The heartache of losing my baby was made more painful by the NHS’s callous indifference
From the second those two blue lines appeared on the pregnancy test stick, I’d looked forward to breathing in my baby’s scent and nuzzling its soft, downy cheeks.
In the first few weeks of my pregnancy, I’d fantasised about the wonderful life that lay ahead for my little one. Already the proud mother of a 20-month-old little boy, I had hoped to be blessed with a daughter — beautiful, clever and kind — who might one day become a doctor or an artist — and even a loving mother herself.
But Mother Nature had other plans: eight-and-a-half weeks into my pregnancy, I started to bleed and was referred for an ultrasound scan to the North Middlesex Hospital, close to my London home.
As the image of the tiny baby growing inside me emerged on the screen, I dug my nails into my palms, waiting anxiously for the nurse to tell me all was well. Instead, she said: ‘Helen, I’m afraid I can’t find a heartbeat.’
It took a few sickening seconds for me to compute that no heartbeat meant my baby was no longer alive.
Feeling winded — as if someone had kicked me in the stomach — my first thought was that April 19, 2004, the day my baby was due to be born, no longer had any special significance for our family.
The news was all the more difficult to bear as the previous day, a casualty doctor had told me he could ‘confidently say’ I was not miscarrying, despite the bleeding, and that he was referring me for a scan merely for my peace of mind.
However, it was not this false hope that caused me the most distress. It was the events that followed my sad discovery in that stuffy, windowless ultrasound room — treatment so inhumane I would be shocked to hear of it happening in a Third World hospital — that haunt me today.
So when I read last week that the NHS watchdog, the National Institute for Health and Clinical Excellence (NICE), is demanding that staff be retrained to show ‘dignity and respect’ to women who have miscarried babies, rather than treating them as though they are on a heartless ‘conveyor belt’ system, I was relieved and angry in equal measure.
Angry, as I imagined all those women who have suffered this loss in the nine years since my own miscarriage — up to one in three pregnancies ends this way — being treated as callously as I was. Relieved because it seems at last that someone has finally realised that women like me deserve real care and consideration.
Before my own miscarriage, I hadn’t given much thought to what losing a baby entails, but had assumed that an unviable embryo would naturally expel itself without much pain or fanfare, a bit like a menstrual period.
Yet, as women who’ve experienced traumatic miscarriages will know, this isn’t always the case.
Following my scan on that mid-September morning, I was asked by a matter-of-fact doctor if I wanted an operation to have the baby suctioned out of my womb.
Surgery would be undertaken under general anaesthetic — something I would have preferred to avoid, given the risks, however small those might be.
But the alternative was to let nature take its course: bleed heavily — possibly for weeks — and perhaps discover, among the blood loss, my tiny, lifeless embryo.
Squeamish and scared, I booked to have the operation, named Evacuation of the Retained Products of Conception (ERPC) the following day.
I was not offered counselling, and not one of the medics — who were, granted, rushed off their feet — so much as spoke to me about how I might be feeling.
Neither did they explain what was likely to happen if the baby expelled from my uterus of its own accord. I don’t recall even being told a great deal about what the surgery would entail.
At the very least, a woman whose dreams of a new baby have, in the blink of an eye, been replaced with the fear of undergoing an operation deserves a kind word or reassurance.
Back home, as the only person who had a physical connection with the baby, I felt isolated in my misery. How could I expect my husband to have bonded with our baby the way I had? So I bottled up my feelings.
I was also aware how common miscarriages are, and felt pressured to get over my loss and move on.
At the age of 35, I was no stranger to grief, having lost my father and sister — and, of course, I knew this would be far easier to recover from than their deaths.
My husband, Dillon, took the following day off work so that he could drive me to hospital for the operation and arranged for our son, Daniel, to go to nursery.
I was told not to eat or drink anything after 6am in preparation for theatre, and to call at 10am to check if there was a free bed on the ward.
When I rang, none of the staff knew whether there would be a bed available, and a nurse said someone would get back to me shortly.
I sat by the phone, fantasising about soothing cups of tea, the essential British cure for trauma, and waited. I wasn’t just on hold physically, but emotionally. I didn’t feel I could begin properly to grieve for my loss with the baby still inside me.
Having heard nothing by 1pm, I called the ward again. Still no news. When I phoned back at 3pm, I was told someone should already have informed me that there would be no bed that day and to try again the next.
By then dizzy with thirst and hunger, and feeling too vulnerable to challenge their lack of consideration, I bit back tears — and asked my husband to put the kettle on.
The following day, again having not eaten or drunk in preparation, I rang again, as requested, and an hour later went into hospital.
Staff spent two hours searching for my medical notes, delaying my admission to theatre, and I asked everyone who passed by my bed when I would be taken in. But no one knew.
My husband nipped out periodically for sustenance, sparing me — with my dry mouth and rumbling stomach — the torment of watching him eat.
During this time I don’t recall receiving a single word of comfort or condolence from any of the doctors, nurses or ancillary staff I came into contact with, all of whom made me feel they had far more important things to be dealing with than me.
Added to this was the fact that I began to suffer from a crippling migraine — triggered by the dehydration. After nearly 24 hours without food or drink, I had such thirst that my tongue stuck to the roof of my mouth and I felt sick with hunger.
With nothing to distract me, I became terrified and grappled with images of dying during surgery and my little boy having to grow up without his mum. Irrational, maybe, but there are laws forbidding even the most vicious criminals being deprived of food and water, because it is torturous.
Discovering that I wouldn’t be admitted to theatre until after 9pm was the final straw, and I broke down sobbing in my hospital bed. Struggling to come to terms with the loss of our unborn child, I found the prospect of a night apart from my son unbearable.
Every inch of me ached with the need to feel the pudgy warmth of my toddler in my arms. Having never spent a night away from him before, I could not stand to have to wait until the following day to see Daniel.
So I discharged myself. Not giving a moment’s thought to the emotional — not to mention physical — state I was in, the staff made no attempt to hide their displeasure over my decision to leave.
And instead of guaranteeing that the surgery would take place the following morning, I was told I’d have to wait four days for a re-scan to see if my womb had expelled the ‘remains’ itself.
If nature did take its course, I was instructed to store whatever came away and bring it to the appointment so that the ‘tissues’ could be analysed.
I spent two days housebound, terrified to go out in case the baby ‘came away’. On the third day, I was persuaded to go for a walk in Highgate Woods.
Sitting on a bench in the playground, watching my husband push Daniel back and forth on a swing, I started having painful contractions, something no one had warned me to expect.
I staggered off to the public toilets, clutching my stomach, and, alone in a cubicle, discovered a tiny, transparent sac with my baby inside.
Too small to tell if it was a girl or boy, it looked just like the diagrams in pregnancy books of an eight-week-old foetus. Sitting on the loo seat, I wept for this poor little mite, who we’d so looked forward to welcoming into our family.
In need of a hug, and at a loss to know what I should do, I gently wrapped the baby in loo paper, put it in my handbag and went to find my husband and son.
‘The baby’s out,’ I told Dillon, struggling to find the right words to describe what had just happened.
He put his arm around me as our son looked on, perplexed by my sad face. Huddled together, our little family of three walked back to the car. Had the surgery I’d opted for gone ahead on time, as planned, I would have avoided such trauma.
I was relieved when a scan the following day showed that all the ‘tissue’ had come away and there was no longer a need for an ERPC.
But when I told a nurse that I had kept the embryo and had it with me as instructed, she explained that, as this was my first miscarriage, it was unlikely any analysis would be carried out.
When a woman miscarries repeatedly, embryos are tested for genetic problems — but if it’s the first time it has happened, doctors write it off as just one of those things.
So when she handed me the saline jar to deposit the embryo, I felt a little foolish. She was clearly humouring me. It was unspoken — but we both knew my baby would simply end up in an incinerator.
Tears rolled down my cheeks as I said ‘Goodbye, little one’ — conscious that this would be the only motherly duty I would ever perform for a baby I had so looked forward to nurturing. I never heard anything more about what happened to my baby.
As soon as I felt strong enough, I sent a letter of complaint about my treatment to the hospital’s then Chief Executive, Clare Panniker.
Her reply, which arrived more than a month later, said: ‘Unfortunately we are unable to guarantee when a patient will have an ERPC as these are performed on the emergency theatre list, which is prioritised according to medical emergency.
‘I am, however, aware that this system is highly unsatisfactory, something which your unfortunate experience has highlighted only too clearly, and I have asked that the process be reviewed as a matter of the highest priority.’
I don’t know anyone who has suffered the misfortune of being treated for miscarriage at the North Middlesex Hospital in recent years, so I cannot say whether things have improved.
However, NICE has clearly noted that women who have lost babies are still being treated brutally in many NHS hospitals.
I’ve been blessed to have two more children — Isobel, eight, and Christian, four — since my miscarriage. They were born, at my request, at a different hospital.
Watching them this week with their big brother Daniel, now 11, in a rare and precious moment of unity trimming our Christmas tree, I felt a pang for their brother or sister who never made it.
In an over-stretched, under-funded hospital that baby may not have counted for much, but I will never forget my little one — and will always wonder what might have been.
Grandmother, 53, left lying in motorway fast lane for an hour waiting for ambulance to take her to hospital after car crash
An injured grandmother lay drifting in and out of consciousness on a freezing motorway fast lane for nearly an hour waiting to be taken to hospital following an horrific car crash.
Jan Arbabi, 53, was pulled from the wreckage by her husband Ramin after the couple’s Peugeot 207 span into the central reservation, flipped over and rolled on the M60 in Greater Manchester. But Mr Arbabi was unable to drag his stricken wife from the fast lane.
Other drivers stopped and switched their hazard lights on to protect the scene and gave Jan first aid. Though an ambulance was called at 9.54pm and arrived 15 minutes later, paramedics didn’t have a spinal board to move Mrs Arbabi and it was only when a second ambulance arrived at 10.45pm that she could be taken to hospital.
Mrs Arbabi said: ‘It was very cold and very, very frightening. ‘Why we had to wait so long for the ambulance I don’t know, I’m not happy about having to wait like that.
‘I want to know what went wrong as I don’t want anyone else to go through that. The accident was a horrible experience, I just remember it seeming silent apart from the sound of me screaming. ‘We were so lucky to escape.’
The grandmother of five was a passenger in the couple’s car when a fox ran out across the anti-clockwise carriageway close to the Bredbury junction. Mr Arbabi swerved in a bid to avoid the animal but the car went into a spin.
His wife said: ‘It was like something out of a Stephen King film, from the start when the fox ran out to being left lying in the fast lane.’
Jan and Ramin, 58, had been visiting friends in Chester, Cheshire, when the accident happened on December 13. It was only by chance that the second ambulance with the spinal boards turned up at all. It was flagged down while en route to another accident nearby on the opposite carriageway where a mother and daughter had been cut from the wreckage of a Renault Clio with serious injuries.
Fifteen minutes later, another ambulance arrived to take Mrs Arbabi to hospital. Fortunately both she and her husband escaped with cuts and bruises and were discharged the following day.
A spokesman for the North West Ambulance Service said: ‘We are sorry that the patient feels that they did not receive a timely response from us.
‘We received the call to attend the road traffic accident at 9.54pm. ‘An ambulance arrived at the scene at 10.09pm and commenced treating the patients involved. Following an assessment of one of the patients, a second ambulance was requested which arrived on scene at 10.45pm.
‘We would be happy to discuss the incident in more detail if they wish to make contact with us.’
Up to 90,000 students ‘in Britain illegally’: Thousands fail to attend courses and some don’t even register
Ministers have been notified of up to 90,000 foreign students who may be living in Britain illegally.
Audits by universities and colleges have thrown up tens of thousands of students who may have broken the rules by failing to attend their courses or even register.
In August, London Metropolitan University had its licence to bring in foreign students after inspectors found thousands of illegal immigrants were studying there.
Since then, hundreds of other institutions have been examining their books to find if they have students who should not be in Britain.
The Border Agency revoked the Met’s licence after it discovered a quarter of overseas students sampled were in the UK illegally and around half may not have been attending lectures.
Problems have also been discovered at Teesside university and Glasgow Caledonian university.
UK Border Agency chief executive Rob Whiteman told the Home Affairs committee it had received 90,000 notifications since the Summer.
He said: ‘We are now working through them. We have a new team in the new year in the Liverpool area which includes some DVLA staff transferring over and those 90,000 notifications we have received will be processed by the end of March in terms of triaging them, making a decision on whether there’s important information in them.
‘Because the student notifications are greater than we expected – the London Met position led to a great many notifications coming through – we have created an additional team.’
Immigration Minister Mark Harper told the Committee that revoking London Met’s highly-trusted status had served as ‘a lesson’ to colleges and universities over ‘what would happen if they didn’t meet their sponsorship requirements’.
‘I think perhaps if they weren’t taking that seriously I think they will do now,’ he said.
Mr Whiteman also admitted that the Agency had found a backlog of 50,000 applications from immigrants which have not been entered into the UKBA database.
He said it should be cleared by March.
Committee chairman Keith Vaz asked Mr Whiteman if he could confirm the size of cases for entry to the UK that have been received but not put on the agency’s database.
After hearing the figure was 50,000, Mr Vaz said: ‘You have given me a straight and astonishing number.’
Mr Whiteman said the backlog would be cleared by March.
He said: ‘You must remember we receive one million applications a year. We work on the basis that we want all cases put on the system in a week.’
Last week Home Secretary Theresa May said she wanted to eradicate the abuse of the student visa system and encourage only the ‘brightest and the best’ to come to Britain.
Lord Ashcroft: British voters defecting to UKIP because they are fed up with political correctness
Voters are defecting from the Conservatives to Ukip because they are fed up with political correctness, not because of Europe, Lord Ashcroft said today.
The major Tory donor and Number 10 adviser said Ukip is stealing voters because many are uneasy about “the way life is changing in Britain today”, fuelled by unhappiness about immigration and a benefits culture.
Amid polls showing a surge of support for Ukip, Lord Ashcroft commissioned new research showing 12 per cent of Conservative voters would side with Ukip at the next election. Half of those turning to Ukip are former Tories, he found.
It also showed that just seven per cent of Ukip voters say Europe is the single most important issue for them. It ranks behind economic growth, welfare, immigration and the deficit.
However, he said Ukip’s general outlook, rather than policies, is driving support.
“Certainly, those who are attracted to UKIP are more preoccupied than most with immigration, and will occasionally complain about Britain’s contribution to the EU or the international aid budge,” Lord Ashcroft wrote on his ConservativeHome blog.
“But these are often part of a greater dissatisfaction with the way they see things going in Britain: schools, they say, can’t hold nativity plays or harvest festivals any more; you can’t fly a flag of St George any more; you can’t call Christmas Christmas any more; you won’t be promoted in the police force unless you’re from a minority; you can’t wear an England shirt on the bus; you won’t get social housing unless you’re an immigrant; you can’t speak up about these things because you’ll be called a racist; you can’t even smack your children.
“All of these examples, real and imagined, were mentioned in focus groups by UKIP voters and considerers to make the point that the mainstream political parties are so in thrall to the prevailing culture of political correctness that they have ceased to represent the silent majority.”
He identified the typical Ukip voters thinking “Britain is changing for the worse”.
“They are pessimistic, even fearful, and they want someone and something to blame,” he said. “They do not think mainstream politicians are willing or able to keep their promises or change things for the better. UKIP, with its single unifying theory of what is wrong and how to put it right, has obvious attractions for them.”
However, the peer said David Cameron can win round dissaffected voters by “delivering our promises on immigration, that welfare reform is both firm and fair, and evidence that the right decisions are being made on the economy”.
His comments come after Ukip had a strong showing in the recent by-elections, coming second in Rotherham and in Middlesbrough and third in Croydon North.
Vince Cable, the Liberal Democrat Business Secretary, said the party “should be taken seriously” given its growing support.
Polls have recently shown Ukip getting between seven per cent and 14 per cent of the vote, taking their support to a record high. According to a new Populus poll for The Times, the Tories have dropped six points, leaving them with 29 per cent of the vote, with Labour remaining at 40 per cent and Ukip rising six points to gain 10 per cent of support.
Britain’s drift into becoming a new East Germany derailed in the House of Lords
The House of Lords is one of the few constitutional safeguards in Britain but it can only do so much against a determined government
Cabinet minister Ken Clarke gave ground on the Justice and Security Bill after a series of defeats in the Lords. He told MPs that judges, not ministers, will have the right to decide what is heard in secret, even in cases of national security.
But he admitted that secret hearings could be used when families of dead servicemen sue the Government for negligence. Mr Clarke also insisted that closed proceedings are necessary in cases where suspected terrorists claim mistreatment, to allow evidence from the security services to be submitted.
Ministers have agreed that plaintiffs in civil trials should also have the right to request a secret hearing, not just the Government. They have already ditched plans to hold inquests behind closed doors, following a campaign by the Daily Mail.
At the second reading of the Bill yesterday Mr Clarke told MPs: ‘The Bill leaves it to the judge to decide what is necessary in any particular case, rather than seeking to impose disclosure requirements or fetter the discretion of the judge in deciding whether to have a closed process.’
The government has previously had to pay out millions to suspects because they cannot defend the charges without compromising the intelligence services.
But critics reacted with fury after Mr Clarke also revealed further details of the circumstances in which secret courts might be used. In such cases the government’s evidence is not even disclosed to their opponents lawyers.
Asked whether legal cases brought by the families of service personnel over the death of a loved one as a result of MoD failures could see the use of secret courts – known as Closed Material Procedures (CMPs) – by the Government, Mr Clarke responded, ‘This could actually arise’ in cases where a soldier dies in a ‘highly secret operation’.
He said: ‘I can’t rule out that a CMP application would be made.’ Mr Clarke also refused to rule out that the Government could make use of secret hearings in claims where they might face embarrassment over arms deals, in response to a question from Jeremy Corbyn MP.
Clare Algar, Executive Director of human rights pressure group Reprieve, said: ‘At last the Government has admitted the wide range of circumstances in which these dangerous plans could be used.
Ken Clarke has accepted that secret courts could be used in cases where the MoD has neglected its own soldiers, or the government has been involved in dubious arms deals.
‘Once these plans have passed, ministers will find irresistible the prospect of using a secret court to avoid embarrassing disclosures over negligence or wrongdoing. Parliament must vote against plans for secret courts, or risk putting government above the law.’
Isabella Sankey, Director of Policy for Liberty, said: ‘Our politicians continue to tinker around the edges of a Bill that would change our justice system forever.
‘These concessions are minor nips and tucks, and leave the chilling prospect of secret justice intact. Even the architect of the draft Bill now admits secret courts could apply to many more cases than the Government was originally prepared to admit.”
Tory MP David Davis condemned the proposals as threatening centuries old liberties.
‘What part of this Bill does today is create the power to take parts of the civil judicial system not only out of the public domain but completely out of the normal judicial testing procedure.
‘Evidence can be presented by the Government which the other side cannot see and even the defence lawyers cannot see, that evidence cannot be tested and therefore may be wholly wrong and misleading. This undermines the very thing that makes the system work.’
British schools plan overhaul of 11-plus to beat ‘middle-class tutor factor’ that sees some children coached from the age of five
Clueless. This will just advantage the children of well-connected parents even more. Make the system even more obscure and whom do you think will suss it out?
Grammar school entrance tests will be made ‘tutor-proof’ amid evidence that coaching for middle-class children begins as young as five.
Kent, Britain’s biggest education authority, today unveiled plans to revamp the 11-plus within two years to ease the ‘pressures’ of coaching on children.
Tuition typically begins months before the testing date, with some parents hiring coaches from the early years of primary school.
Under plans to introduce tests ‘as resistant to coaching as possible’, parents and tutors will no longer be able to buy past papers or practice tests.
To test understanding rather than exam technique, questions will be made tougher and less formulaic.
They are likely to focus more on material covered at primary school, instead of requiring pupils to work through endless ‘reasoning’ multiple choice options.
Pupils may also face a new test of reading comprehension and more assessment of their writing skills.
The review was launched amid fears from grammar school heads that bright children from disadvantaged backgrounds are overlooked because they miss out on coaching which helps youngsters reach the highest marks.
Robert Masters, head of the ‘super-selective’ grammar The Judd School in Tonbridge, Kent, criticised a ‘culture of coaching’ that may lead to bright children from poorer homes being ‘leap-frogged’.
Kent’s 11-plus currently comprises tests of maths, verbal reasoning and non-verbal reasoning. There is also a writing task, which is taken into account in the case of borderline candidates.
Councillor Mike Whiting, Kent’s cabinet member for education, is leading moves ‘to design a new approach to assess ability more appropriately – and in a way that is less coachable’.
Changes are expected to be introduced in time for testing in 2014, for entry in September 2015.
The initiative in Kent, which has 33 of the country’s 164 remaining grammars, is likely to be watched closely by other areas where selective schools still exist.
‘Scrooge Academy’: Parents’ fury as Christian primary school bans Christmas nativity play from the timetable
Parents have renamed a Christian primary school the ‘Scrooge Academy’ after it banned Christmas from the timetable.
Oasis Academy has decided there will be no nativity play for its pupils because of its poor academic performance.
The school in Nunsthorpe, near Grimsby, whose students are aged four to 11, says the festivities would interrupt pupil learning as it strives to improve achievements in maths and English.
Parents believe the children are being deliberately punished because the move came just days after the school, prior to its academy conversion, was ranked last out of 44 in North East Lincolnshire in Department of Education Key Stage 2 rankings in Department of Education Key Stage 2 rankings.
Amanda Markey, whose child attends the school, said: ‘They have stolen Christmas from the children.It should be called the Scrooge Academy. Where is the fun?
‘They can take children out of class for assemblies but they can’t find the time to organise a play? To say they cannot have Christmas until their grades improve is really unfair.
‘Surely getting the students to learn a script for a festive play would aid learning, and the performance would build confidence. How can that not be of benefit to their education? The children are really disappointed; it has really affected them.
‘Why can’t they have a bit of fun on the last days of school?’
Helen Merriman-Sellars, 38, whose daughter Bethanie, 6, attends the school, said Christmas could have been incorporated into the children’s lessons.
She said: ‘While I agree that the school needs to focus on education, with a bit of planning they could easily have incorporated things like a nativity into lessons. It’s educational for the children to learn about things like that and it’s also an important part of their childhood.
‘They are not at secondary school level, they are just primary school children. There’s also been a lot of bad feeling because the school left it so late in the day to tell us. If they were going to do this, they should have communicated it earlier to save as much upset.’
A spokesperson from Oasis Academy Nunsthorpe said: ‘The academy realises that some parents are disappointed that we’re not putting on a Christmas play this year.
‘This is because such plays take many weeks of rehearsal time and, given the current context at Oasis Academy Nunsthorpe with very low standards of attainment , the academy needs to prioritise and focus rigorously on raising standards in English and maths for all our students.
‘To do this, our students need to focus on their school work throughout the term. However, this far from means that we’re not having any other Christmas activities and celebrations at the academy and these include a visiting theatre company, special Christmas assemblies, a Christmas fair, carols around the tree and a Christmas dinner for students and their parents to attend.
‘In the future, when education standards have been notably raised at the academy, there will be an opportunity to re-introduce termly music and drama productions without compromising the students’ entitlement to success and progress in key areas such and reading, writing and maths.’
And a spokesperson from the Oasis group, which runs the academy, said: ‘There is a certain irony to the situation, in that people would think a Christian organisation would try to cancel Christmas.
‘Christmas has not been cancelled and there have been other festive events put on instead of a nativity play.We understand that might upset some parents but we are trying to do what is best for the students.’
Britons living longer than previously thought
Britons are living far longer than previously thought with no sign that we are reaching an ‘upper limit’ of how old people will get, a new report has shown.
Figures from the Office of National Statistics published yesterday suggest that most people are living six years longer than current life expectancy projections.
Presently the official life expectancy for a baby boy born in England or Wales in 2010 is 79 years and 83 for a girl.
However, for the first time the ONS has looked at the most common age for people to die in recent years. This analysis shows that most men will live to 85 while the majority of women will survive until 89. And it is likely to increase for children born today.
It means the traditional idea of a person’s “allotted span” being “three score years and 10” is dramatically out of step with the experience of people in 21st Century Britain.
And past predictions that average lifespans would eventually hit an ‘invisible wall’ around 90 years may need to be revised, say statisticians. They say there is no obvious sign of an “upper limit” to ageing being reached.
In its report on mortality, the ONS said that it was clear there is now a year-on-year increase not only in centenarians but so-called “super-centenarians” – those aged over 110.
But the figures also show that, for the bulk of the population, the typical lifespan has also increased significantly in recent years.
The report compared the figures with theories from demographic experts in the 1980s that although people are living longer there is still a “boundary” beyond which few would expect to live.
It concludes: “The existence of an upper limit to life expectancy is much debated, as we have seen continued increases in life expectancy at birth over the last 50 years of around two and half months per year for males and slightly less for females.
“The information presented in this report suggests that in England and Wales an upper limit to lifespan has not yet been reached and that we will almost certainly see further increases in the average [age] at death.”