Welcome to Perspective’s newsletter, our view on what’s been happening over the past week, bringing you some of the best independent writing on current affairs, culture, history and life in general. (If this email has been forwarded, you can subscribe here).

Don’t diss London

I live in tranquil Cambridge, where everyone rides old bicycles and looks like Eddie Redmayne in The Theory of Everything – even the Russian spies. So, it’s a culture shock when I prepare to visit my London office. There’s the armour required for Farringdon’s constant jihad and, if I’m travelling to a “no go” zone I need Mad Max’s War Rig and Charlize Theron to escort me to safety. Which is all Sadiq Khan’s fault for giving “our capital city away to his mates”. Although his critics can’t quite decide if these mates are mad mullahs or fellow Net Zero villains like Justin Trudeau (you decide, see our interview with Khan).

Yes, I’m talking about the London mayoral election last Thursday which gave “plain-speaking” Reform UK (former Tory) MP Lee Anderson a fresh chance to claim that Khan is being controlled by Islamists. Far off in Wisconsin, Donald Trump said mass immigration was making London “unrecognisable” and had opened our capital’s “doors to jihad”. While in February Tory MP Paul Scully claimed parts of Tower Hamlets are “no-go areas”. I say bollocks to the lot of ye!

Here's the thing. I’ve been walking around London – often on my own, by night – for 38 years now. Yes, things have changed. Drug and knife crime’s soaring (everyone’s reeling after the senseless murder of fourteen-year-old Daniel Anjorin). But those most affected by gang violence are the lost young men who join gangs and kill one another, for want, it seems, of constructive alternatives. You can’t single out Khan for blame when successive mayors, governments (and other cities) have failed to stem the rising carnage. For change, we need radical solutions and cross-party cooperation.

As for terrorism… My youth was punctuated by IRA attacks and I was shocked awake in Clerkenwell when the 1993 Bishopsgate bomb detonated. Many felt London was a “no go” zone then. It’s true Jihadist terrorism has supplanted the Irish kind – not unconnected with our greater interference in the Middle East. But equally, MI5 keeps a weather eye on far-right terrorists, whereas radical lefties were once seen as a threat. The danger has changed, but it’s not unprecedented. Happily, large-scale protests have become more orderly (yes, even the Gaza ones, which Jewish friends attend) with only fringe elements trying to disrupt them. Look at the 1980s’ Poll Tax and Brixton riots for true, bloody turmoil.

Meanwhile, King’s Cross, once a rat’s nest of pimps and criminals, is infinitely more salubrious than it was in the 1980s. Ditto Shoreditch, Battersea, Shepherd’s Bush and Vauxhall. I could go on FOREVER. And lest you think I never go anywhere challenging, I often stay close by Roehampton’s neglected Alton Estate, where I go for solo runs after dark. Yes, I stick to well-lit routes with bus stops, but I take the same precautions in Cambridge.

The truth is we fear what we don’t know or understand. And Trump, Anderson and Scully don’t comprehend the great beautiful diverse beast of a city that is London. Khan does, which is why he’s still mayor.

Unhappy kids on “happy” pills

The Cass Report’s conclusions on puberty blockers given to children at the Tavistock and other clinics made welcome reading for many of us. The long-term effects were clearly unknown and Perspective contributors as different as bestselling author and trans woman Diana Thomas and Observer leader writer Sonia Sodha have each expressed opposition to the medication. But what I feel has been missed in this noisy debate is a far wider, longer-running scandal – the desperate shortfall in provision for mental health issues in young people.

Child and Adolescent Mental Health Services (CAMHS) are so understaffed and dire that most parents I know find them worse than useless. If you’re earning enough to muster cash for private therapists, they have waiting lists a mile long. And the complexities of young people’s distress – especially post-covid and lockdown – tests even the most seasoned medics’ wisdom. They’re dealing with ADD, ADHD, OCD, eating disorders, self-harm, gender and body dysmorphia. It’s all ramped up by social media, inequality, our poisoned planet, war drums and a hopeless future. “School refusal”, meaning children with anxiety so overwhelming they can’t face the classroom, is rampant, affecting hundreds of thousands. These youngsters need support, help and an overhauled education system with trained counsellors in every school.

But what do they get? A two-year waiting list for CAMHS. When/if you do secure an appointment – by which time the child is suicidal or lashing out – the beleaguered shrink tends to suggest antidepressants. In other words, yet another relatively novel medication never intended for the highly plastic work-in-progress that is the teenage brain. SSRIs are prescribed all too readily, though they’re hard to wean yourself off and worked little better than placebos in original trials. They also have side-effects: some people feel their emotions are suppressed, others report a drop in libido, still others become manic. Readers who’ve been tracking the over-prescribing of “happy pills” may remember the Seroxat scandal and the link to suicides in young people.

I’m not an anti-meds zealot or a psychiatrist. I believe numerous lives are improved or saved by appropriate use of antidepressants. However, I know from personal experience how swiftly they’re offered to teens in lieu of other measures. In 2023 over a million prescriptions were issued to kids aged 13-19 for the first time. Campaigners have said we’ve “chemically castrated” young people by giving them puberty blockers. I worry we’re numbing a far greater number because we don’t have better solutions for our mental health epidemic.

Britannia hospital

I’m so tired as I type this that every blink threatens to weld my eyes shut. The overhead glare of the A&E waiting room – where I’ve just spent ten hours and 56 minutes – remains burnt into my retina. Last night I’d sat down to write a very different article for this newsletter, but a distressed call from a young relative who’d taken a freakish fall (no drugs or alcohol involved) and “face-planted into the corner of a brick wall” saw the night turn out differently. These days everyone has their own NHS horror story. But it’s only through experiencing reality first-hand that you fully grasp what our “world-beating” health service has become.

Like every quest, our hospital journey can be divided into stages. We set off with all the innocence and confidence of Frodo Baggins and Samwise Gamgee in search of Mount Doom. My young relative’s face resembled a Halloween mask, but the wounds weren’t life-threatening; A&E was busy, but not overflowing. So we settled in to the processing area with that uniquely British sense of camaraderie: stiff (or swollen) upper lip and gritty determination. There were no frills – not even a water point – but this was the NHS, where all wait equally, without fear or favour. After three anxious hours we were summoned into the inner sanctum, behind the card-controlled door.

The blurred mental borders of the next seven hours lay somewhere between hope, worry, boredom and sheer frustration. Did I mention despondency? Every hour or so, hope would rise: a junior medic would take his (perfectly normal) blood pressure, and another would appear to repeat the same questions about what happened. But not once did anyone engage with the wounds or try to clean them. Even when blood erupted from behind a self-administered plaster, it took twenty minutes to locate some gauze to stem the flow. Sometime around 5am an administrator in an incongruous pink tracksuit spontaneously brought us and our fellow long-haulers some stale sandwiches. “I used to be proud to work here,” she told us. “Now I just feel shame.”

It’s tempting to let that be the last word, but the reality is more complex. I later learnt there were just four doctors, all junior, servicing emergencies in that large London hospital that night. At some point it became obvious that our all-night vigil was a charade: there was no chance of being seen until the morning shift arrived. Everyone knew it. Worst of all was the sense of resigned acceptance by patients and staff alike. This was the new normal and as the pink-tracksuit lady told me: “It’s getting worse.”

It is not that the level of medical skills has declined. When the morning cavalry arrived, just before 9am, my relative received the high-quality care long associated with the NHS. But it followed eleven hours of indifference. It’s easy to blame overcrowding, but the ward was not particularly full that night. You could say the NHS needs more money, but to the lay person the statistics are ambiguous – showing healthcare expenditure as a percentage of GDP declining, but overall funding on the increase. Wherever that money is going, it’s not into care at the coalface. And so, grateful as we felt when we skirted the lengthening A&E queue and emerged into a blustery spring day, it was hard not to sense that the NHS is just another victim of the profiteering, corruption and rot that is eating away at Britain’s ulcerated guts.

More about the state of the NHS on our website:

Echoes of 1968

My generation has distinct memories of the bad old days on college campuses. Through the late 1960s and early ’70s they were the staging grounds for sometimes violent protests over America’s military involvement in Vietnam and a military draft that sent so many young men to their deaths. Students walked out of classes, closed schools and occupied buildings, reaching a crescendo, of sorts, in 1970 when four students were shot and killed by the Ohio National Guard at Kent State University.

What came of it all? Not much, apart from young people brandishing their First Amendment right of free speech. The far-away fighting dragged on another five years before the US lost the war and more than 58,000 servicemen in the process. Nor did it help that Robert McNamara, defence secretary through much of the conflict, confessed in a memoir twenty years later that America’s involvement was a mistake and he knew it all along.

These thoughts came flooding back last week as I watched dozens of campuses around the country erupt in violent protests, demonstrations, tented occupations and confrontations with police over the Israel-Hamas war and US military support for Israel.

But to me, parallels with the campus protests of yore are valid only in their sound and fury. The animating issue back then was a distant war and misguided US policy that provided human fodder for it. Today’s protests reflect a swirl of interconnected “isms” that invite counter arguments of equal passion. Anti-Semitism. Colonialism. Zionism. Nationalism. Racism. Woke-ism. And dare I say it, Narcissism.

For now, the protests remain on campus. Looming are the Republican and Democratic conventions this summer, for presidential nominees to be certified. When Democrats met in Chicago in 1968, police clashed violently with anti-war protestors, drawing attention away from the official proceedings and staining Hubert Humphrey’s anointment. Months later, he lost to Richard Nixon.

It’s a safe bet protestors will greet Republicans in Milwaukee in July and Democrats a month later in Chicago. This bodes well for neither party. With their nominees assured – Donald Trump and Joe Biden – the conventions are drained of suspense, leaving TV cameras to roam outside in search of the real action.

The protests of 1968 had no bearing on the war, and the public sympathised more with the police than the demonstrators. Therein lies a message for today’s protestors: Unless the “isms” are resolved, nothing much changes.

Book of the Week

Enlightenment 
By Sarah Perry
(400pp, Vintage, £20, hb)
Reviewed by Louisa Young

It’s great news when Sarah Perry falls in love. Her passion for a mysterious East Anglian sea monster led to the phenomenon that was her second novel, The Essex Serpent; in Melmoth she obsessed over the loneliest being in the world. And now she has fallen in love with a comet. Who can blame her? We will all be in love with comets, the way she writes. It’s not just that her stories are so compelling and their stuff so interesting, it’s that this woman’s prose could write you into love with a brown paper bag.

Our hero is a dignified middle-aged man, a (sometimes) strict Baptist, second cousin in some ways to John Cole of  Perry’s first novel, After Me Comes The Flood. Thomas Hart dresses calmly, has no visible private life, lives by the railway in a small Essex town and writes a column for the local newspaper. He also goes to London to make merry with handsome boys, but that’s a character switch which takes place on the train, for obvious reasons, and ne’er the twain shall meet on the wrong territory.  His heart’s devotion is to a young girl from Chapel, Grace, a beautifully drawn, tough, feral, innocent animal of a girl. Their friendship is a delight (until it’s not). Life is quiet. But there’s a ghost, an untold story, a telescope, movements in the stars and stirrings from history. There’s a sinking Big House, a lost grave, a mysterious vagrant in a filthy red velvet coat, and a handsome boy who breaks a window in the chapel with a stone which hits Grace on the head; how she longs for a scar…

We all know that Perry can weave a deeply unsettling mood out of a few drops of mist, a flash of fabric and a drift of passing scent. Some may have the urge to make a cull of her adjectives, but  personally, after reading this (and reading it onscreen, which I hate and never do) I will openly swear there is not a word out of place here. Plenty else is out of place: for the first quarter I had trouble reconciling details of the period, which seemed at once 1880s and the 1980s it claimed to be: knitted shawls and litter-strewn riverbanks; strip-lighting and virgin maidens. But of course this is part of it: you can only give yourself up. Perry is right back on form, with her rustling Rumanian lady-ghost, her sugar-dredged cakes, her dripping, malevolent nature waiting to get you, her wit and wisdom and almost throwaway aperçus: “That he was a man of seventy surprised him every morning in the mirror, and he’d removed the clock from his bedside table, disliking the slicing tick that pared down the remaining time to a little stub,” she writes. And: “You can’t expect to feel only one thing at a time,” said Thomas, “though certainly that would be convenient. You can want to see her, and want not to see her, and neither cancels the other out: you are a woman, not an algebraic equation.”

It is easy and delightful to relish the mud and the terror, the lost letters and the beautiful eyelashes, buildings burning and lakes flooding and mysterious signs appearing on damp, crumbling walls. There is a classic hilariously horrible character in Lorna, painted and hypocritical, plus some of the best bad weather you’ll find anywhere (which makes sense for Essex) and a thread of feminist reclamation of history. But by the end, astronomy and quantum physics are dancing a complex yet vital waltz with love, twining the Gothick atmosphere with Carlo Rovelli, EM Forster’s Only Connect  and Jeanette Winterson’s “Everything is relational, everything is about our interaction with something else”. 

I reeled out at the end, seeing stars, my head spinning, and went straight to the letterbox searching for the printed copy, so I could read it again as nature intended.