Students must address ticking-time-bomb of inequality

Students have a role in bridging communities given socio-economic divisions and a new higher educati

Higher education and its recent funding reforms, with headlines stressing cuts, should not detract us from what this means for social inequality and the ordinary people of Britain today.

Britain has faced the greatest rise in income inequality of any rich country since 1975, according to the OECD, with wealth being preserved amongst a tiny minority through “education and marriage”. Meanwhile, poverty continues to rise for Britain’s children as indicated by the Institute of Fiscal Studies who predict an additional 500,000 children will live in households with absolute poverty by 2015 increasing the total to 3,000,000.  This year will see students pay up to £9,000 fees per annum, while UCAS admitted that the admissions process to University favours rich students from private schools. This is after the SuttonTrust taught us in 2010 that 16 per cent of pupils eligible for free school meals progress to university in comparison to the 96 per cent from independent schools.

We now fear that the impact of the higher education reforms will be far greater than envisaged. The unjust fees system will not only lead to the higher education sector favouring the rich, it will also fuel a continuing cycle of social inequality that drives apart the rich, who can access University, from the poor, who cannot. Martin Hall, a Vice-Chancellor who promoted equality under South African apartheid believes “Britain is sitting on a time bomb when it comes to inequality”. 

This is no time to be despondent. It is precisely the time to be courageous. It is time to do things differently.

The student movement must accept its role in fighting this inequality head on, beyond internal policy battles and campus life. We can take responsibility for the aspirations of our nation’s children. Our efforts to confront government should be characterised by a new approach that challenges its modus operandi (outlined by Usman here). We require a transformational attitude that does not necessitate millions of pounds nor state-reliance, but focuses on activating the human potential of University students. 

Students have a powerful role as activists for social justice through higher education by engaging with those communities that have been hit the hardest. Led by their Unions, students must build bridges with Universities for pupils at their local schools and colleges. Mentoring programmes like HEAPS must be pursued, and widening participation should be part of the fabric of the student movement.

Higher education institutions should work with their student unions in devising and delivering Access Agreements for the approval of the Office for Fair Access. This proposed mentality shift, which connects University students with schools and communities, nurtures creative approaches.  We should support the development of flexible and work-relevant higher education options. Unions should cultivate entrepreneurship and provide training so that students generate their own value amidst unemployment. HEFCE states that 2,350 businesses were set up by recent graduates in 2009/10. The student movement can only lead on this by reforming itself as an inclusive environment that reflects students from all walks of life. 

Aimhigher persistently battled social inequality by raising the aspirations of young people to continue their education. As an initiative independent of institutional recruitment strategies, it took pupils from 2,500 schools and 300 colleges, with no higher education heritage, into universities. Countless young peoples’ thinking was positively influenced through their engagement with Aimhigher student ambassadors and associates.  In Manchester, UCAS applications increased by 50 per cent from 2003-2009, driven by bigger increases in the poorest boroughs.  Pupils from the program remarked, “Uni is not as boring and pointless as I thought it would be”, and “if I don’t start doing things today, I might end up putting them off for the rest of my life”. Outreach is proven as the single most effective way to encourage non-traditional students into higher education – but sadly the government axed Aimhigher’s funding and the initiative formally closed in July 2011.  

In the city of Manchester, where 27 of 32 wards rank in the most deprived nationally, the Longsight district sees low numeracy and literacy rates; with rising unemployment.  Usman is a living example of why access matters, so we conclude with his own experience.

With a mother who sacrificed her studies to support a family, I was motivated by a student in my youth club to attend University. Six-years later I have inspired countless children in my neighbourhood to follow in my footsteps, and have realised that children who believe in the future and aim higher have the power to overcome the barriers to higher education. Today I am proud to have become the voice for seven million students, and now we must be clear: we must not neglect communities like my own that need us the most. It is high-time that our university experience became a means to addressing social inequality in Britain today. 

Usman Ali is Vice-President Higher Education of the National Union of Students, the national voice for 7 million students

Jo Wiggans is Director of Aimhigher Network and former Director of Aimhigher in Greater Manchester

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The surprising truth about ingrowing toenails (and other medical myths)

Medicine is littered with myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery.

From time to time, I remove patients’ ingrowing toenails. This is done to help – the condition can be intractably painful – but it would be barbaric were it not for anaesthesia. A toe or finger can be rendered completely numb by a ring block – local anaesthetic injected either side of the base of the digit, knocking out the nerves that supply sensation.

The local anaesthetic I use for most surgical procedures is ready-mixed with adrenalin, which constricts the arteries and thereby reduces bleeding in the surgical field, but ever since medical school I’ve had it drummed into me that using adrenalin is a complete no-no when it comes to ring blocks. The adrenalin cuts off the blood supply to the end of the digit (so the story goes), resulting in tissue death and gangrene.

So, before performing any ring block, my practice nurse and I go through an elaborate double-check procedure to ensure that the injection I’m about to use is “plain” local anaesthetic with no adrenalin. This same ritual is observed in hospitals and doctors’ surgeries around the world.

So, imagine my surprise to learn recently that this is a myth. The idea dates back at least a century, to when doctors frequently found digits turning gangrenous after ring blocks. The obvious conclusion – that artery-constricting adrenalin was responsible – dictates practice to this day. In recent years, however, the dogma has been questioned. The effect of adrenalin is partial and short-lived; could it really be causing such catastrophic outcomes?

Retrospective studies of digital gangrene after ring block identified that adrenalin was actually used in less than half of the cases. Rather, other factors, including the drastic measures employed to try to prevent infection in the pre-antibiotic era, seem likely to have been the culprits. Emboldened by these findings, surgeons in America undertook cautious trials to investigate using adrenalin in ring blocks. They found that it caused no tissue damage, and made surgery technically easier.

Those trials date back 15 years yet they’ve only just filtered through, which illustrates how long it takes for new thinking to become disseminated. So far, a few doctors, mainly those in the field of plastic surgery, have changed their practice, but most of us continue to eschew adrenalin.

Medicine is littered with such myths. For years we doled out antibiotics for minor infections, thinking we were speeding recovery. Until the mid-1970s, breast cancer was routinely treated with radical mastectomy, a disfiguring operation that removed huge quantities of tissue, in the belief that this produced the greatest chance of cure. These days, we know that conservative surgery is at least as effective, and causes far less psychological trauma. Seizures can happen in young children with feverish illnesses, so for decades we placed great emphasis on keeping the patient’s temperature down. We now know that controlling fever makes no difference: the fits are caused by other chemicals released during an infection.

Myths arise when something appears to make sense according to the best understanding we have at the time. In all cases, practice has run far ahead of objective, repeatable science. It is only years after a myth has taken hold that scientific evaluation shows us to have charged off down a blind alley.

Myths are powerful and hard to uproot, even once the science is established. I operated on a toenail just the other week and still baulked at using adrenalin – partly my own superstition, and partly to save my practice nurse from a heart attack. What would it have been like as a pioneering surgeon in the 1970s, treating breast cancer with a simple lumpectomy while most of your colleagues believed you were being reckless with your patients’ future health? Decades of dire warnings create a hefty weight to overturn.

Only once a good proportion of the medical herd has changed course do most of us feel confident to follow suit. 

This article first appeared in the 20 April 2017 issue of the New Statesman, May's gamble

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