Kamis, 28 Maret 2024

Could assisted dying be coming to Scotland? - BBC

Scottish Liberal Democrat MSP Liam McArthur signs a board in the lobby of the Scottish Parliament for other MSPs to record their support for his Member's Bill on assisted dying,Getty Images

Scotland could become the first UK nation to provide terminally ill people with assistance to end their lives if a bill being introduced at Holyrood is approved.

Supporters of the legislation say it would ease suffering.

Opponents worry that some terminally ill people could feel under pressure to end their lives.

The Assisted Dying Bill is drafted by the Lib Dem MSP, Liam McArthur, who expects it to be debated this autumn.

The bill is published on Thursday and will potentially be voted on next year.

The Scottish government says ministers and SNP backbenchers will not be instructed how to vote, as the matter is an issue of individual conscience.

First Minister Humza Yousaf, who is a Muslim, has indicated that he is likely to vote against the bill, which is also opposed by the Church of Scotland, the Catholic Church in Scotland, and the Scottish Association of Mosques.

Under the proposals, a patient could only request medical assistance to end their life if they had a terminal illness and had been ruled mentally fit to make the decision by two doctors.

Mr McArthur says "the terminal illness would need to be advanced and progressive" and the medics would have to ensure there was "no coercion."

In addition, the patient must be aged 16 or over, a resident of Scotland for at least 12 months, and must administer the life-ending medication themselves.

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In Scotland, it is not illegal to attempt suicide but helping someone take their own life could lead to prosecution for crimes such as murder, culpable homicide or offences under the Misuse of Drugs Act 1971.

In England and Wales, the Suicide Act 1961 makes it an offence to encourage or assist the suicide or attempted suicide of another person. In 2015, the House of Commons decided against changing the law by 330 votes to 118.

In Northern Ireland, a similar offence is set out in the Criminal Justice Act 1966.

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This will be the third time that the Scottish Parliament has considered the issue.

In 2010, MSPs rejected Margo MacDonald's End of Life Assistance Bill by 85 votes to 16.

The independent MSP, who had Parkinson's Disease, died in 2014 and the cause was taken up by Patrick Harvie of the Scottish Greens.

The following year, his Assisted Suicide Bill was rejected by 82 votes to 36.

The title of Mr McArthur's bill — Assisted Dying rather than Assisted Suicide — reflects a change in approach from campaigners.

Critics such as Dr Fiona MacCormick of the Association for Palliative Medicine (APM) say the new terminology is "harmful and unhelpful," adding, "they've used very euphemistic language to talk about suicide."

Mr McArthur says he would "strongly disagree," because "we're talking about people with a terminal illness, and the fact they are going to die has already been established."

The MSP for Orkney Islands believes there has been a significant "mood shift" among his fellow parliamentarians since the issue was last debated and is hopeful that his proposal will be approved.

Gillie Davison assisted dying supporter Hawick

So is Gillie Davison, whose husband Steve died of throat cancer last April, at the age of 56.

Ms Davison, from Hawick in the Scottish Borders, says even high-quality palliative care did not ease his suffering in the final days and hours.

"It wasn't a good death because he was distressed and he was upset," she explains.

"It wasn't what he wanted. He wanted that choice."

She believes an assisted dying bill would have allowed her husband to "go to sleep" peacefully at home and could prevent other families from enduring a similarly "devastating" experience in future.

Changing the law, she says, would be "compassionate and kind."

But Dr MacCormick says she is concerned about the potential for inaccurate diagnosis and prognosis, undetected coercion, and fluctuating mental capacity in seriously ill patients.

"As a palliative care doctor, when I see patients who are suffering, I don't see the answer to their suffering as being to end the life of the sufferer," she says.

But some terminally-ill patients say they would find the option reassuring even if they did not use it.

Mandie Malcolm

In 2015, at the age of 26, Mandie Malcolm from Falkirk was diagnosed with breast cancer which had spread to other parts of her body.

She was told that her life expectancy was two to five years.

Now 34, Ms Malcolm is still alive thanks to advances in cancer treatment but, she says, she lies awake at night worrying about how her life will end.

Until starting a new drug, she says, she was "bedridden for weeks and in huge amounts of pain.

"I really worry about my death. I worry that I'm going to suffer, horrifically, basically, and it does scare me," she explains.

Ms Malcolm is strongly in favour of the assisted dying law, which she says would mean she could stop worrying about "dying a brutal death" and "enjoy the good times."

"It would mean everything to me and my family," she adds.

But campaigners against the measure point to laws enacted in Belgium and Canada where qualifying criteria have been loosened over time, leading to a sharp rise in the number of "assisted" deaths.

Mr McArthur says his proposed law is not modelled on those "permissive and expansive models" but on places such as the US state of Oregon where "the eligibility criteria has not changed at all" since becoming law in 1997.

He is supported by the broadcaster and campaigner, Dame Esther Rantzen, who recently revealed that she was considering travelling to Switzerland - where assisted suicide has been legal since 1942 - to die after being diagnosed with incurable lung cancer.

She says: "I want to congratulate the Scottish Parliament for prioritising this debate so that they can carefully consider this crucial issue and scrutinise this historic Assisted Dying Bill."

Audrey Birt (who is receiving palliative care from her local hospice – uneasy about a law change):

Audrey Birt from Edinburgh also has terminal cancer, the latest of five breast cancer diagnoses over 30 years, and has spent the past 12 years "in and out of hospital."

But she does not want assistance to end her life and has concerns that, if the law is changed, some patients might feel that they must do so to help their families.

"In Scotland," she says, "we don't like to be a burden.

"That's the aspect I worry about — that there may be pressure," she explains.

Instead Ms Birt, who is 68 years old, says there should be increased investment in palliative care, which she receives at St Columba's Hospice in Edinburgh.

"After coming here and being more aware of what's on offer, I do wonder if it was available to everyone, would that take away some of the fear that is behind the bill?" she asks.

Helen Malo of the charity Hospice UK says her organisation is neutral on the bill but wants better funding of palliative care.

hospice 1

Hospices support more than 21,000 people in Scotland each year, she says. But they are struggling, with only a third of their funding coming from the state, the rest from charitable donations, and rising costs.

"One in four people do not get access to specialist palliative care," adds Ms Malo, who says that, as the nation ages, demand is expected to increase by a fifth by 2040.

"There are fewer specialist palliative care doctors in Scotland than there are MSPs," says Dr MacCormick of the APM.

Without adequate palliative care, she says, the worry is that assisted suicide "is not just a choice. It becomes a suggestion, which then becomes an expectation and that our vulnerable patients are at risk."

Supporters of the bill say they too want more funding for hospices and are prepared for a debate about how and if such a commitment could be woven into the bill.

They also know that moral, religious and practical objections must be overcome if the momentous change they propose is to become law.

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2024-03-28 06:10:55Z
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Pupil behaviour 'getting worse' at schools in England, say teachers - BBC

Stock image of secondary school children next to lockersGetty Images

Nearly one in five teachers in England has been hit by a pupil this year, a survey commissioned by the BBC says.

One teacher told BBC News behaviour was a "never-ending battle". Another said spitting, swearing and chair-throwing were among the things happening often.

A union says its members are reporting worsening violence and abuse from pupils since the Covid pandemic.

The Department for Education (DfE) says it has invested £10m in behaviour hubs to support schools.

Using the survey tool Teacher Tapp, BBC News asked up to 9,000 teachers in England in February and March a series of questions about their experiences with behaviour in the classroom.

A greater proportion of primary and secondary teachers reported pupils fighting, pushing and shoving compared with two years ago.

Lorraine Meah has been a primary school teacher for 35 years, for the last five of which she has chosen to do supply work - covering lessons on an ad-hoc basis - because it is more flexible.

Over that time, she says pupils' behaviour has worsened.

Lorraine Meah, supply teacher
Gemma Laister

She says she has seen nursery and reception-aged children "spitting and swearing", with the worst behaviour from five and six-year-olds with "dangerous tendencies" like throwing chairs.

"You will get three or four children in your class displaying challenging behaviour. That's hard to deal with when you've got a class of 30," says Mrs Meah, who teaches in the Midlands.

Another Midlands-based teacher, Zak Copley, did supply teaching for a year and also says behaviour is "definitely getting worse" and sometimes feels like a "never-ending battle".

On one occasion, the computer science teacher said he had to pull pupils apart after they began "throwing punches" at one another.

"The room got absolutely ransacked," he says, remembering that displays were "ripped off the wall".

On another occasion, a pupil who had been sent out of class tried to break back into the room with a cricket bat, he said.

In Dewsbury, West Yorkshire, St John Fisher Catholic Academy for 11 to 18-year-olds is working hard to improve its behaviour.

In 2022, it was rated "inadequate" by Ofsted, whose inspectors found poor behaviour by pupils, including frequent fighting, made others feel unsafe.

"There was a culture of bullying and an atmosphere of intimidation," says Karl Mackey, the school's fifth head teacher in six years.

"We had a lot of internal truancy - kids going into toilet cubicles vaping and using mobile phones."

Karl Mackey, head of St John Fisher Catholic Academy in Dewsbury
BBC/Dan Nelson

Since Mr Mackey joined a year ago, his new behaviour policy has seen pupils rewarded for good attendance.

Corridors are closed off to stop children being able to wander the whole school if they leave a lesson. There are strict rules about going to the toilet during lessons and mobile phones are banned.

He has also brought in more subjects including dance, drama and music.

Year 9 pupil Tamika was excluded from her previous school, and says pupils at St John Fisher have "settled down" since the rule changes.

"I find it easier to co-operate with teachers and speak to them if I am struggling with a lesson, and I can get my head down," she said.

"There are less students going round kicking off. If they do, there will be steps in place for them to reflect on their behaviour - like going into isolation, or being sent home."

Mr Mackey says the school tries its best to avoid suspending children if possible.

He says the whole school community, including local residents, have noticed children behaving better.

"There's been a real shift. This year you'll see them in lessons every single day, not late, in perfect uniform, trying their hardest," he added.

In the Teacher Tapp survey, the BBC also found:

  • 30% of all teachers said they had witnessed pupils fighting during the week they responded to the questions
  • Two in five respondents said they had witnessed aggressively violent behaviour that needed an intervention in a single week
  • 15% of secondary teachers said they have experienced sexual harassment from a pupil when working at school.

Dr Patrick Roach, general secretary of the NASUWT union, says teachers are reporting that violence and abuse in schools "have risen notably" since the pandemic.

"This is being compounded by cuts to specialist behaviour and mental health services for children, which have left teachers doing their best to fill the gaps and meet the needs of pupils that really require the skills of specialist counsellors and therapists," he said.

The DfE says "decisive action" is being taken to improve pupil behaviour.

A spokesperson added it had doubled its mental health and wellbeing scheme for head teachers this year, backed by £1.1m.

Teacher and union representative Debra de Muschamp stands smiling outside school

In 2020, the DfE launched a £10m behaviour hub programme to allow hundreds of struggling schools to be paired with others to learn new ways of dealing with poor behaviour.

The programme finishes this year.

Abuse from parents

One in five respondents to the BBC's survey said they had experienced online abuse from a parent or guardian since September. A similar number said they had experienced verbal abuse.

Head teachers' union NAHT says some members are experiencing growing problems among a "minority" of parents.

"It can be face-to-face, on the telephone, on social media... enough is enough," says Debra de Muschamp, a regional NAHT secretary who runs three primary schools in north-east England.

NAHT, which is running a local campaign to tackle parent-on-teacher abuse, says head teachers have had tyres slashed and been physically assaulted.

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2024-03-28 00:55:35Z
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UK weather warnings for wind and rain issued in run-up to Easter weekend - The Guardian

Heavy rain and strong winds could disrupt travel and pose a risk to life in the run-up to the Easter weekend, forecasters have said.

The Met Office issued yellow warnings across parts of Northern Ireland and the south of England.

Forecasters said heavy rain could affect travel and infrastructure in the east of Northern Ireland on Wednesday and Thursday, with 15-20mm of rainfall in some areas.

A yellow warning for 70mph (113km/h) gusts would be in place on Thursday for most of the south coast of England, from East Sussex to Cornwall.

The Met Office said there was a small chance of injuries and risk to life as a result of the strong winds and large waves, as well as the possibility of hail and thunder.

For those travelling over the bank holiday weekend, the RAC advised drivers to beware the changing road conditions.

People living in affected areas should expect longer journey times, potential power cuts and disruption to mobile phone coverage.

The Met Office said the forecast for the Easter weekend remained unsettled but it was likely to be bright and breezy, with temperatures of up to 15C (59F) in west London and 14C in Manchester on Sunday, typical for this time of year.

A spokesperson for RAC Breakdown, Rod Dennis, said: “With plenty of classic early spring weather over the Easter bank holiday weekend, drivers getting away will definitely need to be on their guard and ready to cope with rapidly changing road conditions.

“Slowing down in the heaviest of downpours on Good Friday and Easter Saturday is a must as stopping distances will be far greater.”

The Met Office spokesperson Grahame Madge said: “Good Friday sees low pressure continuing to feed showers and longer spells of rain across the UK, although drier spells will develop in the east.

“Saturday continues this pattern but, for many, Easter Sunday is likely to be the best day of the weekend before conditions turn more unsettled again on Easter Monday.”

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2024-03-28 02:30:00Z
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Rabu, 27 Maret 2024

Public satisfaction with NHS at lowest ever level, survey shows - BBC

Surgeons at workGetty Images

Public satisfaction with the NHS has dropped again, setting a new low recorded by the long-running British Social Attitudes survey.

Just 24% said they were satisfied with the NHS in 2023, with waiting times and staff shortages the biggest concerns.

That is five percentage points down on last year and a drop from the 2010 high of 70% satisfaction.

The poll - the gold-standard measure of the public's view of the health service - has been running since 1983.

More than 3,000 people were polled by the National Centre for Social Research across England, Wales and Scotland in the autumn.

Health is devolved so it is up to each nation to decide on policies for the NHS.

The findings on the NHS, published by the Nuffield Trust and King's Fund think tanks, show once again that performance has deteriorated after a new record low was seen last year.

In total, since 2020, satisfaction has fallen by 29 percentage points.

Of the core services, the public was least satisfied with A&E and dentistry.

Chart showing satisfaction levels with NHS

The survey also showed satisfaction with social care had fallen to 13% - again the lowest since the survey began.

The major reasons for dissatisfaction were long waiting times, staffing shortages and lack of funding.

When asked about government choices on tax and spending on the NHS, 48% backed increasing taxes and spending more on the NHS, but 42% preferred to keep taxes and spending the same and 6% backed reducing taxes and spending less.

Those with the highest incomes were more likely to want to increase taxes and spend more.

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'I feel let down'

Samuel Wilson

Samuel Wilson, 45, who lives in Worthing, West Sussex, has been left unable to work due to mobility and pain problems following two hip replacements.

He is now awaiting further treatment. "I can't walk very far without excruciating pain," he says.

"I feel let down. The NHS is there to help you, not make things worse. I feel they have treated me disdainfully. The nurses are polite, I've found, and even my surgeon.

"But they are not providing the level of care required. And they know they are not providing the level of care required but trying to deal with them is like banging your head against a brick wall."

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Rory Deighton, the NHS Confederation's acute network director, said the figures "reflect exactly how people are feeling".

"Times are tough, it's hard for staff and I think people recognise that," he told BBC's Breakfast programme. "We've had a really hard year."

He said the focus for NHS leaders in the next 12 to 24 months would be on improving GP and dental access, and cutting waiting lists.

As well as calling for increased spending on hospitals, GP surgeries and social care, Mr Deighton said there was a "really strong link" between industrial action and the size of waiting lists for elective treatments.

Junior doctors in England have staged 10 walkouts since March last year in a row over pay and recently voted to continue strike action.

Jessica Morris, from the Nuffield Trust, said the findings were worrying.

"As we approach a general election, political parties should be frank and realistic about the challenges ahead of them if they are to turn this situation around.    

"Despite such low levels of satisfaction, the public continue to back the principles underpinning the NHS.

"The public has not fallen out of love with the idea of a publicly funded, free-at-the-point-of-use NHS, but they are losing confidence that it will support them and their loved ones in the best possible way when they need it."

Chart showing satisfaction levels with NHS

The Patients Association said it was "dismayed" by the survey results.

And Royal College of Nursing general secretary Prof Pat Cullen said: "Enough is enough".

"Voters must now make NHS and care services the central issue of the general election," she said.

"An NHS that was once a world-leader is now treating patients in corridors, doorways, and store cupboards. The status quo has become intolerable."

But a Department of Health and Social Care spokesman said progress was being made, with some signs that the waiting list was falling, while investment was being made in key areas, such as GPs.

"We are fully committed to a faster, simpler and fairer NHS, free at the point of need," he said.

A Scottish government spokesperson said other research showed people in Scotland were more satisfied with the way the NHS was run than this survey suggested.

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2024-03-27 07:15:09Z
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Clapham chemical attacker granted asylum despite concern over lies, papers reveal - Evening Standard

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  1. Clapham chemical attacker granted asylum despite concern over lies, papers reveal  Evening Standard
  2. Ezedi: Church limited Clapham attacker's attendance after sex assault  BBC
  3. Tory minister warns of 'loophole lawyers that are grooming people' to gain asylum  The Independent
  4. Churches risk undermining asylum system after Clapham attacker's conversion, says Home Office  The Telegraph
  5. Clapham chemical attack suspect was granted asylum despite concerns over honesty  The Guardian

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2024-03-27 07:23:27Z
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Politics latest news: Ministerial resignations 'not surprising', insists Tory frontbencher - The Telegraph

Ministerial resignations are “not unsurprising or unnatural” at this stage in the election cycle, a Tory frontbencher insisted after Rishi Sunak suffered a double blow yesterday. 

Robert Halfon unexpectedly quit as skills, apprenticeships and higher education minister, while James Heappey followed through on his stated intention to step down as armed forces minister. 

Andrew Griffith, the science minister, sought to downplay the significance of the resignations as he argued the Tories have a “broad and deep bench to draw from”. 

Asked why he believed ministers were quitting ahead of the general election, Mr Griffith told Times Radio: “These are ministers that have given a great deal to this country, they have done a big tour of duty in government and they have also been parliamentarians for a long and distinguished period of time.

“We are very fortunate in the Conservatives, we have a broad and deep bench to draw from and so it is not unsurprising or unnatural at this point in the cycle that out of the many ministers that we have in government that some have decided that their next tour of duty lies elsewhere.”

You can follow the latest updates below and join the conversation in the comments section here

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2024-03-27 09:49:00Z
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4m hours of raw sewage discharges in England in 2023, data expected to show - The Guardian

More than 4m hours of raw sewage discharges poured into rivers and seas last year, a 129% increase on the previous 12 months, new figures are expected to reveal on Wednesday.

Total discharges from the 14,000 storm overflows owned by English water companies that release untreated sewage into rivers and coastal waters increased by 59% to 477,972, making 2023 the worst year for sewage spills, according to an early estimate of the Environment Agency figures seen by the Guardian.

Senior industry sources were preparing for the government to turn its guns on water companies after the record year of discharges. The Environment Agency said it was setting up a whistleblowing hotline for people who work in the industry to report any activity that concerns them.

The heavy rainfall over the autumn and winter is likely to be blamed by the industry for the huge rise. Storm overflows are supposed to be used only in extreme weather but for many years they have been used routinely, discharging raw sewage even on dry days in some cases. The academic Peter Hammond has shown how water companies are routinely using storm overflow discharges in their water management.

This year, for the first time every storm overflow has been fitted with a monitor, known as an EDM, but the scale of the rise in discharges is beyond what full monitoring would be expected to provide.

The scale of releases into waterways comes as rivers in England are at crisis point, suffering from a toxic cocktail of raw and treated sewage pollution, chemical toxins and agricultural runoff.

The revelations will put pressure on the water industry and the government, whose plans to tackle storm overflows have been criticised for not going fast enough. The plan aims to eliminate only 40% of raw sewage overflows into rivers by 2040 and discharges would continue being released into waterways until 2050.

In the last few weeks ministers have engaged in a flurry of announcements in anticipation of the shocking data on record sewage spills.

These included an announcement of a £180m plan to fast-track action on sewage discharges, in the face of criticism not enough is being done.

The water industry wants to invest a record £96bn to the end of the decade to tackle sewage discharges, leaks and the impending water supply crisis but has been criticised for passing the costs on to customers for investment that should have been carried out years ago.

The regulator Ofwat has to decide whether to allow companies to increase water bills to pay for the investment. Some customers will face huge bill rises to pay for vital infrastructure work. Thames Water is seeking to raise bills the highest of any company, by 40 per cent. Ofwat is the ultimate arbiter of whether the industry will be allowed to pass the cost directly on to customers as they seek to tackle years of underinvestment and the pressure of extreme weather from climate change.

When the full data from every storm overflow in England is released by the Environment Agency on Wednesday, some rivers and seas are likely to be shown to be suffering hugely from sewage pollution.

As well as total discharges increasing from just over 301,000 in 2022, the average discharge per storm overflow has increased to almost 35, a 52% increase, suggesting huge surges in spills into some waterways.

More than 60 discharges a year from a storm overflow should spark an investigation by the Environment Agency. The agency is in the middle of a criminal investigation into potentially illegal discharges by water companies and the regulator Ofwat is investigating six firms for widespread illegal sewage dumping from treatment works via storm overflows.

Industry insiders said groundwater ingress into pipes is to blame for some of the scale of the discharges.

Figures from the Met Office show 2023 had four individual months within the top 10 wettest on record and the UK recorded its sixth wettest October since 1836 last year.

Met Office assessments said Storm Babet in the autumn brought the third wettest three-day period on record for England and Wales. In November Storm CiarĂ¡n was an exceptionally powerful storm, comparable to the Great Storm of 16 October 1987. Rainfall in the autumn of last year was 410mm, which is 122% of the 1991-2020 average.

Defra has been approached for comment.

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2024-03-27 02:30:00Z
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