Number of general practices shrinking but patient lists ballooning in England

Over past decade, practice numbers fell by 20%, but average list size expanded by 40% Total NHS general practice workforce grew 20% in 2015-22, but GP numbers fell by 15%

BMJ Group

Over the past decade the number of NHS general practices in England has shrunk by 20%, but patient list sizes have expanded by 40% to just under 10,000, on average, finds an analysis of three national primary care datasets, published in the open access journal BMJ Open.

And while the total NHS general practice workforce grew 20% between 2015 and 2022, as a result of increases in admin staff and other practitioners, the number of GPs per 1000 patients fell by 15% over the same period, when accounting for working hours, the analysis shows.

Major structural and organisational changes have taken place in general practice in England over the past decade,but it’s difficult to get an overall picture because information about different aspects of general practice is dispersed across multiple datasets, explain the researchers. 

They therefore combined information from different national data sources to describe changes in the organisational structure, workforce, and appointments provided by different types of staff in English general practice, and to consider the implication of these trends. 

They drew on general practice data collected by NHS England, the Office for Health Improvement and Disparities, and the Care Quality Commission, covering periods of between 5 and 10 years from 2013 to 2023.

They found that the numbers of people registered with an NHS general practice in England grew by 11% from 56,042,361 to 62,418, 295 between 2013 and  2023. And the average proportion of patients aged 65 and over rose from just over 16% to 18%.

But the total number of practices fell from 8044 to 6419, equivalent to 178 fewer practices a year and an overall reduction of 20%, while the average practice list size increased by 40% from 6967 to 9724 patients, equivalent to 291 more a year. 

The number of large practices with lists exceeding 20,000 patients also rose from 1% (81) of practices in 2013 to 6% (355) in 2023. 

Between September 2015 and September 2022, the total number of qualified GPs working in NHS general practice in England rose from 34,474 to 36,492. But after taking working hours into account, the number of those working the equivalent of full time fell from 27,948 to 27,321.

The average number of GPs fell from 0.53 to 0.45 for every 1000 patients, representing a fall of 15%, with the fall significantly steeper among male GPs: 23% vs 4% of female GPs.

The proportion of practices reporting a GP trainee rose from just over a third (35%) to half (50%) between 2018 and 2022. But there’s no guarantee that, once qualified, GP trainees will work full time in general practice or stay in it, the researchers point out.  And the NHS continues to rely on doctors who qualified overseas: they make up a quarter of GPs in NHS general practice.

As to other staff, the average number of nurses remained relatively stable between 2015 and 2022, with, on average, 97% of practices employing a nurse.  But the average number of other roles, which include pharmacists, social prescribers, physician associates and paramedics, rose by 67%, with the proportion of practices directly employing these other staff rising from 72% to 89%. 

Admin roles also rose by 14% over this period, making up over half of the NHS general practice workforce by September 2022.

Using new national data, the researchers estimated that between 2018 and 2023 there were between 63 and 119 (average of 98) general practice appointments/week for every 1000 patients, carried out by all types of practitioner. Appointments peaked between September and November each year, and dipped between April and August 2020 in the wake of the first COVID-19 lockdown. 

GP appointments ranged from 35 to 57/week/1000 patients, with no clear trend over time, after accounting for population increases. Appointments with nurses ranged between 18 and 28 /week/1000 patients. Appointments with other practitioners ranged between 17 and 26/week/1000 patients. 

Both GPs and other practitioners represented the same proportion (19%) of the NHS general practice workforce by September 2022 once working hours were accounted for. But GPs continued to provide half of all appointments despite the fall in their numbers, while other practitioners provided around a fifth.

“Falling GP numbers delivering the same number of appointments/1000 [patients] seems unsustainable; therefore, there is likely to be a tipping point in the near future where the majority of appointments in English general practice are no longer delivered by GPs,” suggest the researchers.

The researchers note some limitations to their analysis—among them, the discrepancy in population data provided by NHS England and the Office for National Statistics, and the ‘experimental’ nature of NHS England’ appointments data.

Other general practice work, such as managing correspondence, prescriptions, reviewing test results, staff supervision, management and quality improvement activity isn’t captured by appointments data either. And online consultations delivered through separate messaging software may not be included while workforce data are unlikely to cover overtime, which is common in general practice, they point out. 

And they weren’t able to distinguish between practices that closed for good, and those which were taken over by another practice to become a ‘branch’ surgery.

“The move towards larger-scale organisations has been encouraged by government policy and professional bodies to improve quality and generate economies of scale through shared back-office functions, joint service delivery, and standardised processes. However, the evidence regarding whether larger organisations deliver better-quality primary care or are more cost-effective is mixed,” comment the researchers.

Similarly, the diversification of the general practice workforce has also been driven by national policy and proposed as a solution to GP shortages, but concerns have been raised about the impact on continuity of care, cost effectiveness, equity in role distribution, and safety without sufficient GP oversight, they add.

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Journal

BMJ Open

DOI

10.1136/bmjopen-2023-081535 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

The changing shape of English general practice: a retrospective longitudinal study using national datasets describing trends in organisational structure, workforce and recorded appointments

Article Publication Date

3-Sep-2024

 

A sensory pen which can read Braille could improve literacy amongst the visually impaired

Reports and Proceedings

University of Bristol

 

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Full braille-tip pen

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Credit: George Jenkinson

A pen which can transform Braille into English text has been developed by experts at the University of Bristol.

Braille literacy is frequently reported as being in decline, this is despite visually impaired people often expressing a desire to learn it, and Braille literacy being a highly valued skill by those who are capable. This is often attributed to the lack of available learning resources, particularly away from large urban centres.

The handheld device, which includes a one-centimetre sensor with 19 channels programmed to read Braille, has demonstrated high accuracy in early trials.

Lead author Dr George Jenkinson explained: “This device, Braille-tip, was designed to aid people’s ability to learn independently, and will hopefully form part of the solution to increasing Braille literacy and allow people to reap the benefits of reading and writing.”

Braille-tip is a compact soft tactile sensor which can be mounted on a standard pen and is designed to dynamically assist with reading and learning Braille.

Dr Jenkinson  continued: “I used the handheld device to read multiple passages of Braille, and analysed how accurately it could process the tactile cues (Braille bumps) into English text.”

Fluid channels are used to transmit tactile information from 19 sensitive areas under a silicone membrane to a single camera. Its sensory response is calibrated to detect raised Braille dots on embossed cardboard designed for Braille-readers, and its functionality is demonstrated by reading Braille aloud, with an 84.5% success rate when operated by hand.

The algorithm works in real time which means it does not rely on training or deep learning. It is predictable, explainable, and portable to other tactile sensors. This results in code that is robust, and straightforward to edit.

Braille is a standardised and highly structured communication medium. A variety of techniques are used by people to read Braille, where a common advanced technique involves using both index fingers from each hand. In this, the trailing finger may be used to check and re-read certain letters and to find the beginning of the next line while the leading finger continues to read. Braille-tip may be used like the leading finger, to assist learning readers.

The team plan to extend the functionality of the device so that it is easier to operate accurately.

George added: As soon as possible, the device should be tested with participants, and prototypes should be made available to the intended end-users so that their desires and the potential use for such a device can be assessed in earnest.

“A co-design approach that involves users is much more likely to have a positive real-world impact than an approach siloed in the laboratory.

“The pattern of the errors suggest that they came from the way the device was held and operated, suggesting that the algorithm and sensor are likely to be able to reach much higher accuracy close to 100% if the design is improved.”

Braille is frequently included in public spaces and devices such as transport hubs, elevators, and cash point machines to increase accessibility for users. A device capable of reading Braille letters encountered in these public spaces would enable those who are visually impaired and Braille-illiterate to engage with the space or device, and give them the ability to practice reading Braille independently.

 

Paper:

‘Braille-tip: Structured Small-Footprint Tactile Sensor for High Acuity Dynamic Tactile Tasks’ by George P. Jenkinson, Andrew T. Conn and Antonia Tzemanaki presented at IEEE EMB's 10th International Conference on Biomedical Robotics and Biomechatronics.

Braille tip pen and finger

Tip and Braille 

Credit

George Jenkinson

Fig 4 [VIDEO] |

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Braille-tip: Structured Small-Footprint Tactile Sensor for High Acuity Dynamic Tactile Tasks

Article Publication Date

4-Sep-2024

 

Sleep-deprived, cyberbullied teenagers addicted to smartphones now a common phenomenon

Survey sends a clear signal to parents to manage digital device use at home

University of South Australia

Combine cyberbullying, smartphone use, lack of sleep and poor mental health, and you have the perfect storm for a teenage meltdown.

Australian researchers have polled more than 50,000 primary and secondary school students aged 7-19 years about the link between their sleep and nighttime phone habits, experience of cyberbullying and stress levels.

Researchers from the Behaviour-Brain-Body Research Centre at the University of South Australia found that across all genders and age groups, phone use overnight not only robbed children of sleep, but it also had a negative impact on their mental health, especially among those who had been cyberbullied.

Whether one habit causes or stems from another is not crystal clear, but the study findings should send a clear signal to parents about the need to manage digital device use at home.

Approximately 66% of teenage girls and 58% of teenage boys (aged 12-19 years) reported being cyberbullied at least once in the preceding school term. Among the girls, 17% said they slept less than eight hours a night and the corresponding figure for the teenage boys was 13%.

Stress levels in the moderate-to-severe range were reported by 38% of teenage girls and 23% of teenage boys.

While cyberbullying and lack of sleep were not as common in primary aged children (7-11 years), one in five reported moderate-to-severe stress.

For the purposes of the study, “nighttime” refers to phone use when children are supposed to be sleeping, not prior to bed.

UniSA researcher and co-author Dr Stephanie Centofanti says that girls are particularly vulnerable because their smartphone use at night is higher than other age groups and they start using social media at a younger age.

“We found that frequency of nighttime phone use and getting less than eight hours sleep a night not only peaked in early adolescence but was also more evident in young girls,” Dr Centofanti says.

“Pre-teens are at higher risk for socio-emotional disorders because they are at a developmental stage where they are less prepared cognitively, behaviourally and neurobiologically.”

The researchers say that outside of the digital environment, boys are more likely to be physically bullied, while girls normally resort to psychological or relational bullying, which is more easily enabled online.

Approximately 15% of children in the study reported being cyberbullied, with a higher frequency of boys in primary school and girls in secondary school.

More than one third of primary school children and over 60% of teenagers in the study reported using their phone at night when they were supposed to be sleeping.

Of the children who experienced cyberbullying, almost 75% admitted they checked their phone throughout the night, compared to less than half for those who had never been cyberbullied.

“It is clear that parents need to pay closer attention to managing smartphone use at night, particularly if their children are more vulnerable to cyberbullying, and to ensure their children get enough sleep,” Dr Centofanti says.

The findings are published in the journal Adolescents.

Notes for editors

“Nighttime phone use and past exposure to cyberbullying and their impact on sleep and psychological wellbeing in Australian children aged 7-19 years” is co-authored by researchers from the University of South Australia and Resilient Youth Australia. DOI: 10.3390/adolescents4030025

 

 

 

 

 

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Journal

Adolescents

DOI

10.3390/adolescents4030025 

Method of Research

Survey

Subject of Research

People

Article Title

Nighttime phone use and past exposure to cyberbullying and their impact on sleep and psychological wellbeing in Australian children aged 7-19 years

 

How to solve the challenges faced by the carbon sequestration function of Chinese plantations in the future?

Higher Education Press

 

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Image

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Credit: Lei DENG, Haitao HU, Jiwei LI, Xue LI, Chunbo HUANG, Zhijing YU, Hailong ZHANG, Qing QU, Xiaozhen WANG, Lingbo DONG, Zhouping SHANGGUAN

Since the first industrial revolution, the rapid development of the human economy and society has directly exacerbated the process of CO2 emission from human activities such as fossil fuel combustion, industrial processes, agriculture, and land use activities. With the continuous increase of global greenhouse gas concentration dominated by CO2, the greenhouse effect is becoming more and more obvious, and the trend of global warming is becoming more and more serious. To cope with the continuous warming of the global climate and mitigate climate change, China, as a responsible country in the world, actively advocates and practices global climate governance, such as the international community's climate change governance system. After long-term efforts, China has reversed the rapid growth of CO2 emissions. However, at present, China’s CO2 emissions still rank first in the world, and the pressure for substantial emission reduction in the future is huge. Therefore, while vigorously reducing emissions, it is also necessary to use the photosynthesis of forests to sequester CO2, and ultimately offset CO2 emissions and sequestration, that is, carbon neutrality. Since the 1970s, China has launched some major ecological construction projects and carried out afforestation work, making China a country with the largest plantation area in the world. However, due to the lack of comprehensive analysis of the evolution law of carbon sequestration capacity of plantations, carbon sequestration benefits, carbon sequestration, and emission reduction paths and benefits, there is no consensus on the role and realization path of forest carbon sequestration in the process of achieving carbon neutrality targets, and a systematic theoretical system has not yet been formed. The carbon sequestration function of large-scale plantations in China faces some challenges, such as the current distribution status of plantations in China. What is the current contribution of plantations to China's carbon sequestration? How to enhance the sustainable carbon sequestration capacity of plantations in the future? Solving these problems is crucial for China to cope with global climate change.

To solve the above problems of carbon sequestration capacity of plantations in China, Zhouping Shangguan, Deng Lei, and their team from Northwest A&F University, based on the summary and analysis of the existing plantation construction, pointed out that China’s plantation area accounted for 32.94% of the national forest area, accounting for 8.31 % of the land area, the national plantation preservation area has achieved steady growth for 40 consecutive years, but the growth rate slowed down this year. The current plantation is dominated by young forests, indicating that the carbon sequestration potential is large in the next few decades. From 1970 to 2000, China’s forest carbon stock increased by 40%. From 2001 to 2010, the forest carbon sequestration rate of the Natural Forest Protection, Grain for Green, Three-North Shelterbelt Forest, China Rapid-Growing and High-Yield Forest Construction, and Beijing-Tianjin Sandstorm Source Control projects accounted for 63.4%–71.2 % of the country, accounting for 25% of the total carbon sequestration of all vegetation restoration projects in the world.

Although in the past, planted forests have sequestered a large amount of CO2 in China, there are some challenges facing China’s planted forests as afforestation continues. It mainly includes: (1) The afforestation space is reduced, and the difficulty of expanding the total amount is increased. (2) The area of cultivated land afforestation is large and faces the risk of reversal; (3) The overall quality is not high and the productivity is low. (4) Wood dependence increased, and the contradiction between supply and demand is prominent; (5) Super-intensity logging is serious. In this regard, the researchers put forward effective countermeasures, mainly to (1) further promote the land greening action and multi-faceted expansion of ecological development space. It is necessary to fully tap the afforestation potential of existing forest land, improve the utilization rate of forest land, continue to promote the construction of key ecological projects, and promote the realization of land greening; (2) strengthen scientific management and improve the quality of plantation resources. To promote the construction of a forest management system, the implementation of forest quality improvement; (3) optimize plantation structure and enhance timber supply capacity. Through intensive management of plantations, existing forest reform and cultivation, tending and replanting and replanting, efforts should be made to reserve and cultivate rare and large-diameter forest resources, gradually reverse the long-term shortage of rare and large-diameter timber in China, and meet the needs of people for high-quality timber for a better life; (4) strengthen supervision, and effectively protect the afforestation results. It is necessary to accelerate the reform of forest harvesting management and improve the forest harvesting management system. At the same time, improve the information level of forest resource monitoring, realize the normalization of resource monitoring and management, and effectively protect the results of afforestation. These countermeasures are based on a full understanding of the dynamic evolution of plantation carbon sequestration, and propose future plantation carbon sequestration paths and benefit improvement solutions, which will promote plantations to better serve China's carbon neutrality goals.

This study has been published in Frontiers of Agricultural Science and Engineering in 2024, Volume 11, Issue 3. DOI: 10.15302/J-FASE-2023534.

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Journal

Frontiers of Agricultural Science and Engineering

DOI

10.15302/J-FASE-2023534 

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Pursuing the goal of carbon neutrality in China: path for realization of carbon sequestration in planted forests

 SUSTAAINABLE DEVELOPMENT GOALS

How Sub-Saharan Africa can achieve the SDGs by 2100: A new report by Earth4All

In advance of the UN Summit of the Future, Earth4All has released a new report detailing two possible futures for Sub-Saharan Africa this century.

The Club of Rome

 

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To achieve the pace and scale of change required for meaningful SDG progress by 2050, the report identifies several urgent policy levers which need to be implemented simultaneously.

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Credit: Earth4All

In the best-case scenario, called the "Giant Leap," Sub-Saharan Africa could see poverty drop from 500 million to 25 million people, hunger nearly eradicated, and universal access to education, clean water, and sustainable electricity. On the other hand, the "Too Little Too Late" scenario paints a grim picture where poverty rises to 900 million, hunger still affects 180 million, and over a billion people lack clean water. The Too Little Too Late scenario is based on existing policies in the region. These two scenarios highlight the critical importance of action this decade to drive five extraordinary turnarounds in the areas of poverty, inequality, empowerment, food, and energy.

 

Key highlights from the modelling for Sub-Saharan Africa include:

 

• Poverty reduction: Under the Giant Leap scenario, poverty decreases dramatically from 500 million to 25 million people by 2100, compared to a rise to 900 million under the Too Little Too Late scenario.
• Hunger Eradication: Hunger is nearly eradicated in the Giant Leap, with undernourishment dropping to 20 million, in stark contrast to 180 million under the Too Little Too Late scenario.
• Education Access: The average schooling years increase to 13, up from 8 years under the Too Little Too Late scenario.
• Water Access: Universal water access is achieved by 2070, significantly improving from over one billion without access in the Too Little Too Late scenario.
• Electricity Access: Sustainable electricity access reaches over 95% by 2050, compared to 75% still lacking access under the Too Little Too Late scenario.
• Climate Mitigation: Carbon emissions are reach acceptable levels by 2040 as opposed to dangerous levels that push global temperatures even higher.
• Economic Growth: Decent work and economic growth see significant boosts, with unemployment falling to 50 million by 2100, compared to 150 million in the Too Little Too Late scenario. Workers' disposable income and GDP per capita also see substantial increases, doubling in comparison to the Too Little Too Late scenario. And inequality is greatly reduced with labour’s share of GDP reaching 60% by 2040, thereby making Africa one of the most equal regions in the world

 

 

The new research from Earth4All, an international team of economists and scientists, shows the policy levers needed to ensure that the SDGs are met in Sub-Saharan Africa by 2100. The report ‘SDGs for All: Africa’ equips policymakers with practical solutions designed to accelerate SDG implementation and to respond to the planetary emergency. It concludes that policymakers can step up the implementation of the SDGs by 2030 and beyond and achieve wellbeing for all. But this is only possible by enacting five ‘extraordinary turnarounds’ that break with current trends.

 

“The challenge for Sub-Saharan Africa this century is that economic transformation must now take place in the shadow of a climate emergency. This is a breakthrough or breakdown moment for the continent. It teeters on the brink of two vastly different futures: one of transformative progress and one of deepening despair. As we approach the UN Summit of the Future this September, the time for bold, decisive action is now—to ensure a 'Giant Leap' towards a future where poverty and hunger are eradicated, and every individual has access to education, clean water, and sustainable energy. Our choices today will shape the destiny of millions. We must act, and we must act decisively.” Said Jane Kabubo-Mariara, Executive Director of the Partnership for Economic Policy and member of the Earth4All Transformational Economics Commission.

 

"The UN Sum

 

Spurring more biofilm growth for efficient wastewater treatment

Foaming plastic carriers creates uneven surfaces, more area for necessary microorganisms

Osaka Metropolitan University

 

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How foamed polypropylene carriers are used in moving bed biofilm reactors.

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Credit: Osaka Metropolitan University

For the sake of the environment and our quality of life, effective treatment of wastewater plays a vital role. A biological method to treat sewage using moving, biofilm-covered plastic items known as carriers has been gaining prominence, and an Osaka Metropolitan University-led team has found ways to make the process more efficient.

The moving bed biofilm reactor (MBBR) process purifies wastewater by putting these carriers in motion to get the biofilm’s microorganisms into greater contact with organic matter and other impurities. The more biofilm that can be attached to the plastic carriers, the more microorganisms that are available to clean the wastewater.

OMU Professor Masayuki Azuma and Associate Professor Yoshihiro Ojima of the Graduate School of Engineering worked with a team from Kansaikako Co., an Osaka-based company specializing in water treatment-related products, and found that polypropylene carriers foamed to create uneven surfaces and more surface area allowed 44 times more biofilm formation than smooth plastic carriers.

Moreover, adding waste biomass such as composted seaweed when foaming further enhanced the performance of the foamed plastic carriers, especially in terms of nitrate removal during the MBBR process.

“Since there is a wide variety of wastewater, it will be necessary to prove that these foamed carriers also have superior suitability to various wastewater,” stated Professor Azuma. “It is clear that the addition of waste biomass improves the performance of the carriers, so we expect that further performance enhancement can be achieved depending on the additive.”

The findings were published in Environmental Technology & Innovation.

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About OMU 

Established in Osaka as one of the largest public universities in Japan, Osaka Metropolitan University is committed to shaping the future of society through “Convergence of Knowledge” and the promotion of world-class research. For more research news, visit https://www.omu.ac.jp/en/ and follow us on social media: X, Facebook, Instagram, LinkedIn.

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Journal

Environmental Technology & Innovation

DOI

10.1016/j.eti.2024.103747 

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Nitrogen conversion performance of a polypropylene carrier designed to promote biofilm formation through foaming

 

Infertility challenges amongst endangered wild songbird population revealed in new study

A ground breaking study has provided the most comprehensive estimate to date of infertility rates in a threatened wild animal species.

University of Sheffield

 

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Female Hihi

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Credit: The University of Sheffield

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• A new study using 10 years of data has provided the most comprehensive estimate of infertility rates to date in a threatened wild animal population
• Researchers from the University of Sheffield found infertility accounts for 17 per cent  of hatching failure in an endangered songbird, the hihi, with the majority of hatching failure being caused by embryo death
• This is the first study to find a link between small population size, sex ratio bias, and reduced fertilisation rates in wild animals
• By considering the impacts of population size and sex ratio on fertility, conservationists can better manage the numbers and composition of animals in populations to improve fertility rates

A groundbreaking study has provided the most comprehensive estimate to date of infertility rates in a threatened wild animal species. 

Using 10 years of data, researchers from the University of Sheffield, the Zoological Society of London, and the University of Auckland, New Zealand, have uncovered critical insights into the reproductive challenges faced by the endangered hihi, a rare songbird native to New Zealand.

The first to establish a link between small population size, sex ratio bias, and reduced fertilisation rates in wild animals, the study highlights the significant reproductive challenges faced by threatened species with small population sizes and biassed sex ratios.

The research team analysed over 4,000 eggs and assessed the fertility of nearly 1,500 eggs that failed to hatch. The findings revealed that infertility accounts for an average of 17 per cent of hatching failures in the hihi, while the majority of hatching failures are caused by early embryo death.

The study revealed that embryos are most vulnerable within the first two days of development, with no significant difference in survival rates between male and female embryos or any impact from inbreeding. Additionally, infertility rates were observed to be higher during years when the population was smaller and male numbers exceeded female numbers, indicating that elevated stress from increased male harassment of females may play a role in these findings.

The hihi, known for its high levels of female harassment by males and frequent extra-pair paternity, is an example of the reproductive challenges faced by species with skewed sex ratios. In extreme cases, females may be subjected to up to 16 forced copulations per hour, a behaviour that is both energetically costly and stressful, potentially contributing to reduced fertility.

By considering the impacts of population size and sex ratio on fertility, conservationists can better manage the numbers and composition of animals in populations, therefore improving fertility rates. 

Fay Morland, PhD student at the University of Sheffield, and lead author of the study, said: “One of our key findings is that embryo mortality at the very early stages of development is the most common reason hihi eggs fail to hatch, however, the exact causes of failure at this stage remain unknown. These results highlight the urgent need for more research into the reproductive challenges faced by threatened species, to better understand and mitigate the factors driving their risk of extinction.”

Dr Nicola Hemmings, from the University of Sheffield’s School of Biosciences, and leader of the research group that undertook the study, said: "Our research highlights the importance of understanding the factors that affect fertility in endangered species. The link between male-biassed sex ratios and lower fertility rates suggests that managing population composition could be crucial for improving reproductive success in conservation programs."

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Journal

Proceedings of the National Academy of Sciences

DOI

10.1073/pnas.2319104121 

Article Title

Demographic drivers of reproductive failure in a threatened bird: Insights from a decade of data

Article Publication Date

26-Aug-2024

Don’t stop with taking down Thatcher’s portrait

By David Osland

Peter Mandelson famously once proclaimed: “We are all Thatcherites now.” The former MP for Hartlepool was speaking for himself, of course.

That precise choice of words, annunciated in Rupert Murdoch’s newspaper The Times, was primarily designed to discomfit anyone foolishly harbouring vaguely pinko sentiments in the Labour Party of the early 2000s.

But the barb packed a punch. The Third Way, the label dreamed up by those who sought to dignify Labour’s political direction of the period by according it the standing of an ideology, very much did take the Thatcher revolution as its starting point.

Privatisation was extended rather than reversed. Economic policy remained within a free market framework. Bob-a-job businessmen were systematically glorified and even gifted with ministerial appointments. Council houses continued to be sold.

The need for nuclear weapons went unquestioned. There were one or two important concessions on employment rights, but the anti-union laws stayed on the statute books.

In short, New Labourism came to praise Caesar, not to bury her. Those of us who maintained that most of Britain’s long-running problems were deepened rather than resolved on her watch went unheeded.

As if to acknowledge the intellectual debt, prime minister Gordon Brown later commissioned a portrait of Margaret Thatcher, at a cost of £100,000 at the price levels then prevailing. The painting has graced 10 Downing Street ever since.

Well, until recently, anyway. Word that Keir Starmer has ordered its removal has been a major news story in Britain this week.

Uproar on the front page of the Daily Mail. Predictable condemnations followed from the usual suspects on the much-diminished front bench of the Conservative Party.

But who are they to deny the tenant of rented property the right to change disagreeable wall hangings?

I have been to countries in which it is obligatory for shops and offices – and highly advisable for private homes – to display a picture of the monarch or the president for life. They haven’t tended to be happy places.

Starmer came to political activism in the Thatcher era and some of the credible causes he stood for at the time make it inconceivable that he did not share the dislike of Thatcher not uncommon during that period.

That is the context for an article that appeared under his byline in a stridently rightwing publication as recently as last December, in which he praised Thatcher for bringing about “meaningful change” and even “setting loose our natural entrepreneurialism”.

It won’t have won over many Tories. But it put a lot of Labour backs up.

Some of Starmer’s critics have burdened him with accusations of insincerity, seeing in him a propensity to say whatever any given audience wants to hear. Bigging up Maggie in the Sunday Telegraph is the kind of thing that hands them ammunition.

The truth is that Margaret Thatcher is not a saint. She doesn’t intercede with the Almighty in Heaven on behalf of control of the M2 money supply. Touching the hem of her garments does not cure those suffering from the king’s evil. The veneration of her relics is not compulsory.

Yet somehow she has been elevated to the status of deity in the cult that was still in government until a couple of months ago, with Liz Truss even cladding herself in quaintly anachronistic pussybow blouses, as befits a true votary.

I’d put a decent wager on every one of the six people running for the Conservative leadership styling themselves a Thatcherite at some point in the coming campaign. The invocation of the sacred name still has the power to find the selectorate’s G-spot.

Britain has now rejected these people, and Starmer has pledged his administration to a decade of national renewal. God knows we need that.

Taking down Thatcher’s portrait is the perfect symbolic starting point; the question now is whether he will take down her political legacy.

David Osland is a long-time leftwing journalist and author. Follow him on Twitter at @David__Osland

Image: Margaret Thatcher. Source: Nationaal Archief: entry ad2e0288-d0b4-102d-bcf8-003048976d84. Photographer: Rob Bogaerts for Anefo, available under the Creative Commons CC0 1.0 Universal Public Domain Dedication