Why no party can afford to be anti-nuclear

The Lib Dems must abandon their anti-nuclear stance and develop a realistic energy policy.

Of all the dangers of a hung parliament, the lights going out is not thought to be one of them. Yet this could be the perverse result, if the Liberal Democrats end up holding the balance of power and insist on halting the UK's nuclear new-build programme as their condition for joining any cross-party coalition. Already, the heads of companies such as RWE npower are reconsidering nuclear investments and holding back until the political landscape becomes clearer.

This is a mistake the Lib Dems do not need to make. They could learn the lesson of the German Greens, who made closing the country's nukes a condition for joining the Social Democrat-led coalition in 1998 -- a policy that has resulted in proposals for dozens of new coal-fired plants in an effort to address Germany's looming energy gap.

By attempting to be populist but appearing merely outdated, the Lib Dems have produced an energy policy that is by far the least realistic of the plans by the three major parties. On 19 March, the Conservatives launched a sensible plan for a carbon tax on electricity generation to encourage investment in both nuclear and renewable power. After years of dithering, Labour is now on track with its large-scale offshore wind programme, nuclear new-build and major grid upscaling.

The Lib Dems are left with wishful thinking. The writer David MacKay summarised their approach in his book Sustainable Energy: Without the Hot Air as "Plan L", which would leave a zero-carbon Britain dependent on imports for two-thirds of its electricity, and on coal for much of the rest. (This is "clean coal" -- a technology yet to be invented on the required scale.)

I was puzzled to hear the Lib Dem energy spokesman, Simon Hughes, lamenting, on Radio 4's The World Tonight, the "health effects" of nuclear power as a reason for his opposition to it, even though no plausible scientific case can be made. Coal, on the other hand, kills thousands every year -- in the United States, 23,600 people suffer a premature death due to coal's dirty emissions. That's 35 per plant per year, meaning that, in all probability, my local coal plant at Didcot has already killed more people than Chernobyl.

Hughes would do well to consult Wade Allison's new book, Radiation and Reason. Allison, professor of physics at Oxford University, begins by reminding us that out of all the radiation we each receive annually, half comes from naturally occurring radon, 9.5 per cent from "the decay of radioactive atoms that occur naturally within the human body", 15 per cent from medical procedures and less than 0.5 per cent from other man-made sources. Less than 0.1 per cent comes from the discharges from civil nuclear power. Hughes's arguments about putative health effects are just recycled urban myths.

Allison's book looks at evidence from Chernobyl and Hiroshima which demonstrates that very low doses of radiation are unlikely to have negative health effects, and may even be beneficial. (Of those who took a big hit in Chernobyl, roughly 50 died from radiation poisoning; others with lower doses have closer-to-normal mortality rates.) Further evidence comes from radiotherapy, which exposes people to radiation to defeat cancer -- without causing new tumours in consequence.

In other areas, the Lib Dems take science seriously. My local MP, Evan Harris, has recently distinguished himself in the campaign to show that homoeopathy is bogus. I hope he can persuade Hughes and the wider party to base their energy policy on science, rather than conjecture.

This article appears in this week's edition of the New Statesman.

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Mark Lynas has is an environmental activist and a climate change specialist. His books on the subject include High Tide: News from a warming world and Six Degree: Our future on a hotter planet.

This article first appeared in the 29 March 2010 issue of the New Statesman, Hold on tight!

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British mental health is in crisis

The headlines about "parity of esteem" between mental and physical health remain just that, warns Benedict Cooper. 

I don’t need to look very far to find the little black marks on this government’s mental health record. Just down the road, in fact. A short bus journey away from my flat in Nottingham is the Queens Medical Centre, once the largest hospital in Europe, now an embattled giant.

Not only has the QMC’s formerly world-renowned dermatology service been reduced to a nub since private provider Circle took over – but that’s for another day – it has lost two whole mental health wards in the past year. Add this to the closure of two more wards on the other side of town at the City Hospital, the closure of the Enright Close rehabilitation centre in Newark, plus two more centres proposed for closure in the imminent future, and you’re left with a city already with half as many inpatient mental health beds as it had a year ago and some very concerned citizens.

Not that Nottingham is alone - anything but. Over 2,100 mental health beds had been closed in England between April 2011 and last summer. Everywhere you go there are wards being shuttered; patients are being forced to travel hundreds of miles to get treatment in wards often well over-capacity, incidents of violence against mental health workers is increasing, police officers are becoming de facto frontline mental health crisis teams, and cuts to community services’ budgets are piling the pressure on sufferers and staff alike.

It’s particularly twisted when you think back to solemn promises from on high to work towards “parity of esteem” for mental health – i.e. that it should be held in equal regard as, say, cancer in terms of seriousness and resources. But that’s becoming one of those useful hollow axioms somehow totally disconnected from reality.

NHS England boss Simon Stevens hails the plan of “injecting purchasing power into mental health services to support the move to parity of esteem”; Jeremy Hunt believes “nothing less than true parity of esteem must be our goal”; and in the House of Commons nearly 18 months ago David Cameron went as far as to say “In terms of whether mental health should have parity of esteem with other forms of health care, yes it should, and we have legislated to make that the case”. 

Odd then, that the president of the British Association of Counselling & Psychotherapy (BACP), Dr Michael Shooter, unveiling a major report, “Psychological therapies and parity of esteem: from commitment to reality” nine months later, should say that the gulf between mental and physical health treatment “must be urgently addressed”.  Could there be some disparity at work, between medical reality and government healthtalk?

One of the rhetorical justifications for closures is the fact that surveys show patients preferring to be treated at home, and that with proper early intervention pressure can be reduced on hospital beds. But with overall bed occupancy rates at their highest ever level and the average occupancy in acute admissions wards at 104 per cent - the RCP’s recommended rate is 85 per cent - somehow these ideas don’t seem as important as straight funding and capacity arguments.

Not to say the home-treatment, early-intervention arguments aren’t valid. Integrated community and hospital care has long been the goal, not least in mental health with its multifarious fragments. Indeed, former senior policy advisor at the Department of Health and founder of the Centre for Applied Research and Evaluation International Foundation (Careif) Dr Albert Persaud tells me as early as 2000 there were policies in place for bringing together the various crisis, home, hospital and community services, but much of that work is now unravelling.

“We were on the right path,” he says. “These are people with complex problems who need complex treatment and there were policies for what this should look like. We were creating a movement in mental health which was going to become as powerful as in cancer. We should be building on that now, not looking at what’s been cut”.

But looking at cuts is an unavoidable fact of life in 2015. After a peak of funding for Child and Adolescent Mental Health Service (CAMHS) in 2010, spending fell in real terms by £50 million in the first three years of the Coalition. And in July this year ITV News and children’s mental health charity YoungMinds revealed a total funding cut of £85 million from trusts’ and local authorities’ mental health budgets for children and teenagers since 2010 - a drop of £35 million last year alone. Is it just me, or given all this, and with 75 per cent of the trusts surveyed revealing they had frozen or cut their mental health budgets between 2013-14 and 2014-15, does Stevens’ talk of purchasing “power” sound like a bit of a sick joke?

Not least when you look at figures uncovered by Labour over the weekend, which show the trend is continuing in all areas of mental health. Responses from 130 CCGs revealed a fall in the average proportion of total budgets allocated to mental health, from 11 per cent last year to 10 per cent in 2015/16. Which might not sound a lot in austerity era Britain, but Dr Persaud says this is a major blow after five years of squeezed budgets. “A change of 1 per cent in mental health is big money,” he says. “We’re into the realms of having less staff and having whole services removed. The more you cut and the longer you cut for, the impact is that it will cost more to reinstate these services”.

Mohsin Khan, trainee psychiatrist and founding member of pressure group NHS Survival, says the disparity in funding is now of critical importance. He says: “As a psychiatrist, I've seen the pressures we face, for instance bed pressures or longer waits for children to be seen in clinic. 92 per cent of people with physical health problems receive the care they need - compared to only 36 per cent of those with mental health problems. Yet there are more people with mental health problems than with heart problems”.

The funding picture in NHS trusts is alarming enough. But it sits in yet a wider context: the drastic belt-tightening local authorities and by extension, community mental health services have endured and will continue to endure. And this certainly cannot be ignored: in its interim report this July, the Commission on acute adult psychiatric care in England cited cuts to community services and discharge delays as the number one debilitating factor in finding beds for mental health patients.

And last but not least, there’s the role of the DWP. First there’s what the Wellcome Trust describes as “humiliating and pointless” - and I’ll add, draconian - psychological conditioning on jobseekers, championed by Iain Duncan Smith, which Wellcome Trusts says far from helping people back to work in fact perpetuate “notions of psychological failure”. Not only have vulnerable people been humiliated into proving their mental health conditions in order to draw benefits, figures released earlier in the year, featured in a Radio 4 File on Four special, show that in the first quarter of 2014 out of 15,955 people sanctioned by the DWP, 9,851 had mental health problems – more than 100 a day. And the mental distress attached to the latest proposals - for a woman who has been raped to then potentially have to prove it at a Jobcentre - is almost too sinister to contemplate.

Precarious times to be mentally ill. I found a post on care feedback site Patient Opinion when I was researching this article, by the daughter of a man being moved on from a Mental Health Services for Older People (MHSOP) centre set for closure, who had no idea what was happening next. Under the ‘Initial feelings’ section she had clicked ‘angry, anxious, disappointed, isolated, let down and worried’. The usual reasons were given for the confusion. “Patients and carers tell us that they would prefer to stay at home rather than come into hospital”, the responder said at one point. After four months of this it fizzled out and the daughter, presumably, gave up. But her final post said it all.

“There is no future for my dad just a slow decline before our eyes. We are without doubt powerless – there is no closure just grief”.

Benedict Cooper is a freelance journalist who covers medical politics and the NHS. He tweets @Ben_JS_Cooper.