Long stories short
- Shell reported record annual profits of £32.2 billion, accrued mainly thanks to the war in Ukraine.
- The US said it was boosting its military presence in the Philippines to counter the Chinese threat to Taiwan.
- Nikki Haley, former Republican governor of South Carolina, is planning to run for president.
Health professionals in England and Wales are up to twice as likely as those in other jobs to take their own lives.
Why it matters. The answer is another question – what does it say about the state of a health service when the people who are employed to look after a population’s mental and physical health are not being looked after themselves?
This is the health service that fought through the pandemic with catastrophic shortages and loss of life, and which lost one in ten staff last year because of burnout and low pay.
The territory. Trends in suicide rates should be approached with caution. A range of factors can lead to someone ending their own life. Attributing patterns can risk oversimplifying and obfuscating the person, and tragedy, behind each death. That said, Dame Clare Gerada, president of the Royal College of General Practitioners and chair of Doctors In Distress, told Tortoise she fears suicide is becoming “an occupational hazard” of working in the NHS.
The data. Our analysis of ONS data for England and Wales found:
- In 2021, the reported suicide rate for men working in healthcare was a third higher than for men working in other sectors, at 20.4 suicides compared with 15.2 per 100,000 workers.
- The rate for female healthcare workers was almost twice that for other female workers, although suicides among women were fewer across the board at 4.4 per 100,000 in non-healthcare roles compared with 8 per 100,000 in healthcare roles.
- Between 2011 and 2021, the suicide rate among men who are not healthcare workers fell by 1.5 percentage points, while the rate among men who work in healthcare increased by over 3 percentage points.
- For women, overall rates increased but the rate among healthcare workers increased nine times faster – by 1.8 points compared with 0.2.
To note: this data doesn’t include those who have attempted suicide or those on leave for mental ill health such as anxiety, depression or stress – the most reported reasons for absence in the NHS.
A reminder that in England alone, the NHS has 130,000 vacancies, a third of which are for nurses.
Behind the numbers: Dr Vaishnavi Kumar was a 35 year-old junior doctor working at Birmingham’s Queen Elizabeth Hospital. In June last year, she took her own life.
Two weeks ago her family released details of a letter she left in which she wrote: “I am sorry mum, I can blame the whole thing on QEH”. Kumar’s father, also a doctor, told the BBC: “Junior doctors are suffering… please help them”.
Behind the stories. We invited medical health professionals and campaigners to a ThinkIn to ask why so many health workers are in distress and what can be done. They said:
Inside the health sector there is
- insufficient mental health support for workers, compounded by a culture of bullying, harsh working conditions and pressure to deliver more with fewer staff; and
- extra pressure from General Medical Council (GMC) investigations into alleged mistakes, a process that while necessary can take months. Five doctors died from a confirmed suicide between 2018 and 2020 while under investigation, according to the GMC.
External factors include
- an increase in depression, anxiety, severe stress and burnout for healthcare workers as a result of the pandemic; and
- heightened levels of abuse directed at primary care staff, fuelled by anti-GP rhetoric in some media outlets.
No magic pill. Suicide has no cure, but early warning systems and better support could help prevent it. Campaigners want specialist psychological services to be available from day one for trainees and for the junior doctors, paramedics, nurses and midwives who are balloting or taking strike action over pay and working conditions.
But “you can recommend all the support you want,” says Adam Kay, the author and former doctor. “If you are doing two or three people’s jobs at once it is utterly meaningless.”
Notably missing from the government’s announcement this week of a “blueprint” to improve the service for patients was a long-awaited NHS workforce plan for the next 15 years. The Department for Health told Tortoise the plan would be published “in due course”.
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CAPITAL ECONOMY, BUSINESS AND FINANCE
A month ago the FTX crypto exchange was smouldering digital rubble and last rites were being read for the whole crypto edifice. FTX is still a scandal of vanishing billions that may never really have existed, but Bitcoin, the big beast of the blockchain, was trading this morning at $23,880, up 40 per cent so far this year, and the Bank of England is hiring experts to regulate the crypto space as if it’s here to stay. What gives? “Usage, adoption and innovation remain a much more positive picture than pricing and investor sentiment was reflecting,” one savant tells Bloomberg from deep inside the crypto beltway. Translation: diehards are hanging in there because they stand only to lose by selling up, and the Fed’s dovish words on inflation suggest surplus assets may soon be on the hunt again for unconventional returns as rates come down. Buy the dip? Too late for that.
TECHNOLOGY AI, SCIENCE AND NEW THING
The gene editing company Colossal Biosciences has announced it will try to “bring back” the dodo which has been extinct since the 17th Century. Try is the key word. Although well funded by VC – $150 million has been put aside for the project – the journey from extracted DNA to a living, breathing dodo is a formidably complex multi-stage process that could take decades. Scientific American has a helpful explainer of how it might work. But even then, if there’s nobody around to teach the dodo how to be a dodo, as one paleogenomics researcher asks, is it really a dodo? Colossal has previously announced projects to bring back woolly mammoths and Tasmanian tigers. Question: isn’t it a better use of time and resources to protect the animals currently on the brink of extinction than re-creating those already extinct?
The 100-year life health, education AND GOVERNMENT
Bird flu spillover
The worst outbreak of bird flu is getting worse, with signs the virus is spilling over into mammals. Figures seen by the BBC show the virus has killed around 208 million birds around the world (the vast majority from culling to prevent spread) and at least 200 recorded cases in mammals. In the UK, the Animal and Plant Health Agency (APHA) tested 66 mammals and found nine otters and foxes were positive for avian influenza (HPAI) H5N1. To note: the risk to the public is very low. The otters and foxes with the disease are believed to have caught it from eating sick birds and there is no evidence of transmission between mammals. But there will be more surveillance and testing in the UK to counter a virus “on the march”.
Our planet CLIMATE AND geopolitics
Four months after the death of 22 year-old Mahsa Amini in police custody, protests across Iran have cost more than 300 lives, including 44 children, according to Amnesty International. At least 14,000 people have been arrested. Four people have been executed. Street protests have given way to civil disobedience, says the WSJ, while the regime has also been adjusting its tactics: the Washington Post has published an extensive visual investigation into protests in the southeastern province of Sistan-Baluchestan showing how Iran’s Revolutionary Guard Corps has been working with riot police and plainclothes agents to brutally suppress demonstrations. The UK has issued new sanctions against Iran but calls to designate the guards as a terrorist organisation have stalled, with the Times reporting this morning that the process is “on ice”.
CULTURE soCIETY, IDENTITY AND BELONGING
“I think it has started”
Russia has twice as many soldiers in Ukraine as it deployed in its initial invasion force, according to Ukrainian intelligence, and is launching or preparing to launch offensives at several points on the eastern front line with a view to retaking territory lost last year. Ukraine’s President Zelensky said last night he thought Russia’s next big push had already started. The troop numbers are startling: 320,000 in theatre with up to 250,000 more in reserve. “The main fights are yet to come,” Oleksii Danilov, head of Ukraine’s national security and defence council, told Sky News on Tuesday. The race to re-equip Ukraine to fight them is now existential, and Ukraine’s demands for F-16 fighters are more urgent than ever. The NYT reckons it will get them in the end – Biden and Scholz just have to go through months of ritual dithering first.
Additional reporting by Giles Whittell and Jessica Winch.
Photographs Getty Images
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