. My proposals are as follows:

  1. Abolish the Osborne bricks and mortar tax break by re-establishing a single allowance rate for Inheritance Tax.
  2. Extend that principle across the range of tax and benefit policies for the elderly to ensure that there is no financial incentive for potential recipients of inheritances to encourage their parents/relatives to stay in their homes, if they wish to move.
  3. Keep the carer’s allowance universal, so that those caring for relatives at home or in nearby accommodation can continue to draw it.
  4. Resist lobbying from the care sector and residents’ heirs for the taxpayer to take on more of the cost of residential fees to protect inheritances. Despite the political clamour, such proposals would be paid in part from by the taxes of those who are looking after relatives either at home or in neighbouring accommodation. That would doubly incentivise more people to move into residential homes, further increasing cost and – critically – still further reducing national resilience.
  5. Offer tax incentives to the elderly to move out of family homes into sheltered accommodation, including a permanent end to stamp duty on such properties. (Ironically, many councils pay ‘key money’ to release family accommodation but there is no scheme for owner occupiers). Gareth Lyon’s excellent article on this site pointed out how small this sector still is compared with Australia and new Zealand.

Shakespeare’s adage “sorrows … come not as single spies, but in battalions” is apt in the era of globalisation.  We simply do not know what shocks and challenges are just ahead. We must recognise that how we structure social care – and the associated tax and benefit framework for the elderly and their heirs – has profound consequences for resilience in major crises. It is also important for services under pressure in ‘peacetime’.

Creatura Mario: A pandemic pregnancy – and the stess, anxiety, and guilt of being barred from my wife’s side at hospital.

20 Dec

Mario Creatura works in communications and campaigns. He is a councillor in Croydon, a former Special Advisor in 10 Downing Street and was a Parliamentary candidate in the 2019 General Election.

It was a cold, dark night in December last year, two weeks into the General Election campaign. I had just got in from an afternoon of campaigning, wolfed down some dinner and was in the process of running out the door for the next session when my wife, Amy, pulled me to one side.

She was pregnant with our first child. It may be twee, but it was an incredibly happy, instantaneously life-changing moment. And, of course, it suddenly put everything into perspective: I was standing for Parliament but, a split second later, my priorities had shifted to thinking less about knocking on doors in the drizzle and towards the tiny, poppy seed-sized kid inside Amy.

Fast forward a few weeks, and the first scan revealed we were having not one baby, but two: a one in 250 chance. We were elated at the news we were having twins, and couldn’t believe our luck.

I accompanied my wife to every scan, every trip to the hospital – that is, until the pandemic hit. All of a sudden, the guidance changed. I was banished from my wife’s side and relegated to the car park, anxiously waiting for updates that all was well.

The rules were there for a very good reason. We needed to protect the NHS, and keep the risk to the incredible key workers in the hospital as low as possible. We understood the justification on an intellectual level, but that didn’t make it any easier emotionally. We are in the same household; she’ll have whatever I had. Why the separation?

Being pregnant at all comes with many potential hazards, but having a multiple pregnancy is officially classified as ‘higher risk’. There’s any number of additional complications that can occur at any point, simply because you have two or more children growing inside you. Reading the self-help books and online guides were informative but did little to reduce our stress levels

There were many times when I should have been by my wife’s side, when things weren’t going as smoothly as we’d hoped, but I was prevented from doing so. The guilt was palpable, and the impact real. It was made worse knowing that friends and acquaintances were going through the same thing. I subsequently learnt that many NHS Trusts were routinely preventing a partner or family member from accompanying pregnant women for scans and, in some cases, all stages of labour.

That’s why, when the tenacious Alicia Kearns launched her campaign in September, I was an immediate and enthusiastic supporter. It turns out that Government Covid guidance permitted partners to attend both scans and the entirety of labour, yet many trusts hadn’t cascaded this down adequately to maternity teams.

At that time, the guidance from NHS England was for expectant mothers to work out access with their midwife, who had total discretion on partner attendance. That led to national disparities, with large unintended consequences.

From the Prime Minister and the Health Secretary on down, the Government backed the campaign – and you’d be forgiven for thinking that was the end of the matter.

Yet three months on, a poll published this week for the incredible Twins Trust found that four out of ten women carrying twins or triplets were still being forced to go through scans alone. And whilst 40 per cent of families said they had one or both twins taken to specialist units after birth, partner access to the children varied from hospital to hospital.

I was able to attend the birth and, immediately after, I spent a few precious hours with my expanded family before being asked politely to leave. One of my boys needed urgent neonatal care, the other needed treatment for ten days after birth. Every day I delivered nappies, snacks and a change of clothes, but each time I had to hand them to a nurse – consigned to video calling my wife on the phone.

Whilst the hospital staff were truly phenomenal, it didn’t change the fact that, in June of this year, I was prevented from seeing my newborn children and wife when they needed me the most.

hankfully, that research, and yet more campaigning from MPs, led to NHS England this week issuing new guidance telling maternity teams them that expectant mothers will have a right to “access to support from a person of her choosing at all stages of her maternity journey”. These people will get a rapid Covid test on arrival, and so there’s no reason why partners shouldn’t be with pregnant women every step of the way. Why on earth did it take three months to communicate something so straightforward?

Back in June when the contractions started, I was continuing my increasingly dependent relationship with the hospital car park. Being separated from my wife as she started labour was for me emotionally (if not physically) agonising. Amy was incredibly brave, and for all intents and purposes had to go through 90 per cent of the labour on her own, frantically snatching the odd minute here and there to Whatsapp or call me.

When the moment came, thankfully, I was near and allowed to rush to her side. The birth was complicated, but the team at East Surrey Hospital could not have supported us better. The professionalism and the care we experienced was world-class, and while the entire experience was impacted by the pandemic it was nevertheless a feeling of total, unadulterated joy when little Milo and Rocco entered the world at 5.04am and 5.18am respectively.

We were lucky: many others have had significantly more traumatic experiences exacerbated by partners not being present. Seventy-none per cent of those quoted in the Twins Trust survey said the pandemic had taken a toll on their mental health. with 47 per cent saying they were allowed to bring a partner to some but not all ultrasounds. And with approximately 19 per cent of expectant mothers saying they received worrying news at a scan, it should be easy to see why this new direction from NHS England is so vitally important.

There is a broader lesson that I hope will be taken from this situation. The pandemic is sadly far from over, and it will take some time for the hope-giving vaccine to be rolled out sufficiently. Roughly 1,800 babies are born in the UK every month. These 1,800 women and their partners deserve to know what they can and can’t do as early and as clearly as possible. The virus has complicated what is an already tricky, stressful process. I hope NHS England and their subsidiary hospitals will learn from this experience to better communicate to their expectant mothers.

A pandemic pregnancy is tough enough; let’s try to ease some of the added anxiety as parents-to-be prepare to bring their little ones into the world.

David Gauke: Next week’s spending review – and why our holiday from spending restraint is coming to an end

21 Nov

David Gauke is a former Justice Secretary, and was an independent candidate in South-West Hertfordshire at the recent general election.

For reasons that some readers will understand, the departure of Dominic Cummings from Downing Street was not a source of great sorrow for me. It appears that I am not alone. Nonetheless, Cummings’ resignation/dismissal makes the Prime Minister’s job much harder in at least one respect.

We are already pushing the limits on when a free trade agreement with the EU can be agreed in order for it to be in place by the end of the year. Boris Johnson continues to appear to be undecided as to whether he is willing to make the necessary concessions in order to get a deal (thus upsetting hardline Brexiteers) or leave without a deal (wreaking further damage to the economy and the integrity of the United Kingdom).

Both options have been apparent for some time, and they are sub-optimal for the Prime Minister and the country. Now he really has to choose.

If he compromises, some people will say that, without Cummings, the Prime Minister lacks a spine. Cummings may well be one of the people making this point.

If he does not get a deal, the Prime Minister’s strategy must be to convince the Leave half of the country that the ensuing mess is the fault of the European Union (it will be a hopeless task to avoid the blame with the other half of the country). To do that, he will need a communications strategy that is ruthless, aggressive and lacking in self-doubt, entirely untroubled by the overwhelming evidence pointing to a different interpretation of the situation. These are exactly the circumstances in which Cummings has a track record of success.

This is a bad time for the Prime Minister to fall out with his most influential adviser.

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Anyone entering politics will be aware that there may come a moment when there is a conflict between what one perceives as the national interest and the furtherance of one’s career.

We can currently see this playing out in the United States, as Donald Trump continues to refuse to accept the election result. With a few honourable exceptions, most senior Republicans have gone along with this nonsense. Presumably, none of them believe the election was rigged in favour of Joe Biden, but they dare not say so because of the fear of offending the Republic base.

Although not as egregious, there are similarities in the UK. Fear of offending the Conservative grassroots has inhibited too many senior Tories in setting out the realities of our departure from the European Union for far too long.

At this particular time, the talk of Westminster and Whitehall is that the overwhelming majority of the Cabinet favour a compromise with the EU because they are conscious of the consequences of failing to get a deal. But the ambitious amongst them know that to be seen to be associated with compromise on Brexit is a career damaging move.

As a consequence, they keep their heads down, content to let others challenge the prejudices of their party’s more extreme supporters. If things ultimately go as badly as they might, history will not judge kindly.

– – – – – – – – – –

The Prime Minister’s announcement of an ambitious green agenda will, we are told, help create thousands of green jobs. The increase in defence spending will, we are told, help create 10,000 new jobs. Such announcements are always treated as being good news – a further justification for a policy.

There are good arguments to be made for reducing carbon emissions and improving our defence capabilities but, while the fact that pursuing these policies requires the employment of more people may be good news for the individuals concerned, for the Government and society as a whole, this is a cost not a benefit. Employing people is expensive. And if they are employed to do one thing, they are no longer available to be employed to do something else which society or the economy might value.

I do not always agree with everything Nigel Lawson says, but he has a point when he states that “a programme to erect statues of Boris in every town and village in the land would also ‘create jobs’ but that doesn’t make it a sensible thing to do”.

To give an equally absurd example, it is not a cause of celebration that, from January, the country is going to require an additional 50,000 customs agents because of increased bureaucracy involved in trading with the EU. I repeat, this is a cost not a benefit.

– – – – – – – – – –

Wednesday will see the Spending Review, albeit one that is less comprehensive than first intended. I suspect much of the focus will be on the Office for Budget Responsibility’s assessment of the public finances, which is likely to be ghastly.

Borrowing this year will certainly be a peacetime record and might not be far behind a wartime record, either. To some extent, that does not matter as much as it might do – we can get our debt away easily and cheaply enough in a world where markets are much more forgiving of high levels of Government debt than they were even a few years ago.

But the worry will be that, even a few years down the line when the virus is behind us, we will still be borrowing very large sums of money. Exceptional borrowing in an exceptional year is one thing, but one cannot expect to get away with that forever.

Something will have to be done – but when? One of the many challenges for the Chancellor is that the political and economic cycles are misaligned.

Politically, he would want to get tax rises or spending cuts (and it will be mainly the former) in place early in a Parliament so that the pain is well out the way by the time we get to 2024.

Economically, the consensus view is that early tax increases might choke off a recovery so better wait a while. On that basis, even with the recent good news on vaccines, 2022 would be the earliest point for tax increases (and plenty would argue for later).

The politics of tax increases also appears to be immensely difficult. The Prime Minister seems dug in on the tax lock (preventing increases in the rates of income tax, national insurance contributions and VAT, which between them raise two thirds of Government revenue) whilst the back benchers also appear squeamish about any kind of fiscal consolidation.

As a country, we have given ourselves a bit of a holiday from thinking about the public finances. This coming week might indicate that this holiday will soon be coming to an end.

– – – – – – – – – –

Should we relax Covid-19 restrictions to save Christmas? It would be lovely to have a normal Christmas, but I am not sure proponents of seasonal break in restrictions have thought this through.

There is every reason to believe that Christmas would be a super spreader event, resulting in the deaths of thousands just weeks before we will have vaccinated the vulnerable.

For too many families, making the wrong decision about Christmas 2020 could mean that all future Christmases will be tinged with sadness, loss and guilt. Just be patient; we are nearly there.

Jonathan Gullis: The blight of Covid gives us new reason to cut back school holidays

16 Nov

Jonathan Gullis is MP for Stoke-on-Trent North, and a member of the Education Select Committee. He was previously a secondary school teacher.

The Government has rightly decided to extend free school meals for the holidays, and give hard-pressed families reassurance that their kids will be fed this winter. But at a time when many kids are falling behind due to the pandemic and many families are struggling, we should go further.

It is time to cut school holidays, to give disadvantaged students time to catch up with their peers after long gaps in learning due to covid and to further ease the pressure on family finances. We could cut two weeks from the long summer break, and even shave a few days off at Christmas and Easter, to help children reclaim their futures.

As a former teacher, I know the problems that long holidays create for poorer families. Holiday learning loss contributes to widening attainment gaps between economically advantaged and disadvantaged students. Evidence gathered during the lockdown in April shows that pupils were doing on average two and a half hours of school work per day.

When broken down based on eligibility for free school meals a shocking gap can be observed. Around a quarter of pupils eligible for free school meals spent on average no time or under an hour on schooling compared with 18 per cent of those students not eligible.

The same survey found that roughly a fifth of free school meal pupils had no access to a computer at home, compared to seven per cent for other students. Another survey found that some pupils could return to school having made only 70 per cent progress compared to a normal year in reading and only 50 per cent in maths.

Another factor contributing to the attainment gap is the home environment, and specifically the involvement (or lack of) parents in a child’s educational development. Disadvantaged parents are less likely to support children because they may be in work, or lack the money to pay for tutoring, learning software or homework clubs.

These combined factors contribute to disadvantaged children falling behind their peers during long holiday breaks. Studies have found that only after seven weeks of teaching in the autumn do some children exceed the level of education they achieved prior to the summer.

And that’s before the impact on family finances. The average cost of holiday childcare in the UK is £133 per week. Between 2003 and 2015, nursery costs increased by 77 per cent while earnings have remained roughly the same. It is estimated that the loss of free school meals adds between £30 and £40 per week to parents’ outgoings during school holidays.

There is also evidence that long school holidays cause an increase in child poverty. Evidence from charities suggests that food bank use accelerates significantly among families during the long summer holidays as they struggle to feed their children every day. Every year, three million children are at risk of going hungry over the summer period every year.

Long periods out of school also have a knock on effect on children’s physical health. Evidence shows that children from more disadvantaged backgrounds suffered a greater loss of fitness following the summer holidays. The poorest quarter of kids see a drop in their fitness levels 18 times greater than the wealthiest 25 per cent over the summer.

There is wide variation the length of school holidays around the world. In some parts of Asia, including high performing countries like South Korea and Japan, students are only on summer holiday for four weeks, whereas in Italy and Portugal pupils are typically out of school for up to 13 weeks.

A number of academics have made the case for shorter summer holidays, including Professor Tina Hascher of the University of Bern, who has argued that four weeks of summer holiday should be enough to ensure pupils, teachers and parents are able to enjoy a degree of respite whilst mitigating the effects of the summer slide in learning.

When I was a teacher, I recognised the value of the summer break. It is an important time for students to rest and recover after a long academic year. But, I also know from experience the difficulty some students face when they start the year in September after a long summer of losing academic ground.

Lockdown has taught us the difficulties that come with long stints away from the classroom, with learning suffering, health suffering, families struggling financially and a widening attainment gap between well off and disadvantaged students.

This is why I am proposing that the Government introduce a shorter summer break of four weeks from Summer 2021, and consider reducing other holidays, including the upcoming Christmas break. These new weeks of learning should be used for structured activities and education in the term-time either side.

We cannot change the past. The time that has been lost has been lost. But we can make up for that lost time. Reducing the length of school holidays will help close this attainment gap, while reducing the burden on working families.

Edward Davies: Work and relationships are the core components of mental health. The lockdown has damaged both.

4 Nov

Edward Davies is Director of Policy at the Centre for Social Justice

The Coronavirus crisis will have many knock-on effects, but one of the biggest – the decline in the nation’s mental health – is already daily headline fodder.

Research published in the British Journal of Psychiatry found that recent suicidal thoughts had increased from one in 13 to one in 10 respondents since March: that’s the equivalent of an extra 830,000 adults thinking of ending their life.

A mega-survey conducted by Mind, the mental health charity, found that more than half the adult population reported a deterioration in their mental state during lockdown. Even six months on from telling us all to ‘stay at home’ ONS analysis finds almost four in 10 adults reporting high levels of anxiety in October.

The Department of Health in England has said, predictably, that it is increasing investment in mental health services in response. But maybe it shouldn’t. We need to learn from the last few months that addressing the mental health needs of the country is not about an ever-increasing spiral of public service spending.

Child and Adolescent Mental Health Services (CAMHS) are overwhelmed, and the knee-jerk response to expand them is understandable. But by the time a child gets there they are already likely to be suicidal. We must go much further upstream.

The last six months have reminded us that good public services, important though they are, are not at the root of mental wellbeing. In fact, the two core components have little to do with public services or government at all, and were profoundly undermined by the lockdown: our work and our relationships.

First, on work, there are few more important things to a person’s mental health than having a reason to get up in the morning. The Royal College of Psychiatrists is unequivocal about the importance of employment for people with mental health problems, they say it is “central to personal identity; provides structure and purpose to the day; gives opportunities for socialisation and friendship; and increases social networks – a core component of social capital”.

And secondly, on relationships, the evidence is even stronger. The Grant Study, a landmark 75-year longitudinal study of Harvard students, is utterly unequivocal about the importance of our relationships to mental and physical health:

“So what have we learned? What are the lessons that come from the tens of thousands of pages of information that we’ve generated on these lives? Well, the lessons aren’t about wealth or fame or working harder and harder. The clearest message that we get from this 75-year study is this: good relationships keep us happier and healthier. Period.”

The quality of our close relationships is fundamental to child mental health, too. Family instability is the single biggest reason that children report attending CAMHS. But, deeper than that, NHS data shows the very structure of our family relationships has a fundamental impact on the mental health of our children.

A primary school child with married parents has a six per cent chance of a mental disorder. It rises to 12 per cent for cohabiting parents and 18 per cent for lone parents.

This overwhelming evidence on work and relationships is reflected in the “happiness data” initiated by David Cameron and still quietly being collated by the ONS. After our health itself, the two most significant factors in an individual reporting that they are satisfied with their life is their marital status and employment status – way more important than other items we might assume, such as housing or income.

So what does that mean coming out of this crisis? It means that whenever policy talk turns to mental health, we need to remember the lessons of both this recent pandemic and thousands of years of history and evidence.

Public services are hugely important, but we will not prevent this problem by constantly pouring water on the fire.

If we want to truly tackle mental health problems in this country, we need to go deeper. We need to ask why, if close relationships are so important, we have allowed the most stable relationship form – marriage – to collapse to a quarter of the rate of a generation ago.

Why do our homes get smaller, our commutes get longer, and more people than ever live completely alone? As a start we should invest in greater relationship support in the early years of children’s lives and revive the Government’s Family Test to ensure housing and economic policy supports rather than hinders families’ wellbeing.

The Government has committed (but not spent) £2.5 million to conduct research into family hubs; this shouldn’t be a dry exercise, but should be done quickly enough to provide a road map to the delivery of family hubs in every part of the country.

Rev-up family support at pivotal moments like the birth of a first child. Birth registration should be a gateway into family support at the very moment parents need it most. Simply fire-fighting this problem with well-intentioned hoses of ever more school counsellors and spiralling public services will never prevent it in the first place.

Frank Young: Educational Long Covid. Why the collapse of schooling over lockdown will haunt the poor for years to come.

3 Nov

Frank Young is Political Director at the Centre for Social Justice

If the Marcus Rashford affair has taught us anything, it is that the Government is in urgent need of a poverty strategy to plug the hole in thinking when emergency measures come in.

Until recently, being Education Secretary was the Cabinet job everyone wanted, and for good reason. Number crunchers at the Department for Work & Pensions worked out some years ago that, for a poor child, failing at school was the number one predictor of staying poor in adult life. It’s as simple as that.

Well before state schools were closed down last spring (with private schools moving almost entirely online), the so-called educational attainment gap persisted as an annual reminder of this particular pathway into future poverty. Disadvantaged pupils are particularly prone to low levels of literacy and numeracy – and this in turn leads to low pay, insecure jobs and unemployment.

If we really want to ‘build back better’ when the pandemic is in the rear view mirror, we will need to tackle educational inequalities of outcome, in much the same way that we need to build houses.

More than half a billion school days have been missed since March, with children from disadvantaged backgrounds having less contact with their teachers and less work marked than wealthier children. In the first month of lockdown, private school children were twice as likely to take part in daily online lessons as those in state school.

The full impact of school closures on children’s outcomes is not yet known, but the closures are likely to have worsened the attainment gap. The exam fiasco over the summer will have further disrupted education for children at a critical time in their studies. This is a form educational Long Covid that will have an impact on already disadvantaged lives for many years to come.

We seemed to have stopped talking about the ‘root causes’ of disadvantage as we chase our tail to lockdown, bail out and subsidise our way out of the pandemic. Any poverty strategy will need to take a long hard look at where the educational disadvantage starts – and that is in the home. Between the ages of four to 16, a typical British child will spend only 15 per cent of their time at school. Damian Hinds got this when he described family life as the last educational “taboo”.

Home environments marked by multiple transitions, disrupted attachment to a parent and frequent conflict increase the likelihood of children displaying externalising behaviour problems, leading to poor engagement and attainment at school.

The experience of lockdown has only increased made the situation worse. In response to the escalating education crisis, we spend £26 on catch-up schemes for every £1 we spend on reducing conflict within families. That’s an argument for increasing the £1 – not decreasing the £26 that is desperately needed.

Our nursery sector is teetering on the brink following an extended, enforced shutdown. It is too soon to tell how many will shut their doors, unable to make running a nursery work but as ever this will hit the poorest hardest. At just 3 years old, disadvantaged children are almost 1.5 years behind their more affluent peers in their early language development.

Once attainment gaps arise, they are hard to close. Children who attend high-quality settings for two to three years are almost eight months ahead of children who attend none. This is exactly where we need to focus a renewed push to tackle poverty and disadvantage.

Schools are receptacles of disadvantage – whether it is a dysfunctional home life or a terrible start in life. We can now predict longer term educational underperformance from the earliest days: when Frank Field looked at this issue he found more than half of children in the bottom 20 per cent of attainment in school at school will remain at the bottom when they take their GCSEs.

As Robert Halfon has said on this website, we need a poverty strategy. The money set aside for catch-up should be rolled into the next spending review to give schools a permanent pot for focused, back-to-basics tuition in literacy and numeracy.

Small is beautiful when it comes to catch up – and we can lock this into our efforts to rebuild from the pandemic. Teachers make the difference, and getting the best teachers into schools with disadvantaged catchments should be a big priority. High-quality teaching is particularly transformative for disadvantaged pupils. Over a school year, these pupils get 1.5 years’ worth of learning with high-quality teachers; they lose half a year’s learning when taught by poorly performing teachers.

Don’t overlook family support, hidden away in the Department for Work & Pensions. The Reducing Parental Conflict programme now has three years of evidence based interventions to stabilise family life. It is much an education issue as it is a poverty issue for the department doleing out welfare payments. We need action now to tackle children going without – but we also need a plan that tackles disadvantage early on.

Philippa Stroud: The Coalition stopped officially measuring poverty – which left its successor unsightedover free schools meals

28 Oct

Philippa Stroud is Chief Executive Officer of the Legatum Institute, and leads the Social Metrics Commission.

Marcus Rashford presents the Conservative Party with a problem. No Conservative believes that any child in this country should ever go hungry, but we also want to build a society in which parents are able to earn enough to support their own children and, where that is not the case, in which there is a welfare state that supports those in need. These are our long-term objectives.

So what happens at a moment of crisis when there is a short-term need, and why has the call for the expansion of holiday provision of food and activities to support an additional 1.1 million children in the short term gathered such momentum?

In 2016, the Government abolished the old measure of poverty as an official measure. This means since that year it has been walking blind. Policy decisions have been made in a vacuum without a tool that shines a spotlight on the needs of the most disadvantaged.

The Government has made some great decisions, but without the certainty that what they are doing is hitting the target. Has poverty gone up? Is it plateauing? Until there is an agreed metric that tracks this, who can say?

That is why I launched the Social Metrics Commission (SMC) in 2016, drawing from left and right, and have proposed a new set of poverty metrics: to end the war on poverty measurement so that we could put our energy into working towards an effective poverty reduction strategy.

By the SMC measure, until the start of Covid-19, Conservatives could rightly declare that work was the best route out of poverty and, with record high levels of employment, this strategy was clearly effective, with 90 per cent of households where both adults work full time being out of poverty.

But during this global pandemic, the SMC measure also tells us it is those in deep poverty who are being most significantly impacted by the virus. Two in three (65 per cent) of those employed and in deep poverty prior to the crisis have seen reduced hours or earnings, been furloughed, and/or lost their job.

Although these numbers are not tracked by the Government, the public instinctively feels this to be the case. Locally, Conservatives know this too and are responding with short-term fixes.

The London borough of Kensington and Chelsea for example has promised £15 food vouchers over half-term for its 3,300 local children eligible for free school meals. Councillor Josh Rendall, the lead member for family and children’s services, said: “This is not a long-term solution but this is an exceptional year and we know it has been a tough one for many families.”

Conservatives have a good story to tell. Number 10 and 11 have worked tirelessly to put the entire resources of Government behind protecting the British people from Covid-19, including in the short term with increased support in the benefit system, the Job Retention (and soon Support) Scheme and, in the long term, through improved services for mental health and education, tackling the costs of housing and driving forward the levelling up agenda.

But in the absence of an effective poverty measure, we are unable to quantify the positive impact of all of these choices, gain credit for a comprehensive strategy on poverty, or identify whether there are short term challenges that still need to be addressed.

We need to be able to say that no child in Britain will go hungry on our watch – but we can’t. And we are allowing others to create a narrative for us, and in the absence of an agreed poverty measure and subsequent strategy, we always will. This does not need to be the case.

Had we had the SMC measure already in place, we would have been monitoring the impact of Covid-19 on the most vulnerable during this time of crisis. Had we adopted the SMC measure, we would have known in May that although the pandemic is hitting everyone, it is hitting those in deepest poverty the most and that short term measures may be required to see the poorest through this time.

It was Will Quince, a Work and Pensions Minister, who first announced that the department was taking forward the SMC measure of poverty and developing Experimental Statistics, back in May 2019. But even now, when accurate and timely data is needed more than ever, the work has stalled.

I know there will be some who will be nervous about a new measure of poverty, even one that has gained consensus across the political spectrum and already won the Government much political capital. But the measure is in effect a framework. It is the best way of capturing the “who” is in poverty – the “who” we need to be concerned about and looking out for. The Government can then decide where it wants to place its effort – so at a time like this it would have focused on those most impacted.

The Government could decide to focus on those who are moving in and out of poverty and close to the labour market (the top seven million). That is in effect what the £20 uplift has done in Universal Credit.

Or, it could decide to focus energy and resources on those in deep poverty – those who are 50 per cent below the poverty line (bottom 4.5 million). This is the most vulnerable group and where I would put my energy and effort at a time of national crisis. This is who many of the public thinks of as being in poverty, which is why they are so concerned now and why Rashford has received so much support.

I know that many Conservatives, like myself, came into politics because we were concerned about the long-term drivers of poverty. We feel deeply concerned about the most vulnerable in the nation. We know that poverty is about money, but that it is also about family, education and skills, debt, housing, sickness and disability, and employment. It is about the support being there when you need it so that you can get up and onto your own two feet again and find your own way out of poverty for you and your family.

This is a moment to take action in the short term – as the Government has been doing and still needs to do – but it is also a moment to get our house in order for the long term: to adopt the SMC poverty measure and build a comprehensive poverty strategy so that now and in the future we can say hand on heart, on our watch: no child went hungry.

Ryan Bourne: If you want to feed hungry children, don’t target food poverty. Aim to reduce poverty as a whole.

28 Oct

Ryan Bourne is Chair in Public Understanding of Economics at the Cato Institute. 

Covid-19’s initial economic impact fell disproportionately on those least able to mitigate it. An Institute for Fiscal Studies paper in July found that single parents, low educated poor households, and ethnic minority groups suffered the worst relative hit. Since then, workers in low-wage services industries such as hospitality, transport, and retail, have faced both the worst of unexpected job losses and uncertainty about their income.

With this unique shock, it is unsurprising that a welfare state built around previous experiences has exhibited failures in protecting against hardship. Falling incomes, especially for those without savings or access to government benefits, have consequences. The Food Standards Agency reports greater food bank use, self-reported hunger, and families eating out-of-date produce.

That context is why the Government faces intense pressure over extending free school meals during school holidays through Easter 2021. Given the uncertainty around the efficacy of other government support, you can see the temptation to follow the advice of Iain Martin, who proposes caving to Marcus Rashford’s campaign again. Give the “£20m, handshake with Marcus R on steps of Number 10 on Monday and Royal Commission into child poverty,” Martin tweeted.

That defeat might seem a small price to pay to end the optics of opposing meals for hungry children, regardless of any questions you might have about the realities, or the desirability of extending the government scheme. As Isabel Hardman writes, the belief that Conservatives are insensitive to “food poverty,” coming first in righteous anger over food bank use in 2010-2015 and now “free” school meals, has hung around the Conservatives for a decade, whether fair or not.

Martin’s short-term solution, however, neglects that campaigners won’t be satiated by extending out-of-term meal vouchers to Easter 2021. Rashford’s campaign’s ultimate aim, remember, is to implement the Dimbleby Review, which would double the number of kids on benefit-triggered free school meals by extending eligibility to every child from a Universal Credit household (an extra 1.5 million kids.)

Crossbench peer Baroness D’Souza is already pushing for out-of-term meal vouchers to become a permanent feature. Combined, that would be billions of pounds, year on year, not tens of millions.

Come next year, no matter the labour market’s health, the Government will face the same criticism. If much of austerity taught us anything, it’s that even when acute need passes, wrapping up programmess will renew accusations that Conservatives “want to starve kids” by “snatching” their lunches.

Milton Friedman’s warning that “there’s nothing more permanent than a temporary government programme,” in part stems from recipients’ aversion to losses. A Royal Commission packed with do-gooders who examine food poverty in isolation will bring further demands for spending and diet control.

That is why, I suspect, some Conservative MPs vociferously oppose the Rashford campaign. It’s not heartlessness, or even this specific extension they oppose, but the precedent and direction of travel. They can foresee the vision of government this type of reflexive policymaking and its paternalistic particulars end with.

The problem for them is that they are on a hiding to nothing in claiming this specific measure risks creating longer-term “dependency” or “nationalising children” if the public think today’s needs are real. Conservatives who believe in a small, limited state have to have answers —about what responsibility the Government should have in dealing with hardship, what tools it should use, and what its role should be for those falling through gaps.

After ten years in government and riding cycles of support for the welfare state, there’s a lack of clarity in the Party’s position, with a mix of preferences among its MPs for income support, service provision, civil society solutions, and combinations of the three. There is a clear, principled alternative vision of how to deal with poverty if the Tories want it. But it requires getting off the fence.

That alternative would say that “food poverty” is not distinct from poverty. Free school meal campaigners are broadly right that hunger is not usually caused by parental fecklessness.

Therefore, logically, food poverty largely results from insufficient disposable income for some families. If widespread hunger is evidenced, the debate should therefore be about whether benefit levels or eligibility are sufficient to meet basic needs—the goal of a safety net welfare state.

This type of limited support that trusts people to use top-ups for the betterment of their families is vastly preferable to a paternalistic state stripping us of responsibility, through demeaning out-of-term food vouchers akin to U.S. style food stamps.

In deep unexpected crises, the case for additional emergency income relief is greater. But if there really is a more structural problem of hunger, then it demands examining why wages plus benefits are insufficient to deliver acceptable living standards. Rather than just look at benefits then, we should examine living costs, too—the poor spend disproportionately high amounts on housing, energy, food, clothing and footwear, and transport.

My former colleague Kristian Niemietz wrote a free-market anti-poverty agenda back in 2011, which I’ve pushed MPs to adopt since. He showed that market-friendly policies on housing (planning reform), food and clothes (free trade), energy (ending high-cost green regulations), childcare (reversing the credentialism and stringent ratios), and cutting sin taxes to economically-justified levels could shrink poverty by slashing the cost of living for the poor, so reducing food hardship, homelessness and more.

Most of this agenda would require no extra spending or busybodying from government paternalists; some of the policies would bring the double-dividend of raising wages .

The Government has ambitious policies in a number of these areas. But why are they never linked to the poverty discussions? As they press for planning liberalisation, why is nobody highlighting how cheaper housing would lessen these tales of distress? Why is nobody identifying the discrepancy of some campaigning about food poverty while opposing trade deals that would make food, clothes, and manufactured goods cheaper, to the huge relative betterment of poor consumers?

Sure, there would be families who make bad decisions and find themselves in trouble, even in a world of cheap and abundant housing and an effective safety net.

But instances of poverty owing to lack of resources would be much lower and these thornier challenges (often stemming from addictions, loss, ill-health, criminality and more) are much better identified by local charities and civil society groups anyway, as Danny Kruger argued in the Commons last week in relation to hinger. Giving nearly three million kids “free” school meals year-round would be an absolute sledgehammer to crack any remaining nut.

In today’s emotive debates, it’s not enough to just oppose proposals when the need is perceived as urgent. Conservatives must be better at re-setting the debate on their terms—a task much easier if they held a clear vision of the role and limits of state action.

James Frayne: Expect people to prepare for minor civil disobedience at Christmas

27 Oct

James Frayne is Director of Public First and author of Meet the People, a guide to moving public opinion.

How much do the public care about Christmas? Will they be prepared to endure a minimal so-called “Digital Christmas” in the name of keeping the R-rate down?

Of course, everything depends about the perceived state of the country in mid-December. But let’s try to think about where we’re heading, where we might be at that point, and then about what the public might accept.

Let’s deal with the obvious first: those things that might make the public more willing to accept a Digital Christmas.

  • Concerns for the NHS will rise during the winter. Just as people know the NHS always struggles in the winter, so they’ll also know significant numbers of Coronavirus cases would be a terrible additional burden. While there appears to have been a large increase in hospital admissions during these early days of a second spike, it isn’t clear that hospitals are much more burdened than they otherwise would be (I suspect for complex reasons). Nonetheless, people will be alert to any change; and, clearly, if there is a serious surge in admissions and visible shortages of beds and care, with large numbers of deaths, people will think very differently about things, Christmas or not.
  • Optimism about a 2021 vaccine will be visible. I’m unclear at this point what the prospects of an effective vaccine will do to public opinion in the Christmas period. At one level, it might encourage people to play it safe for one last time before better times in the new year. (“If we can all make one last sacrifice…”) But it could also make people think their behaviour doesn’t matter so much, because help is on the way. I think they’ll certainly take a devil may care attitude if it appears that, contrary to the hype, a vaccine looks like it’s still many, many months away and if coverage is likely to be minimal. Politicians have wisely played down the idea of a game-changing vaccine for this reason
  • Public opinion is currently changing rapidly; people are becoming less willing to accept the rules as they are. At the moment, only a significant minority want looser rules and guidelines, the majority want things as they are; but the direction of travel is clear. A surge in serious cases and / or deaths would change things and make people more cautious, but a general uptick along the lines we’ve seen recently, or an uptick that mirrors seasonal admissions, would likely see demands for looser restrictions grow.

Let’s now look at those things that might make the public more hostile to a Digital Christmas.

  • Exasperation with the rules/guidelines will likely be much higher. We’ve known for some time people are struggling to understand the various rules and guidelines which are complex and change regularly.  (Unforgivably, Government Ministers themselves have struggled to remember what they are). But exasperation will turn to anger as we approach Christmas if the prospect of a Digital Christmas looks real. At this point, people won’t be irritated because the rules are complex; rather, they’ll be angry the rules seem inconsistent, bordering on stupid, as we’ve seen in Wales. They’ll ask, why, for example, people can still visit pubs, but can’t enjoy a single day with their closest relatives – some of whom might be on their own. There will be endless comparisons: why can we do this but not this?
  • Minor rule-breaking will increase. There are signs that this is on the rise, and that more people are becoming comfortable with risk. Forget the illegal raves and other illicit gatherings: I’m referring to regular minor rule-breaking – people not isolating for 14 days when they’ve come into contact with those that have tested positive; more people foregoing masks in supermarkets; people visiting others’ houses when they shouldn’t; and so on. This is surely likely to increase significantly in the coming weeks; more people seem to be thinking they’ll probably be OK if they break the rules in a minimal way (a massive change from the spring). The Government is alive to this; it’s been suggested the 14-day quarantine figure might be reduced. But the seal has been broken; rule breaking, however minor, is going to become common and by Christmas will likely be the norm.
  • Fears for the economy – and the high street in particular – will rise. Concerns for the economy is going to keep going up as Government support slowly tapers off and unemployment and business bankruptcies tick up. Because it’s so visible, the high street plays a disproportionately important role in the public mind; it’s a signifier for the health of the economy more generally. Given the health of the high street will be on people’s minds into Christmas – as it always is – public concern for the economy will be heightened.
  • Knowledge about the cause of infections will be higher. Partly because we simply know more about the Coronavirus and its effects – which the media is now passing on in more detail and more regularly – the public are going to increasingly question Government and scientific advice. They’re going to become more discerning judges of public policy. In the face-off between Greater Manchester and the Government, and in the criticisms of Government policy levelled by the hospitality industry, we are seeing more people ask questions about the causes of infections and the nature of their rise. In such a climate, people are more likely to question the basis for Government decisions on Christmas.

What does all this mean?

It’s hard to say at this point. As I’ve written a few times recently on this site, my strong sense at this point is that public opinion is moving against harsh measures because of a perception that –

(a) we always go back to square one whenever we loosen measures, so what’s the point?

and

(b) because concerns about the economy are finally starting to catch up with the reality of the grave economic situation.

My sense is that, for the reasons stated above, unless there’s a really very serious surge in deaths, and unless hospitals are demonstrably seriously more burdened than they would otherwise be (and not simply under the usual seasonal strain), then people will be extremely angry about the prospect of a Digital Christmas.

In turn, I would expect people to prepare for widespread minor civil disobedience; by that I don’t mean people having 20 people around for Christmas, but that many, many people will plan to invite guests from outside their bubble, and prepare to breach the rule of six for a few hours.

I’ve seen it said that people would accept a minimal Christmas if it appeared to be part of a consistent, national policy of restrictions.

I disagree with this view one hundred per cent; the point is, outside of a total national lockdown of the sort we saw in the Spring, it will never look like rules are being applied consistently and with good judgement. If people are already claiming that it’s ridiculous you can, say, go on a political demonstration but you can’t visit your elderly relatives, think how angry they’ll be around Christmas. (Incidentally, if any politicians did appear to breach their own rules in this period, it really would hit the fan).

You occasionally see people sneering about the public obsession with Christmas: it’s only one day; we’re not really a religious country; it’s not relevant to other faiths and those with none; and so on.

Of course Christmas isn’t primarily a religious festival for most; but it’s a day when people take time out to meet family members they might not otherwise see; and when many people try to include those that otherwise live lonely lives in something joyful.

The English aren’t naturally “big family” people: we have tight nuclear families, not the extended families you see in parts of Europe and Asia. Christmas is the exception. The Government should do everything possible to make sure people can enjoy something that feels vaguely festive. Or, yes, they’ll pay a price. Just watch Labour do everything they can to have their Christmas Cake and eat it on this issue.