Shining a light on an epidemic of health stories

As I was thinking about how to make sense of the various stories I read last week, the word ‘prism’ came into my mind. I couldn’t think why, but it was a persistent thought. You might remember from school days, a prism refers to a transparent solid used to refract or scatter a beam of white light. Later that same day, a post in my social media time line made me laugh out aloud - Where do bad rainbows go? To Prism. It’s a light sentence, but it gives them time to reflect (thanks to Liz Ann) and I thought okay, prism it is.

The prism I shined my light through were the surprising number of health-related stories published last week. There were quasi health stories like Wetherspoons banning customers from playing music on their phones or facetiming using their phone. The ban was introduced to promote the Weatherspoon mission of ensuring tranquillity in their pubs. Tranquillity as in peace of mind, being calm and freedom from anxiety or anger.

I’m also at an age where I enjoy tranquillity in my life. However, I am also of an age that puts me in danger of what has been called ‘uncompensable heat stress’ (UHS). According   to a study published in the Lancet Planetary Health last week, the recent heatwaves have raised my risk of serious health problems or even death for folk aged 60 and above. Its the consequence of the body losing its ability to cool itself. Just to reassure folk, I had my older man’s health MOT recently and all appears fine. One heatwave is okay, a succession of them, maybe not so.

I don’t think there was much sun shining at a Dumfries and Galloway farm last week. A case of Bovine spongiform encephalopathy (BSE) was confirmed. Daily Mail and Sun readers might be more familiar with the term ‘mad cow disease’. Back in 1990, BSE was a disaster for UK agriculture. Four million cattle were slaughtered in an attempt to contain the outbreak. Sadly, 178 people died after contacting Creutzfeldt- Jakob disease through eating BSE infected beef. A tragedy indeed.

Then there was the frightening story of Donald Trump declaring the MMR vaccine (Measles, Mumps and Rubella) given as a combined vaccination could be, in his words ‘quite lethal’. Not as lethal, perhaps as actually catching measles. It is a high contagious disease. In 2025, 960 people died of measles in the UK. In a disease that is more likely to kill young children, the largest group of these folk who died from measles were those over the age of 35.  We have been here before.

In 1998, the now disgraced Andrew Wakefield (a gastroenterologist, and not infectious diseases expert) caused a massive drop in measles vaccinations and an increase in deaths from measles in the UK during the late 1990’s and early 2000’s. Just like Trump and his medically unqualified Secretary of Health, Wakefield’s assertions that there was a connection between the MMR vaccine and autism is completely without scientific evidence.  It is a sad case of putting populist politics before hard science. The results are likely to be devastating for many generations of US communities.

Politics play a part in my penultimate prism scattering of health stories. There is a major outbreak of Ebola in the Democratic Republic of the Congo. The current outbreak is the result of a mutated virus called Bundibugyo. There is no effective vaccine or antiviral. Nearly 5000 cases have been reported, and last week over 2300 deaths had been recorded so far in this outbreak. Despite this already being the second worst outbreak in history, media coverage is almost completely absent. The silence is deafening.

The main province affected, Ituri, is a politically unstable region, and routine public health services such as childhood vaccinations have been severely disrupted. Equally, the US and to some extent, the UK, have stepped back from providing overseas aid which doesn’t help this situation. Under Trump, the US stopped its membership of the World Health Organisation, the only viable organisation capable of mounting an international aid response. They did so, very successfully in 2014, but the world has changed significantly since then, and so far, there is no international response.

You might think none of these matters to us here in the UK, but I suggest it probably does. Let me use my last shard of light to illuminate my thinking. Yesterday, the Cyprus Ministry of Health confirmed that a 74 year old man was being treated in an intensive care unit for a case of West Nile virus. It is a life-threatening disease. Again, there is no approved vaccine for this disease. It is a mosquito-borne infection, and he had never travelled outside of Cyprus. As the world appears to be heating up, the spread of mosquitos moves inexorably across western Europe. Perhaps take a little time to reflect on that thought.

The circle of life: birth and death

I start this week’s blog, with the sad news that Jason Arday has died. Although there has been no official cause of death announced, it appears the campaign of misinformation, and media hounding proved too much. As I noted last week in my blog, such intense and often unfair media scrutiny would undoubtedly have an impact on his mental health and wellbeing. Sadly, it seems I might have been right. Whatever else people might think, Jason was a father, brother, son, and partner. I hope he is finally able to rest in peace.

On a slightly more positive media topic, every week, NHS England posts an online news update. Last week’s headline included the announcement of the ‘Big Conversation’ giving people a chance to say what they expect/want from a National Care Service. However, it wasn’t this announcement, as welcome as it was, that caught my attention. It was an article further down the newsletter. It talked about the hundreds of thousands of women, who have accessed the morning-after pill in the first five months, since it was made available free of charge. Up until March this year 305,000 doses of the morning after pill were dispensed. The report doesn’t make it clear if this was 305,000 women though.

It is a brilliant intervention. As well as getting the morning after pill, women can also get advice about contraception and even take away a supply of contraceptive pills without the need to see their GP. In the 12 months to February 2026, the number of new women starting regular contraception doubled to 115,000. It’s a great example of preventive and health-promoting care. Reading the story, however, drew me down a new rabbit hole; one where I was left wondering whether this service contributes to the declining birth rate?

Indeed, birth rates have been steadily falling since 2010. In 2025, the UK saw its lowest number of live births, some 585,000, which was 10,000 fewer than year before. It was also the lowest overall figure since 1977. This meant that the estimated number of children born per woman was just under 1.4 in 2025. In order for countries to maintain a healthy population, the fertility rate needs to be more like 2.1 children per woman. It’s a worrying trend for future generations.  

Whilst there has been an overall decline in fertility rates, the most dramatic fall is to be found in those women aged 20-24 and 25-29 age groups. These are the so-called Generation Z. Today, the average age of first-time mothers is 30.9 years. It’s perhaps easy to see why women might be choosing not to have children. Clearly people have more choice over how they want to live their lives. We live in an increasingly turbulent and volatile time, and many will feel it’s not the best time to bring children into such a world.

It’s also an increasingly expensive world. The rise in the cost of living has not abated. Many people today are focusing on career pathways, getting a better salary, getting onto the housing ladder (40% of people aged 25 are living with their parents). Many women in Generation Z don’t see marriage, as something they necessarily want. Whether in a relationship or not, many men and women are happier with the freedoms not having children allows them. I’m a Baby Boomer, and moving closer to the death point on the circle of life and death. But I do worry not only for Generation Z, but the new Generation Alpha folk (those born after 2013).

There was one more baby* story last week, that as a provider of health care, left me feeling very challenged. I attended a webinar hosted by Penny Dash, Chair of NHS England. It was an opportunity to discuss the outcomes of both the Amos and Ockendon reviews into maternity services. These reviews showed both poor quality and unsafe practices were sadly the norm across too many maternity services. We heard some of the verbatim evidence submitted by parents who had experienced poor care and from some, who had lost their babies at birth. It was harrowing, and I could understand the fear that women might have in contemplating the birth of their child.

Interestingly for me, it was folk from mental health services, who were the most vocal contributors to the webinar, perhaps recognising the importance of compassionate care. One of the ‘take home’ messages for me was the notion that when things go wrong, which unfortunately they sometimes will, an apology should not simply be an event, but should be thought of as a process. Something, perhaps, the detractors of Jason Arday might want to think about.

 

*Actually, there were two other baby stories – the second one noted that the most popular date for giving birth is 28^th September, and has been for several years, and in England and Wales, babies are least likely to be born on Boxing Day.

Unlocking the door to greater access to mental health care

There was much in the news last week that made me stop and think. For example, the recently published outcomes from a study undertaken by researchers in Taiwan and the US. This looked at the link between medication (Viagra and Cialis) used to treat erectile dysfunction and the increased risk of blindness. Specifically, the development of glaucoma, a condition that affects over a million people in the UK.

Possibly because of the way my mind is wired, I thought about the work of Ivan Illich, and his notion of iatrogenesis. This concept can be found in his seminal work ‘Medical Nemesis’ published over 50 years ago. Essentially, he posited that in the case of health care, iatrogenic consequences (harm) can happen even where there has been the ‘correct’ application of medical interventions. In modern terms, maybe think protocols.  Thankfully the researchers were keen to note that their research could not point to a definitive correlation between taking the little blue pill and going blind.

Turning a blind eye appears to be what the great and the good might have been doing at Cambridge University. I don’t know if that is the case or not, but you can’t have helped noticing the plight of Jason Arday. He’s the Cambridge professor accused of plagiarism and embellishing his CV. It is not for me to say anything about these allegations; that is for others to work through. I was more concerned about the way in which he has been treated by both mainstream and social media.

I puzzle over the motivation for such behaviour from these keyboard warriors. Indeed, no sooner had his letter of resignation been published, than folk on social media had run the script through ChatGPT announcing that there was a 90%-100% certainty it had be written using AI. Whatever the truth regarding the allegations against him, to be hounded day after day must have had an adverse on his mental health and wellbeing. I sincerely hope he is able to get the help and support he might need to regain some welcome equilibrium back into his life.

The big announcement last week, which will impact upon anyone seeking help for their mental health was the £343 million investment in neighbourhood community hubs and mental health emergency departments. It is welcome news for sure. Across England, mental health services have always fared badly compared to physical service provisions. In recent years there has also been a reduction in the resources for mental health care, yet the demand for such care has steadily increased.  

This announcement is significant and follows a number of recent and important changes to mental health policy. A new national mental health strategy is being developed, alongside a Modern Service Framework for severe mental illness. Earlier last month, the Mental health personalised care framework: the modern care programme approach was published. This is aimed at improving services for all people with a severe mental health problem. There are clear new expectations of service providers, around the assessment and management of risk. It needs to be an approach that ensures better quality and safe care is provided, both for hospital care and when people are discharged back into the community. These are not and should not be changes in policy that lie dormant on a shelf somewhere. Responding to these changes will require improvements in what we currently do and the future transformation of the services being provided.

The new money, announced last week, brings with it opportunities and challenges. Not least of which is how such centres could be run; what operating model is likely to be the most effective in bringing about change; and where will the staff come from? All of which, we are currently looking at in our organisation.

Fundamentally, anyone with a mental health problem should simply have just one front door to pass through to gain help. This can be a physical or a ‘virtual’ door (just have a look here at what they are doing in Singapore). Deciding on how to best meet a person’s needs should be a joint endeavour and not one determined simply by a professional or care group response. New buildings are always welcome, but how these are used is probably more important, if we are to avoid future iatrogenic consequences for our service users and their carers.

Let’s care about the future of care

Back in 2024, I was invited to a 200-year anniversary dinner at the University of Manchester. The pre-dinner speaker was Sir Chris Whitty, currently the Chief Medical Officer for England. He spoke about how the population’s health has changed over those 200 years. Chris is a great speaker, and uses data very effectively in getting his point across. One of my take aways from that evening was the notion that if we live long enough, we will all get cataracts and some form of dementia. It was a sobering thought.

The last couple of weeks have seen much discussion about UK social care, much of which has been focused on the financial and emotional costs of caring for someone living with dementia. The Prime Minister’s father lives with dementia. My mum lived with dementia in the last decade of her life.  Despite the very best efforts of my dad, my brothers and sisters, eventually mum’s needs meant that she could no longer be cared for at home, and she was admitted to a residential care home. She died aged 91.

Hers is a familiar tale. In March this year, there were nearly 800,000 people aged over 65 who were said to have dementia in the UK. Nearly 500,000 had been formally diagnosed with dementia. It estimated that by 2040, there will be 1.4 million people living with dementia. Currently the cost of dementia across the UK is £45 billion. By 2040 it is estimated this will increase to £90 billion. These are State borne costs, and account for almost 78% of local councils funding across most of England.

Individual families are often faced with meeting the costs of their loved one’s care. Residential care averages at around £1000 a week. Where nursing care is also required, such as that my mum received, the cost rises to an average of £1300 a week. My mother’s care was funded through the NHS due to her primarily having health-based needs. The dementia just added to her overall complex care needs. While help with such costs is available there are strict criteria that often make accessing such financial help difficult. For example, if you have savings of more than £23,400 you are not eligible for any financial help. People can require residential nursing care for many years, and the overall costs of such care can run into £100’s of thousands. Many families have to sell off their parents’ house in order to pay for the costs of care.

Surprisingly, a survey undertaken by the Kings Fund last year revealed that 33% of those asked believed such care was free at the point of use, with a further 18% stating they didn’t know. Despite what Chris Whitty had to say about if we all live long enough, we will all get dementia, currently 1 in 3 people alive today will be diagnosed with dementia.

Last week saw Baroness Louise Casey announce the start of her ‘Big Conversation’ as part of her review of adult social care in the UK. The review is said to provide the evidence required to create a National Care Service. The ‘Big Conversation’ is aimed at both gathering people’s experiences of the current system, and educating people about the realities of social care. Against such a background it is perhaps not surprising that our new Prime Minister has set solving the problems of creating a National Care Service as one of his high priorities. Last week he bluntly observed that the NHS is likely to collapse without the effective reform of the current social care system. The delivery of the outcomes of the Casey review has now been brought forward by 12 months.

However, Burnham has a tough task. Securing cross political party support is but just one issue, persuading people to pay (in one way of another) for social care services, is also likely to be difficult. Finding people with the skills and knowledge to provide such care will require a different way of thinking (maybe a unified national health and care workforce) as much as it will require future investment. I don’t know what the solutions might be, but I feel that none of these challenges should be seen as insurmountable problems.  

I’m on the waning side of the Chris Whitty life trajectory. That said, I am an early baby boomer. Over my lifetime I have benefited from greater economic opportunities, had the best the NHS has been able to provide, and continue to benefit from the triple locked UK pension system. I’m living a life far removed from poverty, (although of course there are many folk my age who are not so fortunate), and touch wood, I enjoy good health. However, for the sake of us all, I sincerely hope this time around we can achieve a breakthrough in what has so often been seen as intractable issues in delivering a national care service.