A Trident nuclear submarine. Photo: Getty
Show Hide image

The government is trying to slip Trident replacement through the backdoor

The Mutual Defence Agreement is a US-UK nuclear deal that lays the foundation for replacing our Trident nuclear weapons system – it must be exposed and challenged.

In the last months of its political life, the Coalition Government is stepping up nuclear cooperation with the United States, under the guise of a routine treaty renewal. But far from being just another piece of foreign policy housekeeping, the renewal of the Mutual Defence Agreement (MDA) in July of this year, is actually a further step towards replacing Britain’s Trident nuclear weapons system – but without the open, democratic debate which such a momentous decision warrants. Majority public opinion is against the replacement of Trident, and with concerns about transparency and accountability in government increasing exponentially, it seems ill-advised for our political leaders to try and pull a fast one on nuclear weapons behind the scenes.

The treaty in question dates back to 1958 when the US and UK signed the "Agreement between the UK and the USA for cooperation in the Uses of Atomic Energy for Mutual Defence Purposes". Generally referred to as the MDA, the treaty established an agreement between both countries to exchange classified information to develop their respective nuclear weapons systems. It is this treaty which ensures that Trident is both technically and politically dependent on the US. Originally, the MDA prohibited the transfer of nuclear weapons, but an amendment in 1959 allowed for the transfer of nuclear materials and equipment between both countries. This amendment is extended through a renewal of the treaty every ten years, most recently in 2004. Changes to the historic amendment this year are a cause for significant concern.

The treaty already ensures that the two countries’ nuclear programmes are inextricably linked. The UK warhead is a copy of the US one, with some components directly bought from the US. With the UK’s nuclear warheads expected to be non-operational by the late 2030s, a decision on their replacement will be intrinsically linked to the work taking place as part of the MDA. The UK leases from the US the Trident II D5 missiles it uses and British submarines must regularly visit the US base in Kings Bay, Georgia, for the maintenance and replacement of these missiles. The UK government recently paid the US £250m to participate in a missile life extension programme and participates in numerous exchange visits with staff from the US nuclear weapons laboratories. Britain also participates with the US in ‘sub-critical’ nuclear tests (tests which fall just short of releasing a nuclear explosion).

With the new amendments to the treaty, Britain will become even more dependent on US expertise for its own nuclear weapons programme and existing collaboration on warhead design will be extended to the nuclear reactors which would power a Trident replacement submarine.

The renewal has to be ratified on both sides of the Atlantic and Obama has already given the go-ahead from the US side. But much as successive UK governments may wish to view ratification as an automatic process to be slid through without question, there is a Westminster scrutiny process which a number of parliamentarians are availing themselves of. The government is required by law to lay any treaty that it has signed before Parliament for 21 days. The text should be sent to relevant select committees and any requests for debates should be considered favourably.

In 2004, government managed to avoid debate. The treaty was laid before Parliament just before the Summer Recess with an announcement that it had been signed a week earlier. This was in spite of the fact that MPs had been asking questions for months about the government’s intention to renew the MDA. This was an obvious – and successful – attempt to avoid any democratic scrutiny.

This time the government isn’t getting away with it quite so easily. Thanks to repeated questioning and an Early Day Motion from Jeremy Corbyn and other concerned MPs, the treaty is currently on the table for its 21 days and a Westminster Hall debate is taking place this week on the 6 November at 1.30pm. MPs may not be able to overturn the government’s ratification of the renewal, but the very fact of open discussion is important in itself. Correctly understood, this renewal is part of the attempt to impose Trident replacement on the British people through a number of seemingly unrelated steps. It must be understood and exposed as such.

Kate Hudson is general secretary of the CND 

Flickr/Michael Coghlan
Show Hide image

Why does the medical establishment fail to take women in pain seriously?

Women with mesh implants have been suffering for years. And it's not the only time they have been ignored. 

Claire Cooper’s voice wavered as she told the BBC interviewer that she had thought of suicide, after her mesh implant left her in life-long debilitating pain. “I lost my womb for no reason”, she said, describing the hysterectomy to which she resorted in a desperate attempt to end her pain. She is not alone, but for years she was denied the knowledge that she was just one in a large group of patients whose mesh implants had terribly malfunctioned.

Trans-vaginal mesh is a kind of permanent “tape” inserted into the body to treat stress urinary incontinence and to prevent pelvic organ prolapse, both of which can occur following childbirth. But for some patients, this is a solution in name only. For years now, these patients – predominantly women – have been experiencing intense pain due to the implant shifting, and scraping their insides. But they struggled to be taken seriously.

The mesh implants has become this month's surgical scandal, after affected women decided to sue. But it should really have been the focus of so much attention three years ago, when former Scottish Health Secretary Alex Neil called for a suspension of mesh procedures by NHS Scotland and an inquiry into their risks and benefits. Or six years ago, in 2011, when the US Food and Drug Administration revealed that the mesh was unsafe. Or at any point when it became public knowledge that people were becoming disabled and dying as a result of their surgery.

When Cooper complained about the pain, a GP told her she was imagining it. Likewise, the interim report requested by the Scottish government found the medical establishment had not believed some of the recipients who experienced adverse effects. 

This is not a rare phenomenon when it comes to women's health. Their health problems are repeatedly deprioritised, until they are labelled “hysterical” for calling for them to be addressed. As Joe Fassler documented for The Atlantic, when his wife's medical problem was undiagnosed for hours, he began to detect a certain sexism in the way she was treated:

“Why”, I kept asking myself, when reading his piece, “are they assuming that she doesn’t know how much pain she’s feeling? Why is the expectation that she’s frenzied for no real reason? Does this happen to a lot of women?”

This is not just a journalist's account. The legal study The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain found that women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively. 

An extreme example is “Yentl Syndrome”. This is the fact that half of US women are likely to experience cardiovascular disease and exhibit different symptoms to men, because male symptoms are taught as ungendered, many women die following misdiagnosis. More often than should be acceptable, female pain is treated as irrelevant or counterfeit.

In another significant case, when the news broke that the most common hormonal birth control pill is heavily linked to a lower quality of life, many uterus-owning users were unsurprised. After all, they had been observing these symptoms for years. Social media movements, such as #MyPillStory, had long been born of the frustration that medical experts weren’t doing enough to examine or counter the negative side effects. Even after randomised trials were conducted and statements were released, nothing was officially changed.

Men could of course shoulder the burden of birth control pills - there has been research over the years into one. But too many men are unwilling to swallow the side effects. A Cosmopolitan survey found that 63 per cent of men would not consider using a form of birth control that could result in acne or weight gain. That’s 2 per cent more than the number who said that they would reject the option of having an annual testicular injection. So if we’re taking men who are afraid of much lesser symptoms than those experienced by women seriously, why is it that women are continually overlooked by health professionals? 

These double standards mean that while men are treated with kid gloves, women’s reactions to drugs are used to alter recommended dosages post-hoc. Medical trials are intended to unearth any potential issues prior to prescription, before the dangers arise. But the disproportionate lack of focus on women’s health issues has historically extended to medical testing.

In the US, from 1977 to 1993, there was a ban on “premenopausal female[s] capable of becoming pregnant” participating in medical trials. This was only overturned when Congress passed the National Institutes of Health (NIH) Revitalisation Act, which required all government funded gender-neutral clinical trials to feature female test subjects. However, it was not until 2014 that the National Institutes of Health decreed that both male and female animals must be used in preclinical studies.

Women’s exclusion from clinical studies has traditionally occurred for a number of reasons. A major problem has been the wrongful assumption that biologically women aren’t all that different from men, except for menstruation. Yet this does not take into account different hormone cycles, and recent studies have revealed that this is demonstrably untrue. In reality, sex is a factor in one’s biological response to both illness and treatment, but this is not as dependent on the menstrual cycle as previously imagined.

Even with evidence of their suffering, women are often ignored. The UK Medicines and Healthcare Regulatory Agency (MHRA) released data for 2012-2017 that shows that 1,049 incidents had occurred as a result of mesh surgery, but said that this did not necessarily provide evidence that any device should be discontinued.

Yes, this may be true. Utilitarian thinking dictates that we look at the overall picture to decide whether the implants do more harm than good. However, when so many people are negatively impacted by the mesh, it prompts the question: Why are alternatives not being looked into more urgently?

The inquiry into the mesh scandal is two years past its deadline, and its chairperson recently stepped down. If this isn’t evidence that the massive medical negligence case is being neglected then what is?

Once again, the biggest maker of the problematic implants is Johnson&Johnson, who have previously been in trouble for their faulty artificial hips and – along with the NHS – are currently being sued by over 800 mesh implant recipients. A leaked email from the company suggested that the company was already aware of the damage that the implants were causing (Johnson&Johnson said the email was taken out of context).

In the case of the mesh implants slicing through vaginas “like a cheese-wire”, whether or not the manufacturers were aware of the dangers posed by their product seems almost irrelevant. Individual doctors have been dealing with complaints of chronic or debilitating pain following mesh insertions for some time. Many of them just have not reported the issues that they have seen to the MHRA’s Yellow Card scheme for identifying flawed medical devices.

Shona Robison, the Scottish Cabinet Secretary for Health and Sport, asked why the mesh recipients had been forced to campaign for their distress to be acknowledged and investigated. I would like to second her question. The mesh problem seems to be symptomatic of a larger issue in medical care – the assumption that women should be able to handle unnecessary amounts of pain without kicking up a fuss. It's time that the medical establishment started listening instead. 

 

Anjuli R. K. Shere is a 2016/17 Wellcome Scholar and science intern at the New Statesman

0800 7318496