The Russian regions that are banning "gay propaganda"

This legislation essentially prohibits the public discussion of homosexuality. The British press is

This legislation essentially prohibits the public discussion of homosexuality. The British press is depressingly silent.

By the week's end, the St. Petersburg Assembly hope to make it illegal for any person to write a book, publish an article or speak in public about being gay, lesbian or transgender. Campaigners are currently attempting to prevent such a move. It's too late for Arkhangelsk and Ryazan, those regions already having criminalised what is termed "gay propaganda".

It would be easy to be unaware any of this was happening -- considering the complete lack of coverage it has gained from mainstream British media. The Bill is now said to be stalling -- though as a result of "technical difficulties" in applying the law, rather than foreign pressure. When referring to a law that seeks to bind the mouths of minorities, there's a bleak irony in our own press falling silent -- particularly since they are doing so willingly. This is not Russia, where the murders of outspoken journalists go unsolved and independent media outlets are shut down. The British press has the freedom to report this news but simply chooses not to. As his ruling party sought to continue on its path to wipe out "unapproved" voices, the story that filled the news was Putin being jeered at a sporting event. Nothing else appeared to matter, the Russian-reporting quota filled by the image of the PM posturing his way into a martial arts ring.

Slowly but surely -- and without much notice -- regions of Russia are hoping to pull off their most brazen attempt yet, taking a national crisis in freedom of speech and aiming to fully silence a specific group. What they are seeking to criminalise is not even active dissent, but simply a divergence from the "norm" that the authorities are desperate to protect.

It's apparent with the quickest glance at what is being proposed. The exact wording of the law prohibits the so-called propaganda of "sodomy, lesbianism, bisexualism and transgenderism, and pedophilia to minors." In comparing consensual adult acts to child abuse, it is in fact the Regional Assemblies that are attempting propaganda, exacerbating the general public's fear of "homosexual perversion".

It was only in 1993 that homosexuality was de-criminalised in Russia. Eighteen years isn't much time to overcome a culturally engrained history of arrest and torture. The first gay pride parade in Moscow was banned and same-sex relationships were deemed "satanic" by its Major. Gay rights activists are making huge strides, though, and it cannot be underestimated how detrimental laws like this are to the fight for progress.

The proposal waiting to be passed in St. Petersburg contradicts every law, convention and decree Russia has signed up to -- from their own Federal Law to the UN Universal Declaration of Human Rights. It also contradicts basic logic, demanding (as it does in practice) the ability to exclude under-18s from events running in open public places. This is, of course, all part of the tactic: the authorities are making it impossible for anyone to promote ideas of tolerance to any sort of audience.

If they can't come for you for the relationship you're in, they come for you for the words that you write and the things that you say. As another Russian region votes on whether to bring out the gag, the British press should look at the silence falling from their own lips.

Frances Ryan is a freelance writer and political researcher at the University of Nottingham. She blogs at Different Principles and tweets@frances_ryan

Frances Ryan is a journalist and political researcher. She writes regularly for the Guardian, New Statesman, and others on disability, feminism, and most areas of equality you throw at her. She has a doctorate in inequality in education. Her website is here.

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The NHS's sustainability is under threat if more isn't done to look after its staff

More work is needed to develop the health service's most precious resource.

As the NHS nears its 70th anniversary, the time is ripe for a workforce rescue plan. Staffing worries, even more than funding pressures, are the biggest cause of concern for NHS trust leaders. There are not enough trained health workers in the UK to meet today’s needs, let alone those of the future.

Demands on hospitals, mental health and community trusts, and ambulance services are growing. More patients need treatment. Increasingly, they require complex care, with specialist expertise. This is not just about numbers. We need a clinical workforce that is skilled and equipped to work in new ways to deal with the changing needs of the population it serves. 

That means improving the supply of people coming to work for the NHS, and doing more to develop and motivate them so they want to stay. These problems are not new but the scale of the challenge has reached a tipping point which threatens the future sustainability of the NHS.

Ministers rightly point out that the NHS in England has more clinical staff than ever before, but numbers have not kept pace with rising demand. The official "shortfall rate" for nurses and midwives across England is close to 10 per cent, and in some places significantly higher. Part of this is down to the recognition, after the events at troubled health trust Mid Staffordshire, of the importance of safe staffing levels. Yet for successive years during the coalition government, the number of nurse training recruits fell.

Far from being a problem just for hospitals, there are major nursing shortages in mental health and community trusts. Between 2009 and 2016 the number of district nurses employed by the NHS in England fell by more than 40 per cent. Just as the health service tries to accelerate plans for more treatment closer to home, in key parts of the workforce the necessary resources are shrinking.

There are also worrying gaps in the supply of doctors. Even as the NHS gears up for what may prove to be its toughest winter yet, we see worrying shortfalls in A&E consultants. The health service is rightly committed to putting mental health on an equal footing with physical health. But many trusts are struggling to fill psychiatry posts. And we do not have enough GPs.

A key part of the problem is retention. Since 2010/11 there has been a worrying rise in “leaver rates” among nurses, midwives, ambulance staff and scientific technical staff. Many blame the pressures of workload, low staffing levels and disillusionment with the quality of care. Seventy per cent of NHS staff stay on for extra hours. Well over a third say they have felt unwell in the past year because of work-related stress.

Add in cuts to real basic pay, year after year, and it is hardly surprising that some are looking to other opportunities and careers outside the public sector. We need a strategy to end pay restraint in the NHS.

There is also a worrying demographic challenge. Almost one in three qualified nurses, midwives and health visitors is aged 50 or older. One in five GPs is at least 55. We have to give them reasons to stay.

NHS trusts have made important strides in engaging with their workforce. Staff ratings on being able to report concerns, feeling trusted to do their jobs, and being able to suggest improvements are encouraging. But there are still cultural problems – for example around discrimination and bullying – which must be addressed locally and nationally.

The NHS can no longer be sure that overseas recruits will step in to fill workforce gaps. In the early 2000s many trusts looked beyond Europe to meet nursing shortages. More recently, as tougher immigration and language rules took hold, a growing proportion came from the EU – though not enough to plug the gap.

Now we have all the uncertainty surrounding Brexit. We need urgent clarity on the status of current EU nationals working in the health and care systems. And we must recognise that for the foreseeable future, NHS trusts will need support to recruit and retain staff from overseas. The government says it will improve the home-grown supply, but that will clearly take time.

These problems have developed in plain sight. But leadership on this has been muddled or trumped by worries over funding. Responsibility for NHS workforce strategy is disjointed. We need a co-ordinated, realistic, long-term strategy to ensure that frontline organisations have the right number of staff with the right skills in the right place to deliver high quality care.

We must act now. This year's long-delayed workforce plan – to be published soon by Health Education England – could be a good place to start. But what we need is a more fundamental approach – with a clear vision of how the NHS must develop its workforce to meet these challenges, and a commitment to make it happen. 

Saffron Cordery is the director of policy and strategy at NHS Providers