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

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By Nick Triggle

Health correspondent

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.

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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.

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.

'I feel let down'

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."

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."

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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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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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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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 Ciarán 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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Rishi Sunak forced into mini-reshuffle after two ministers quit amid Tory exodus - Evening Standard

As part of the changes, Nus Ghani has been selected to be Minister for Europe in the Foreign, Commonwealth and Development Office; Leo Docherty will serve in the Ministry of Defence, Kevin Hollinrake will go to the business department, Luke Hall will be a minister in the Department for Education and Alan Mak will serve as a parliamentary under secretary.

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Churches risk undermining asylum system after Clapham attacker's conversion, says Home Office - The Telegraph

Churches risk undermining the integrity of the asylum system, Home Office sources have said, as it emerged the Clapham chemical attacker was allowed to remain in Britain despite lying and failing a Christianity test.

Immigration files published on Tuesday showed that convicted sex offender Abdul Ezedi was granted asylum after he claimed he had converted to Christianity and his application was backed by a Baptist church minister.

The minister’s evidence was critical in persuading an immigration judge to allow his application, despite a Home Office warning that he was “using religion for his own ends” after he gave incorrect answers to questions about Christianity. Evidence presented in court also showed that he had lied persistently about his background.

A source close to James Cleverly, the Home Secretary, said he had called a meeting with the “vast majority” of Christian churches following Ezedi’s death.

The source said: “We wanted to relay the potential damage to those churches of being seen, rightly or wrongly, as acting against the integrity of our asylum system, where Christian conversion has been brought up at appeal. In this case, the consequences were appalling.

“That reputational risk is only amplified by the fact someone who denied knowledge of Ezedi at the time had in fact known of him within their church, and had supported and vouched for him.”

Ezedi, a 35-year-old Afghan national, had twice been refused asylum by the Home Office, and was considered so dangerous by the Baptist Church that it drew up a “safeguarding contract” for the safety of parishioners over his sex assault and exposure convictions.

Abdul Ezedi died in the Thames while on the run Credit: Metropolitan Police/PA

He came to the UK illegally in 2016 and died in the River Thames while on the run after attacking a 31-year-old mother and her two daughters with a corrosive substance in Clapham on Jan 31.

Ezedi was granted asylum by the immigration tribunal judge on his third appeal in November 2020 after he claimed he had converted to Christianity and would be persecuted if he returned to Afghanistan.

Tim Loughton, a member of the home affairs select committee, called for a full investigation. “The details of this shocking case go to underline the suspicions we have had all along that migrants are playing the Christianity card to game the system in too many cases,” he said.

“But there is a worrying disconnect here between the Home Office who look at these cases rigorously and decide there is not a credible claim, then on the same evidence tribunals seem to think they know better and overrule the detailed work that the Home Office has already done.

“Clearly the system is not working properly. We need to have a full investigation into why it is that in too many cases, tribunals think they know better and are overruling the experts in the immigration service.”

Church accused over ‘conveyor belt’ of baptisms

The comments come after the Church of England faced accusations from a priest that it had become complicit in a “conveyor belt” of asylum seeker baptisms used by migrants to remain in the UK.

Rev Matthew Firth, who was priest in charge at a parish in the North of England, told The Telegraph earlier this year that he had discovered around 20 cases where failed asylum seekers sought baptisms at his church to support their appeals for leave to remain.

The Church of England had previously said that “it is the role of the Home Office, and not the Church, to vet asylum seekers”.

The files show that Ezedi persistently lied about his background, including about whether he had worked in the UK before. A judge who rejected his asylum appeal in February 2017 ruled that he had fabricated accounts of his background that created a “wholly unreliable and inconsistent” picture that was “lacking credibility”.

He gave differing accounts of how his brother died, changed his story about whether he was a Sunni or Shia Muslim and claimed he had never worked in the UK when he had had a job as a car mechanic, according to the documents. He also claimed that he had depression and suicidal thoughts, and that he had been shot by the Taliban.

The Home Office also told the tribunal that Ezedi had been unable to explain the reasons for his conversion, or demonstrate a clear understanding of Christian principles and beliefs during an interview. 

Despite concerns about his honesty, Judge William O’Hanlon believed his conversion was “genuine” and allowed Ezedi’s appeal on asylum and human rights grounds, overturning the Home Office’s rejection of his claim.

Judge O’Hanlon conceded that while Ezedi had been discredited on multiple occasions, he decided to allow the appeal on the strength of the “most compelling evidence” from Rev Roy Merrin, a Baptist minister.

Rev Roy Merrin supported Abdul Ezedi's asylum application Credit: NNP

Rev Merrin admitted he was aware of people who fraudulently claimed conversion with “ulterior motives” but told the tribunal he did not consider Ezedi as such a person. Rev Merrin had attended tribunals on four previous occasions to support Christian convert asylum seekers and wrote in support of Ezedi’s conversion.

Judge O’Hanlon granted asylum after concluding Ezedi’s conversion was “genuine”.

He said: “Having considered all of the evidence before in the round, notwithstanding my concerns as to the honesty of [Ezedi] in relation to certain aspects of his account, I find that [Ezedi] has been consistent in his evidence with regard to his conversion to Christianity.”

Ezedi only revealed that he had converted to Christianity after his first asylum appeal had been rejected in 2017, claiming he had “forgotten” to tell officials about his alleged attendance at Grange Road Baptist Church in Jarrow, Tyne and Wear.

Ezedi’s claim was supported by letters from a Catholic church Justice and Peace Refugee Project, the British Red Cross, and Grange Road Baptist Church representatives. It included pictures of him distributing Christian leaflets in Newcastle city centre and of him being baptised.

Pictures of Abdul Ezedi handing out leaflets on Christianity in Newcastle city centre were included in his asylum claim

Abdul Ezedi only mentioned his conversion to Christianity in his third appeal for asylum

Multiple mistakes on Christianity questions

In its evidence to the immigration tribunal, the Home Office said Ezedi had been unable to explain the reasons for his conversion, or demonstrate a clear understanding of Christian principles and beliefs.

Home Office officials told the tribunal that they did not accept his conversion was “genuine and long-lasting”, that he previously lied and continued to be “dishonest” and was prepared to “use religion for his own ends”.

In his Home Office interview, he insisted he had read the bible every day for three years, but asked what the Old Testament was about, he replied: “Jesus Christ.”

Asked to name Jesus’s main followers, he replied: “Simon, Peter, Jacob, Andrew…12 people, Disciples.” Grilled about what God created on the third day, he answered: “Good Friday and Easter Sunday and Resurrection Day.”

A few days after the Home Office interview, Ezedi’s immigration lawyers sent a statement on his behalf blaming the interpreter for his mistakes and correcting some of the factual errors. In the statement, he wrote: “The interpreter was Kurdish Iranian and I could not understand the dialect. I couldn’t understand his pronunciation.”

Ezedi’s claim for asylum had been initially rejected in May 2016, with an appeal dismissed in February 2017. However, Ezedi lodged a further appeal in March 2019, a year after he was convicted of sexual assault and indecent exposure in 2018 and handed a two-year suspended jail sentence.

Because he was not jailed, he was still eligible to claim asylum. However, it was only on his third appeal that he revealed he had converted to Christianity.

Asked by the judge to explain why he did not mention it in his 2017 appeal, Judge O’Hanlon said his “response was somewhat vague, namely he had ‘forgotten’ to do so”.

However, the judge said he “did not find anything adverse” to Ezedi’s asylum claim as he “had only started attending the church in February of 2016”. He was baptised in June 2018 after attending the evangelical Alpha course.

Judge O’Hanlon admitted Ezedi had “not been honest” in “several” aspects of his account but said: “I remind myself of the fact that [Ezedi] may not have been honest about certain aspects of his claim does not necessarily mean that he is lying about other matters, in this case his claimed Christian conversion.”

He cited a previous Supreme Court judgment involving a Somalian asylum seeker, saying: “We must be very careful not to dismiss an appeal just because an appellant has told lies. An appellant’s own evidence has to be considered in the round with other evidence.”

Abdul Ezedi pictured on CCTV after the chemical attack in Clapham Credit: Metropolitan Police

Church agreed to let sex offender attend services under contract

Ezedi was allowed to continue attending church under a special contract drawn up by the Baptist church, newly released documents show.

A 2019 Baptists Together contract set out “agreed boundaries for the welfare and safety” of Ezedi and other worshippers at a church in Newcastle Upon Tyne.

The two-page document outlines how he was not allowed to be alone at Grange Road Baptist Church and had to be chaperoned at all times.

The contract, renewed every six months, says: “This agreement is being put in place because of a conviction of sexual assault and exposure.”

It required Ezedi “to be accountable” to “carefully chosen individuals”, all of whom were men, who would “support” him.

It adds: “They are aware of the conviction and will endeavour to pastorally listen to you, care for you, advise you and pray for you.”

Ezedi was given a suspended sentence in 2018 for grabbing a woman’s buttocks and exposing himself at a Newcastle bus stop.

The full indictment said he “intentionally touched” a woman in “circumstances being that the touching was sexual” and non-consensual between Feb and June 2017.

The second charge stated that he “intentionally exposed his genitals intending that someone would see them and be caused alarm or distress” on June 5 2017. The indictment clarified the offence as involving “masturbating”.

At the time of the offences, he was living at a hostel in the Fenham area of Newcastle, working in a pizza take away in Jarrow and attending church there.

He was required to sign a document pledging only to go to the church on Sundays if he stayed “in the vicinity of at least one of the male supporters”.

He vowed: “I will only come to church for the Sunday service. I will not enter the church without one of my male supporters being present. I will stay beside my supporter all the time. I will leave the church when my supporter leaves or before them.”

His pledges included agreeing to “not sit alone in the church at any time” and “any concerns” about his behaviour would be “shared securely” during “pastoral care meetings”.

The suspended sentence Ezedi received at Newcastle Crown Court was not severe enough to reach the threshold for deportation.

The victim of his assault later revealed how he began pestering her for sex soon after they became friends.

“If he’d been jailed for attacking me then surely he would have been deported,” the woman told The Sun. “But the failings didn’t end there because someone from a church gave him a reference so he could gain asylum.”

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China cyber-attacks: this growing threat to UK security will not go away - The Guardian

In March last year an integrated review of the UK’s defence and foreign policy said it would protect the country’s “democratic freedoms” from Chinese state attacks.

A few months later the Electoral Commission confirmed why democratic institutions and processes were on the threat list as it revealed that a cyber-attack – by a then unidentified assailant – had accessed the data of 40 million voters.

On Monday the UK government said an unnamed Chinese state-backed actor was behind the sortie and that a Beijing-affiliated group, called APT31, was likely to have been responsible for targeting the email accounts of four British parliamentarians who have been critical of China.

The list of targets cited by the integrated review went beyond democratic institutions and processes however, and outlined the scale of the Chinese cyber-threat. The economy, critical national infrastructure and supply chains were also mentioned. Last year the all-party intelligence and security committee of parliament said China had the resources to target the UK “prolifically and aggressively”, referring to “hundreds of thousands of civil intelligence officers” and a “highly capable and increasingly sophisticated cyber-espionage operation”.

The Electoral Commission was just the latest target of a data-gathering operation that is global and is “being done on an industrial scale”, according to Alan Woodward, a professor of cybersecurity at Surrey University.

While names and addresses on their own are not enough to pose a substantial threat to electoral integrity, they could be combined with other data to target specific voters in swing seats, he said.

“The attackers were able to walk off with what on the face of it does not sound like high-value data. But when you combine it with information elsewhere, like social media accounts, you can start to narrow it down to specific individuals or groups that should be targeted,” he said.

In a recent report, the US cybersecurity firm Secureworks said it had seen Chinese hackers attack organisations around the world deemed a high priority for Beijing’s economic strategy including biotechnology, aerospace, renewable energy and microchips. The aim of the attacks was to secure data and intellectual property.

Defence industry supply chains in the western world have also been targeted. In 2022 the director of the FBI, Christopher Wray, warned western companies that China was trying to “ransack” their intellectual property. In the same year a Chinese government intelligence officer was sentenced to 20 years in prison in the US for crimes including an attempt to steal aircraft engine technology from General Electric.

Don Smith, the vice-president of threat research at Secureworks, said China could run the “full gamut” of cyber operations. The latest incidents outlined by the UK government on Monday were consistent with a wide-ranging strategy, he added, which covers intellectual property theft, targeting rival states such as the UK and attacking non-governmental organisations.

“The Chinese are involved in the full gamut of cyber operations,” Smith said. “These range from traditional cyber-espionage for reasons of national security, to carrying out cyber-espionage for commercial advantage and targeting those perceived to be enemies of the Chinese state.”

In a statement on Monday, the US deputy attorney general, Lisa Monaco, said China’s global hacking operation aimed to “repress critics of the Chinese regime, compromise government institutions and steal trade secrets”, as the US charged seven alleged Chinese hackers with conspiracy to commit computer intrusions and wire fraud in a day of joint action with the UK.

China wants to be a world-leading power in the field of artificial intelligence. According to some observers, this could be where the Electoral Commission hack, and others like it, have serious consequences as half the world heads to the polls this year.

Darktrace, a British cybersecurity firm, said on Monday the adoption of generative artificial intelligence – which can create plausible audio, text and image from a simple hand-typed prompt – has the potential to “increase levels of disruption and allow for more sophisticated techniques to sow misinformation, access sensitive information and influence voters”.

Oliver Dowden, the deputy prime minister, said on Monday the UK “will not hesitate to take swift and robust actions wherever the Chinese government threatens the United Kingdom’s interests.”

Those threats will undoubtedly continue – and not just for the UK.

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2024-03-26 02:30:00Z
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