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The Independent
06-07-2025
- Politics
- The Independent
Starmer's fatal flaw? He believes in nothing – and is proud of it
I came in for one simple reason: that I wanted to change the lives of working people for the better. And I don't believe in anything else.' Last week, as Keir Starmer tried his best to celebrate a year in government, he fell once again to boasting that he didn't believe in anything. For the prime minister, it is a virtue that there is no such thing as 'Starmierism', as it means he's not weighed down by dogma. He went on to say that he didn't believe in performative politics or rhetorical speeches, because it was the change that mattered. Of course, it is the change that mattered, but Sir Keir is still talking as vaguely as the cover of his manifesto about 'change' without being able to flesh it out. Last week's events suggested that he doesn't really know. The government had to gut a bill that it had claimed was about welfare reform, but which was dominated by Treasury-driven cuts to benefits. He was launching an NHS plan which, while difficult to disagree with in its broad brush principles, felt rather as if it had been taken out of the bottom of a chest freezer in a dusty garage owned by New Labour and reheated. The plan offered little detail on how the government plans to implement something that reformers have discussed for decades: redirecting the NHS towards a more balanced focus on preventive and community medicine, rather than its current emphasis on acute care. Neither the welfare 'reforms' nor the NHS plan contained big, stunning new ideas that no one had thought of before. Given that the problem for the NHS is not a lack of an idea but a repeated failure to implement it over many years and dozens of governments, you'd think the focus might have been precisely on how to make this new plan different. We are told that the blueprint for actually changing things will come in the NHS planning guidance, to be published earlier than usual this year, so that the health service can get on with the changes it needs. Yet the plan was also severely undermined by the long timetable for social care reform. Some medium-term recommendations are expected to arrive next year, but full-scale reform and funding overhauls will not come until the next parliament, if Labour remains in power. Those who've spent the past few years working in both Starmer's shadow cabinet and the current cabinet table say that the two things that really drive him are making things work properly and the importance of family. He has long been a stickler for meetings starting on time (more of an achievement than you'd expect in Westminster) and would get very energised in opposition when he had the opportunity to point out something else that the Tories were doing badly. Starmer still gets very excited when talking about things that the last government did badly, forgetting that he now has a chance to shape public services to his vision, as well as just not being as incompetent as he feels the last government was. The problem is that even a more efficient state run by people who believe that actions are more important than speeches (hardly an original insight in itself) won't deal with the ballooning benefits bill or the creaking NHS. Taken together, the spending needs of the welfare state and the health service are equivalent to a small country. They are co-dependent systems: NHS waiting lists keep people on sickness benefits for longer, while staying out of work contributes to poor mental health and higher demand for treatment. So the longer they go without reform, the deeper each arm of the state pulls the other. Starmer understands this. But his handling of the benefit cuts makes it much harder to tackle the root causes. By allowing the Treasury to dictate cuts instead of proper (and initially costly) reform of benefits, and by pretending that the former was the latter, Starmer has made the case for real reform harder. As with the damage that Theresa May's botched proposals for social care in 2017 did to any attempts to change that system, now Starmer has made benefits even more toxic. Backbenchers will be so paranoid about changes that they won't be prepared to give ministers the benefit of the doubt that they are introducing them for moral rather than fiscal reasons, and aware that if they just push the prime minister for long enough, he will cave. As he boasted, he doesn't believe in anything, really, other than a nebulous concept, and so he'll happily drop detailed plans if they become inconvenient. Not believing in anything means that Starmer has allowed the Treasury to dominate in policy-making. Labour MPs shouldn't blame Rachel Reeves for trying to do her job: they should blame Starmer for letting her brief in keeping the markets calm by pleasing the Office for Budget Responsibility become the overriding mission of the government. Whatever was going on personally for the chancellor on Wednesday when, already clearly emotional, she was set off by her boss's very public failure to back her at prime minister's questions, there was something very telling in her reported remark just before the session that 'I'm just under so much pressure'. It was more than just someone having the sort of bad day we all have from time to time, but a comment that underlined how much the chancellor is trying to carry this government – even though that is very much not her job. Politics today is also overwhelming, and not just because of the pace of the news agenda or the way in which social media heaps opprobrium on a group of people largely trying to do the right thing. The scale of government is now vast, and yet it is still run out of a terraced house. Ministers are finding it increasingly hard to work out just how much the government should be involved in, let alone how they could possibly row back from areas where it has overreached. We often compare this new Labour government with the post-war Clement Attlee administration, but the truth is that politics today is groaning in a way that those governments were not. It is increasingly hard for prime ministers and chancellors to stay across a state this big and complicated, and the machinery of government or politics isn't able to help them. That's not to say that you can't do better than Starmer. He can't blame a sprawling state for the lack of belief that he seems to think is a virtue. He doesn't realise that one can be full of belief and vision while still refusing to be chained by dogma. He seems to think that there is a binary between believing in change and just relying on fancy speeches and 'performative politics'. Even that phrase 'performative politics' reveals a lot about what Starmer thinks of the business of getting things done. He doesn't like politics and thinks it silly, as opposed to the important art of bringing your party with you to bring about the change you want and the country needs. However, more critical than any of that is that he doesn't know what the change is that he wants, even after a year of being able to bring it about.
Yahoo
05-07-2025
- Health
- Yahoo
Are whole-body MRIs worth the hype?
When you buy through links on our articles, Future and its syndication partners may earn a commission. In recent years, celebrities like Kim Kardashian have taken to social media to tout the supposed benefits of whole-body MRI scans. Companies that offer the service promise that the scans can spot a range of conditions, including cancer, aneurysms, liver disease and multiple sclerosis, in as little as an hour. And if the initial scan looks clear, the companies encourage clients to return periodically to check up on their health status. But are full-body MRIs really a silver bullet, or just another expensive health fad? According to Dr. Matthew Davenport, a professor of radiology at the University of Michigan, for most people, whole-body MRI scans aren't only unnecessary but can actually lead to their own set of problems. Structural MRI scans visualize the inside of the body using magnetic fields and radio waves. Because they render detailed 3D images of internal anatomy, they're useful for detecting various conditions, including blood clots, musculoskeletal injuries, tumors, and neurological or cardiovascular problems. But doctors normally order these scans only when they already suspect that something is wrong based on an individual's symptoms, medical history and other test results. In some circumstances, doctors may recommend regular whole-body MRIs for certain patients as a preventive measure, Davenport said. But this generally occurs only when patients are diagnosed with rare disorders that put them at high risk of developing cancer. Such conditions include Li-Fraumeni syndrome, a genetic disorder that increases the risk of developing cancer at a young age. The idea is that the regular scans could spot lesions in these high-risk individuals, potentially flagging them for further testing. However, for people without such conditions, there's little reason to get regular full-body MRIs, Davenport said. "There is no scientific evidence that whole-body MRI in asymptomatic, average-risk patients improves health," he told Live Science in an email. In fact, full-body MRIs may actually do more harm than good, he said. That's because tests that can be used for diagnostics, like MRI scans, are likely to discover incidental findings. Incidental findings are unexpected results that occur from a medical test ordered for a different reason. For example, a person might get an MRI of an injured rib and then have a suspicious mass pop up on the scan. Sometimes, these findings end up pointing to a previously undiagnosed condition that requires treatment. But more often, they're just benign abnormalities in the body that pose no threat. Related: The 10 deadliest cancers, and why there's no cure About 15% to 30% of diagnostic imaging tests raise at least one incidental finding, estimates suggest. That means people who get regular whole-body MRIs are likely to find abnormalities in their bodies that may not indicate any serious health issues. "The vast majority of findings identified by whole body MRI in a patient without specific risk factors will be findings that would not improve health if they had not been detected," Davenport said. Nevertheless, you may not know if an incidental finding is important without further tests, so these results can prompt additional diagnostic tests, biopsy procedures and even unnecessary surgeries — not to mention the health anxiety that can accompany those procedures. Because of this, Davenport argues that ordering too many medical imaging tests on otherwise healthy people is likely to backfire. Currently, no major medical societies recommend whole-body MRIs for people without conditions that put them at high risk of cancer. Davenport also pointed out that companies that offer full-body MRIs benefit from a highly profitable business model in that clients pay for the tests out-of-pocket. Full-body MRIs typically cost anywhere from $1,000 to over $4,000, depending on the provider and specific service they're offering. Some insurance plans may cover whole-body MRIs in high-risk individuals, but because the scans are elective for most and not backed by clinical guidelines, they're generally not covered by private or government insurance in the U.S. RELATED STORIES —Who needs more exercise: Women or men? —Can weight loss drugs help you drink less alcohol? —What is alkaline water, and does it have any benefits? While on one hand, whole-body MRIs may stoke health anxiety and lead to potential overtreatment, in some people, they may also provide a false sense of security, Davenport suggested. For many medical conditions, such as colon cancer and blood cancer, MRIs aren't used as a primary diagnostic tool because the scans don't necessarily pick up the diseases. Davenport recommended that the general public stick with established medical screening procedures recommended by physicians rather than relying on whole-body MRI. "It is possible we will see a future where imaging like whole body MRI is used for routine screening," Davenport said. "However, substantial research is needed before that." This article is for informational purposes only and is not meant to offer medical advice.
RNZ News
05-06-2025
- Business
- RNZ News
Concerns over Pasifika healthcare access in Aotearoa
The Fono chief executive Tevita Funaki Photo: Dominic Godfrey / RNZ Pacific The chief executive of The Fono, New Zealand's largest Pacific health provider, has raised concern about Pasifika healthcare access in the Budget. Fiugalu Tevita Funaki told PMN there are some wins and some concerns in the country's 2025 budget . "I think primary care for us is around access. There are some significant issues around access and even looking at some of the baseline funding to alleviate some of the issues within primary care is actually not in there." Fiugalu said any money towards after-hours care is important. He said there are some Auckland practices delivering after-hours care, but it was important to be in an area where Pasifika live and can easily access. He said the literacy around how to access care is also important. He acknowledged the issues with overcrowding at Middlemore Hospital and said there's no doubt Pasifika tend to go to secondary care like hospitals rather than primary care in winter. "My view around health is that the investments to reduce the burdens on secondary care, where the cost is actually huge, is investments around primary care and investments around preventive medicines." Fiugalu said The Fono's relationships with Pacific clients at the primary care level support the view that investments in primary care eases the pressure on secondary care. "This is why I'm going to flag around the lack of investments into primary care, because that's where the preventative measures, the ongoing engagements with our families, [is] actually happening - at the primary care level." Minister of Health, Simeon Brown, argues the 2025 Budget "provided a significant boost" to primary care, "to make it easier for patients to see a doctor, and avoid unnecessary hospital visits". In a statement, he said this included NZ$285 million in performance-based funding over three years, to support primary practice to be more accessible for patients and deliver more services in the community; and NZ$447 million in 24/7 digital health services, after-hours and urgent care, and more funding for training doctors and nurses to work in primary care. Brown told RNZ Pacific his priority is ensuring that "all New Zealanders have access to timely, quality healthcare". "I am advised that Health New Zealand's Pacific Health Group is working closely with their Pacific provider partners to prioritise the health of Pacific communities. "Health New Zealand advises me that there are several campaigns targeting Pacific communities and families to alert them to the best ways to prioritise and manage their health, and to navigate the health system this winter. "These include Pacific language resources and translation services, and programmes run with Pacific health providers including The Fono." New Zealand's Pacific peoples minister says Pasifika people should see themselves in the Government's 2025 budget . "It is an economic growth agenda and Pasifika people will benefit from economic growth."
