Regular readers will be well aware that the blog has not had my usual attention over recent months and that has largely been due to the various consequences of my treatment journey whilst under the superb care of our wonderful NHS. I'm told I'm doing very well and my oncology consultant regularly beams a smile that somewhat unnervingly reminds me of Wallace, that well-known occupant of 62 West Wallaby Street.
I had a PET scan on Friday in readiness for a short course of precautionary radiotherapy that starts on Friday. This is the third time, and I've never really given it much thought, until that is last night and listening to Inside Science on BBC Radio 4. It turns out I've been rather lucky because there's currently a shortage of medical isotopes that are vital for the process, with many patients having diagnoses delayed. Why? Because a nuclear reactor in the Netherlands unexpectedly shut down and has been 'offline' for a month.
It turns out that these isotopes used to be made in nuclear research reactors all over the place, including here in the UK, but due to having become life-expired, have closed down, hence the NHS has to purchase from a dwindling worldwide supply. One might well wonder how such a predictable situation could have been allowed to develop? Apparently the Welsh Government has had their eye on the ball and last year produced a plan for a former nuclear power station site in North Wales. This from BBC news website last week:-
Nuclear medicine shortage will lead to deaths
Lives will be lost because of a shortage of specialist medicine used to detect diseases such as breast and bowel cancer. That is the stark warning from experts who have said the lack of medical radioactive isotopes available in the UK means delays in tests to diagnose cancer. It has also led to renewed calls for the UK to develop its own manufacturing facility, rather than rely on imports of nuclear medicines. It follows a proposal to build a new £400m medical laboratory at the site of a former nuclear plant in north Wales.
The scheme dubbed Project Arthur would see a small-scale nuclear reactor placed at Trawsfynydd in Gwynedd, to produce the radioactive materials. The nuclear-based medicine is used to help detect cancer tumours in patients and track the progress of the disease. But there have been no fresh supplies available to be shipped to the UK after a reactor in the Netherlands was forced to halt production for the whole of last month.
"For every month that we don't have diagnosis, or a person doesn't have a diagnosis, their chances of succumbing to cancer increase by 10 per cent," said Prof Simon Middleburgh, at Bangor University's Nuclear Futures Institute. "It is actually resulting in people dying from this now. "These people are not getting the diagnosis, they are not getting those cancers caught early on, cancer will spread, people will die. "It's going to be hundreds if not thousands due to just this month's shortage in isotopes this time around."
Prof Middleburgh said it was why he had been backing the case for Project Arthur, which was originally unveiled by the Welsh government in January 2023. A feasibility study was commissioned into the project, and since then a business case is being submitted to the UK government asking for the cash to approve the scheme, providing a home-grown supply of the nuclear isotopes needed for the whole of Britain.
"The business case is there, it's not new technology, it's old technology - we can buy it of the shelf," said Prof Middleburgh. "It's not just a Wales thing - it's an across the UK thing - we're all ready to go, it is just time to press the green button and get on with it."
Radioisotopes can be used to diagnose cancer and treat certain types of the disease such as prostate and liver - when they are injected or swallowed and absorbed by cancers from within the body. Using them is a very common way of treating people or diagnosing people in the NHS already.
People typically get a dose of the nuclear medicine which is put into their body and it radiates. A gamma, for example, is a type of radiation. When it leaves the body, it can be detected to show its size and location on a scanner. But it should not be confused with external radiotherapy where they blast tumours from outside the body with radiation.
It is estimated it would take until about 2030 to get a facility up and running, if it was approved now. In the meantime, the UK government's Department of Health and Social Care said it was working to address the current shortages in nuclear isotopes.
"We know this may be concerning for patients and we are working closely with the company involved to resolve the issue," said a UK government official. "We are also working in close partnership with NHS England and the devolved governments to distribute available stock and prioritise patients with critical needs."
The Welsh government insisted it was still behind the proposals for Trawsfynydd, and said it was working with all partners to develop and progress plans. "We will provide an update on progress in due course." However, the Plaid Cymru MP for the area, Liz Saville-Roberts said action needed to be taken sooner rather than later, to help avoid a repeat of the current isotope shortage.
"Welsh government need to be pushing the business case as hard as possible. They need to have it costed, they need to work with Bangor University who will be alongside this, and the UK government has got to recognise - yes - this will cost, but look at the cost if we don't. We are going to be talking about a cost in life."
Lives will be lost because of a shortage of specialist medicine used to detect diseases such as breast and bowel cancer. That is the stark warning from experts who have said the lack of medical radioactive isotopes available in the UK means delays in tests to diagnose cancer. It has also led to renewed calls for the UK to develop its own manufacturing facility, rather than rely on imports of nuclear medicines. It follows a proposal to build a new £400m medical laboratory at the site of a former nuclear plant in north Wales.
The scheme dubbed Project Arthur would see a small-scale nuclear reactor placed at Trawsfynydd in Gwynedd, to produce the radioactive materials. The nuclear-based medicine is used to help detect cancer tumours in patients and track the progress of the disease. But there have been no fresh supplies available to be shipped to the UK after a reactor in the Netherlands was forced to halt production for the whole of last month.
"For every month that we don't have diagnosis, or a person doesn't have a diagnosis, their chances of succumbing to cancer increase by 10 per cent," said Prof Simon Middleburgh, at Bangor University's Nuclear Futures Institute. "It is actually resulting in people dying from this now. "These people are not getting the diagnosis, they are not getting those cancers caught early on, cancer will spread, people will die. "It's going to be hundreds if not thousands due to just this month's shortage in isotopes this time around."
Prof Middleburgh said it was why he had been backing the case for Project Arthur, which was originally unveiled by the Welsh government in January 2023. A feasibility study was commissioned into the project, and since then a business case is being submitted to the UK government asking for the cash to approve the scheme, providing a home-grown supply of the nuclear isotopes needed for the whole of Britain.
"The business case is there, it's not new technology, it's old technology - we can buy it of the shelf," said Prof Middleburgh. "It's not just a Wales thing - it's an across the UK thing - we're all ready to go, it is just time to press the green button and get on with it."
Radioisotopes can be used to diagnose cancer and treat certain types of the disease such as prostate and liver - when they are injected or swallowed and absorbed by cancers from within the body. Using them is a very common way of treating people or diagnosing people in the NHS already.
People typically get a dose of the nuclear medicine which is put into their body and it radiates. A gamma, for example, is a type of radiation. When it leaves the body, it can be detected to show its size and location on a scanner. But it should not be confused with external radiotherapy where they blast tumours from outside the body with radiation.
It is estimated it would take until about 2030 to get a facility up and running, if it was approved now. In the meantime, the UK government's Department of Health and Social Care said it was working to address the current shortages in nuclear isotopes.
"We know this may be concerning for patients and we are working closely with the company involved to resolve the issue," said a UK government official. "We are also working in close partnership with NHS England and the devolved governments to distribute available stock and prioritise patients with critical needs."
The Welsh government insisted it was still behind the proposals for Trawsfynydd, and said it was working with all partners to develop and progress plans. "We will provide an update on progress in due course." However, the Plaid Cymru MP for the area, Liz Saville-Roberts said action needed to be taken sooner rather than later, to help avoid a repeat of the current isotope shortage.
"Welsh government need to be pushing the business case as hard as possible. They need to have it costed, they need to work with Bangor University who will be alongside this, and the UK government has got to recognise - yes - this will cost, but look at the cost if we don't. We are going to be talking about a cost in life."
Good to hear you've been one of the 'lucky' ones. Hopefully all goes well for you, Jim.
ReplyDeleteMeantime the dismantling of anything of value, the meaning of 'professional' & pandering to the ultra wealthy while hammering the 'ordinary working person' continues as if there was never a change of govt.
For example, there are parallels between the impact of role boundary erosion, e.g. teachers & teaching assistants, lawyers & legal assistants, police & cso's, probation officers & pso's, doctors & pa's/aa's.
"About 3,500 PAs and about 100 equivalents who work in anaesthesia – called anaesthetic associates – are working in hospitals and GP surgeries in England."
Friend of the private sector, streeting, is now calling for a "review":
https://www.theguardian.com/society/2024/nov/20/wes-streeting-review-physician-associates-nhs
In the probation-based scenario there are a majority of skilled & diligent pso's who do not cross a line; but a minority who think they can do as they please. These are the few that create havoc, the disruptors who think they have entitlement.
The lack of respect for role boundaries has eroded respect, professionalism & performance.
"Taken together the number of “medical associate professionals” (MAPs), as they are known in the NHS, is due to treble to about 10,000 by 2037 under the service’s long-term workforce plan."
Exactly what has happened with pso numbers... they have escalated at pace, particularly once the Trusts were established.
Dec 2000 - 7,571 POs
March 2024 - 5,160 FTE band 4 probation officers
*** minus 2,400 ***
Dec 2000 - 1019 PSOs
March 2024 - 5,908 FTE band 3 pso's
*** plus 4,900 ***
I have every sympathy on this erosion expansion debate. However it was all sliced off the role because probation unions failed to illustrate which aspects of the role depended on professional qualification. The tasks that needed assesment real understanding and log the daily tasks as po only. Unfortunately there were few tasks that fitted the status required as professional duties and even reports were watered away to verbal court blathering by psos who thought they were rumpole.
DeleteFrom Guardian:-
ReplyDeleteTech firm Palantir spoke with MoJ about calculating prisoners’ ‘reoffending risks’
Exclusive: Rights group expresses concerns as it emerges US spy tech company has been lobbying UK ministers
The US spy tech company Palantir has been in talks with the Ministry of Justice about using its technology to calculate prisoners’ “reoffending risks”, it has emerged.
The proposals emerged in correspondence released under the Freedom of Information Act which showed how the company has also been lobbying new UK government ministers, including the chancellor, Rachel Reeves.
Amnesty International is among the organisations expressing concern about the expanding role Palantir is attempting to carve out after it was controversially awarded a multimillion-pound contract with the NHS last year.
The prisons minister, James Timpson, received a letter three weeks after the general election from a Palantir executive who said the firm was one of the world’s leading software companies, and was working at the forefront of artificial intelligence (AI).
Palantir had been in talks with the MoJ and the Prison Service about how “secure information sharing and data analytics can alleviate prison challenges and enable a granular understanding of reoffending and associated risks”, the executive added.
The discussions, which started under the Conservative government, are understood to have included proposals by Palantir to analyse prison capacity, and to use data held by the state to understand trends relating to reoffending. This would be based on aggregating data to identify and act on trends, factoring in drivers such as income or addiction problems. Lord Timpson did not respond to the letter.
A Palantir spokesperson said: “Advanced software that automatically integrates data could provide a single, constantly updating source of truth for prison capacity across the UK – helping to maximise the use of finite prison spaces. This kind of solution has parallels with how our software supported the Covid-19 vaccine rollout, where it provided a clear, real-time picture of takeup at a local, regional and national level.”
However, Amnesty International UK’s business and human rights director, Peter Frankental, has expressed concern. “It’s deeply worrying that Palantir is trying to seduce the new government into a so-called brave new world where public services may be run by unaccountable bots at the expense of our rights,” he said. “Labour faces the serious challenge of ensuring digital technologies are used in line with human rights, including protecting people’s privacy, right to equality, non-discrimination and data protection.
“Ministers need to push back against any use of artificial intelligence in the criminal justice, prison and welfare systems that could lead to people being discriminated against, unfairly targeted and other miscarriages of justice. The Post Office scandal is a stark warning of what can happen when digital technologies are considered infallible.”
Concerns about Palantir have been compounded by the political role played by its co-founder and chair, Peter Thiel, a major Silicon Valley supporter of Donald Trump, as well as a backer and former employer of the vice-president-elect, JD Vance. Thiel once wrote: “I no longer believe that freedom and democracy are compatible.”
Other letters released to the Guardian reveal that Palentir’s co-founder and chief executive, Alexander Karp, wrote to ministers including Reeves, asking to meet to discuss how to help drive growth and use of its products at government departments.
Karp is a self-described “socialist” but has spoken of Palantir being a counter to “woke” companies and is known for making provocative statements, claiming the company believed “the west is a superior way to live”.
This was reflected in a letter Karp wrote to the science minister, Peter Kyle, telling him: “Our company was founded to help strengthen critical institutions across the west.”
Guardian yesterday:-
ReplyDeletePublic’s understanding of paedophiles has not improved, says charity boss
Rev Harry Nigh, who set up Circles in 1994 to support sex offenders, says it is easy for politicians to say ‘lock them up’
Public understanding of paedophiles has not improved over the past 30 years, according to the founder of the pioneering charity Circles, which offers support to some of society’s most reviled offenders.
While the Rev Harry Nigh says child protection must always be paramount, he stresses the importance of breaking the isolation and shame that often leads people who commit child sexual abuse to reoffend, arguing that “anything that drives people underground even further endangers the community itself”.
The Circles programme provides a local network of volunteers who support and hold accountable their “core member”, a child sexual offender who wants to reintegrate into the community after serving their sentence.
Visiting London from Canada – where he established the first “circle” in 1994 – to celebrate the 30th anniversary of the now international movement, Nigh said: “I don’t think that the public perception has improved an awful lot and while there is a little bit of credibility with this work now it’s a very fragile thing.”
It was 30 years ago that Nigh, a Mennonite minister in Hamilton, Ontario, and a small number of volunteers from his congregation came together to support a child abuser and lifelong recidivist, known as Charlie, when he was released from prison.
Since then the grassroots programme has expanded across Canada and then was introduced to the UK in the 00s by the Quakers, and developed elsewhere in Europe and Australia – with evaluations consistently showing a significant impact on reoffending.
“There’s been no master plan,” said Nigh. “We started with one guy who needed to have some support. It’s an amazing thing to see it spread like that.”
With public funding squeezed in Canada as it is in the UK, Nigh fears the rightward trend in politics makes it tougher for decision-makers to justify supporting these interventions.
“When there’s an impulse that moves to the right, it’s a very easy call for politicians to say ‘lock them up’. There’s a kind of redirection of anger for political purposes.
“But this is one of the most creative ways in which we can invest public funds for community safety. How does withdrawing funding for these initiatives affect the rate of offences against children and vulnerable people in their community? It’s short thinking.”
Over the years the Circles movement has adapted to the changing nature of child sexual abuse and proliferation of online offending. In the UK, the Reboot programme offers structured sessions that focus on developing the offender’s offline hobbies and relationships as well as coping mechanisms for future online challenges.
But the core model of grassroots community support – and accountability – has remained the same for the past three decades: “It’s not just about risk management, it has to be about affirmation,” Nigh said. “Just to reinforce the humanity of the person is really important.
“That’s a very powerful thing for a person to be able to find a new narrative of his life that can lead him forward. But it’s not all hugs and kisses. There can be some very hard conversations in the Circle and confrontations. But the studies show that men with a Circle are 70 to 80% less likely to reoffend than a control group.”
Nigh said he could understand why many members of the public considered these offenders unworthy of help, but takes the position that “it’s better for people to be checking in on a guy who is isolated in a basement apartment somewhere, than for him to have no one”.
DeleteHe said a “small but significant” number of Circles volunteers had experienced sexual abuse as children themselves.
The grassroots nature of the programme “allows people to get their hands dirty, to have a face-to-face experience of walking with people as they leave prison”.
“The underlying principles of restorative justice are what’s guiding this work, that harm cannot be remedied completely by locking people up. There will be a time when people need to be restrained, of course. But these are people who have finished their prison sentence. And so what do they come out to?”
Often wondered how your treatment was going Jim, but never felt comfortable enough to ask.
ReplyDeleteThat it's going so well is great news to hear!
https://news-sky-com.cdn.ampproject.org/v/s/news.sky.com/story/amp/more-prisoners-are-being-transferred-to-less-secure-jails-to-tackle-overcrowding-crisis-sky-news-understands-13256381?amp_gsa=1&_js_v=a9&usqp=mq331AQIUAKwASCAAgM%3D#amp_tf=From%20%251%24s&aoh=17321011795631&referrer=https%3A%2F%2Fwww.google.com&share=https%3A%2F%2Fnews.sky.com%2Fstory%2Fmore-prisoners-are-being-transferred-to-less-secure-jails-to-tackle-overcrowding-crisis-sky-news-understands-13256381
'Getafix
More prisoners are being transferred to less secure jails to tackle overcrowding crisis, Sky News understands
DeleteThe Ministry of Justice said only "less-serious offenders" who meet "a strict criteria" are eligible to be moved to lower security prisons.
The prison service is starting to recategorise the security risk of offenders to ease capacity pressures, Sky News understands.
It involves lowering or reconsidering the threshold of certain offenders to move them from the closed prison estate (category A to C) to the open estate (category D) because there are more free cell spaces there.
Examples of this could include discounting adjudications - formal hearings when a prisoner is accused of breaking the rules - for certain offenders, so they don't act as official reasons not to transport them to a lower-security jail.
Prisoners are also categorised according to an Incentives and Earned Privileges (IEP) status. There are different levels - basic, standard and enhanced - based on how they keep to the rules or display a commitment to rehabilitation.
Usually 'enhanced' prisoners take part in meaningful activity - employment and training - making them eligible among other factors, to be transferred to the open estate.
Insiders suggest this system in England and Wales is being rejigged so that greater numbers of 'standard' prisoners can transfer, whereas before it would more typically be those with 'enhanced' status.
Open prisons have minimal security and allow eligible prisoners to spend time on day release away from the prison on license conditions to carry out work or education.
Grand news that your treatment is going well. It must be a tough haul. Thank you Jim for all you do, and I'm wising you well. I'd like to pause a while to acknowledge your astonishing contribution to a ground-up account and analysis of the state of probation, and here's hoping any next moves are ground-up informed.
ReplyDeleteAnd on we go, back to the subject. Good R4 briefing room episode today. Worth a listen.
The Briefing Room BBC R4 or BBC Sounds
Deletehttps://www.bbc.co.uk/sounds/play/m002553f
Our prisons are overcrowded, the Government recently released a group of prisoners early to ease the pressure. Britain seems to incarcerate more people per head of population compared to any other Western European country. Now the Government has announced there is going to be a Review of Sentencing to see what we can do to reduce the number of people in prison.
Recently an eight week consultation period began, during which members of the public can send in their thoughts on how to tackle these issues.
Why have prisons have become so over-crowded, and what we can do about it?
John Podmore, former prison governor and prison inspector and author of Out of Sight Out of Mind: Why Britain's Prisons Are Failing
Nicola Padfield, Emeritus Professor of Criminal and Penal Justice, at the University of Cambridge
Catherine Heard, Director of the World Prison Research Programme