Image by: PA Images / Alamy

3 min read18 May

Dave Clements’ book is lucid, well-informed and honest, highlighting a plethora of problems in the SEND system that many in education are reluctant to acknowledge. It is also is a deep cry of parental pain: the author has skin in the game.

As he lays out, the recent explosion in SEND is not about physical disability or cognitive impairment. Instead it is overwhelmingly about children like Clements’s son, diagnosed with one or more conditions of autism, ADHD and other disorders linked to behavioural problems.

Clements shows that some (not all) of this come from overdiagnosis. He does not mention the highly influential 2013 American DSM-5 definition of autism, which lowered the diagnostic bar substantially. One participating psychiatrist has apologised for his part, saying the wider definition is contributing to “massive, careless over-diagnosis of autism”. The book discusses how unnecessary diagnoses can affect children, reducing their agency and self-belief as well as lowering others’ expectations of them. And it recognises the problems when services are overwhelmed by demand from children who may not need or benefit from them, at the expense of those who really do need them.

It is easier for the state to be kind than to be honest

He bravely tackles parenting: some children’s very real problems may not be intrinsic to the child but about poor parenting, without the boundaries and certainties that children need to develop healthily. But our reluctance to stigmatise makes it easier to label children without naming the likely cause.

And equally bravely, he tackles the perverse incentives in the education, benefits and welfare systems. A SEND label can unlock extra help at school and other accommodations and dispensations: a reader and scribe and extra time for tests and exams, and may entitle the family to extra benefits. A rational parent will fight to keep this even if a child no longer needs the package.

Clements describes the burdens this creates for schools, but omits the evidential gap: we know little about what (beyond coherent and well-sequenced curriculum, well taught in an orderly classroom) is effective for different types of SEND, and almost nothing about what represents good value to the public purse – there is no NICE for SEND.

Spending more money on a child will not necessarily improve their experience or outcomes. But parents desperately want to believe that something can be done, and it is easier for the state to be kind than to be honest. This may explain why we already spend £15bn a year – more than £500 from every household – on high needs SEND and children’s disability living allowance, with no real idea of what difference this spending makes.

The tragedy is that the current system was created with good intentions, by governments of all colours. Statutory entitlements for SEND (and social care) were never expected to bankrupt local authorities and starve them of resources for other functions. But even bad law is difficult to unpick. The current government has already essentially ducked with its SEND white paper, which will create more workload in schools and, probably, more dissatisfied parents believing their children are being short-changed. Time to think again.

Baroness Spielman: Conservative peer and former Ofsted chief inspector

The Crisis in the Classroom: How the needs explosion is destroying education

By: Dave Clements

Publisher: Luath Press

3 min read18 May

I was out knocking doors the day after Josh Simons announced he’d be stepping down. I’ll be honest, I wasn’t quite sure what to expect.

This is, historically, a Labour heartland and a seat that went our way just a couple of years ago. But last week, 24 out of 25 council seats in Wigan went to Reform.

I knew it would be tough. It wasn’t what I expected. The first door I knocked belonged to a woman in a semi-detached, path of white pebbles across grey stone.

She wasn’t in any hurry to close it. Surprised Labour was out this early, she said. I told her why it matters, why this party needs to rebuild trust in places like this.

She called her husband through from where he was decorating. Yorkshire and Lancashire, together chatting over a doorstep, unhurried, the way politics almost never allows.

He’d voted Reform the week before, and in the general election. If Andy Burnham stood here, he said he’d have to have a “really deep think”, but could convince him to come back to Labour. Eight days after putting a cross next to the party in teal, this man was genuinely reconsidering.

That matters. A few doors down, someone else put it with a directness I won’t forget. “I’ve got a bit of Labour left in me, just need to find a way to get it out.”

These aren’t voters who have abandoned us. They are voters who want a reason to come back. There is a difference, and Westminster forgets it constantly.

Andy Burnham’s name came up again and again. Not as a political calculation, but with the warmth you reserve for someone you actually know. “He’s done a lot for Manchester. I’d be sad to see him go as mayor.”

But they’d be glad to have him as their MP too. Everybody had a story, a friend, a family member, one degree of separation from the man. That kind of proximity counts for more than any amount of targeted advertising. I also heard something generous about Josh Simons, who is standing down. “He’s a young lad who moved his family from Cambridge and chose to bring them up locally. You can’t ask for more than that.” People notice authenticity. They always have. It’s a small reminder that north and south aren’t opposing forces.

They’re simply waiting for the right moment to be bound together. There were doors that didn’t swing so easily. I won’t pretend otherwise.

Whether it was schoolchildren running excitedly around the corner ready for their weekend to start, or a group of people having a chat outside the local chippy, there was a sense that people here look out for each other, and that underneath the frustration, something is still there.

The argument that Reform voters are beyond reach is not just wrong, it is condescending. We have been here before. In the ashes of 2019, we didn’t win back the voters we’d lost by telling them they were wrong to choose Johnson and the Tories.

We asked them why. And then we listened, properly, and acted accordingly. That is how we won. It is the only way we ever win.

The people I met in Makerfield weren’t making an ideological statement. They were asking to be listened to. And they were, when given the chance, very willing to have that conversation. Nigel Farage is in for a fight here. This is a seat with Labour in its bones. The right candidate, with roots that people can feel, can remind it of that. We should rise to that challenge.

Despite what you or we might think, in the eyes of the Scottish Football Association this ISN’T a pitch invasion. This is simply what a football match in progress looks like.

Because according to the absolutely extraordinary statement they’ve released this evening, that was game time. The clock was still running, nothing was being added to account for the fact that there were thousands of thugs rampaging across the field, and the game was still happening in that moment, until it was ended four seconds later.

It’s far from the only astonishing line in the statement.

There’s also the admission that the game ended because Hearts manager Derek McInnes, being advised by police before the game was over, feared for the safety of his players and didn’t want to risk carrying on.

That is, in the SFA’s view, if your team’s winning a game with a minute to go and you don’t want to take a chance on the other side scoring, you should not only pile onto the pitch but also do your active best to scare the living daylights out of their players, and the ref will just keep the clock ticking until time runs out, even though there isn’t even a ball any more.

(We imagine it’s proudly sitting on someone’s mantelpiece somewhere in the East End of Glasgow at the moment.)

The laws of the game are absolutely clear.

The referee CANNOT reduce the time declared by the fourth official, and he MUST add time for both goal celebrations and “interference by an outside agent”, ie thousands of thugs on the field of play. The SFA appear to have simply unilaterally overridden those global laws put in place by the International Football Association Board and said “Nah, it’s optional if there are a load of Neanderthal morons terrifying the players”.

It merits saying again: according to that SFA statement, this is not an interruption to play. This is a football match in normal progress, before full-time.

(Just two minutes later, incidentally, the pitch had been cleared and the last minute or so of the game could have been played.)

It is no small feat for the SFA to have limboed under even the incredibly low expectations bar we set for them. But hats off to them, they’ve done it with spades to spare.

Credit: Adobe stock

Product innovators such as Tunstall Healthcare, Nyobolt, BMW Mini, Thales, Google, Amazon, Toyota, and many others, who are significant investors and employers in the UK, are increasingly concerned about a complex and untransparent technology licensing system.

That system is the licensing of Standard Essential Patents (SEPs). SEPs cover technologies that are voluntarily contrib­uted to standards such as 5G, wi-fi, and video compression for streaming, with a binding promise to be licensed on fair terms. While smartphones and computers have long supported these standards, the connectivity boom means that these standard­ised technologies now reach into key British growth sectors such as automotive, energy, and medical devices. However, the current situation acts as a brake on British ambition.

The problem lies in how these technologies are licensed. Royalty demands are often disproportionate to the technolo­gy’s underlying value and are made under the threat of market exclusion through court-ordered injunctions. The Intellectual Property Office has identified serious concerns in this area, noting evidence that licensing demands have exceeded court adju­dicated rates by up to 500 times.¹ UK courts, too, have repeat­edly found that SEP holders demand royalties far exceeding a fair rate and rely on the threat of injunctions in negotiations.²

These are not abstract concerns, but direct costs borne by innovative companies operating in the UK. Smaller companies are often hit hardest. The government’s Telecoms Supply Chain Advisory Council noted SEPs are “very highly concentrated among a small number of companies, none of which are UK-owned.” The result is a one-way outflow of value from the UK economy.

Yorkshire-based Tunstall Healthcare provides connected devices that enable elderly and vulnerable people to live inde­pendently at home. Its wearable alarms and remote monitoring systems are used by local authorities and NHS trusts to reduce hospital admissions and improve care.

These devices depend on standardised connectivity tech­nology like 4G and wi-fi. Hundreds of thousands of patents are alleged to be essential to just these two standards alone, meaning companies like Tunstall must negotiate licences with multiple SEP holders, often through opaque and complex processes. Despite facing unfair demands, the cost of being unable to sell products owing to a court-ordered injunction is greater. Challenging the demands is also costly; one recent litigation cost £31m. Even large companies will settle at exces­sive cost to avoid this outcome.

UK companies face millions of pounds in excessive fees, but the impact is not confined to balance sheets. For health-tech, higher licensing costs are passed down the supply chain – to the NHS, local authorities, and ultimately to taxpayers. Lost R&D and reduced product functionality harm businesses and customers alike. Other medium-sized businesses, such as Nyobolt – an innovative, Cambridge-based smart battery systems company – have also reported how SEP licensing uncertainty directly reduces investors’ willingness to provide growth capital.

This week, a large group of UK and global companies will gather in London for the Fair Standards Alliance’s General Meeting. Our message is clear: without reform to curb exces­sive demands, the current system will continue to stifle inno­vation, deter investment, and place innovative UK companies at a structural disadvantage.

We are calling on the government to legislate for this pro-growth measure in the next session. Find out more at www.fair-standards.org.

We are hosting a reception in Parliament, with many companies in attendance.

Please drop by from 3.30pm to 5.00pm in the Home Room on Tuesday 19 May, to hear these concerns first-hand.

References

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1. Intellectual Property Office, ‘Consultation on Standard Essential Patents’, 15.07.2025
2. IAM, ‘Ask versus outcome: FRAND valuation, judicial analysis and the continuing gaps in SEP litigation’, 16.01.2026

To mark May’s Arthritis Awareness month, our upcoming report, The Silent Treatment: Why an Arthritis Diagnosis Matters, highlights the key barriers to a timely and personalised arthritis diagnosis. The report brings together insights from people with arthritis and healthcare professionals to highlight the delays and issues faced at each stage of the diagnosis pathway.

The importance of a diagnosis for people with arthritis cannot be underestimated – in terms of the treatment and support it offers for proactive symptom management, the role it can play as part of secondary prevention, and the validation it can provide for those who have been struggling without answers. It’s critical to get things right.

Arthritis can affect every aspect of someone’s life, from their ability to work, care for family, move independently and live free of pain. Last year, Arthritis UK’s research report, Left Waiting, Left Behind: The Reality of Living with Arthritis, surveyed almost 8,000 people, with 32 per cent stating that arthritis severely or very severely impacted their life in the past year. 60 per cent reported living in pain most or all of the time due to their arthritis.¹

Alongside the impact on the individual, a delayed diagnosis can also come at a cost to the NHS. For inflammatory arthritis, early diagnosis directly reduces the risk of permanent joint damage, persistent pain and disability in the long term. Therefore, delayed diagnosis can lead to higher costs overall for the health system, as patients may then need intensive treatment with high-cost medicines for longer periods.²

Delayed diagnosis also costs the economy. If people are left waiting without the right support, they may struggle to stay in or get back into work. One study cited in the report, which looks at a type of inflammatory arthritis called axial spondyloarthritis, has estimated the economic cost of a delayed diagnosis to be £193,512 per person. Based on estimated prevalence rates of axial spondyloarthritis ranging from 0.3 to 1.2 per cent of the UK population, the total annual economic cost of delayed diagnosis was estimated at between £3.1bn and £12.5bn.³

Delays can beset the entire diagnosis pathway, beginning when people first experience symptoms. The limited societal understanding of arthritis and its symptoms means that people may downplay symptoms and delay seeking medical advice. Commonly held misperceptions, for example, that only older people can get arthritis, mean that people may dismiss symptoms.

Heard of osteoarthritis and I associated it with being like an old person’s illness. So, I just brushed it off that I didn’t have that

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(Lived experience workshop participant)

Once people do enter the health system, they may face additional delays. Despite the best efforts and dedication of healthcare professionals, they are working in a stretched system that has not historically prioritised musculoskeletal (MSK) health. It means people’s symptoms may be missed; there are delays to diagnostic tests, referrals and appointments; and limited availability of health professionals and services to deliver the multidisciplinary support people need.

When people receive their diagnosis, they may not just be presenting with physical deterioration. They may often be struggling with other aspects of their wellbeing, such as their mental health. The National Early Inflammatory Autoimmune Diseases Audit found that between 2023 and 2034, 60 per cent of patients had probable depression or anxiety at the time of diagnosis.⁴

This underlines the need for a holistic approach that factors in what people are struggling with at the point of diagnosis, including their mental health. Crucially, for people with arthritis, diagnosis is more than just a label. It can be the gateway to the information, care and support that can be life-changing.

People need a personalised conversation that factors in their needs and sets them up for the road ahead, as they process being diagnosed with a long-term condition. To deliver these effective diagnosis conversations, health professionals need the appropriate training to support them to do so and training that supports them to diagnose and care for people with arthritis more generally. Despite the increased prevalence of MSK conditions like arthritis, this has not translated into proportionate MSK content as part of the medical curriculum. Healthcare professionals could benefit from supplementary training and courses to boost confidence and fill in any knowledge gaps.

Think it was quite clear my mental health wasn’t great, but that was never really discussed. It was well, you know, we’ll get you on this treatment and these meds should do the thing that should help

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(Lived experience workshop participant)

A formal diagnosis, with a name and clearly communicated information, equips people with the language and confidence they need to speak about their condition, explain how it affects them, and articulate their needs. Additionally, simple signposting, such as to the Arthritis UK website, can unlock a range of information and support, including on work and benefits. Access to these resources could make a big difference to someone’s ability to work or access information about financial support.

I think the validation is so important, [it provides] a huge sense of relief that [I] haven’t been imagining it… would have been really good to have it some years previously when I was still working, because I’ve been in so much pain at work

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(Lived experience workshop participant)

The barriers around an arthritis diagnosis also demonstrate a broader issue. At a system level, MSK conditions lack the strategic prioritisation, national strategy, dedicated local or regional leadership, and sustained infrastructure.

Urgent action is needed now to improve the rate and experience of diagnosis for people with arthritis. People with arthritis should not be left in pain, in the dark, or given the silent treatment while they wait for a diagnosis. Getting it right from the outset will deliver benefits across the health and social care system and wider economy, allowing people with arthritis to get control of their lives back.

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1. Arthritis UK. (2025) Left Waiting, Left Behind: The Reality of Living with Arthritis. A lived experience survey [Online]. Available here: https://www.arthritis-uk.org/media/3tgj3rxh/ arthritisuk_leftwaitingleftbehind_report_digital.pdf
2. Getting It Right First Time (2021) Rheumatology GIRFT Programme National Specialty Report. [Online]. Accessed here: https://gettingitrightfirsttime.co.uk/wp-content/uploads/2021/09/ Rheumatology-Jul21h-NEW.pdf
3. Zanghelini, F., Xydopoulos, G., Howard Wilsher, S., Afolabi, O., Webb, D., Eddison, J., Ingram, T. A., Clark, C., Hamilton, J., Sengupta, R., Gaffney, K., Fordham, R. (2025) What is the economic burden of delayed axial spondyloarthritis diagnosis in the UK?, Rheumatology. 64(9):4913–4920. https://academic.oup.com/rheumatology/article/64/9/4913/8120097
4. National Early Inflammatory Autoimmune Disease Audit (NEIAA) (revised 2025) State of the Nation Summary Report 2024. Accessed here: Ref.-428-NEIAA-SoN-Report-2024-revised-March-25.pdf

(Illustronaut/Alamy)

5 min read19 May

One of the challenges of writing about Brexit’s lingering impact on the UK economy is that, outside of a Marvel movie, it is still not possible to experience a reality that never came to pass. Every assessment therefore involves comparing the UK’s economy as it exists today with one that might have existed had the UK remained a member of the EU.

This is both standard economic modelling practice, and a source of frustration for those who argue that the economic impact of Brexit has been overstated. After all, how can anyone know with certainty what would have happened if the vote had gone the other way?

What should be less controversial, however, is that putting new trade barriers between yourself and your largest trading partner comes with economic costs, even if we can debate their scale and duration.

The question from a UK perspective is whether the additional flexibility associated with controlling its own trade and regulatory trajectory has been sufficient to offset the trade and investment costs of leaving.

On trade, the UK initially moved faster than the EU in securing new deals with Australia, New Zealand, and India, alongside accession to CPTPP. But the EU is catching up, or arguably overtaking, with the announcement of its own agreements with Australia, New Zealand, India, Indonesia and with Mercosur, the South American trade bloc.

More importantly, the economic gains associated with modern free trade agreements tend to be modest, often amounting to little more than fractions of a percentage point of additional GDP. They were always unlikely to compensate fully for the additional friction introduced into UK-EU trade.

Perhaps the clearest recent example of Brexit-related flexibility has been the UK’s approach to the United States under President Trump. Here, the UK was able to move more quickly and secure more favourable tariff treatment in several sectors, while making fewer concessions overall – although the bioethanol sector may take a different view. Unlike the EU, the UK avoided large investment pledges and purchase commitments, while also securing the first, and currently only, dedicated pharmaceutical arrangement with the US.

On regulation, the revealed preference of the UK – particularly in the context of food and manufactured goods – has been that it rather likes EU rules after all. Despite some targeted changes, for example in respect of gene editing of crops or fertiliser usage, successive governments have chosen to retain EU food safety rules and product standards in all but name.

There has been a quieter but more sustained divergence from the EU on services rules, where the UK has opted to take a more flexible, pro-innovation approach. This is most evident in areas such as AI, where the UK has so far opted for a lighter touch framework than the EU.

At the same time, proximity and economic exposure mean that EU policy decisions continue to have an outsized impact on the UK, despite Brexit. Measures such as higher EU tariffs on steel or efforts to promote a more explicit “Made in Europe” industrial agenda risk compounding some of the trade friction already created by Brexit itself.

So, what comes next?

Some degree of rapprochement with the EU was always inevitable. Recent discussions have focused on targeted measures – for example, an SPS agreement to improve agri-food trade, and linking the UK and EU emissions trading systems (ETS). Both make sense. Reducing inspections, cutting paperwork and removing irritants such as “Not for EU” labels would ease costs at the margins, while ETS linkage could help avoid unnecessary costs for carbon-intensive exporters.

But these are practical improvements, not macroeconomic game changers. They should improve trade flows in specific sectors without fundamentally changing the overall trajectory of the UK economy.

On regulation, the revealed preference of the UK – particularly in the context of food and manufactured goods – has been that it rather likes EU rules after all

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The government has nonetheless signalled that it wants to go further. Rachel Reeves and others have hinted at closer alignment with EU rules in areas considered to be in the UK’s “national interest”, while legislation expected later this month would give ministers greater powers to facilitate more dynamic alignment with EU regulation.

The trade-off, however, remains fundamentally the same. The kind of frictionless trade the UK says it wants – fewer checks, smoother borders, easier market access – increasingly resembles the arrangements enjoyed by countries such as Norway or Switzerland, both of which depend on accepting shared rules and ongoing alignment. In other words, the economic benefits are difficult to separate from constraints on autonomy.

The EU, meanwhile, remains understandably cautious about opening ambitious new negotiations without clarity on what the UK is prepared to offer in return. There is also the question of durability: whether any deepening of the relationship would survive a future change of government in Westminster.

The next phase of Brexit is therefore unlikely to involve a dramatic reset. More likely, it will consist of incremental and occasionally messy trade-offs, with modest economic gains in some areas and political friction in others, gradually determining where the UK chooses to position itself between autonomy and market access. 

Sam Lowe is a partner and Kathryn Watson a director, both at Flint Global