## UK Launches Consultation to Make Vapes Less Appealing to Young People

The UK government has launched a formal 12-week public consultation aimed at reducing the attractiveness of vaping products to children and teenagers. The initiative targets the colourful packaging, cartoon imagery, and enticing flavour names that health officials say are drawing young people toward nicotine addiction.

### What the New Proposals Would Mean

Under the proposed regulations, vape products would be required to adopt plain, standardised packaging with tight restrictions on branding. Flavour descriptions would be stripped back to simple, generic terms — such as "apple" or "cola" — eliminating the kind of imaginative, youth-oriented names currently used by many manufacturers.

Additionally, vaping products would be moved out of open display in retail environments, mirroring the restrictions already placed on cigarettes and tobacco. Health experts argue there is no justifiable reason for nicotine products to feature neon colours, cartoon graphics, or marketing language clearly designed to attract a younger audience.

## Health Secretary Calls for Urgent Action

Health Secretary James Murray has been vocal in pushing these measures forward, stating that evidence clearly shows too many young people are being drawn into experimenting with vapes due to their visual appeal and varied flavour options.

"We must act now to reduce the appeal of addictive vapes to our children," Murray said. "Vapes are less harmful than cigarettes and can play an important role in helping adult smokers to quit, but they should never be designed or marketed in ways that tempt children."

He emphasised that the goal is to strike a careful balance — protecting young people from nicotine dependency while preserving access to vaping as a legitimate cessation tool for adult smokers.

## Part of a Broader Legislative Push

This consultation follows the recent passage of the Tobacco and Vapes Act, landmark legislation designed to establish the UK's first smoke-free generation. Under this law, individuals aged 17 or younger at the time of enactment face a lifelong ban on purchasing cigarettes, as it will be illegal to sell tobacco to anyone born after 1 January 2009.

The Act also grants authorities the power to prohibit vaping in vehicles carrying children, in playgrounds, outside school premises, and at hospital sites — effectively expanding the scope of existing smoke-free legislation.

### A Series of Rolling Restrictions

The new consultation builds on an already-implemented ban on single-use disposable vapes and precedes further planned restrictions, including:

- A ban on vape sales through vending machines
- An end to vape advertising and sponsorship deals
- Mandatory quit-smoking information inserts in cigarette packaging
- Plain packaging requirements extended to all tobacco products, including rolling papers and cigars

## The Scale of Youth Vaping in Britain

The urgency behind these measures is underscored by troubling statistics. According to the charity Action on Smoking and Health, approximately one million young people — nearly one in five individuals aged 11 to 17 in Great Britain — reported having tried vaping in 2025. NHS staff have reported children as young as 13 admitting to regular vaping use.

For the first time, the number of vapers in Britain has also overtaken the number of smokers, marking a significant shift in nicotine consumption habits across the population.

## Public Input Welcomed

The government is actively encouraging members of the public, health professionals, retailers, and industry stakeholders to participate in the consultation process. Officials hope broad engagement will help shape regulations that effectively safeguard young people without undermining the legitimate role vaping plays in adult smoking cessation programmes.

The UK government is consulting on plain vape packaging and simpler flavour names to reduce youth appeal, following the landmark Tobacco and Vapes Act.

UK Plans Stricter Vape Branding Rules to Protect Children

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UK Government Moves to Strip Vapes of Child-Friendly Branding and Flavour Names

## Why Heatwaves Hit Women Harder — And What Needs to Change

As record-breaking temperatures continue to batter the UK, health experts are sounding the alarm on a lesser-known truth: extreme heat does not affect everyone equally. Women, in particular, face a distinct and often underestimated set of risks when heatwaves strike — and specialists say it's time for greater awareness and targeted protective measures.

## The Biology Behind the Vulnerability

According to Dr. Nighat Arif, an NHS GP specialising in women's health, heatwaves act as a serious "stress-test" for the female cardiovascular system. Two core biological factors are at play: hormonal fluctuations and the way women's bodies physically respond to heat.

Research, including a 2025 study, confirms that women produce less sweat and only begin perspiring at higher temperatures compared to men. This means the body is slower to shed excess heat — and because less visible sweat appears on the skin or clothing, women may not even realise how much physical strain they're under.

Additionally, women tend to have a higher core body temperature and a greater percentage of body fat, which acts as an insulating layer, trapping heat rather than releasing it. When this is combined with the natural hormonal fluctuations tied to the menstrual cycle, perimenopause, menopause, pregnancy, and breastfeeding, the brain's temperature regulation system can be thrown significantly off balance.

## Beyond Biology: Social and Economic Factors Also Play a Role

Dr. Cat Pinho-Gomes, an academic public health consultant at UCL's Institute for Global Health and co-author of a major review on sex differences in heatwave-related deaths, emphasises that the risks aren't purely biological.

Socioeconomic circumstances — including lower average wages and the disproportionate caregiving responsibilities many women carry — can limit a woman's ability to properly protect herself during extreme heat. Women may find it harder to rest, stay hydrated, or access cooler environments when they are the primary caregiver for children or elderly relatives.

Age is another compounding factor. Because women live longer on average than men, they are more likely to be among the elderly population most vulnerable to heat-related illness. Older individuals also face higher rates of dementia, which can impair the ability to recognise thirst, and may rely on diuretic medications for blood pressure management — both of which increase exposure to heat stress.

Women may also be marginally more likely than men to die from heatwave-related causes, though researchers note that more data is needed to draw firm conclusions.

## How the Menstrual Cycle Intensifies Heat Stress

For women who menstruate, extreme heat can collide painfully with their monthly cycle. During the second half of the cycle, rising progesterone levels push core body temperature even higher. Then, when a period begins, oestrogen — the hormone that drives the body's thermoregulatory system — drops to its lowest point, placing additional strain on the heart as it works to cool the body down.

Women who experienced a heatwave while menstruating have described severe fatigue, dizziness, fainting episodes, intense brain fog, and overwhelming exhaustion — symptoms that go well beyond typical period discomfort.

Menstruation also leads to iron loss, which is particularly significant for women with heavy periods. Low iron compromises the body's ability to deliver oxygen efficiently, adding yet more demand on an already overworked cardiovascular system.

## Perimenopause, Menopause, and the Heat Connection

For perimenopausal and menopausal women, falling oestrogen levels already trigger hot flushes and night sweats under normal conditions. During a heatwave, these episodes can become more frequent and far more intense — a reality that is expected to worsen as global temperatures rise, according to research on the impact of climate change on menopause.

Women who have been placed in a chemical or surgical menopause — a treatment used for hormone-sensitive cancers and conditions such as endometriosis — face the same challenges.

One woman described her hot flushes during a recent heatwave as "truly horrendous, especially at night time" — a sentiment echoed by many others navigating menopause in increasingly extreme summer temperatures.

## A Call for Targeted Action

The overarching message from health professionals is clear: heatwave safety guidance needs to better reflect the specific vulnerabilities women face. Generic heat advice is not enough. From period management strategies to menopause support and broader access to cool environments, a more tailored and gender-informed approach to heat health is urgently needed — especially as climate change makes extreme summers the new normal.

Experts explain why women face greater health risks during heatwaves, from hormonal changes to social factors — and what needs to change.

Why Heatwaves Are Harder on Women's Bodies

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Why Heatwaves Are Harder on Women's Bodies Than Men's

## German Doctor Receives Life Sentence After Killing 15 Patients in His Care

A Berlin court has sentenced a 41-year-old German palliative care physician to life imprisonment after finding him guilty of deliberately murdering 15 of his own patients. The case has sent shockwaves through the medical community and raised serious concerns about patient safety in home-based care settings.

### The Convictions

The doctor, identified only as Johannes M. under German privacy legislation, was convicted of killing 12 women and 3 men over a period spanning September 2021 to July 2024. His victims ranged in age from just 25 to 94 years old. While all were severely ill at the time of their deaths, prosecutors emphasized that none of them were considered to be facing imminent death.

During home visits, the doctor administered lethal combinations of medications to his patients — without their knowledge or consent. On multiple occasions, he reportedly attempted to conceal his crimes by setting fire to the homes of his victims.

### A Particularly Disturbing Timeline

In one chilling sequence of events in July 2024, just days before his arrest, the doctor allegedly claimed two lives in a single day. He first administered a fatal dose to a 75-year-old man at his home in central Berlin, then traveled to a neighboring district where he killed a 76-year-old woman hours later. Authorities say he attempted to burn down the woman's home afterward but was unsuccessful.

### The Doctor's Confession

For the majority of the yearlong trial, Johannes M. remained largely silent. However, last month he broke that silence, admitting to having killed twelve of his gravely ill patients. He claimed he had persuaded himself that his actions were merciful, believing he was sparing his patients from prolonged suffering and physical decline.

"Throughout it all, I thought this was the best thing for everyone," he told the court, before offering an apology for the pain he had caused.

### Victims' Families Speak Out

For the families of those who died, the courtroom proceedings brought little comfort. Relatives struggled to reconcile the doctor's self-justifications with the reality of their loved ones' lives and wishes.

The mother of the youngest victim — a 25-year-old woman who died in 2021 — broke down in tears as she addressed the court. "She never said she didn't want to live anymore," she said.

The son of a 72-year-old victim who passed away in 2024 recalled his mother's plans to visit the Baltic Sea with her sister. "My mother wanted to keep on living," he told the court.

### Potentially One of Germany's Worst Serial Murder Cases

Authorities believe the 15 confirmed murders may represent only a fraction of the doctor's actual crimes. Prosecutors are currently investigating an additional 76 cases potentially linked to Johannes M. If those cases result in further convictions, German media report it could rank among the most extensive serial murder cases in the country's modern history.

The doctor told the court he intends to cooperate more fully in the upcoming proceedings related to the additional investigations.

### The Court's Ruling

The Berlin court determined that the severity of the doctor's guilt was exceptional. Beyond the life sentence, the court ordered that he be placed in preventive detention upon completion of his prison term — a measure typically reserved for offenders deemed a continued danger to society. He has also been permanently banned from ever practicing medicine again.

A Berlin court sentenced palliative care doctor Johannes M. to life in prison for murdering 15 patients. Prosecutors are now investigating 76 additional cases.

German Doctor Jailed for Life After Murdering 15 Patients

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German Palliative Care Doctor Sentenced to Life in Prison for Murdering 15 Patients

## The Silent Struggle Behind Closed Doors

For many families, the transition from raising children to watching them flourish as independent adults never quite arrives. Instead, some parents find themselves navigating an uncharted, emotionally exhausting reality — caring for adult children who are unable to work, pursue education, or build lives of their own. These are their stories.

## A Father's Perspective: Rethinking What Progress Looks Like

One parent of a neurodivergent teenager approaching adulthood describes the experience as deeply unsettling. His son, who struggles with social communication and forming relationships outside the family unit, faces a world that often feels hostile and confusing to him.

Like many parents, this father admits to falling into the trap of comparison — measuring his son against peers who have already stepped confidently into the workforce, romantic relationships, and broader social circles. He reflects honestly that, as a man, it is particularly hard not to compare his son's journey with his own adolescence, which was filled with experimentation, risk-taking, and the kind of carefree independence that society tends to celebrate in young people.

Yet he offers an important counterpoint. Despite the weight of dependency and the added pressures on the family, his son has quietly developed qualities that are just as valuable as conventional independence — a genuine sense of humor, thoughtfulness toward others, and a respectful disposition. These are the traits, he argues, that we hope to see in any well-rounded adult. Sometimes growth simply looks different than we expect.

## Two Sons, Two Very Different Journeys

Another couple wrote in recognizing their own experience in the original letter almost word for word. They are parents to two sons in their early twenties whose life paths have diverged dramatically, despite being raised in the same household under the same values.

Their younger son has spent six years in self-imposed isolation and is classified as not in employment, education, or training — commonly referred to as NEET. He is only now beginning to engage with a private counselor, a resource the family can access only because of their financial situation. For years, they received no support from schools or public services, largely because their son refused to engage with any of them.

The family was even fined for school non-attendance and came close to facing legal proceedings — a process only interrupted by the COVID-19 pandemic and its associated lockdowns. Despite being articulate and clearly intelligent, their son has few formal qualifications and struggles to find his footing in a world that doesn't seem designed with him in mind.

What helped, perhaps unexpectedly, was simply talking about it. When they began opening up to friends, they discovered just how widespread this issue truly is. The isolation of their experience began to ease as others shared their own stories in return. The counselor has also provided an informal assessment that has helped the family understand how their son's mind works and how to communicate with him more effectively — bringing a noticeable reduction in household tension and a profound sense of relief, even if only as a small first step.

## Eleven Years and Counting: A Mother's Exhausting Vigil

For one mother, the journey began when her daughter withdrew from mainstream school at the age of 13 — over a decade ago. Since then, the family has tried a range of options in the hope of finding something that would stick.

Her daughter enrolled with Red Balloon of the Air, a charitable organization originally founded to support children who had experienced bullying. Through this program, she worked with a support worker and tutor weekly, focusing on practical activities like cooking and woodwork. While she showed initial enthusiasm, her engagement consistently faded over time.

A subsequent enrollment at a local further education college on an animal care course followed a similar pattern — promising at first, then abandoned after just three months, partly following a medical procedure from which she never returned to her studies.

Today, her daughter's days are spent reading, playing online games, watching videos, and largely avoiding the outside world. She has no friends, rarely leaves the house, declines to exercise, and overeats — often out of sheer boredom. Weekly sessions with an occupational therapist have introduced activities such as bread baking, but the results mirror everything that came before: a flicker of interest that quickly dims. Her mother writes with unmistakable exhaustion: they are, quite simply, at their wits' end.

## A Professional Voice: Parenting Doesn't Have an Expiry Date

A family therapist with nearly four decades of experience in children's services and child and adolescent mental health services (CAMHS) offered a broader professional perspective on these deeply personal accounts.

She points to two critical failures in how society approaches parenting. The first is the widespread lack of recognition that parenting is a lifelong commitment, not one that ends at 18. The second is the damaging cultural assumption that parenting is something a person either succeeds or fails at — a binary judgment that ignores the enormous complexity involved.

She is particularly concerned about what happens when young people transition from CAMHS into adult mental health services. At the point when a child turns 18, parents are routinely excluded from communications about their child's mental and emotional health — a practice that has, in some cases, led to devastating outcomes.

Her message is clear: our children remain our children for the entirety of our lives. While the nature of the parental role naturally evolves as both parent and child age, the need for support does not disappear. She argues firmly that adequate family support across all stages of life is sorely lacking — and that seeking such support should never be treated as shameful or taboo.

## Breaking the Silence Around Families Left Behind

What unites all of these voices is a profound sense of isolation, and a quiet determination to be seen and heard. These are not stories of failure — they are stories of love persisting through impossible circumstances, of families adapting, problem-solving, and refusing to give up on their children, no matter how difficult the road becomes.

The scale of this issue is far larger than public discourse currently acknowledges. Families navigating the realities of NEET adult children, neurodivergence, mental health crises, and social withdrawal deserve not just sympathy, but tangible support — from healthcare systems, educational institutions, and wider society alike.

It is time to bring this conversation out of the shadows.

Families share emotional accounts of supporting adult children who are unable to work or study, calling for greater awareness and systemic support.

Parents Struggling With Adult Children Who Cannot Live Indep

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When Adult Children Can't Fly the Nest: Parents Share Their Struggles and Search for Answers

## Bangladesh's Measles Crisis: How a Nation Lost Its Hard-Won Progress

Not long ago, Bangladesh was celebrated as a public health success story. Measles vaccination rates had climbed above 90%, and the World Health Organisation was acknowledging the country's "substantial progress" toward eliminating the disease entirely. Today, that achievement lies in ruins.

Since mid-March, more than 120,000 suspected and confirmed measles cases have been recorded across the country. Nearly 750 people — the vast majority of them children — have lost their lives. And according to UNICEF, even those devastating figures likely understate the true scale of the crisis.

## Inside the Overwhelmed Wards

In the city of Mymensingh, the measles ward at Medical College Hospital tells the story more clearly than any statistic could. The facility, designed to accommodate patients across 32 rooms, is currently housing close to 130 patients. Families without beds have spread blankets across hallways, their sick children lying beside them with nowhere else to go.

"I have never seen an outbreak this huge," says Dr Mohammed Golam Mawla, a paediatrician working amid the chaos.

Among the patients is a baby boy whose nostrils are too tiny to hold standard oxygen tubes in place. Doctors have resorted to bandaging and taping the tubes to his face just to keep him breathing. His father, Mohammad Alam Mia, has been at the hospital for two weeks watching his son struggle. "My baby isn't getting any better," he says quietly.

### A Ten-Hour Journey, a Desperate Father

Another patient, a young boy named Arafat, was rushed to the hospital after a nearly ten-hour journey. His father collapsed and lost consciousness in the ambulance as his son became unresponsive during the trip. Doctors later diagnosed Arafat with pneumonia and heart failure — both life-threatening complications of measles. His father, Mohammad, has already exhausted his savings and turned to neighbors for financial help just to keep his son alive.

## How Did It Come to This?

The question on every doctor's lips is the same one Dr Mawla poses aloud: "This disease was under control in our country. Why did this suddenly happen?"

Miguel Mateos Muñoz, UNICEF's spokesperson in Bangladesh, describes the outbreak as the result of a "perfect storm" — a convergence of multiple failures arriving at the worst possible time.

### Vaccine Procurement Delays Under the Interim Government

Bangladesh has endured years of political instability. In 2024, mass student-led protests brought down the authoritarian government of former Prime Minister Sheikh Hasina. The interim administration that followed, led by Muhammad Yunus, is alleged by UNICEF to have delayed placing vaccine orders while it explored new suppliers and restructured its procurement financing.

Muñoz says UNICEF repeatedly warned the administration to act swiftly. "We were worried about possible vaccine gaps increasing, and it unfolding into what we're now seeing," he said.

The current government under Tarique Rahman claims it inherited a significant vaccine shortage upon taking office. The BBC reached out to Muhammad Yunus for comment, but he declined to be interviewed.

A senior health official from Yunus's administration, Syedur Rahman, pushes back against the narrative, insisting no shortage existed and that UNICEF's earlier communications "did not contain any specific warning about a potential measles outbreak." He added that experts, including representatives from other UN agencies, had suggested competitive procurement could lead to better cost efficiency over time.

### Other Contributing Factors

Vaccine procurement issues alone do not fully explain the scale of this outbreak. UNICEF also points to:

- **COVID-19 disruptions** that interrupted routine childhood immunisation schedules
- **No mass measles-rubella vaccination campaigns** since 2020
- **Severe overcrowding** in communities and healthcare facilities
- **Eid holiday travel** that accelerated the spread of the highly contagious virus

Measles transmits through the air — a cough, a sneeze, or even simply breathing near an infected person is enough to pass it on.

## Families Left Without Vaccines

Three hours from the capital Dhaka, a mother named Mosammat Nila Akhter describes bringing her ten-month-old daughter, Maliha, to a local clinic in February for her scheduled measles vaccine. She was told none were available.

Weeks later, as the outbreak surged, Maliha was hospitalised with pneumonia. After being discharged, her parents noticed a rash spreading across her stomach. Rushing back to the hospital, they were turned away due to a lack of beds and forced to wait three hours at a second facility before another child's discharge created space.

"No matter how much we wiped her body down, her fever didn't come down," Akhter recalls. "The doctors just kept saying, 'keep wiping her body.'" She also alleges that bed shortages resulted in measles patients and non-measles patients being placed in the same wards — a situation that could only accelerate the virus's spread.

## A Warning to the World

Bangladesh is not facing this crisis in isolation. The United Kingdom, once declared free of measles, lost that elimination status this year following a notable rise in cases. The United States has similarly recorded increasing measles infections in recent years. In both countries, vaccination rates among children under five have fallen below the 95% threshold required to achieve herd immunity.

Public health experts are now pointing to Bangladesh as a stark warning: even brief interruptions in vaccine coverage can unravel decades of hard-won progress with terrifying speed. The measles virus does not wait for political transitions to resolve, procurement decisions to be finalized, or health systems to catch up.

For the families crowded into hallways in Mymensingh, that lesson has come at an unbearable price.

Bangladesh is battling a catastrophic measles outbreak with over 120,000 cases and hundreds of children dead. Learn what caused the crisis and what it means glo

Bangladesh Measles Outbreak: 120,000 Cases and Rising

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Bangladesh Measles Crisis: Over 120,000 Cases and Hundreds of Children Dead

## MenB Vaccine Shows No Effect Against Gonorrhoea in Groundbreaking Trial

The Meningitis B vaccine does not provide meaningful protection against gonorrhoea infections, according to a significant new study — raising serious questions about its continued use as a preventative tool for at-risk populations.

The National Health Service in the UK began offering the vaccine to men who have sex with men in August 2025, following earlier research that suggested it could reduce gonorrhoea infections by as much as 38%. However, those findings are now being called into question.

## What the GoGoVax Trial Found

A clinical trial conducted by the University of New South Wales in Sydney, and published in the prestigious New England Journal of Medicine, has delivered a sobering verdict: the MenB vaccine appears to be ineffective at preventing gonorrhoea.

The trial, known as GoGoVax, followed 587 men over a two-year period. Participants were divided into two groups — one receiving the actual MenB vaccine and the other receiving a placebo. The results revealed virtually no difference in new gonorrhoea infection rates between the two groups. Those who received the vaccine recorded 291 new infections, while those given the placebo recorded 285 — a negligible difference that offers no statistical basis for effectiveness.

The study's authors noted that their findings aligned with two additional independent studies, and argued that when viewed collectively, the evidence provides "strong support that the MenB vaccine is not effective for gonorrhoea prevention."

## How the MenB Vaccine Became a Gonorrhoea Candidate

The 4CMenB vaccine was originally developed to protect infants against meningitis B. However, because the bacteria responsible for meningitis B and gonorrhoea are closely related — both belonging to the Neisseria family — researchers theorised the vaccine might offer cross-protection against gonorrhoea as well.

Early observational studies appeared to support this idea, prompting health authorities in multiple countries to explore its potential as a gonorrhoea prevention tool. In the UK, the Joint Committee on Vaccination and Immunisation (JCVI) greenlit its use for gay and bisexual men, a demographic disproportionately affected by the infection.

## UK Health Authorities Hold Their Position — For Now

Despite the concerning new data, the UK Health Security Agency (UKHSA) has stated it will not be making any immediate changes to its vaccination programme.

Dr Mary Ramsay, Director of Public Health Programmes at the UKHSA, acknowledged the study but stressed the importance of drawing on a broad evidence base before revising policy.

"Over 30,000 people in England have already begun this vaccination course, and this data will provide more robust insight into vaccine impact and effectiveness," she said. "These findings will be published in due course."

The agency maintains that its own domestic studies will yield more comprehensive results and is monitoring the situation closely.

## Gonorrhoea Rates Remain Alarmingly High

The urgency surrounding gonorrhoea prevention cannot be overstated. Infection rates in England reached a record high of 82,592 cases in 2022. While numbers have since declined to approximately 63,943 in 2025, they remain more than double the figures recorded a decade ago in 2015.

Gonorrhoea is a bacterial sexually transmitted infection spread through sexual contact. Symptoms can include pain, unusual genital discharge, and inflammation — though a significant proportion of those infected experience no symptoms at all, making undetected transmission a major public health concern.

According to the European Centre for Disease Prevention and Control, men who have sex with men remain the group most disproportionately affected by gonorrhoea across Europe.

Adding further complexity to the situation is the growing prevalence of antibiotic-resistant strains of the infection, which are making treatment increasingly difficult.

## Experts Call for a Reassessment

Public health specialists and sexual health advocates have responded to the findings with a mixture of disappointment and urgency.

Dr Odile Harrison, Associate Professor at the University of Oxford's Population Health Infectious Disease Epidemiology Unit, described the results as "disappointing" but cautioned against abandoning the search for a viable gonorrhoea vaccine altogether.

"Gonorrhoea remains a major global public health threat, particularly in light of the continued emergence of antimicrobial resistance," she said. "An effective vaccine remains a high priority."

Taku Mukiwa, Head of Health Programmes at sexual health charity the Terrence Higgins Trust, called on the JCVI to urgently reconsider the existing vaccination programme in light of the new evidence.

"If the evidence has changed, the approach has to change too," he said. "Rates of gonorrhoea in the UK are sky high — and this is especially true among gay and bisexual men."

Mukiwa also emphasised that regardless of how the vaccine debate unfolds, proven preventative measures must remain front and centre.

"What we know for certain is that condoms and regular STI testing remain the cornerstones of prevention. We must continue working to bring down the stubbornly high rates of sexually transmitted infections in this country."

## What Comes Next?

The debate around MenB's role in gonorrhoea prevention is far from over. The UKHSA's ongoing domestic studies may yet produce findings that challenge or nuance the Australian trial's conclusions. However, the GoGoVax results — particularly when combined with two corroborating studies — have undeniably shifted the scientific conversation.

For now, individuals are strongly encouraged to rely on condoms and regular sexual health screenings as the most reliable tools for preventing the spread of gonorrhoea and other STIs.

A major Australian trial found the MenB vaccine offers no protection against gonorrhoea, raising questions about the UK's vaccination programme for at-risk men.

MenB Vaccine Does Not Prevent Gonorrhoea, Study Finds

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MenB Vaccine Fails to Protect Against Gonorrhoea, Landmark Australian Trial Reveals

## Eating Smart When the Temperature Rises

When a heatwave hits, the last thing most people want to do is stand over a hot stove — and appetite often takes a nosedive too. But does extreme heat actually call for a change in what we eat? Nutrition experts say yes, and the adjustments are simpler than you might think.

Here are four key things to keep in mind when you're hot, hungry, and looking for relief.

---

## 1. Should You Eat More Protein in a Heatwave?

The short answer is no. According to Aisling Daly, senior lecturer in nutrition at Oxford Brookes University, there is no increased need for protein during a heatwave.

What's more, protein-rich foods like meat, poultry, and fish typically require cooking — which is the last thing anyone wants to deal with in scorching heat. Even firing up an outdoor BBQ can feel unbearable.

### Smarter Ways to Cook When It's Hot

If you do need to cook, consider reaching for your air fryer. Research from Radio 4's *Sliced Bread* found that air fryers use less than half the energy of a conventional oven. They're also smaller and faster, meaning they generate significantly less ambient heat in your kitchen.

Don't overlook your slow cooker either. Despite running for longer periods, slow cookers are typically more energy-efficient and produce even less heat than air fryers — making them a surprisingly smart choice during a hot spell.

### Why Protein Actually Heats You Up

Here's a lesser-known fact: digesting protein causes your body to generate more internal heat than digesting carbohydrates or fats. That's because the stomach, intestines, and liver have to work harder to break down and absorb complex protein molecules — a process that produces heat as a byproduct.

In other words, that sizzling steak might leave you feeling even hotter. Opt for fruits, vegetables, and carbohydrates instead, as they're far easier to digest.

### Best Protein Options for Hot Weather

Dr. Daly recommends leaning on pre-cooked meats, bean salads, eggs, and Greek yogurt — which can even be enjoyed frozen. Blending a smoothie with fruit, vegetables, yogurt, and a spoonful of peanut butter is an easy way to get a nutritious, balanced meal without breaking a sweat.

Lighter fish options like tuna, salmon, and prawns are also excellent choices. Vegetarians can meet their protein needs through lentils, nuts, milk, tofu, and cheese.

---

## 2. Hydration Is Everything — But It's Not Just About Water

When temperatures climb, your body loses water through sweat at a much faster rate. Failing to replace that fluid leads to dehydration, which can quickly become dangerous.

The NHS typically recommends six to eight glasses of fluid per day, but during a heatwave, your requirements can increase substantially. Dr. Charlotte Mills, a food and nutrition scientist at the University of Reading, notes that individual fluid needs vary widely based on age, body size, activity level, and overall health.

Athletes, pregnant women, and breastfeeding mothers are among those who need to be especially vigilant about staying hydrated.

### Eat Your Water

Rehydration isn't limited to what's in your glass. As Dr. Daly explains, "We need to eat our water as well as drink it" — and most fruits and vegetables are between 80% and 90% water by weight.

Foods with over 90% water content include:
- Cucumber
- Tomatoes
- Lettuce
- Celery
- Watermelon
- Strawberries

Apples, carrots, cooked broccoli, pears, oranges, grapes, and pineapple all fall in the 80–89% range. By contrast, boiled eggs are about 75% water, while digestive biscuits contain just 2.8%. Even a cheese and tomato pizza is 38% water, and takeaway chips come in at roughly 51%.

### How to Tell If You're Dehydrated

A quick and reliable indicator of hydration status is the color of your urine. Dark orange or brown urine signals that your kidneys are conserving water — meaning your body is running low. Feeling fatigued, unfocused, or dizzy are also warning signs. Left unaddressed, heat exhaustion can progress to heatstroke, which is a serious medical emergency.

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## 3. Hot Drinks Can Actually Help Cool You Down

It might seem counterintuitive, but reaching for a warm cup of tea on a hot day is actually backed by science. According to Dr. Daly, warm or room-temperature drinks are just as effective at cooling you down as cold ones.

Research indicates that consuming a hot drink prompts your body to sweat more rapidly in order to shed the excess heat. Cold drinks, on the other hand, slow down the sweating response. Either way, your body is working to maintain its core temperature at around 37 degrees Celsius — so that beloved cup of tea might not be such a strange choice after all.

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## Final Takeaway

Navigating a heatwave doesn't mean abandoning nutrition — it just means being smarter about what you reach for. Prioritize hydrating foods, keep protein sources light and pre-cooked where possible, and don't underestimate the power of a good smoothie. Your body will thank you for it.

Struggling to eat well in extreme heat? Discover expert-backed foods and drinks that keep you cool, hydrated, and nourished during a heatwave.

Best Foods and Drinks to Stay Cool During a Heatwave

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What to Eat and Drink During a Heatwave to Stay Cool and Nourished

## Health Groups Pressure Burnham to Abandon UK-US Pharma Agreement

Andy Burnham is facing mounting pressure from doctors and health campaigners to tear up the controversial UK-US pharmaceutical trade deal, with warnings that the agreement places drug company profits far above the wellbeing of NHS patients.

The deal, signed in December of last year, has been defended by ministers as a mechanism to shield British medicine exports from American tariffs while expanding patient access to potentially life-saving treatments. However, critics argue that the agreement amounts to a capitulation to pressure from Donald Trump's administration — one that will force the NHS to spend billions more annually on US-supplied drugs.

## What the Analysis Reveals

A damning assessment by academics from the University of York, the University of Liverpool, and Christchurch Hospital in New Zealand paints a stark picture of the deal's consequences. According to their findings, the agreement would divert approximately £44.7 billion away from NHS health services by 2036 in order to cover inflated drug costs — unless the government provides substantial additional funding to offset those expenses.

The knock-on effect of such a dramatic reduction in NHS service spending, researchers warn, could result in **229,000 excess deaths** over that same period. This figure follows a Guardian report last week revealing that the NHS would need to redirect £45 billion from essential care in order to meet its new financial obligations under the deal.

## A Letter Demanding Change

In a coordinated letter seen by the Guardian, 19 prominent health organisations have written directly to Burnham — widely expected to succeed Keir Starmer as Labour leader and Prime Minister within weeks — urging him to scrap the agreement entirely.

The letter, coordinated by the SOS NHS coalition, calls on Burnham to make a **"decisive break"** with current policy and dedicate his leadership to rebuilding the health service from the ground up. Signatories include Medact, the Doctors' Association UK, and Doctors in Unite, who also raise concerns about Private Finance Initiative arrangements at neighbourhood health centres, recent NHS workforce reductions, the growing role of private healthcare providers, and Palantir's controversial NHS data contract.

## Voices From the Front Lines

Dr Tony O'Sullivan, co-chair of Keep Our NHS Public and a retired consultant paediatrician, was unsparing in his criticism of the deal.

"Donald Trump's demands for higher drug prices are set to drain an estimated £45 billion from the NHS over the next decade," he said. "At a time when patients are waiting longer than ever for treatment, handing over billions more to US pharmaceutical giants is like trying to put out a fire while pouring petrol on the flames."

Dr O'Sullivan highlighted the NHS's already fragile state, noting that approximately 16,000 people die unnecessarily each year due to delays in emergency care, while millions remain stranded on waiting lists. He called on Burnham to meet with healthcare campaigners and those with frontline NHS experience, describing the leadership transition as a crucial opportunity to reverse policies that have consistently placed corporate interests over patient welfare.

Hope Worsdale of patient advocacy group Just Treatment was equally forceful in her condemnation, describing the deal as signed "to inflate drug company profits" and calling it a profound betrayal of both the NHS and the British public.

"Andy Burnham has said this is the last chance to save the Labour party," Worsdale said. "It is also the last chance to save the NHS. As prime minister, he must deliver the life-saving investment his predecessors failed to prioritise, scrap the dangerous pharma deal, and stop private companies ripping off our NHS."

## Burnham's Record and His Silence

Despite the mounting calls for action, Burnham has not publicly responded to questions about whether he intends to challenge or dismantle the UK-US trade agreement.

His NHS track record is mixed. When he last served as Health Secretary following 2009, Burnham made headlines by declaring the NHS the "preferred provider" of NHS care — a bold move intended to push back against accelerating privatisation. Yet a year later, he approved a PFI deal for the Royal Liverpool Hospital, managed by facilities company Carillion. The project ran years behind schedule and exceeded its original budget by £300 million before Carillion collapsed into liquidation.

## A Defining Moment for the NHS

With Burnham poised to take the reins of government, health organisations across the country are watching closely. For campaigners, the stakes could not be higher — they view the scrapping of this pharmaceutical agreement not merely as a policy decision, but as a defining test of whether a Burnham-led government will genuinely champion the NHS or allow it to be quietly dismantled by commercial and international pressures.

Health groups warn the UK-US pharma deal could cause 229,000 excess deaths by 2036, urging Andy Burnham to scrap it and prioritise NHS patient care.

Burnham Urged to Scrap UK-US NHS Drug Deal Over Death Risk

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Health Groups Demand Andy Burnham Scrap 'Deadly' UK-US Pharmaceutical Trade Deal

## Male Testosterone Levels Have Plummeted Over Five Decades, Researchers Find

A sweeping new analysis has revealed a dramatic and sustained decline in men's testosterone levels over the past half-century — a finding that scientists say signals a deepening crisis in male reproductive health that society can no longer afford to ignore.

Presented at the annual meeting of the European Society of Human Reproduction and Embryology in London, the research found that total testosterone levels among men fell by approximately 54% between 1972 and 2019. That translates to a steady drop of more than 1% per year — a trend researchers describe as unmistakable and deeply concerning.

## What the Research Reveals

The study was a meta-analysis drawing on six separate long-term studies, each tracking testosterone levels across at least three distinct time periods. Combined, the dataset covered 118,593 men from five countries — Israel, the United States, Brazil, Finland, and Denmark — spanning nearly five decades of hormonal data.

Every individual study pointed in the same direction: testosterone levels were falling. When the data was pooled together, the cumulative decline came to 54%, with the rate of decrease appearing to accelerate noticeably after the year 2000.

"We saw an over 50% decline in total testosterone over this time period," said Professor Hagai Levine of the Hebrew University-Hadassah Braun School of Public Health and Community Medicine in Israel. "It reflects a more than 1% decline each year, so this is not a fluke, this is not a statistical error. It's a very strong trend."

## What Is Driving the Decline?

Researchers point to a combination of lifestyle and environmental factors as likely contributors to the downward trend.

### Obesity and Metabolic Health

Rising global rates of obesity and type 2 diabetes are considered major drivers. Excess body fat accelerates the conversion of testosterone into oestrogen, which directly suppresses the hormone's levels in the bloodstream. Professor Levine estimated that between one quarter and one half of the total observed decline could be attributed to obesity and metabolic syndrome alone.

Notably, obesity was not controlled for in the combined analysis, which researchers acknowledge as a limitation of the current findings.

### Environmental and Chemical Exposure

Beyond lifestyle factors, the research team also flagged environmental influences — particularly endocrine-disrupting chemicals found in everyday household products — as potential contributors. Rising global temperatures linked to climate change were also mentioned as a possible factor, though the evidence remains less definitive in this area.

"We live in an environment that is not ideal for our health in terms of our exposure to chemicals, in terms of climate, and in terms of health behaviours," said Levine.

While studies on air pollution and hormone-disrupting chemicals have produced mixed results, Levine argued that the precautionary principle should guide policy decisions. "We should find better ways to prevent exposure of the general public to hazardous chemicals. And we don't do it well enough at the moment."

## Why Testosterone Matters

Testosterone plays a central role in male health that extends well beyond reproduction. The hormone regulates sperm production and libido, supports muscle mass and bone density, and influences mood, energy, and metabolism. When levels decline, the effects can ripple across a man's overall physical and psychological wellbeing.

"Reproductive health is a very important signal of general health," Levine noted, framing the testosterone decline not merely as a fertility issue but as a broader public health concern.

## A Growing Debate in the Scientific Community

The findings arrive amid an ongoing and sometimes heated scientific debate about the state of male fertility. The same research group previously published work suggesting that sperm counts have fallen sharply over the past 40 years — a claim that has drawn both widespread attention and significant scrutiny.

Professor Channa Jayasena, a reproductive endocrinology consultant at Imperial College London, described the latest testosterone findings as "an important reality check" and expressed greater confidence in this data given its longitudinal nature.

"The fact that these studies have been done over several periods in history makes me actually convinced," he said. "I do think male reproductive health is declining and appears to have been declining over time."

## A Warning About Testosterone Supplements

Despite the alarming statistics, experts are cautioning against turning to testosterone supplements as a quick fix — particularly as such products are increasingly being promoted across social media platforms.

Professor Allan Pacey, a professor of andrology at the University of Manchester, warned that supplementing testosterone can actually backfire for men concerned about fertility.

"The solution that's being promoted is that we give you testosterone," he said. "But if you give a man testosterone, you switch off his sperm production. I've seen that in the clinic."

The relationship between testosterone therapy and reproductive health is complex, and medical professionals urge men experiencing symptoms of low testosterone to seek proper clinical evaluation rather than self-medicating.

## A Call for Urgent Action

For Professor Levine, the evidence now demands a serious public health response. "I think that we have a major crisis in male reproductive health and it's currently not given enough attention," he said.

With testosterone levels declining across multiple countries over multiple decades, scientists are increasingly calling on governments, healthcare providers, and environmental regulators to treat this trend as the significant public health challenge it appears to be.

Scientists warn of a male reproductive health crisis after data shows men's testosterone levels declined by 54% between 1972 and 2019. Here's what we know.

Men's Testosterone Levels Have Halved in 50 Years

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Male Testosterone Levels Have Dropped by More Than Half Over the Past 50 Years, Scientists Warn

## US-UK Drug Deal: A Turning Point for NHS Patient Access

Claims that the recent US-UK pharmaceutical agreement could lead to hundreds of thousands of excess deaths have drawn sharp criticism from healthcare industry leaders, who argue such warnings are both misleading and damaging to patients who stand to benefit from expanded access to new medicines.

### Challenging the Alarmist Narrative

Richard Torbett of the Association of the British Pharmaceutical Industry has spoken out against the suggestion that the US-UK drug agreement poses a public health risk. According to Torbett, the analysis underpinning the claim of 229,000 excess deaths in England relies on a heavily criticised modelling methodology for calculating NHS healthcare spending value — and draws on incomplete data to reach its conclusions.

Far from being a threat, Torbett argues the deal reflects a necessary and long-overdue correction to how the NHS evaluates medical innovation.

### New Treatments Already Reaching NHS Patients

Within just the past three months, the reformed pricing framework has already delivered tangible results. A range of new medicines — including treatments for multiple cancers, blood disorders, and autoimmune conditions — have been made available to NHS patients that would otherwise have faced significant delays or outright rejection.

This progress has been made possible by an upward revision of the National Institute for Health and Care Excellence (NICE) cost-effectiveness threshold — a benchmark that had remained frozen for nearly 25 years. During that time, the NHS gradually fell behind comparable European nations in providing patients with timely access to innovative treatments, particularly in oncology and rare disease management.

### Reframing the Debate Around Patient Benefit

While the need for financially sustainable medicines funding is not in dispute, critics of the deal are being accused of framing a modest policy adjustment as something far more dangerous than the evidence supports. This framing, according to Torbett, overlooks the very real human cost borne by patients who are waiting — or have waited — for access to life-changing therapies.

It also fails to consider the broader economic opportunity the deal presents: the potential to attract greater pharmaceutical investment into the UK, which could in turn generate increased resources for the NHS and fuel the development of the next generation of medical treatments.

### Addressing Deep-Rooted Inequities in Medicine Access

Nick Hoile, Senior Director and Chief Operating Officer for Health at MHP Group, echoes this call for a more patient-centred perspective. Government data reveals a stark disparity: for every 100 patients in comparable countries who receive a newly launched medicine within its first year on the market, only 48 patients in the UK receive the same treatment in the same timeframe.

This access gap represents a systemic inequity that the US-UK pharmaceutical deal directly aims to address. Hoile challenges critics of the agreement to put forward credible alternative proposals for how the UK can bring its standard of patient care in line with peer nations — rather than simply opposing reforms that could close this persistent gap.

### A Necessary Step Forward

The debate surrounding this deal ultimately centres on a fundamental question: how does the UK balance fiscal responsibility within the NHS against its obligation to provide patients with access to modern, effective treatments? For industry advocates, the answer lies in embracing reforms that reflect the true value of medical innovation — reforms that are already beginning to deliver results for patients across England.

Industry leaders defend the US-UK pharmaceutical deal, highlighting new NHS treatments and challenging claims it will cause excess deaths in England.

US-UK Drug Deal: What It Means for NHS Patient Access

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How the US-UK Pharmaceutical Deal Could Transform Patient Access to Life-Saving Medicines

## The Unexpected Fitness Trend Winning Over the Over-50s

When Rumman Talukder turned 60, he made a deliberate decision to step outside the boundaries of what society typically expects of people his age. Every Sunday, the IT consultant makes the drive from his home in Stanmore to a circus school in Ware, Hertfordshire, where he practises a breathtaking aerial move known as the Mermaid — hanging from a trapeze by one arm, back arched, legs coiled around the rope.

"My wife thinks I'm mad," he admits with a smile. "But in the run-up to turning 60, I decided I wanted to challenge myself — to pursue things not normally associated with someone my age."

Talukder describes the feeling as nothing short of being "indomitable." And he is far from alone.

## A Growing Movement Across the UK

Across Britain, a quiet but compelling trend is taking shape: older adults are signing up for circus skills classes — and discovering that juggling, trapeze work, and hula hooping are far more than just novelty entertainment.

In Hertfordshire, **Generation Circus** has been running a pilot programme for older participants for the past year and now holds weekly sessions. Its oldest member is approaching 97 years old. In London, the **National Centre for Circus Arts** in Hoxton has recently launched dedicated classes for older people and is planning a six-week aerial skills course later in the year. On the south coast, **Sweet Circus** in Eastbourne has introduced monthly sessions. All three organisations are actively seeking funding to grow their offerings.

Emma Taylor, the founder of Generation Circus, says the impact on participants goes well beyond physical fitness.

"A lot of people sign up simply because it sounds like an enjoyable way to keep active," she explains. "But circus immediately opens up an entirely new world. Before long, they're buying their own hula hoops and rigging up equipment in their back gardens."

## The Science Behind the Skills

While large-scale research into circus arts specifically remains limited, early studies are encouraging. Small-scale research has found that older adults who take up juggling and poi show measurable improvements in balance, with some participants also reporting sharper attention and faster cognitive processing. Brain-imaging research has gone even further, suggesting that learning to juggle can actually alter the structure of the brain itself.

For Talukder, however, the appeal has nothing to do with neuroscience.

"I see people in their 70s and 80s doing things I never imagined, and I realise there is no age at which you should feel prevented from trying something entirely new," he says.

## More Than Movement: The Social Lifeline

The social dimension of circus schools is proving just as vital as the physical benefits — particularly at a time when Age UK estimates that around one in 14 people aged 65 and over in the UK experience chronic loneliness.

Taylor has observed a striking transformation in her participants beyond the physical. "They begin to carry themselves differently. They seem brighter, more vibrant," she says. "They go home and look up new tricks on YouTube. They go to circus shows together. They talk about what they want to learn next. It all stems from training together in a real circus school environment, week after week."

## 'A Shot of Life in the Arm'

For Carol Masson, 70, circus school has been nothing short of life-saving — and she says so without hesitation. The retired housekeeper was devastated by the loss of her daughter four years ago, and the grief pushed her to a very dark place.

"I would stay in bed and sometimes even think about suicide," she says candidly.

Today, Sundays are the highlight of her week. "After every class I feel like I've had a shot of life in the arm. There's so much fun and joy. Everything else just disappears."

Even a hip replacement in February has not dampened her enthusiasm. She returned to class the following month, focusing on juggling and hula hoops while rebuilding her strength. "Generation Circus is mental and physical therapy in abundance," she says. "I just wish I could do it every day."

## Rewriting the Rules of Disability

Claire Howard, 54, uses a wheelchair and has experienced 121 transient ischaemic attacks — commonly known as mini-strokes. The idea that she might one day teach circus skills would once have seemed laughable to her.

"The first session, I looked at the trapeze and just wanted to turn around and leave," she recalls.

She stayed. And a year later, she has developed such impressive wheelchair-adapted hula hoop techniques that she now instructs able-bodied members of the class.

"I've gone from having no purpose in life to rediscovering my inner child," she says. "As a wheelchair user, you're constantly reminded of what you can't do. Here, I have skills that many able-bodied people simply don't have. That means everything."

## Reconnecting With Joy

Corinna Hartwig found her way to circus after years of personal loss — the death of her mother when she was 12, followed by the passing of her father four years ago. Therapists had encouraged her to reconnect with her inner child, but she struggled to find a meaningful way to do so.

"I didn't know how until I started going to circus," she says. "Now, once a week, I can be playful, happy and creative again."

Diane Bernier, recreational programme manager at the National Centre for Circus Arts, believes this sense of possibility is at the heart of what makes circus so powerful for older adults.

"People realise their life doesn't have to follow a single predetermined path simply because of their age," she says. "They discover they can still learn entirely new things — and that is an extraordinarily powerful revelation."

## Better Than Being Young?

Back in Ware, Sarah Hodson, 63, still finds it amusing that she now spends her weekends training at a circus school — alongside her 96-year-old mother, Jane.

"Never in a million years did I think I'd end up here," she laughs. "People our age are often told they should be doing water aerobics or chair yoga. Then you look around the room and see someone older than you hanging upside down from a trapeze, with someone even older swinging from their arms."

But perhaps Hodson puts it best when she reflects on what separates this joy from anything she experienced in her youth.

"In some ways, it's better than being young," she says. "Because we've rediscovered that sense of joy, fearlessness and freedom — without the self-consciousness that comes with youth."

From trapeze to juggling, adults over 50 across the UK are joining circus schools — and reaping surprising physical, mental, and social health benefits.

Older Adults Find Joy and Fitness in Circus Skills Classes

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Never Too Old for the Big Top: Why Older Adults Are Embracing Circus Skills

## Burnham's Devolution Pledge and the NHS Blind Spot

Andy Burnham has made devolving power to regions and local communities a cornerstone of his political platform. His ambitious 10-year plan promises to shift decision-making away from Westminster and place it firmly in the hands of the people it affects most. Yet critics argue that a fundamental contradiction is already taking shape — one that could undermine the entire premise of his devolution agenda before it even gets off the ground.

If the current health bill passes in its existing form, NHS foundation trusts will lose a critical layer of democratic accountability — a development that sits in direct opposition to everything Burnham says he stands for.

## The Role of Governors in NHS Foundation Trusts

Under existing legislation, NHS foundation trusts are legally required to maintain a council of governors. These individuals serve as unpaid volunteers, democratically elected by both the general public and NHS staff. Crucially, they operate independently from NHS management structures, giving them the freedom to genuinely represent the interests of local communities.

One of their most significant responsibilities is the power to appoint the chair of the trust — a decision that carries enormous weight in shaping the direction and values of local healthcare services.

### What the New Health Bill Would Change

The proposed health bill would eliminate the statutory requirement for these governor councils entirely. In practice, this means individual trusts would be left to oversee their own governance with far less external scrutiny — a situation critics describe as allowing them to "mark their own homework."

Perhaps more alarming is the proposal to shift the appointment of trust chairs away from local bodies and hand that authority directly to Whitehall. Rather than communities having a say in who leads their local NHS trust, the decision would be made centrally by government officials — a move that represents the very centralisation Burnham has pledged to dismantle.

## A Safety Net, Not Just a Democratic Formality

Daughne Taylor, Chair of the National Lead Governors Association, has been vocal in her opposition to these changes. She argues that the removal of independent governor councils is not merely an administrative concern — it is a genuine public safety issue.

Independent governance bodies serve as an early warning system. When local NHS services begin to deteriorate or mismanagement takes hold, empowered and independent governors are positioned to raise concerns before problems spiral into full-blown crises. Stripping away that mechanism removes a vital safeguard that communities depend on.

## A Better Path Forward

Rather than dismantling these structures, Taylor and fellow critics are calling for all NHS trusts to be required by law to maintain a council of governors. They also propose a shift from a fully elected model to a locally selected one — a change that would retain community representation while significantly reducing the administrative costs associated with running elections.

The key principles these bodies must uphold include:

- **Independence** from NHS management at all levels
- **Representation** of both the public and NHS staff
- **Authority** to appoint trust chairs at the local level
- **A statutory right** to speak openly and challenge leadership at board meetings

## Conclusion: Devolution Must Include the NHS

Andy Burnham's vision of a more democratic, locally accountable Britain is compelling — but it rings hollow if the NHS is quietly excluded from that vision. True devolution cannot selectively apply to some public services while others are drawn further under central control.

For Burnham's platform to have genuine integrity, his commitment to local empowerment must extend into healthcare. Anything less is not devolution — it is simply a redistribution of who holds the power, without ever giving it back to the people.

Andy Burnham's devolution agenda clashes with a new health bill set to remove democratic NHS governor councils and centralise trust appointments in Whitehall.