Politics
Huge demand for new obesity drugs risks overwhelming NHS, Streeting told | Obesity
More than 200 doctors and medical experts have warned that the unprecedented demand for new obesity drugs is threatening to overwhelm the NHS.
In a joint letter to the health secretary, Wes Streeting, the healthcare professionals call for an urgent review of services for millions of people struggling with weight.
The letter, coordinated by Obesity Health Alliance (OHA), says: “New pharmaceutical treatments have resulted in unprecedented public demand for treatment services and added enormous pressure on already stretched commissioning structures. This has made action to address longstanding issues across the entire scope of treatment services an immediate priority.”
The OHA points out that 4.1 million people in England are eligible for the weight-loss drug Wegovy, and yet the NHS estimates that by 2028, fewer than 50,000 people a year will receive treatment, even with new funding.
Huge demand for the new drugs, which also include Mounjaro, has exposed problems with the existing services, the letter says.
Katharine Jenner, the director of the OHA, said: “While the drugs, are safe and effective to be used, they’re just placing even more pressure on the already stretched services.”
Speaking to the BBC Radio 4’s Today programme she said: “Rather than being a silver bullet, as it’s quite often talked about, these weight-loss drugs are really just so far only highlighting the weaknesses in our current system.
“So, we’ve all joined together to say that we need urgent government action to make these services, sustainable and equitable.”
The letter to Streeting says: “Our vision is for a fully resourced system that delivers equitable access to appropriate, tailored and sustained support services to people living with overweight and obesity. This means guaranteeing a consistent, equitable and evidence-informed treatment pathway based on individual needs, providing appropriate person-centred support for all, in a non-stigmatising way.”
Some specialist obesity management services are so overstretched that they have closed their waiting lists entirely, according to a report by the OHA launched alongside the letter.
It said: “Most people living with overweight or obesity do not receive the recommended level of support from overweight and obesity management services. Provision of all levels of evidence-based services is insufficient and unavailable to a significant number of people.”
On Tuesday, Streeting and Keir Starmer, the prime minister, suggested that the rollout of the weight-loss jabs could help boost both the nation’s health and the economy.
Officials have announced plans for new trials to assess the impact of a weight loss treatment on worklessness and the impact obesity has on the NHS.
A five-year trial in Manchester will assess the “real-world effectiveness” of Mounjaro, also known as tirzepatide.
Mounjaro, manufactured by Lilly, has been hailed as the king of weight-loss jabs after a previous study found people taking the drug, along with support to make changes to exercise and diet, lost an average of 21% of their body weight over a 36-week period.
NHS officials have suggested that the rollout of the drug across England will need to be staggered owing to anticipated high levels of demand.
The OHA said the phased access plan suggests the rollout will take place over 12 years “due to the cost implications and lack of services in primary care to support access for all who are eligible”.
A Department of Health and Social Care spokesperson said: “We’re tackling the obesity crisis head on – restricting junk food advertising on TV and online, along with banning the sale of high-caffeine energy drinks to children under the age of 16.”
An NHS England spokesperson said: “With the sheer number of people potentially eligible for these treatments and GP teams already delivering record numbers of appointments, the NHS is working with the government and industry to develop new kinds of services which mean approved treatments can be rolled out safely, effectively and affordably, without impacting on other people’s care.”
Politics
Kemi Badenoch hits back at Robert Jenrick’s ‘disrespectful’ jibe
Kemi Badenoch has hit back at her Tory leadership rival Robert Jenrick’s claim that her decision not to set out detailed policies was “disrespectful” to the party’s membership.
Speaking to Political Thinking with Nick Robinson, Badenoch said she would not use that word about another candidate and that everyone had “their own campaign approach”.
“If this was a general election, yes, it would be wrong to be standing with no policies. This is not a general election,” she told Nick Robinson.
She added: “He [Jenrick] doesn’t know what he’s going to be standing on in four years’ time.”
Jenrick stood by his criticism in an interview with BBC Radio 5’s Matt Chorley.
“Kemi and I disagree on this point. I believe you have to start with principles and values, but I think that is not enough. You also have to have policies.”
He argued that the public were “deeply sceptical” of politicians and the best way to win them back was to set out policies and “lay out the trade-offs”.
“The age of policy-free politics is over,” he said, adding that it was “wrong” to ask party members to support you “on the basis of a plan for tomorrow”.
During the leadership campaign, Jenrick has said he wants to leave the European Convention on Human Rights, encourage housebuilding and oppose Labour’s plans on reaching net-zero carbon emissions.
Defending her approach, Badenoch said the party members know what her principles are. She said she would take time to design policies adding: “We have time, we don’t need to rush.”
She said she did not want to make promises “unless I know how I am going to deliver it”.
Earlier in the week, Jenrick told BBC Radio 4’s Westminster Hour: “I think it’s disrespectful to the members and the public to ask for their votes without saying where you stand on the big issues facing our country today.”
Conservative Party members are currently voting between the two candidates and a result is due on 2 November.
Unlike her rival, Badenoch has not done many media appearances, however in a wide-ranging interview she spoke to Nick Robinson about her thoughts on net-zero, immigration and Covid lockdowns.
On the environment, she said she was a “net-zero sceptic” but not “a climate change sceptic”.
She said she did not want to do something “because it looks good” and “before we figured out how to do it”.
She pointed to speeches she had made in Parliament on subject asking: “Lot’s of schoolchildren will be very happy, but where is the plan?”
She added: “Is net-zero a solution or is it a slogan… I am not sure we have properly thought that through.”
On immigration, she said “numbers matter but culture matters more”.
For several years, Conservative politicians have promised to get down the numbers coming into the country, but immigration has continued to rise, hitting record levels in 2022.
Badenoch said there should be a cap on numbers but it was also important to ensure those arriving “love British culture”.
Asked how the government should decide this, Badenoch said it was important to establish from which countries “successful migrants” were coming from.
“We should be getting to a point where we can say we’re happy to take more from countries A, B and C and for countries X, Y and Z, we’re going to have stricter rules.”
During the coronavirus pandemic, Badenoch was a Treasury minister. She said she would not apologise for spending “a lot” during Covid but added: “I think we just overran it to the point where it made inflation worse than it needed to be.”
She also said she thought the government “overdid it in terms of the length of lockdown”.
“There was a King Canute sort of situation. I thought that we were trying to do too much, that this was where government was overstretching itself and we weren’t trusting people enough.
“The biggest thing I hated was the fixed penalty notices.”
The notices were issued by the police to people who breached Covid rules, resulting in fines of between £200 and £10,000.
Both Boris Johnson and Rishi Sunak, the prime minister and chancellor during the pandemic, were issued with fines for breaching the regulations.
Badenoch said: “If Boris did not bring in those fixed penalty notices, he would not have had the Partygate scandal, certainly not to the extent that it was… he got caught in a trap that he had set for himself.”
She said Conservatives had “strayed away” from their principles of freedom.
Asked about her own leadership style, Badenoch said she aspired to be a “fun” leader and would try to bring some “humour” and “light-heartedness” to her approach.
“I think that we’ve been very gloomy. We’re not the gloomy party. We are actually quite an optimistic and fun party and I want to bring that out.”
Reflecting on her own background, she compared finding out that she was a British citizen to “finding out that you’d won the lottery”.
Badenoch explained that because she was born in Nigeria, a Commonwealth country, before a 1983 rule change, she qualified to be British – something she only found out when she was 14 years old.
She said there was a “very unpleasant sort of ethno-nationalist anti-Kemi wing” who called her an “anchor baby” – a term used in the United States to refer to people who ensure their children are born in the country in order to gain residency.
Badenoch was born in the UK because her mother had come to get medical care at a private hospital, but she said that is not why she qualifies as a British citizen.
Politics
‘Extreme wealth’ tax demanded by cross-party MPs
A dozen Labour MPs have joined a cross-party call for an “extreme wealth” tax in this month’s Budget.
The MPs have written to chancellor Rachel Reeves to demand a new 2% tax on assets worth more than £10m, which they claim could raise £24 billion per year.
The left wing Labour MPs and two Labour peers have joined forces with MPs suspended by Sir Keir Starmer, including former shadow chancellor John McDonnell, and former leader Jeremy Corybn, who was elected as an independent.
The call is also backed by the Greens, Plaid Cymru, the SDLP, Alliance and one Liberal Democrat MP.
The Labour Party has been asked for comment.
The chancellor is finalising details of her first Budget, to be announced on Wednesday 30 October. Government sources have told the BBC this will include tax rises and spending cuts to the value of £40bn.
In their letter to Reeves, the 30 MPs and peers say an extreme wealth tax is needed as billionaire wealth has increased by almost £150bn in only two years, between 2020 and 2022, but revenue from wealth taxes has remained stagnant at around 3.4%.
One of the MPs, Zarah Sultana, who represents Coventry South, flagged Oxfam research showing the richest 1% of Britons hold more wealth than 70% of the UK population.
“Austerity is, and always has been, a political choice,” she said. “It is grossly unfair that children and pensioners are being pushed into poverty while billionaire wealth continues to grow.
“We urgently need wealth taxes to rebalance power, fund essential public services and build a society where the needs of the many take precedence over the greed of a few.”
Reeves told the party’s autumn conference there would be “no return to austerity” under this government and promised a boost to government investment, designed to kickstart growth.
The MPs are also asking Reeves to equalise capital gains tax (CGT) and income tax rates in her budget.
They say this would “rectify unfairness in the tax system, where working people are subject to proportionately higher rates of tax”, and raise £16.7bn per year.
At the election, Labour promised not to increase taxes on “working people”, covering VAT (value added tax), income tax or National Insurance (NI), which limits the levers the chancellor can pull to bring cash in.
However, there has been speculation Reeves could increase CGT – charged on profits from the sale of assets like second homes – and also freeze the income tax threshold beyond 2028, potentially dragging more workers into the higher tax bands.
Sir Keir Starmer also did not rule out a National Insurance increase for employers in a BBC interview last week.
Reeves has already taken one unpopular decision, to remove winter fuel payments from 10m wealthier pensioners, which led to a rebellion by seven Labour MPs.
Sultana is one of five MPs who signed the wealth tax letter and who are currently suspended from the Labour Party for voting against the winter fuel payment cuts.
Some observers also wonder if the rebels, who were suspended for six months in July, may decide to team up with Corbyn’s independent group in January rather than re-join Labour.
The Labour rebels have teamed up with four of the smaller Westminster parties, including Wales’ Plaid Cymru and Northern Ireland’s SDLP and Alliance groups, plus all four Green Party MPs.
Green co-leader Carla Denyer called on Reeves to reconsider Labour’s decision to ditch its £28bn green investment pledge earlier this year, and invest more in public sevices.
“We cannot afford to have another government of spending cuts and economic hardship,” she said.
“Labour’s first Budget must take a resolute step to ensure that those with extreme, unprecedented levels of wealth help foot the bill.”
Politics
Sinn Féin leaders correct age of teen texted by senator on record
Michelle O’Neill has corrected the record at Stormont regarding the age of the teenage boy who received inappropriate texts from the former Irish Senator Niall Ó Donnghaile.
On Monday, the first minister and Sinn Féin deputy leader told the Northern Ireland Assembly that party membership files said the boy was 17 at the time.
But the young person had said he was 16 years old.
Sinn Féin leader Mary Lou McDonald has also corrected the record officially in the Dáil (lower house of Irish parliament).
On Tuesday, O’Neill told the assembly she “fully accepted” the age and wanted to correct the information on the record.
She said it was her understanding that the young person was 17 based on the information he had provided in his application to join Sinn Féin.
She also repeated her apology to him saying she was “absolutely so sorry for the hurt caused” by the party’s statement issued following Mr Ó Donnghaile’s resignation in December 2023.
O’Neill had been facing calls to return to the assembly after the Democratic Unionist Party (DUP) submitted an urgent question.
She is also being asked to return to Stormont’s executive office committee on Wednesday for further questioning, but this has not yet been confirmed.
McDonald came to the Dáil on Tuesday to correct the record in which she previously stated the young person was 16 and apologised for her words.
“I have now written to the young person and his mother offering a full, unequivocal and sincere apology,” she said.
“What happened to this young person was wrong, Niall Ó Donnghaile’s behaviour was unacceptable, utterly inappropriate, and no young person should have experienced that.”
McDonald apologises
The Sinn Féin leader also said she was “very sorry” for the hurt the words in her statement following Mr Ó Donnghaile’s resignation.
“That was never, ever my intention, and I apologize to that young person,” she added.
McDonald said it was her understanding the teenager was 17 years old at the time of the incident “because of the information provided on his application, formally applied to join Ográ Sinn Fein, that information was wrong,” Ms McDonald said.
“The young person themselves have made clear that he was in fact 16 at the time, so I want to correct the Dáil record to reflect that he was in fact 16 years of age when the text was sent.”
How did we get here?
Sinn Féin has faced criticism over the last week for its handling of the suspension and resignation of Mr Ó Donnghaile.
Mr Ó Donnghaile, a former Belfast lord mayor, was suspended by Sinn Féin over the issue but the party allowed him to resign on health grounds in 2023 without revealing the complaint against him.
Calls for clarity on the teenager’s age came following a Sunday Independent article where the boy said he was 16 at the time the texts were sent and not 17 as McDonald and O’Neill had previously said.
The message is believed to have been personal in nature but not sexually explicit.
The party has also been questioned over its safeguarding policies after two former press officers gave references to former colleague and convicted child sex offender Michael McMonagle.
On Monday, it emerged that a Sinn Féin employee had resigned after admitting involvement in an incident where a portrait of former DUP lord mayor Lord Browne was damaged.
Speaking at Stormont on Tuesday, the first minister said the employee was “immediately suspended” and the police have been notified.
On Monday evening, McDonald said Sinn Féin accepted the boy’s own account that he was 16 at the time.
“The person knows their age so obviously Michelle [O’Neill] is right, the party records did indicate that he was 17, it was on his application form for membership,” McDonald said.
“But that doesn’t matter now. What matters is that we respond fully to the young person in question and what matters is that the Dáil record is accurate and I will attend to both of those matters tomorrow.”
A Sinn Féin spokesperson said the party record of the boy’s age was “based on the date of birth that [he] provided on his membership documents at the time”.
The spokesperson said it had “since emerged” that the boy was 16 years old.
Politics
Inside the battle to run the Trump White House
Earlier this month, the New York Times reported that Donald Trump was considering Brooke Rollins — his former Domestic Policy Council director now serving as president of a MAGA think tank, the America First Policy Institute — to serve as his chief of staff should he return to the White House.
Within 24 hours, stories emerged that AFPI — dubbed the “White House in waiting” for its quiet role mapping out a second Trump term — had been hacked by the Chinese.
But inside Trump’s inner circle, that wasn’t exactly news: The institute’s online security perimeter had been breached almost a full year prior, then again earlier this month.
The reason news seeped out this time? Because, some Trump confidants speculate, someone who didn’t like Rollins wanted it to.
“The knife-fighting is underway,” one said. “Someone’s like, ‘Oh, she wants to be chief of staff? Well, she can’t even stop her own organization from getting hacked.’”
It’s just one vivid example of the behind-the-scenes jockeying playing out over a crucial White House role even before Trump wins the election. The chief of staff job has always been seen as particularly crucial and particularly fraught for Trump, who ground through four chiefs in four years during his first term. Each, despite wildly different styles and personalities, struggled to rein in Trump and keep him and his administration focused.
Trump himself, those around him say, has been superstitious about making plans before a victory and has been reluctant to discuss the matter much. But among those orbiting the ex-president, tongues are freely wagging.
A host of insiders view the job as crucial to a potential second Trump administration’s success — and had plenty to say about the three people most discussed for the role: Rollins, Susie Wiles and Kevin McCarthy.
The frontrunner
As de facto campaign manager, Wiles probably has the job if she wants it, almost all of the insiders said. Trump, after all, has a history of rewarding those who help him win — tapping RNC chief Reince Priebus as chief and campaign CEO Steve Bannon as chief strategist following his 2016 victory.
But that’s not the only reason people are betting on Wiles, a veteran of Florida politics who grew closer to Trump when he was persona non grata in political circles after Jan. 6.
She’s the biggest reason why Trump has a more professional and organized campaign this cycle, insiders say. They appreciate her instituting order on an otherwise chaotic political menagerie and credit her zero-tolerance policy on backbiting for an era of relative peace in their orbit.
Most importantly: The boss trusts her. While Trump doesn’t always listen, they’ve established a rapport where Wiles can be frank with the former president and tell him when she disagrees — not something many are willing to do in the face of Trump’s occasional temper.
Her few detractors argue Wiles hasn’t had a modern-day government job. She worked on the Hill briefly for Rep. Jack Kemp (R-N.Y.), as a scheduler for Ronald Reagan and in the Labor Department before decamping to Florida, but Beltway politics have changed considerably since then.
Still, those who’ve seen Wiles up close say she’s a quick study. Under Trump, she’s navigated big egos and sharp elbows, assassination attempts, court cases and convictions. “She’s unflappable,” one insider said.
One thing: It’s unclear if Wiles actually wants the job given its grueling nature and how past Trump chiefs departed. She has already had a remarkable three-year run at Trump’s side, and people wonder if she got her fill of personnel drama earlier this year after Corey Lewandowski’s sudden return to the campaign.
The policy hand
According to that Times story, Trump has been soliciting people’s opinions about Rollins and suggesting she’d make “a great chief of staff.” Those who like Rollins say that’s a sharp assessment: She’s a polished policy hand, they argue, who can help get Trump’s legislative agenda passed.
But the story has only crystallized opposition to Rollins among many Trump insiders, who believe she has no business having that job, casting her as a relative newcomer to Trump world whose main attributes are self-promotion and close ties to AFPI’s influential donors. Some worry she’s too close with traditional free-market conservatives and would clash with Trump’s embrace of tariff-heavy “MAGAnomics.”
Still, Rollins has a power base: A Texas native who came up through Gov. Rick Perry’s administration, she grew close to Jared Kushner and helmed domestic policy during Trump’s final half-year in office then gave fellow ex-administration officials a home at AFPI after the chaotic end to Trump’s presidency.
Her critics argue that despite her policy chops, her political acumen is sorely lacking. Some of those who have worked with her believe she’d be eaten alive in the role. The counterpoint is that Trump would not be seeking reelection and thus needs someone who can primarily execute on his agenda. She’s clear-eyed about her political deficiencies, her backers argue, and could outsource that role. (Notably, she brought Kellyanne Conway on at AFPI.)
But what does Trump think? One person told us Trump has lavishly praised her, saying she could run any business in the country. But he’s confronted her in the past over AFPI’s use of his “America First” brand, with the Times reporting he’s sought as much as $50 million in compensation.
The ousted speaker
If Wiles has the political chops and Rollins has the policy know-how, McCarthy backers argue that the former speaker has both: “I think there is an argument to having someone who’s been a legislator,” one Trump ally said, harking back to the difficulties Trump had in 2017 getting his agenda across Capitol Hill.
Some have questioned if McCarthy would actually take the job. A longtime-staffer-turned-longtime-lawmaker, he’s now making big money for the first time in his life.
But those who know him best know better. McCarthy is an inveterate political animal who loves playing the inside game. Perhaps no job in Washington would better harness the relationships he’s built over a lifetime in politics. (Asked in the past about serving under Trump, McCarthy has said he’s not angling a job but wouldn’t rule out taking one.)
Some, in fact, think McCarthy is too eager. Two Trump insiders pointed out to us unprompted that McCarthy’s longtime consigliere Jeff Miller has been lobbying for Howard Lutnick, the Cantor Fitzgerald CEO who is also leading Trump’s transition, prompting questions about Miller’s influence on personnel decisions.
Miller told Playbook he isn’t involved: “Howard has been a friend and client for quite a while, but I have no role — officially, unofficially or in any way whatsoever — in [the] transition.”
As for Trump’s view, it’s complicated. Trump didn’t do much to intervene when MAGA die-hards moved against McCarthy in the House. Some say he viewed McCarthy as a weak negotiator during his months as speaker, and he remains vexed that the Californian didn’t make good on a promise to “expunge” his twin impeachments.
Still, the two remain close and talk frequently. Trump appreciates that McCarthy was one of his earliest congressional allies. But the view among those closest to the ex-president is that they’d be surprised if he gave McCarthy the job.
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Politics
Pie ‘n’ Mash should be protected, says Basildon and Billericay MP
It is as Cockney as a Pearly Queen in a three-wheeler Del Boy van.
Now an Essex MP is to lead a parliamentary debate calling for traditional pie ‘n’ mash with liquor to get protected status, like champagne and Cornish Pasties.
Richard Holden, the Conservative MP for Basildon and Billericay, said the dish was “part of that Cockney diaspora”, describing it as “the original fast food”.
Andy Green, who founded the Modern Cockney Festival, said obtaining the status “may kickstart a fresh look from government agencies and public bodies to recognise the tradition and culture that pie ‘n’ mash represents”.
Campaigners want the dish – mashed potato with minced beef pie and lashings of parsley sauce known as liquor – to be given Traditional Speciality Guaranteed (TSG) status by the government.
Mr Holden will lead the debate in Westminster Hall at 16:00 BST on Tuesday to stop producers claiming it – but with a different recipe.
Mr Holden said: “With British staples like Cornish Pasties, Bramley Apple Pies and Melton Mowbray Pork Pies already enjoying protection, it’s now time we protect this important dish to be recognised and celebrated, as it is enjoyed by families for decades to come.”
‘Alive and thriving’
The TSG status is defined by the specificity and traditional element of the dish and decision makers will need to see a recipe agreed.
Almost 30 years ago there were 60 pie ‘n’ mash shops across London, but there was barely a third of that total left by 2020.
Speaking on BBC Radio 4, Mr Green said there was “a narrative that pie ‘n’ mash shops are closing and maybe pie ‘n’ mash is dying” but, he added, “the reality is it’s evolving”.
“Listed traditional food status would give a mark, a statement that despite rumours of its death, pie ‘n’ mash is very much alive and thriving,” he said.
Mr Green said its Cockney identity had spread further than the traditional areas of east and south London, marked by the spread of pie ‘n’ and mash shops, from Bishop’s Stortford in Hertfordshire to Tunbridge Wells in Kent.
He said some shops were “evolving” with the times by offering vegetarian options and delivery services.
The history of pie ‘n’ mash
The iconic dish which has become synonymous with Cockney culture is thought to date back to the 1840s.
Traditionally, it consisted of a savoury pie filled with minced beef, served with mashed potatoes and a parsley liquor.
But for anyone feeling adventurous, pie ‘n’ mash can also be served with stewed jellied eels – another Cockney favourite.
Those who love it, like the Cockney Modern Festival organisers, say it is an artisan food with recipes handed down throughout generations “like precious family heirlooms”.
Mr Holden said he has written to more than 40 MPs who have a pie ‘n’ mash shop in their constituency, adding: “It’s part of a campaign to celebrate and really promote pie and mash, which has spread out from its beginnings in central and east London, down the Thames Gateway and out into the world.”
He told PA Media: “We’re wanting to celebrate it and I’ve got a couple of pie and mash shops in my part of the Basildon new town.
“I’ve got Stacey’s Pie and Mash and Robins Pie and Mash. Robins is part of a small chain run by a family right across Essex and east London.”
Famous fans of the hearty meal include David Beckham, actor Danny Dyer, and comedians Arthur Smith and Rob Beckett.
The dish has also been immortalised in EastEnders, with Beale’s Eels Pie & Mash House.
Mr Holden said the dish had been enjoyed by families for nearly 200 years.
He said: “It’s part of that Cockney diaspora – particularly for places like Basildon, where you’ve seen all that new build town… people moving out there from the East End and taking some of those traditions with them.
“It’s great to promote a high quality product… it’s the original fast food.”
Daniel Zeichner, Labour’s environment minister, said officials at the Department for Environment, Food and Rural Affairs (Defra) had been involved in discussions.
“They are clear that an application for TSG status requires agreement on the recipe that producers would need to follow to use the name in future,” he said.
“They also understand that all those wishing to use the name would need periodic verification of their practices.”
He said once a formal application had been submitted, a full assessment could then be made.
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