Cancer expert brands Liverpool Care Pathway ‘the most corrupt practice in British medicine’
A senior cancer specialist today condemned the controversial Liverpool Care Pathway as a corrupt and scandalous system used to free hospital beds of the old and sick.
Professor Mark Glaser said the Pathway – in use across the NHS as a way to ease the suffering of the dying – is employed by Health Service managers to clear bed space and to achieve targets that bring more money to their hospitals.
The professor, who treated former Labour Cabinet minister Mo Mowlam during her last illness, said practices in British hospitals are ‘morally bad medicine’ and that he would personally ‘never be treated in a hospital in England’. ‘I would go to America because I don’t trust anybody,’ he said.
He added that he has removed ‘dozens’ of his own patients from the Liverpool Care Pathway.
The intervention by Professor Glaser, consultant oncologist at Imperial College Healthcare NHS Trust, comes at a time of growing concern over the Liverpool Care Pathway.
A centrepiece of the NHS programme for ‘end-of-life care’, it involves removing life-saving treatment from patients considered to be dying. Commonly, patients are heavily sedated and tubes providing nutrition and fluid are removed. Typically a patient dies 29 hours after being put on the Pathway.
But families have complained that loved ones have been put on the Pathway when they were not dying and senior medical figures have said it is impossible to predict when a patient will die.
Leading doctors opposed to the Pathway have said it hastens death and that putting a patient on it is a ‘self-fulfilling prophecy’.
Hospitals receive millions in bonus payments in return for hitting targets for numbers of patients put on the Liverpool Care Pathway.
At the weekend Health Secretary Jeremy Hunt promised to reassure patients by making it a legal requirement for doctors to inform families when a patient goes on the Pathway, and to obtain their consent. He is expected to announce changes to the rules today.
But Professor Glaser said it was not enough. The 67-year-old consultant, who is in charge of radiotherapy at Charing Cross Hospital, in West London, said: ‘I would like to see a whole inquiry set up to look at patients with incurable diseases, and how patients can be managed within a time limit from the beginning of their pathway to really good pain control and symptom control at the end of the pathway.
‘You can’t be just guided by admission rates and targets.’ He added: ‘There is nothing more intransigent and corrupt at the moment in medical practices as the hospice Liverpool Pathway movement. ‘It’s not really active or passive euthanasia, it’s negligence. But it is right that all the managers want the bed space and they will take down drips weeks earlier to get people out. That is a scandal.’
Describing the way he believes staff operate to put patients on the Pathway, he said: ‘The average example is some poor person whose family is absolutely miserable and a nurse comes in, or a very abrupt palliative care doctor, and says they’re going on the Liverpool Pathway.
‘And then you get the treating doctor, such as myself, rung up by the wife or the daughter in tears, saying, “Oh no, we didn’t want this, we were baffled, we didn’t want to do it, we were bullied”.’
He said he has protested on behalf of such families and has removed dozens of patients from the LCP and put them back on normal care. He added: ‘Symptom control is right but taking drips from people, actually putting them on the care pathway, is morally bad medicine.’
Another leading critic is Professor Patrick Pullicino, a consultant at hospitals in Kent, who has warned of hospitals using the Pathway to free beds and get rid of difficult patients. He has also expressed concern at the use of targets and financial incentives for hospitals.
An inquiry into the LCP was started last week by the Department of Health’s End of Life Care Programme, which has been funded with nearly £300million since it was launched in 2008, and which recommends use of the Pathway.
A number of medical associations involved in end-of-life care, including the Association of Palliative Medicine, which represents hospice and specialist hospital doctors, will also take part.
However critics have called for an independent inquiry because the organisations running the inquiry are the same bodies which have been promoting its use in the NHS.
Grandmother told doctors to remove ‘do not resuscitate’ order from her medical file… then died days later unaware a SECOND one had been issued
A care home manager who urged doctors to remove a ‘do not resuscitate’ order from her medical notes died days later unaware that a second one had been issued, a court heard today.
Grandmother-of-seven Janet Tracey, 63, fractured her neck in a car crash two weeks after she was diagnosed with terminal lung cancer.
She was being treated in hospital when doctors issued a DNR notice, apparently without her consent. They cancelled the order when Mrs Tracey objected but she expressed fears to her family that staff ‘wanted to get rid of her’.
Three days later, a second DNR order was placed on her medical notes, with staff writing that it was in her ‘best interests’.
They claim they obtained Mrs Tracey’s and her daughters’ consent – something vehemently denied by the family.
She died two days later, on March 7 last year.
Now her husband David Tracey, a retired engineer, has launched a landmark case at the High Court against Cambridgeshire University Hospitals NHS Foundation Trust for going against his wife’s wishes and ‘acting unlawfully’.
Mrs Tracey – described as ‘a strong woman’ with a ‘thirst for life’ – responded to treatment and, while on a ventilator, wrote a note to an oncologist saying ‘I will do my damnedest’ to get better.
So her family were shocked when a nurse casually told them during a conversation at her bedside, ‘don’t worry about the DNR, it doesn’t affect the other treatment’.
When Mrs Tracey was told about the order, she was apparently ‘horrified’. In a statement read to the court, Mr Tracey, 65, said: ‘I found her in tears, so distressed. It was horrible. ‘She told me the doctor had told her about the DNR and the decision had been made.
‘I told her that neither I nor the girls would do that to her. We managed to reassure her we hadn’t agreed to this.’ He added: ‘At one particular point, she did say they were trying to get rid of her. I told her not to be so silly, which proved to be a mistake.’
The order, issued on February 27, was cancelled on March 2.
Her family claim she was then ‘badgered’ by staff when she was alone to make a decision about her resuscitation options.
On March 5, a second order was issued with the notes, ‘The patient does not want to discuss resuscitation’. It was claimed three of her four daughters had agreed to this.
When Mrs Tracey died two days later, Mrs Noeland found the note and raised it with staff.
She says she had specifically told the medic who issued the second DNR that they had refused consent during a meeting on March 5.
She told the court: ‘I told her I couldn’t agree with it because my mum didn’t agree with it. My mum wanted to live and her tolerance and hunger for life was very, very strong. My mum could do pain.’
Mr Tracey said in a statement to the court: ‘My girls told me they found a second DNR on mum’s notes and the notes said I had agreed. ‘I was disgusted and shocked. I would never have agreed to something against my wife’s wishes.’
In her final days, as her voice became weaker, she wrote a distressing series of notes to her daughters and her husband.
According to the family’s solicitors, she wrote in uncharacteristic capital letters, ‘She wouldn’t give me anything’ and ‘where has my pain relief gone’.
Merry Varney, the lawyer representing the family from law firm Leigh Day & Co, said: ‘This case underlines the importance of a transparent, accessible and consistent policy regarding a patient’s right to know when a decision not to resuscitate them is made.’
Mrs Justice Nicola Davies is hearing evidence to determine the facts before a full judicial review in February, which will seek to clarify whether there is a legal duty to inform patients with capacity when a DNR has been placed on their notes and whether they have the right to be consulted about it.
Mr Edward Faulks QC, representing the hospital trust, suggested yesterday that staff had fully explained the options, including that CPR could sometimes be ‘cruel and futile’. He said doctors had issued the DNRs after consultation with senior medical staff, Mrs Tracey and her family.
The case will reignite public debate over whether it should be patients, or doctors who have the final say over life and death.
A DNR order is a form placed in a patient’s medical file to tell doctors or medical staff to not try to restart their heart if it stops beating.
It is meant to be used to prevent the patient suffering unnecessarily, if resuscitation would most likely extend their life for only a short period of time or they are in great pain.
Efforts to restart the heart through CPR are traumatic and can cause broken ribs and damage to organs.
Doctors are supposed to discuss DNR orders with the patient and relatives first, but there are no national rules or guidelines regarding this.
A spokesman for Cambridge University Hospitals said: ‘Our staff followed best practice in the care of Mrs Tracey. We sympathise with the family on their loss. ‘We have to disagree with the family in their recollection of the facts. We believe our staff acted at all times professionally and in the best interest of Mrs Tracey.’ [By killing her!! Do these vicious British bureaucrats even know what they are saying?]
UK government told anti-Islam film incites terrorism
There is a clear threat of violence below. I wonder how that comports with British hate-speech law?
Britain’s Counter-terrorism Command Unit and Specialist Internet Bureau have taken notice of a representation made by an influential Muslim organisation which is asking the government to ban the blasphemous film “Innocence of Muslims” for posing danger to UK’s national security.
The Jamaat-e-Ahle Sunnat UK, which claims to represent the majority of Muslims in Britain, has approached the home secretary and police forces around the country requesting that the movie be removed from YouTube on the grounds that it incites racial and religious hate crimes and openly encourages violence in the name of faith.
The group didn’t request that the film, which caused outrage among Muslims across the world, be banned for being offensive, nor that it will incite hatred against the Muslims but rather that it would encourage violence by Muslims to non-believers.
Raja Zahid Nawaz confirmed to The News that his organisation had been contacted by the security officials with assurance that the contents of the letter were being studied and all the activity around the film online and otherwise was being monitored.
Ghulam Rabanni, Secretary General of the organisation, told The News that the blasphemous film is not about the “freedom of speech”. “This film is aimed at inciting religious and racial hatred. It incites extremism and terrorism and will lead to the radicalisation of young Muslims in the UK. It encourages physical and violent attacks on non-Muslim communities around the world. It encourages child abuse. It will damage the fabric of a multi racial and multi faith society and it will lead to tensions and disturbances within the UK and in particular in inner city areas. We have asked the government to ban the film on YouTube.”
Outrage at BBC scandal conceals the fact that British culture encourages paedophilia. Believe me, I know what I’m talking about
By James Rhodes
Yet another bloody article about Jimmy Savile. We read more and more about the horrors that went on and the now incontestable fact that others knew it was happening, and we get all shouty and indignant. It reveals the irksome, irritating side of Twitter, the tabloid press, self-published blogs and the loud, chatty guy in the pub. The moral high ground. The furious bleating and self-righteousness of the whiter-than-white populace.
The outcry will not do any good at all. How many times since “Never again” has it happened again? Using words like “molest” and “abuse” runs utterly counter to the horror of child rape. As do the prison sentences handed down upon conviction. You can serve longer in prison for saying “I’m going to kill you” (maximum sentence 10 years) than you can for having sex with your three-year-old daughter (maximum sentence seven years). Newspapers happily show pictures of 14-year-old girls sunbathing and use sexual language to describe them while at the same time appearing indignant and appalled at the crimes of Savile, Glitter et al.
The culture of celebrity has the same shroud of secrecy, power and authority as the Church. Why on earth should we be surprised at sexual abuse going on in those circles? The only thing that surprises me is that people actually seem surprised. In any environment where there is power, there will be an abuse of that power.
When I was at school I was sexually abused. Let me clarify: I was serially raped when I was a child, between the ages of five and 10. At least one other teacher knew it was happening and even after voicing their concerns to the relevant authorities within the school, nothing was done and the horrors continued. (Over two decades later, and only after a statement from both me and another teacher, did the police arrest and charge the rapist with 10 counts of buggery – at the time of arrest he was a part-time boxing coach for boys under 10.)
We read about things like this and we think “how awful” and then get on with eating our cornflakes, but no one really wants to look beneath the surface. The physical act of rape is just the beginning – each time it happened I seemed to leave a little bit of myself behind with him until it felt like there was pretty much nothing left of me that was real. And those bits do not seem to come back over time. What goes too often unreported and unexamined and unacknowledged is the legacy that is left with the victim.
Self-harm. Depression. Drug and alcohol abuse. Reparative surgery. OCD. Dissociation. Inability to maintain functional relationships. Marital breakdowns. Being forcefully institutionalised. Hallucinations (auditory and visual). Hypervigilance. PTSD. Sexual shame and confusion. Anorexia and other eating disorders. These are just a few of my symptoms (for want of a better word) of chronic sexual abuse. They have all been a part of my life in the very recent past and the abuse I went through was 30 years ago. I am not saying that these things are the inevitable result of my experience; I imagine that some people can go through similar experiences and emerge largely unscathed. What I am saying is that if living life is the equivalent of running a marathon, then sexual abuse in childhood has the net effect of removing one of your legs and adding a backpack of bricks on the starting line.
I don’t want to be writing about things like this. I don’t want to deal with the inevitable feelings of shame and exposure that will come from it. And I don’t want to deal with the accusations of using my back story to flog albums, being full of self-pity, attention-seeking or whatever other madness will no doubt end up in the comments below. But neither do I want to have to keep quiet, or even worse, feel as if I should keep quiet, when there is so much about our culture (which is in many ways so incredibly evolved) that allows, endorses, encourages and revels in the sexual abuse of children. Paedophilia has acquired a grim, vaguely titillating, car-crash fascination that the press have jumped all over.
We simply cannot on the one hand have sexualised images of children on billboards and magazines, underwear for six-year-olds with pictures of cherries on them, “school disco” themed nights at bars and community service sentences for downloading “indecent” images (indecent? Saying “shit” in church is indecent – this is abominable), and on the other hand regard the Savile story with abject horror. It just does not equate. This is not about censoring what the press can write (typical example from one tabloid: “She’s still only 15, but Chloë Moretz … The strawberry blonde stepped out with a male friend in a cute Fifties-style powder blue sleeveless collared shirt which she tied at her waist – revealing just a hint of her midriff”). or what pictures they can publish. It is about protecting minors who do not have a voice, who are not capable of understanding certain matters and who cannot protect themselves.
This has all been said before. And nothing has really changed. We forget (who would want to remember this stuff?), we think shouting loudly will absolve our collective guilt and change things for the better, we point fingers and form lynch mobs. We paint “paedo scum” on convicted (or suspected) paedophiles’ homes. And yet what we need to do is open our eyes fully and simply not tolerate this, rather like we’ve done and continue to do so effectively with homophobia and racism. We need to look at providing more visible therapy for both victims, perpetrators and those who have urges that threaten to make them perpetrators. We need to overhaul sentencing guidelines and start tackling the issues with more clarity and integrity. Whatever it takes for as long as it takes needs to be the guiding principle here, because otherwise we will, to use a well-worn but apposite phrase, simply continue the cycle of abuse.
London Police ‘could be sued over plan to give top jobs to black people and women’
Britain’s biggest police force is to become the first public body to adopt a policy that gives priority for top jobs to black people and women.
The Metropolitan Police will recruit senior officers and promote civilian staff from minority groups in ‘tie-break’ situations where they are just as qualified as white or male candidates.
Scotland Yard’s diversity board has warned that the ‘positive action’ policy, made legal by equality laws last year, will be controversial.
The move could trigger lawsuits by job applicants who lose out and is likely to raise concerns that successful candidates were chosen to fill quotas rather than on merit. But a meeting chaired by Met Commissioner Bernard Hogan-Howe took the decision to use positive action after it was given Government advice.
Minutes of the policy forum meeting on July 11 state: ‘The Forum were supportive of using a legal provision that could potentially deliver a more diverse workforce.
‘It accepted the Diversity Board’s caution but were confident that Legal Services could guide on the few occasions this provision would be used.’
Recent figures show that although one in ten of the Met’s 32,000 officers come from ethnic minorities, there are just two black and Asian men in the highest rank.
In March this year the Met had 7,829 female officers – but only seven in the chief officer tier. Since then three high-profile women have retired.
As part of efforts to make its workforce more representative of London’s population, the Met considered if it should use the new equality law that allows positive action.
The legislation, introduced in April last year, lets employers recruit or promote candidates if they have a ‘protected characteristic’, such as race, that is under-represented.
But Scotland Yard’s Diversity Executive Board warned in an internal paper: ‘This is legislation, ambiguously written, with no case law existing to support legal advice. No public or private sector organisations contacted have plans to use it.’
But Ilana Swimer, an employment expert at law firm Halebury, said: ‘Even if the Met decide to support this provision, it is unlikely to have a significant impact on diversity.
‘Indeed, any employer who recruits a candidate having relied on this provision could open themselves up to challenge by other candidates who feel they have been treated unfairly.’
Charles Crichlow, president of the National Black Police Association, denied it would lead to tokenism.
‘You would be getting your job on merit because it’s only open to equally qualified candidates,’ he said.
A police state created by “anti-fascists”
In their enthusiasm to clamp down on ‘hate speech’, anti-fascists have become an unofficial arm of the state
Given that the key thing about twentieth-century fascism was its extreme authoritarianism, you might reasonably expect those who describe themselves as ‘anti-fascist’ to be anti-authoritarian. You might imagine that these campaigners, more than most, would know the dangers of giving the state too much power and trusting it to determine who may speak and who may not, who is a ‘decent’ person and who is not.
But you would be wrong – certainly if the events in the north-east London district of Walthamstow this weekend were anything to go by. There, anti-fascists campaigning against a protest planned for Saturday by the right-wing, allegedly fascistic English Defence League (EDL) demonstrated that they are uncritically pro-state, and unabashedly pro-authoritarian, trusting the powers-that-be to police public protest and political discourse more broadly.
The modern anti-fascist left has provided plenty of justification for increased state control over political to and fro in modern Britain. It has strengthened the use of public-order laws over political freedom, and it has empowered the state to govern all forms of political speech. That control extends not just to the statements and actions of ‘fascist’ groups, but also to the statements and actions of left-wing groups and anti-fascists, too.
So for the next 30 days, any group – regardless of its grievance – is banned from marching in Walthamstow and the rest of the borough of Waltham Forest and in the nearby boroughs of Tower Hamlets, Newham and Islington. This blanket ban is directly down to the campaigning efforts of left-wing anti-fascist protesters, who have spent the past month taking to the streets to get people to join local Labour MP Stella Creasy in signing a petition to ban the EDL from entering Walthamstow. The successful campaign for a ban was celebrated by Creasy who, ironically, claimed it meant ‘our community can get back to its normal, peaceful and tolerant state’.
In truth, Walthamstow on Saturday resembled a police state. Hundreds of police officers monitored public transport, roads and thoroughfares, looking suspiciously at anyone who walked past. Random searches of people and cars were carried out, which led to three arrests of individuals, not because they were EDL members, but for things like drug possession and driving while disqualified. Many more officers waited in the wings as mobile surveillance-cameras checked the town for anyone who dared take to the streets to express their political views.
While the UK Home Office cannot ban ‘static demonstrations’, the Metropolitan Police used section 14 of the Public Order Act 1986 to ban any EDL event from taking place in London, with the exception of a one-hour rally outside the Houses of Parliament. The anti-fascist protesters were permitted to have a demonstration in Walthamstow, however, and they duly decided to hold a ‘victory rally’ celebrating the fact that they had successfully kept the EDL from marching. Censorious Creasy was cheered by the anti-fascists when she took to the stage.
In what bizarre world is this a victory? In lobbying for the state to ban the EDL, anti-fascist protesters managed to have their own freedom to protest restricted as well. The fact that their own civil liberties would also be affected must have come as no surprise to many of these anti-fascist protesters, given that they were banned from marching in Tower Hamlets last year, too. Some socialist groups, however, did see it as ‘scandalous’ that they were banned from marching. They began chanting ‘Whose streets? Our streets!’, complaining that their human rights were being breached.
So it’s fine to ban the EDL from marching, but not the EDL’s left-wing opponents? Apparently, human rights should not extend to those with the Wrong Views – or perhaps anti-fascists think EDL members aren’t human. It was as if these naive protesters were complaining that the home secretary, Theresa May, couldn’t see who the good guys were.
Given the extent of collaboration between the anti-fascist left and the police, you can see why they might have been miffed. On Saturday, anti-fascist groups such as Hope Not Hate monitored the borough on behalf of the police to ensure no one that even looked like an EDL supporter was allowed into the borough. Searchlight magazine reported seeing ‘six to eight thuggish EDL types wandering around’, who were told they were not welcome. Others took to Twitter to encourage their followers to report to the police any EDL members seen entering the borough. As one anti-fascist Twitterer put it: ‘So glad the #EDL are denied access to #Walthamstow today. We are on EDL watch, [so if EDL members are] seen today anywhere in “Stow”, please let the police know.’
That anti-fascists now take it upon themselves to ensure the law is being enforced, shows the extent to which the left have become an unofficial arm of the state. They have become squealers, the state’s eyes and ears, cheering on the state to intervene.
Surely anyone with an anti-authoritarian bone in their body would be chilled by the state’s clampdown on free expression in huge swathes of London over the next month. These so-called ‘anti-fascists’ are so untroubled by it, they are holding ‘victory rallies’ instead. What’s anti-fascist about that?
Scottish police swoop on landlord for organising an ‘ugliest woman’ competition (when it was actually meant for men anyway!)
Must not mention that women can be ugly??
A pub holding a competition to find the ‘Ugliest Woman’ got a visit from the police after someone reported them for sexism. An unknown complainant demanded the competition be cancelled and wanted the owners of Islay Inn prosecuted.
However, when police arrived at the Glasgow venue they gave manager George Hogg the go ahead after discovering it was, in fact, a competition for men dressed as women.
Mr Hogg told of his disbelief of the complaint and accused the protestor of being ‘over the top with political correctness.’
He said: ‘I have no idea who made the complaint and the police wouldn’t tell me – but if he or she had bothered to read the advert properly, they would have realised that it was not ugly women we were looking for – but ugly men dressed up as women.
‘The first we knew of a potential problem was when two female officers from Maryhill Police Station came into the bar on Thursday night.
‘They told me they had received a complaint about us holding a competition to find the ugliest woman in the bar and that it might constitute some kind of sexist offence.
‘But when I pointed out the facts, the policewomen were clearly amused and quickly told me the matter would go no further.’
The Islay Inn apologised for causing any offense adding: ‘Just so it’s clear to all, our ugly women will be men dressed as women, beard stubble and all.’
Andrew Parr wrote: ‘Ridiculous getting the police involved. Some people are pathetic.
Mark McCarrick added: ‘As if our overstretched police service haven’t got enough to do without being bothered by some silly complaint. ‘I bet the silly fart wouldn’t have moaned had it been an ugly man competition.
Although the competition has been allowed to take place, Strathclyde Police confirmed to the MailOnline that an inquiry into the complaint is still ongoing.
Vigorous daily exercise could help to repair damage from heart failure
If you are a rat
Strenuous daily exercise could help to repair the heart of someone who has just suffered a heart attack, according to a new study.
Researchers at Liverpool John Moores University found that vigorous regular exercise led to dormant stem cells in the heart becoming active. This stimulated the development of new heart muscle.
The findings, published in the European Heart Journal, suggest that scientists could soon be able to improve the quality of life for people suffering from heart disease or heart failure.
British Heart Foundation
This is the first study of its kind to suggest that a basic exercise regime could have the same effect on the heart as injecting growth chemicals to stimulate stem cells to produce new tissue.
The team of scientists, funded by the British Heart Foundation, studied healthy male rats for up to four weeks by exercising them on an intensity-controlled treadmill for half an hour, four times a week.
The rats on a high-intensity programme showed the greatest increase in the size of their hearts, as expected, but also their aerobic capacity – how well the heart, lungs and blood vessels work.
The exercise resulted in more than 60 per cent of heart stem cells becoming active. In adults these stem cells are usually dormant.
After only two weeks the rats had increased the number of cardiomyocites, the ‘beating’ cells in heart tissue, by seven per cent.
Professor Jeremy Pearson, associate director of the British Heart Foundation, said: ‘This study adds to the growing evidence that adult hearts may be able to make new muscle from dormant stem cells.
‘However, much more research is now needed to find out whether what’s been seen in this study can be translated into treatments for human patients.’
The environment will improve, with or without the Greenies
A British view from Madsen Pirie
Despite all the scare stories, I’m optimistic that the next generation will live on a planet that is cleaner and greener, and probably nicer to look at.
Claims are made that our cities, rivers and coasts grow more polluted by the day. In fact some areas have improved considerably. The streets of late Victorian London were awash with horse manure, with children standing at street corners to clear a path in exchange for a small coin.
City air was more polluted when nearly all homes burned coal fires. The London smog of 1952 killed an estimated 12,000 people in a fortnight, with theatres closed because audiences could not see the stage. It prompted the Clean Air Act of 1956.
In the late 1970s most London buildings were black, including Westminster Abbey, the Palace of Westminster and Whitehall. They were cleaned up only when the air became sufficiently soot-free to make it last. The Thames, once toxic to fish, now bears stocks of several species. Other rivers and coastlines are much cleaner than they have been.
Even air pollution from industrial activity is diminishing in Britain and most advanced economies. New technology makes this possible, and it is the poorer and up-and-coming countries that find it too expensive. China is building new coal-fired power stations at a rate of more than one a week, and plans to do so for at least a decade. It will make sense to develop the technology for cleaner burning so that it becomes affordable.
In fact one of the biggest aids to reducing pollution is the switch to natural gas-fired power stations, since it burns much cleaner. With maybe 100 or more years of gas reserves now extractable, the switch from coal to gas will have a major impact on pollution. The switch to electric vehicles charged from gas-fired power will dramatically cut the pollution caused by engines burning petrol or diesel.
The second Green Revolution in agriculture will increase yields from acres under cultivation and bring hitherto marginal land into use. This will give the rainforest more protection than all the pledges and treaties that have hitherto been resorted to.
In all of this it is technology, rather than behavioural change, that is making the difference and which will bring results. We do not have to live more simply, just more cleverly so that we can achieve our aims while leaving a smaller footprint. I have confidence in our ability to do this.