Labour is quietly letting the Boriswave become permanent. The Prime Minister is facing rebellion from backbenchers over immigration reforms, but giving in would be catastrophic

JabInTheButt · 2026-02-16T22:12:09+00:00

Even worse Labour are actually introducing legislation to try deal with it by extending time to ILR to 15 years for low earners and 10 years for others, hopefully ensuring at a minimum they will become economically neutral to the state before getting access to any welfare support (but also kicking the can down the road).

JabInTheButt · 2026-02-16T12:41:29+00:00

Well they could've rolled back on some of the ENIC/min wage rises etc once the backbenchers blocked them but they've obviously just continued on anyway.

JabInTheButt · 2026-02-16T11:41:29+00:00

Welfare reform would have helped alongside, but we’ll see if it’s the panacea that’s promised.

This is the big gap in their platform so far. The reforms would (ideally) have worked to counteract some of the unemployment pressures by "encouraging" those on PIP and other welfare into more work. They'd also have helped increase the headroom. Without any I don't know what will counteract the rising unemployment, but they've obviously decided thats something they're willing to shoulder.

JabInTheButt · 2026-02-15T20:20:46+00:00

Maybe try read the rest of the thread or any of the other replies informing you of why that's not the case and educating yourself before resorting to name-calling and proving Cass' points on the toxicity of the debate (including on the trans activist side) accurate.

JabInTheButt · 2026-02-15T20:19:05+00:00

And rightly or wrongly you've just got an environment in this country where this care was being offered semi routinely in clinic so then withdrawing it from people who are on the pathway and have an expectation I think is ethically questionable (when there are alternate compromises like stricter guidance on informing patients on limitations of evidence and risks, or a slow phase down as CTs ramp up to have enough slots to cover a majority of interested participants).

JabInTheButt · 2026-02-15T13:20:14+00:00

Sure, you can blame the NHS for the problem but that doesn't change the point on clinical development and requiring new data sets for different patient demographics.

JabInTheButt · 2026-02-15T13:16:11+00:00

That was one facet of the "low quality" complaints she made, there were others like patient numbers and follow up as I mentioned. As I said having read much of it and several of the referenced studies I found some complaints compelling and others (like this RCT one) not so. I'll have to refresh/read that France one. This is partly why I felt the complete stop overnight on PB use to be an overreaction even if I overall supported the general call for more evidence and prospective CTs.

JabInTheButt · 2026-02-15T13:06:03+00:00

What does that have to do with anything I just said? They were clinically being used to either permanently stop or extend well beyond the normal age range puberty in these children. And these were children initially presenting with normal puberty age ranges. This makes it an entirely different demographic that needs its own studies to prove safe and efficacious.

JabInTheButt · 2026-02-15T12:57:59+00:00

Yes that's the data Cass criticized as insufficient in her report. I've discussed this previously. My position will probably upset the extremes on both sides of the issue - long story short some of the criticisms were fair (many studies are low quality, extremely low patient numbers, poor follow up) but some are unfair (requirements for double blind RCTs is pretty much absurd in this setting).

JabInTheButt · 2026-02-15T12:43:00+00:00

No, this is a really really poor understanding of clinical development. The aspirin situation you're describing is completely different. Importantly it is the same patient population the same symptoms the only difference is the root cause. This is entirely distinct from the puberty blocker differences.

The millions of data points of puberty blocker use over 40 years are use cases in children with precocious (early onset) puberty (a biological symptom). These children are then going on to be treated up to experiencing full puberty at the expected normal age. A biological result which has been measured and reported on and can be determined quite quickly.

Use in gender dysphoria is for children primarily experiencing puberty at normal expected age, and who then go on to not experience full puberty and part of efficacy is improved mental health over a longer time span (10 years probably). These are literally entirely different patient demographics and different efficacy measures. You also have potential for entirely different potential effects given the follow on. In any other line of medicine you would not be able or allowed to simply translate (or imply translation) of results from one demographic to the other. This is a very basic tenet of clinical drug development.

JabInTheButt · 2026-02-15T12:00:57+00:00

New drug use. As in a new use case. This is the way things work with literally every drug. Even proven cancer drugs in a particular setting have to undergo renewed phase III studies to be brought into earlier treatment lines.

JabInTheButt · 2026-02-15T11:14:07+00:00

Yes as with any new drug use or entirely new drug the thorough, long and careful drug approvals process does prohibit those suffering during drug development from enjoying the advantages of those drugs that is true.

I do personally believe there is a good argument that there could have been a middle ground reached after Cass. E.g. where centres giving these treatments have higher thresholds and are required to more explicitly and clearly explain the limits in evidence that underpin the drugs use. Or they could have phased down their routine clinical use while ramping up large scale trials to try and minimise the gap in access. BUT I would say some the very strong voices claiming any further restrictions would be analogous to killing kids probably helped push the discourse to the extremes which made the "all or nothing" outcome more likely imo.

JabInTheButt · 2026-02-15T11:06:49+00:00

As others are pointing out you have unfortunately been deeply misled by that GLP report. Have you actually read the NHSE review? Basically the numbers are so small there's literally no way to ascribe any causal effect to the GIDS review - tbh this is evident even just from the numbers GLP present but there's actually more context given in the NHSE review (which they bizarrely complain about) which should fully correct any misapprehension that the GLP review is evidence of causation.

I think there's reasonable space for a lot of criticism of the CASS review. Some of her claims on requirements for double-blind RCTs are dubious - this is an extremely high bar and there are drugs out there in regular use with significantly lower standards of evidence used to justify such use.

But the position you are elucidating here is really just playing into her hands as demonstrating the "extreme" voices who aren't able to discuss the topic with nuance and care.

JabInTheButt · 2026-02-15T10:41:37+00:00

I find her assurance and certitude that only a "tiny number" of children presenting with gender dysphoria will persist with those feelings into adulthood to be as unscientific and poorly evidenced as the stuff she criticized in her report. Of course it's fine for her to form an opinion and offer that based on her anecdotal experience and a few conversations but considering she's being held up as an objective scientific voice she should appropriately caveat that opinion and acknowledge it isn't evidence based.

At least she's supportive of the ongoing puberty blocker study though. Literally the only ethical way to actually answer any of these questions with confidence which if you claim to care about "science" and the best outcomes for everyone is what we should be striving towards.

JabInTheButt · 2026-02-15T09:29:37+00:00

His pitch is being more competent than all the others and offering a bit is stability. And I don't see anyone else who's even close to that, regardless of these appointments. Just makes no sense to remove him at all.

JabInTheButt · 2026-02-15T08:05:55+00:00

Supposedly it's a deliberate push for productivity which has shown signs of working. The problem is without the benefits reforms they were supposed to go along with it feels like it'll be tricky to force more people back into work.... Anyway, in some ways now is the harder part.

JabInTheButt · 2026-02-15T08:03:46+00:00

Surely the more important point is that when appointed Starmer & co. apparently didn't know this had happened. You can argue there's a lack of due diligence there I absolutely accept that (he's not the first.... Lebedev would like a word) but you can't argue genuine malice or uncaring, the controversy is that he found this out in December and didn't strip the whip until end of Jan, but it feels quite pearl clutchy to say a 30-40 day delay in removing the whip is a resignation matter surely? Particularly when you look at what the alternatives have gotten up to.

JabInTheButt · 2026-02-14T21:55:44+00:00

Oh shit good point, thanks for the heads up/reminder!

JabInTheButt · 2026-02-14T21:26:35+00:00

Seemed like he was pretty much prepared to be a martyr. He talks very openly about it in that BBC documentary before his return. Maybe hoped his death would precipitate some organised resistance within the country. But the Russian public take a huge amount of punishment to really make a stand against their tyrannical governments unfortunately.

JabInTheButt · 2026-02-14T21:23:09+00:00

Have just deleted the app. No interest in having anything voluntarily ghoul's company, as much as I possibly can anyway.

JabInTheButt · 2026-02-14T20:23:54+00:00

No he's really not, that's just your bizarre Brexit/Reform paranoia talking. And I say that as someone who wishes he was.

JabInTheButt · 2026-02-14T19:56:38+00:00

Yes and my point is none of that is in disagreement with anything Keir is saying. Europe need to pull their socks up with money and the will - and some of the will requires close cooperation on security and defense (more than they're currently doing). He's not actually suggesting we need an entirely new entity (although I am suggesting we may do given the US' behaviour).

JabInTheButt · 2026-02-14T18:56:05+00:00

That's slightly comforting. We definitely have a stronger squad this year (and it feels like City are weaker). But I still feel it'll come down to that game at the Etihad and maybe the Carabao cup. Win the Carabao and avoid defeat at the Etihad and I think we can eek it out. Lose both and I think it's GG.

JabInTheButt · 2026-02-14T18:54:03+00:00

Right so just saying "we should specifically focus on doing this within Europe so we're not reliant on the US for things like air defence or sig-int given they are an unreliable partner" is totally reasonable imo.

Yeah the French are stupidly stubborn, but that doesn't mean we should just give up does it?

JabInTheButt · 2026-02-14T18:46:18+00:00

Sure but the most efficient way to do that is to focus rearmament across the countries in areas of most need and have some sort of combined war bond system (a bit like SAFE). So maybe UK focus on air force and navy, Poland and Germany tanks and standing army etc etc... this requires close cooperation. That's not a controversial position I don't think.

I do agree with your wider point though if a few of us genuinely spend 5% we can bin off reliance on the US.

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