Its author has had to fend off criticism and misinformation, but the report offers hope for a realistic conversation

As the dust settles around Hilary Cass’s report – the most extensive and thoroughgoing evidence-based review of treatment for children experiencing gender distress ever undertaken – it is clear her findings support the grave concerns I and many others have raised. Central here was the lack of an evidential base of good quality that could back claims for the effectiveness of young people being prescribed puberty blockers or proceeding on a medical pathway to transition. I and many other clinicians were concerned about the risks of long-term damaging consequences of early medical intervention. Cass has already had to speak out against misinformation being spread about her review, and a Labour MP has admitted she “may have misled” Parliament when referring to it. The review should be defended from misrepresentation.

The policy of “affirmation” – that is, speedily agreeing with a child that they are of the wrong gender – was an inappropriate clinical stance brought about by influential activist groups and some senior gender identity development service (Gids) staff, resulting in a distortion of the clinical domain. Studies indicate that a majority of children in the absence of medical intervention will desist – that is, change their minds.

David Bell is a retired psychiatrist and former president of the British Psychoanalytic Society

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Stark new projections suggest annual admissions will rise to 151,000, costing the NHS and economy £75bn

The number of people in the UK experiencing a stroke will increase more than 50% to 151,000 a year by 2035, costing the NHS and the economy £75bn in healthcare and lost productivity, stark new projections suggest.

Worsening physical health, rising alcohol consumption and low exercise levels among an ageing population as well as a failure by ministers and the health service to do more to prevent ill health are blamed for the predicted spike in strokes.

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Chronic workforce shortages have put nursing staff under unbearable pressure, says union chief

Nurses in England took an average of a week off sick last year because of stress, anxiety or depression, NHS figures reveal.

The disclosure has prompted concern that the intense strains nurses face in their jobs, including low pay and understaffing, are damaging their mental health and causing many to quit.

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Readers respond to the prime minister’s claim that the UK is suffering from a ‘sicknote culture’

As a retired GP who spent 35 years looking after people with anxiety and depression in primary care, I find Rishi Sunak’s recent comments about GPs “over-medicalising the everyday challenges and worries of life” offensive ( Sunak to cite Britain’s ‘sicknote culture’ in bid to overhaul fit note system, 19 April ). These disabling problems constitute around 40% of all those attending a GP practice.

He clearly has no idea what is going on in his country. People are suffering from multiple stresses, including huge financial pressures largely brought about by his own party’s total incompetence over the past 14 years. People are pretty resilient when dealing with stressful adverse events such as bereavement or job loss or debt in their lives, but when they encounter one more bad thing, they “hit a wall” and become unable to continue. It seems like a hard-wired mechanism that renders them incapable of carrying on.

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Cambridge study finds those from poorest areas have 35% higher risk of second non-breast cancer

Female survivors of breast cancer living in the most deprived areas have a 35% higher risk of developing second, unrelated cancers, compared with those from the most affluent areas, research shows.

Breast cancer is the most commonly diagnosed cancer in the UK, with about 56,000 people being told they have it each year. Improved diagnosis and treatments mean that five-year survival rates are now 86% in England.

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Some shortages are so serious they are imperilling the health and even lives of patients with serious illnesses, pharmacy bosses say

Drug shortages are a “new normal” in the UK and are being exacerbated by Brexit, a report by the Nuffield Trust health thinktank has warned. A dramatic recent spike in the number of drugs that are unavailable has created serious problems for doctors, pharmacists, the NHS and patients, it found.

The number of warnings drug companies have issued about impending supply problems for certain products has more than doubled from 648 in 2020 to 1,634 last year.

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Use of powerful medications linked to elevated risk of serious adverse outcomes including heart failure

Doctors are being urged to reduce prescribing of antipsychotic drugs to dementia patients after the largest study of its kind found they were linked to more harmful side-effects than previously thought.

The powerful medications are widely prescribed for behavioural and psychological symptoms of dementia such as apathy, depression, aggression, anxiety, irritability, delirium and psychosis. Tens of thousands of dementia patients in England are prescribed them every year.

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Like many young people, I have no hope of finding an NHS dentist – and this is only deepening class divisions

• This article won the 16-18 age category of the Guardian Foundation’s 2024 Hugo Young award, which champions political opinion writing

When I was 12 my childhood dentist went private. It was 2018 and I’d just had a consultation with my orthodontist, and had been told I would need at least two teeth removed before my braces could be fitted. My options were: pay (a minimum of) £55 for each tooth extraction, or find a new dentist on the NHS. By pure luck, I was accepted at a different practice. I had my teeth out, then one routine exam, before I received a letter saying that my new dentist had also gone private and I would have to start paying for treatment. I haven’t seen a dentist since.

As of 2024, no practices in Cornwall, where I live, are taking on new NHS patients above the age of 18. With lengthy NHS waiting lists and my 18th birthday rapidly approaching, it’s unlikely that I will ever see an NHS dentist again, unless some serious reform occurs. I’m not alone: thousands of patients in Cornwall are increasingly losing hope of seeing a dentist.

Beth Riding is an A-level student in Cornwall

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Health Foundation report also predicts people in poorest areas will be three times more likely to die by the age of 70

A record 3.7 million workers in England will have a major illness by 2040, according to research .

On current trends, 700,000 more working-age adults will be living with high healthcare needs or substantial risk of mortality by 2040 – up nearly 25% from 2019 levels, according to a report by the Health Foundation charity.

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