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The 50 people who matter today: 41-50

41-50 on our diverse list of individuals, couples and families changing the world, for good and ill.

41. David Ray Griffin

Top truther

Conspiracy theories are everywhere, and they always have been. In recent years, one of the most pernicious global myths has been that the US government carried out, or at least colluded in, the 11 September 2001 attacks as a pretext for going to war. David Ray Griffin, a retired professor of religion, is the high priest of the "truther" movement. His books on the subject have lent a sheen of respectability that appeals to people at the highest levels of government - from Michael Meacher MP to Anthony "Van" Jones, who was recently forced to resign as Barack Obama's "green jobs" adviser after it emerged that he had signed a 9/11 truth petition in 2004.

42. Shahrukh Khan

Special K

For billions of people across Asia, Shahrukh Khan is the biggest star on earth. Since his film debut in 1992, King Khan has been the ruling monarch of Bollywood, the world's largest film industry. "I want people to scream and shout at me," he says. Which is lucky, as he is wildly popular in India, Pakistan and even Afghanistan, where his films were sold on the black market during Taliban rule. A Muslim hero in a Hindu nation, SRK, as he is affectionately known, is the symbol of a younger, confident, richer, globalised India.

43. Joaquín "Shorty" Guzmán

Cocaine knight

At a diminutive 5ft, Mexico's most wanted man is nicknamed "El Chapo" (Shorty). But don't let that fool you - as the top drug lord in a country that provides 90 per cent of all cocaine in the US, Guzmán is instrumental to the international drugs trade and the thousands of lives it claims each year. Head of the Sinaloa cartel, he escaped from prison in 2001 and has since eluded capture. His stake in the US drugs market has amassed him a fortune of $1bn, earning him a place on the Forbes rich list this year.

44. Hugo Chávez

Bolívar's boy

Since being elected president of Venezuela in 1998, Hugo Chávez, the standard-bearer of "21st-century socialism", has survived all attempts to unseat him and has vowed to continue leading the Bolivarian revolution until 2030. His victory earlier this year in a referendum to abolish term limits allows him to run for a third six-year term in 2013. The former army paratrooper's political philosophy, a fusion of Marxism, nationalism and Christian socialism, has inspired left-wing leaders across Latin America - and dismayed US politicians.

45. Peter Akinola

Unhappy clapper

As head of the Church of Nigeria, Akinola is one of the most controversial figures in the worldwide Anglican Communion. He campaigned in 2003 against the consecration of two gay men: Jeffrey John in Reading and Gene Robinson in New Hampshire. The Church of England backed down on John's appointment and a schism was avoided - just. In 2006, at Akinola's invitation, two disenchanted congregations in the US placed themselves under the authority of the Church of Nigeria. And last year's Lambeth Conference was boycotted by 250 traditionalists. Africa is the fastest-growing section of the Church, and Akinola's influence is sure to extend beyond his retirement in March 2010.

46. Anna Wintour

Atomic kitter

Her nickname, "Nuclear Wintour", says it all. The editor of American Vogue is the ultimate ice queen. Both films made about her - one fictional (The Devil Wears Prada) and the other a documentary (The September Issue) - depict her as a terrifying, dictator-like figure, able to shape fashion the world over, from the top designers to the high street chains. But fashion is never just fashion. Wintour's editorial eye will determine what we buy and what we see from one year to the next.

47. Jay-Z and Beyoncé

Pop idols

Beyoncé walks onstage in an explosion of lights and glitter and sequin leotards, and the 20,000-strong crowd bursts into a frenzy of excitement. When she sings "Ave Maria", the arena is hushed. But it's not simply her performance, or her charisma. The woman is a machine. She is somewhere beyond sweaty human reality. Her force and energy seem superhuman. There isn't a lapse, a misstep, not even a glimpse of uncertainty.

Beyoncé is a workaholic. Just as she conquers one thing, she seeks out another and beats that into submission, too. Destiny's Child seems an age ago, after "Crazy in Love", Dreamgirls and her Sasha Fierce incarnation. She has sold over 75 million records, spent more weeks at number one than any other female artist this decade and earned nearly $90m last year, making her the highest-paid entertainer under 30. She has also launched the inevitable fashion line, House of Deréon. She sang for the Obamas; she visits hospitals and rehabilitation centres; she encourages her fans to bring groceries to her US concerts to help feed America. Beyoncé is fast becoming a saint, with the power to convince millions of her cause.

As if Beyoncé weren't enough on her own, she became one half of arguably the most powerful showbiz couple in the world when she married Jay-Z in April 2008.

Jay-Z is a rapper by trade, but by founding Roc-A-Fella Records, running Def Jam and then starting Roc Nation, he has become a vastly influential music industry boss, launching the careers of Ne-Yo and Rihanna along the way. He, too, has a fashion label, Rocawear; and he owns the New Jersey Nets basketball team and invests in smart New York hotels. Together, Beyoncé and Jay-Z preside over an expanding empire. But it's about more than wealth, or power. They have a steeliness about them. They do not make mistakes. There is a feeling that they have somehow gone beyond the foibles of being human to a place where perfection is effortlessly within their control.
Sophie Elmhirst

48. Jóhanna Sigurdardóttir

Ice queen

Has Iceland ever made more headlines than in the past year? Still reeling from the banking collapse of last October, the country has started on the road to recovery with one giant step for womankind. In February, Sigurdardóttir - Iceland's only minister to have gained in popularity in 2008 - became not only the country's first female prime minister, but the world's first openly gay leader. After losing a bid to lead the Social Democrats in 1994, Saint Jóhanna (as Sigurdardóttir has been nicknamed) declared: "My time will come." That time is now.

49. Patricia Woertz

Grain goddess

As CEO of Archer Daniels Midlands (ADM), one of the largest food processors in the US, Patricia Woertz's influence in corn, wheat and soybean production extends across the world. She has been the driving force behind the conglomerate's switch from food to bio-energy, pushing ADM's investment in corn ethanol production and profiting from heavy government subsidies designed to "help the American farmer". ADM brandishes the slogan "Resourceful by Nature", yet it still ranks as the tenth worst polluter in the US.

50. Dan Brown

Conspiracy theorist

Love or hate him, Dan Brown is one of the bestselling authors of all time. The Da Vinci Code, a thriller about a conspiracy to conceal the marriage and modern-day descendants of Jesus Christ and Mary Magdalene, has sold 80 million copies and been translated into 44 languages. Its success triggered a deluge of similar novels, guides to the theories, and books refuting its claims - not to mention a huge spike in tourism to the places it featured. His latest novel, The Lost Symbol, which focuses on freemasonry and the Founding Fathers, has smashed first-day sales records. Watch this space for a mass exodus of conspiracy tourists to Washington, DC.

This article first appeared in the 28 September 2009 issue of the New Statesman, The 50 people who matter

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“They are leaving at an alarming rate”: European NHS workers on the winter crisis, austerity, and Brexit’s impact

“It’s a house of cards, and we’re getting closer and closer to the point where it’s all going to collapse.”

This winter, for the first time in five years, Joan Pons Laplana, an NHS project manager and transformation nurse from Norfolk, “went back to working the front line” because his hospital “had no nurses”. As was the case in many other NHS hospitals nationwide, wards were closed, non-urgent appointments and operations cancelled, and their resources focused on A&E.

“We managed to put a plaster to stop the crisis, but now we need to catch up with the patients and operations and everything,” he says. “And that's like a catch-22.” NHS England recommends a working capacity of around 85 per cent in hospitals to absorb the winter’s patients rise, but Pons Laplana’s hospital is “constantly” working at 90 per cent, he says. “It’s a high stress environment, constantly low on resources and doctors. And now we don't have enough staff.” He sighs: “It’s getting more and more difficult to deliver safe care. At the moment, we’re playing Russian roulette.”

Originally from Barcelona, Pons Laplana has lived and worked in the UK for 17 years. He is one of around 62,000 EU citizens who currently work for the National Health Service, according to House of Commons statistics. Amid the winter crisis and severe financial pressure, the NHS’s next big problem is already unfolding: the prospect of Brexit is driving European NHS workers away. Within England’s NHS services, EU nationals make up almost 10 per cent of doctors, more than 7 per cent of nurses and 5 per cent of scientific, therapeutic and technical staff. Almost 10,000 EU workers had already left the NHS when NHS Digital released its 2017 data last autumn.

“If none of the EU citizens were [in my hospital], I can say without any exaggeration: you could absolutely close tomorrow”, Dr Peter Bauer, 47, a consultant anaesthetist in a Brighton hospital who has worked in the NHS since 1999, tells the New Statesman. In his hospital, he says, the proportion of EU staff is “phenomenal”: “Well over 50 per cent of senior staff is European, it’s about three quarters of the people. It would be disaster.” Mary, a 37-year-old British nurse from London, says her clinic, which employs many Europeans, is struggling to find a cover for her colleague on maternity leave: “Recruitment has fallen massively since Brexit.” With the British government still unclear on citizens’ rights, it is unlikely to stop there.

The ability of competent, skilled European staff to move seamlessly to the UK from the continent, thanks to the EU's freedom of movement, has been “a boom for the NHS”, Bauer says. Recruiting elsewhere (something the NHS has already started doing) will bring additional costs, visa requirements and various other complications that freedom of movement was designed to avoid. “You need these people! If you can't recruit Europeans, you then have to go out of the EU, and it's much more costly and difficult. It's a house of cards, and we're getting closer and closer to the point where it's all going to collapse.”

“If EU citizens like myself decide to go, it would take about 4,200 years to close the gap.”
Peter Bauer, consultant anaesthetist, originally from Germany

Recruitment from European countries has fallen rapidly. For instance, the number of incoming EU nurses fell by 92 per cent after the referendum, contributing to a shortfall in those able to fill the 24,000 nurse vacancies in England alone.

“For the first time, we have seen a reduction in the pool of EU citizens working for the NHS, and that is critical”, says Bauer, who teaches at medical school and has observed the “mismatch of numbers” in terms of graduates – especially a lack of British graduates. “If you want to fill the increased demand with British graduates, you would have to hugely enhance the capacity of British universities to train doctors, and then you would have to put them through specialty training, and that would take decades.”  It takes “about fifteen years” to train an anaesthetist like himself. He laughs: “If EU citizens like myself decide to go, it would take about 4,200 years to close the gap!” Mary, the British nurse, agrees: “Come 2020, we're going to be in serious, massive crap.”

Jettie Vije, a Dutch national who works as a GP practice nurse in Norfolk, meets the “occasional old patient” wanting to discuss Brexit: “They say, ‘Isn’t it great that we’re leaving the EU?’” Vije has been in the UK for four years, which is less than the five-year threshold for settled status; so “great” may not be the best word to describe her situation “I try to keep it on the medical side and not to discuss whether leaving the EU is good or not”, she says. “I am here to do my job as a nurse.”

“I try not to discuss whether leaving the EU is good or not. I am here to do my job as a nurse.”
Jettie Vije, GP practice nurse, originally from the Netherlands

Every EU citizen in the UK knows others who have left. “On a daily basis, I can see that people are leaving”, Pons Laplana says. Portuguese workers at his hospital are “leaving at an alarming rate”. An Italian colleague of Bauer’s is applying to a job in France (“He is probably going to be gone very soon” ); another one, a Czech colleague, has gone part-time, working four weeks in Czech Republic and four in the UK. “The direction isn't for people to be drawn into the UK”, Bauer says.

Mary, the nurse from London, works with colleagues from all over Europe, from Spain and Portugal to Romania and Poland. “Just hearing the conversations they have...  They feel they're not welcome here anymore,” she says, citing one who just moved to Ireland. “Despite what we say and how much we appreciate them, it really doesn't matter” she says. “They're nervous, so a lot of them are leaving.”

The ones who stay behind aren't just losing friends and colleagues to a political decision in which they had no say. Like every Briton, they are attached to their life in the UK as they know it, and to one of its greatest pillars: their employer and health care provider, the National Health Service. As the recent winter crisis has made years of under-funding more apparent and more critical, just like Brits, they worry the NHS may not recover.

European workers have been part of the NHS and British life for years – in Bauer’s case, decades – and have witnessed different government policies. When Bauer arrived in the 1990s, Tony Blair had just taken office: “Over the first ten years, you could see how pumping money into the NHS was leading to a huge increase in the capacity”, he says. There were “more beds, more nurses and doctors”, and small things, too – like “more hand washing basins”. “As the coalition government, and then Cameron, took power, you could see how the investment was scaled back”, he adds.

The NHS is already in dire straits due to the financial pressures exacerbated by austerity. Last September, Chris Hopson, chief executive of NHS Providers, estimated in the Guardian that the Health Service needed an emergency investment of £200m to £350m to avoid a winter crisis. It didn’t come – and non-emergency procedures were cancelled across the country in January. That shortfall is only the start however, and by 2020, the NHS will face a £20 billion funding gap. The Conservative manifesto pledge of an extra £8bn is considered by leading health think tanks and experts to be inadequate. Inflation and demand, which Bauer says “keep rising”, are deepening the gap.

“At the moment, we’re playing Russian roulette.”
Joan Pons Laplana, NHS project manager, originally from Spain

“When the demand is a lot higher than the funding, then there is a gap and that gap is getting wider and wider each year. That's what provoked the crisis,” says Pons Laplana, who has seen stress in his wards go “though the roof” with the pressures. “I reckon 50 of the team have been off at some point because of the stress”, says Mary, who had to take two weeks off around Christmas because she works in a department that treats life-threatening conditions and it all became too much. “We are GPs, we are counsellors, we are social workers... We're everything at the moment.” To add to the stress, the lack of funding and the nurses’ pay cap are making situations like Mary’s more precarious: she says she had to remortgage her house to pay for a £10,000 training that may allow her to be promoted. “To be able to make ends meet, a lot of the staff do extra shifts, some are working fifty hours to have the same quality of life that they had five, six, seven years ago, and pay the mortgages”, Pons Laplana explains. “But a lot of us are getting tired. Tired people make mistakes. And mistakes cost lives.”

These problems would exist without Brexit, but the decision to leave the EU will exacerbate the health services's problems in ways beyond simply driving workers away. The famed “£350m a week for the NHS” pledge wheeled out by the Leave campaign is credited with helping to win the election, but the drop in value of the pound and economic uncertainty mean that, as Bauer points out, “in actual numbers you're seeing so far a reduction of £350m a week” – less cash in the economy is likely to mean less cash for the NHS.

Mary says she is “immensely worried” about the possibility of the British government selling NHS contracts in a future US trade deal struck to make up for lost trade with the EU: “The essence of what the NHS is, care for all, that will go and the thought of that scares me to the bone.” Brexit, Bauer says, is an “unmitigated disaster”: not just because urgent issues like the NHS’ winter crisis are being overlooked by the “completely paralysed” government’s obsession with the UK’s departure from the European Union, but also because it will exacerbate such issues further. The Home Office’s tightening of migration rules will make it harder for the Health Service to hire critically needed staff, he sighs: “It's one more dimension of self-harm on Brexit.”

“EU workers are leaving at an alarming rate”
Joan Pons Laplana

For the EU citizens who are still here, the dilemma is twofold. Leave, because Brexit has made their future and right to work in this country uncertain? Or stay to see the Health Service they have put so much work in fall into pieces? “I worked very hard for three years to be in the managerial position I have,” Pons Laplana says. “If I go back, I will not have the same job. My home is here. My heart is British.” Vije doesn’t think it will come to her leaving, but until the deal is finalized, she cannot be certain: “I'm just waiting and watching.” Although Bauer doesn’t want to leave either, he has started on his contingency plan: getting German passports for his children. “I don't see a rosy economic future for them in the UK”, he says. “Britain is so divided now, the government is divided, the Tories are divided, Labour is divided, families are divided.” 

“Nothing is agreed until everything is agreed” may work as far as the government’s negotiating strategy goes, but it also means EU workers are left in limbo. At a time when the NHS desperately needs staff, if the “really well trained, hard workers, well-educated” EU nurses and doctors to change their mind and go, they will be sorely missed, Mary says. “But then I think, what would I do?” She pauses. “Probably the same.”

Pauline Bock writes about France, the Macron presidency, Brexit and EU citizens in the UK. She also happens to be French.

This article first appeared in the 28 September 2009 issue of the New Statesman, The 50 people who matter