Cable and Hammond fight on as Osborne swings his axe again

Six more departments agree to cuts but Defence, Business, Education, Work and Pensions and Transport are yet to settle.

George Osborne's unusual running commentary on the Spending Review continues. In addition to the seven departments previously named as agreeing to cuts of "up to" 10 per cent, the Treasury has announced that Osborne has reached settlements with the Home Office (with counter-terrorism policing protected), DEFRA, DCMS, the Scotland Office, the Wales Office and the Law Officers Department (incorporating the Crown Prosecution Service, the Treasury Solicitor's Department and the Serious Fraud Office), all of which will be cut by an average of 8 per cent. The seven to settle last month were Justice, Energy, Communities, the Foreign Office, the Cabinet Office, the Treasury and the Northern Ireland Office.

But while the majority of departments have now agreed to further cuts, the absence of some of the biggest spenders from the list (Education and the DWP, as well as Transport and Business) means that, with just 12 days to go, the Treasury still has less than a third (£3.6bn) of the £11.5bn of cuts sought by Osborne. 

Health, International Development and the schools section of the Education budget are all officially protected but the rest still face the Chancellor's axe. Although Theresa May, one of the ring-leaders of the famed National Union of Ministers (NUM) has settled, Vince Cable (Business) and Philip Hammond (Defence) are fighting on. After the head of the army Sir Peter Wall warned that further cuts could damage the force's "professional competence" and "become quite dangerous, quite quickly", the latter is under particular pressure to prevent significant reductions. But Alexander made it clear that he was in no mood to offer special treatment. "In a department where there are more horses than tanks there is room for efficiency savings," he told Sky News. As for Cable, he has previously warned that "further significant cuts will do enormous damage to the things that really do matter like science, skills, innovation and universities", a message that was echoed by the CBI in its Spending Review submission this week. It suggested that £700m of medical research funding currently paid for by the Business Department could be transferred to Health, a move that would break the spirit, if not the letter, of the NHS ring-fence. 

Alexander also signalled that while there would be no further welfare cuts (after £3.6bn were announced in last year's Autumn Statement), this did not mean the Department for Work and Pensions was protected. He pointed out that welfare spending is classified as "annually managed expenditure", rather than departmental spending, adding that "there are lots of areas where the DWP has the capacity to make savings". 

Defence Secretary Philip Hammond stands in front of a Rapier System ground-to-air missile launcher during a visit to RAF Waddington near Lincoln. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

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Relax – there’s new evidence that mindfulness actually works

The relaxation therapy could prevent relapses in sufferers of depression, according to a new study.

If there’s one thing that can be said of buzzwords, it’s that they almost always fall by the wayside in the end. Yet in the field of mental health, one buzzword has survived the best efforts of critics and naysayers – “mindfulness”.

First coined by Dr Jon Kabat-Zinn from the University of Massachusetts Medical School, the term mindfulness was initially characterised as a state of mind that would enable someone to pay “attention on purpose” to the present moment. Modern secular society seems to have embraced it as a form of meditation. Everything from exercise to breathing now has an associated mindfulness manual attached.

However, not everyone is convinced. For example, the recent phenomenon of adult colouring books – devised to promote mindfulness and serve as a form of therapeutic escapism – has been criticised by therapists as over-hyped and not necessarily helpful.

Meanwhile, sceptics have pointed out an alleged bias in the publishing of positive findings from trials using mindfulness as a form of mental health therapy. Researchers at McGill University in Canada “found that scientists reported positive findings 60 per cent more often than is statistically likely” after analysing 124 different published trials involving mindfulness as a form of mental health therapy. In some cases, the practice has even had a reverse effect, inducing anxiety, pain or panic.

However, a new study published in the journal JAMA Psychiatry seems to demonstrate that mindfulness-based cognitive therapy (MBCT) can be a potent treatment in preventing and managing relapse into major depression. Led by the University of Oxford, the study’s researchers conducted the largest meta-analysis (an analysis of various different studies) to date on the therapy’s impact on recurrent depression.

The particular form of mindfulness-based cognitive therapy that was used aimed to equip patients with the skills required to successfully recognise and repel the thoughts and feelings they most commonly associated with the state of depression, in order to prevent any future relapse.

According to the study, “the MBCT course consists of guided mindfulness practices, group discussion and other cognitive behavioural exercises. Participants receiving MBCT typically attended eight 2-2.5 hour group sessions alongside daily home practice.”

Using anonymous patient data from nine randomised trials involving 1,258 participants, researchers found that 38 per cent of those who received mindfulness-based therapy experienced a depressive relapse, in comparison to 49 per cent of patients who didn’t receive treatment. The patient data covered age, sex and level of education – key inclusions, as the meta-analysis was able to show no significant influence by these factors on the therapy’s performance.

The most prominent form of remedy currently available for mental health patients is anti-depressant medication. Four of the nine randomised trials comparatively assessed the impact of therapy alongside medication, to deduce if a combination of therapy with varying doses of medication was more beneficial than medication alone. The patients from the study who received mindfulness therapy along with continued, reduced or discontinued medication were less likely to fall back into depression than patients on maintenance anti-depressants alone. This helps legitimise mindfulness as an option in combating depression’s debilitating effects and reinforces its efficacy, whether it is taken up with or without anti-depressants.

Willem Kuyken, Professor of Clinical Psychology at the Oxford Mindfulness Centre and lead author of the study, called the results “very heartening”. “While MBCT is not a panacea, it does clearly offer those with a substantial history of depression a new approach to learning skills to stay well in the long-term.

“It offers people a safe and empowering treatment choice alongside other mainstay approaches such as cognitive-behavioural therapy and maintenance antidepressants. We need to do more research, however, to get recovery rates closer to 100 per cent and to help prevent the first onset of depression, earlier in life. These are programmes of work we are pursuing at the University of Oxford and with our collaborators around the world."

Though the findings will certainly reinvigorate confidence in mindfulness, Richard Byng from the University of Plymouth and one of the co-authors said, “clinicians need to be cautiously optimistic when tapering off antidepressant medication, and treat each patient as an individual who may or may not benefit from both MBCT and other effective treatments."