Woman's Hour - Child strip searches, Dr Sam Roberts of NICE

Episode Date: August 8, 2022

In 2020, a black 15-year-old schoolgirl, known as Child Q, was strip-searched by police while on her period after being wrongly suspected of carrying cannabis. A safeguarding report on the incident concluded it was unjustified and racism was "likely" to have been a factor. New data published by the Children’s Commissioner has found what she calls a “concerning” number of children have been strip-searched by the Metropolitan Police without an appropriate adult present. BBC reporter Celestina Olulode joins Jessica to talk us through this data and we also hear from Jacqueline Courtenay, a mother from North London who organised a rally about this issue. It's the end of an era - the actor playing Peggy in The Archers is hanging up her mic at the age of 103. June Spencer has played the matriarch since 1951. Her last appearance was on Sunday's omnibus edition. Camilla, the Duchess of Cornwall was a big fan of Peggy's, calling her, "a true national treasure who has been part of my life, and millions of others, for as long as I can remember". Felicity Finch who plays Ruth Archer, has known June for a long time and tells Jessica how the rest of the cast has reacted to the news.Following the launch of the Women's Health Strategy we speak to the new chief executive of NICE - the National Institute for Health and Care Excellence. The agency makes recommendations to the NHS in England and Wales on medicines, treatments and procedures. Dr Sam Roberts took up the post in February 2022. Before joining Nice, she was Managing Director of Health and Care at Legal and General but began her career in clinical practice and spent some time working as a junior doctor in a London hospital.How does it feel to reach the age your Mum was when she died? Our reporter Jo Morris talked to three women whose stories are different but who all feel that the age their Mum passed away has shaped their lives. First, Rachel lives in Devon with her family. Even people who know her really well, don’t know about a feeling she’s been keeping secret.The Commonwealth Games ends today and what a couple of weeks it's been. England have come second, after Australia, in the medals table with Scotland 6th, Wales 8th and Northern Ireland 10th. Across all sports there have been a lot of success for the home nations women. Jessica is joined by Jeanette Kwakye, former Olympic athlete and BBC broadcaster.

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2, and of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme. Peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. Hello, I'm Jessica Crichton. Welcome to the Woman's Hour podcast. Yes, good morning. Welcome to the programme. We'll be discussing the new figures that show the biggest police force in the UK, the Metropolitan Police, strip searched 650 children between 2018 and 2020. Months after the controversial Child Q case came to light, in which a black 15-year-old girl was strip searched at her school, the Children's Commissioner says this was not an isolated case.

We'll be speaking to a mother worried about the particular impact being strip searched has on young girls. And as always, this morning, we'd love for you to get in touch with us. There's an exciting new way that you can do that because Woman's Hour is now on WhatsApp. Yes, you can send us voice notes, pictures, even videos. We're asking this morning whether there are any women who have continued to work or take up hobbies later in life, much later in life. You might have seen that actress June Spencer has retired from the Radio 4 drama The Archers, aged 103 after spending more than 70 years on air. How incredible is that? There's also a 93-year-old woman called Betty who's just been strapped to the

outside of an aircraft doing loop-the-loops. You can watch that video on the BBC website. And to make things even more remarkable for Betty, it's not even her first daredevil stunt. Incredible. So our WhatsApp number is 03700 100 444. That's 03700 100 444. Data charges may apply depending on your provider. So you might want to use Wi-Fi if you can, and you can find the terms and conditions on our website. And of course, you can still get in touch in all the usual ways as well. So for text, it's 84844. Text will be charged at your standard message rate. On social media, we're at BBC Woman's Hour, and you can email us through our website.

Also this morning, we'll be talking to the woman now heading up the National Institute for Health and Care Excellence. Her organisation will play a key role in carrying out the new women's health strategy. We'll also be discussing how NICE make the decision whether or not to fund different drugs. Dr Sam Roberts will be with me live in the studio a little bit later. But first this morning, new figures released today reveal a worrying number of children are being strip-searched by the Metropolitan Police, many without an appropriate adult present. It comes just months after the case of Child Q came to light

when, back in 2020, a black 15-year-old schoolgirl was strip-searched by the Metropolitan Police officers whilst on her period after being wrongly suspected of carrying cannabis. The strip search happened at her secondary school in East London without another adult there. A safeguarding report on the incident said it was unjustified and racism was likely to have been a factor. The Metropolitan Police have apologised and said the officers' actions were regrettable. They declined our invite to come on the programme this morning. So was the child Q case a one-off or is this a regular occurrence? Well, I mentioned those new figures released today and between 2018 and 2020, 650 children were strip searched between the ages of 10 and 17, and almost a quarter of

them without an appropriate adult presence. This has led the Children's Commissioner Dame Rachel D'Souza to believe there is a systemic problem around child protection within the Met Police. Here she is speaking earlier this morning on a Today programme. 25%, about a quarter of them had no appropriate adult there. Now this is the a Today programme. 25%, about a quarter of them, had no appropriate adult there. Now, this is the most intimate search. So these children have not been arrested. They have literally been picked up for stop and search and then a decision's been made to do a strip search.

They're taken either to a police station, to home. One in five cases, we don't even know where they were taken. And they are basically their most intimate visual search is done. Now that's incredibly traumatic. Yeah no question that this is a very traumatic experience and the Met do know that and they are making improvements. So now an inspector has to sign off if officers are going to do this but to me that's not enough. As well as doing good policing, there is a responsibility for all of us who work with children to make sure that children

are safeguarded and their well-being is put first. So that means in this case, there should be an appropriate adult there for this most traumatic of searches. And I think we should be thinking about safeguarding before, during and after these searches and also really asking whether these searches are appropriate. You know, in 50% of those 650 searches, 50% of them, no further action was taken. Now, that makes me wonder whether they were actually done, whether there was really any point in them being done, especially given the intrusive nature and the aftermath, you know, the suffering that the children undergo. Children's Commissioner Rachel D'Souza, they're speaking on the Today programme. So let's get some wider context now from our BBC reporter,

Celestina Olulode. Celestina, good morning to you. Can you just remind us of the Child Q case and why it was so controversial? Yes, Jess. Well, first, I should tell our listeners that there are some distressing details in this case that happened at the end of 2020 when a black 15 year old schoolgirl, as you said, who's being referred to as Child Q was strip searched by two Met Police officers. They were called to her school because she was suspected, wrongly suspected of carrying cannabis. She was on her period when the search was carried out and the police made her take off her sanitary towel. No drugs were found and no appropriate adult was present at the time of that search.

Now, you've mentioned the safeguarding review there and what that found. The governing body of the East London School where the incident happened have apologised, so too have the Met. Charles Kew, though, and her school are suing the Met Police and the school. And the case is being investigated

by the Independent Office for Police Conduct. So I mentioned that earlier, that data that's been published today by the Children's Commissioner. What does that show exactly? So between 2018 and 2020, 650 children were strip searched. Over 95% of them were boys. And in almost a quarter of these cases, no appropriate adult was present. Now, the data also shows that in 2018 specifically, black boys represented 70% of the strip searches conducted without an appropriate adult present. And I think what's really significant about all of this is I've been looking into this case since March and I was at a rally in Hackney. There were hundreds of people there marching in support of Child Q and they they were coming up to me saying we're scared to send our kids to school because how many other cases are there like this?

And they said to me that what if child Q hadn't have told her mother? So it's obviously had quite wide reaching effects. But what have the Met Police have to say? Well, in a statement, the force said that it understood the lasting impact that strip searches can have. It added, though, as well, that in there are occasions, it says, that when these searches are very necessary to prevent harm to children who may be exploited by gangs, county lines and drug dealers. And the force says that it's already made changes and introduced new measures. So it conducts strip searches when they believe they are very necessary but what's the criteria? So according to police guidelines a strip search must only be carried out on when there's suspicion of drug or weapon concealment and this is the crucial thing an appropriate adult must be present

according to the guidelines unless the child says so. But crucially, their parent or guardian must be informed beforehand. That didn't happen in the case of Child Q. And the police watchdog, the IOPC, said that these searches should only happen, again, in the presence of an appropriate adult and in a way that maintains a child's dignity as much as possible. But the Child Q cases, as we understand it, isn't an isolated incident. There are other cases currently being investigated by the IOPC. What can you tell us about those? Yeah, so the police watchdog says that it's already looking into several cases involving

strip searches by Met police officers. And about a week ago, the BBC reported that the Met police said that it's now made a total of 14 voluntary referrals to the police watchdog relating to strip searches of children. And that number includes the case of child Q and another child whose mother says that her child was also on her period when she was strip searched and the IOPC says immediate steps must be taken to ensure the Met carries out these searches in a way that ensures that the best interests of the child and safeguarding needs are a primary consideration. So the Met obviously covers the boroughs of London. Do we know strip searches on children are being used in a similar way by other police forces in the country?

Yeah, so in terms of England and Wales as a whole, figures obtained by the BBC, which were reported on in May, found that there were 13,000 strip searches of young people aged under 18 over the past five years. Now, in fact, the BBC sent a freedom of information request to 43 forces in England and Wales, plus the British Transport Police, and only 31 forces provided data. So we could say perhaps that the true number of searches is likely to be significantly higher. Now, the commissioner said that she has asked all the forces in England and Wales to send her such data. Celestina, thank you for the moment. Thank you for the insight there. Now, in May this year, Radio 4's File on 4 investigated this issue and heard from a mother whose daughter, also a 15-year-old black girl, was strip searched after being wrongly arrested for robbery.

Her words have been voiced by an actor. They've pinned her to the floor and they used, I don't know whether it was a knife or a pair of scissors, to cut off her underwear in front of these grown male officers, which I feel is it's not right. Well, listening to that with me is Jacqueline Courtney, who organised a rally outside Hackney Town Hall back in March after the treatment of Child Q first came to light. As a result of this, Jacqueline has recently been invited to join the Independent Advisory and Scrutinary Group for the City of London Police Force. Good morning, Jacqueline. Thank you for coming into the studio. How did you feel listening to that mother talking about her daughter being strip searched? It's gut-wrenching, I think. And it takes me right back to when I heard about Child

Q back in March. Hearing, well, hearing it, reading about it in the safeguarding review that brought all of this to light is what propelled me to organising that rally. What was it specifically about the Child Q case? What made it so horrific for you? There were so many reasons, but I'll pick out, say, four or five. Firstly, motherhood. That is at the centre of this story for me. Being a mother of myself, mother of three, I felt aggrieved on behalf of Child Q's mother for the way in which her parental authority was so severely undermined. As Celestina said, she wasn't contacted. She wasn't informed about what was happening. The silence as well that we often see when cases like this happen was another thing that propelled

me into action. I didn't want to be silent anymore. I wanted not just to be heard, but to also for the community to be heard because I felt like this was a needed conversation. The timing of it also annoyed me that during a pandemic, December 2020, which is a very disruptive time for children in their learning, especially those sitting crucial exams at the time, such as Shark Child Q, I feel that the school was, their behaviour was egregious in the way that they added to that disruption and almost elevated it. And then also I'm a big, I have a big interest in something called the social contract theory. And the social contract theory is basically about us as everyday people giving our rights over to the government and the state and for them to democratically lead us and, you know, protect us.

And I don't feel that the state did that in this situation through the police, through the school, And for them to democratically lead us and, you know, protect us. And I don't feel that the state did that in this situation through the police, through the school, which is a complete breach of the social contract, in my opinion, this whole case. And finally, Ubuntu, the African philosophy of showing humanity to others. And that's something my mom told me to mention today when I came here. She said, make sure you go tell them about Ubuntu and I mentioned that because the value is a solidarity rally it was a way to to not only bring healing but also create a safe space call for change and show solidarity with child care. In light of all of that then then, in your eyes, is a strip search of a child ever justified or necessary? I don't believe that it is. I understand the Met's points when they say that sometimes certain situations they do need to go to that level.

But let's think about how we, what actually takes place here. What takes place is when a child is strip searched. Sorry, I'm struggling to find the words because you're talking about intimate searches of a child who was supposedly smelling like cannabis. That doesn't mean that you need to go to that extent. You can ask the child, you can search their bag, and then their, you know, their general person, but do you need to go down to checking every bodily orifice of them? I don't think you do. I think that's incredibly dehumanising. And it isn't really something that we would even, a way that we would treat our hardened criminals. So why are we treating a child who's in a mock exam room in that way? It blows my mind. I think about the fact that not to bring the school into this too much, but I think about how fee paying schools.

I took the liberty before I came here of looking up some policies of fee paying schools and how they treat drug misuse in their pupils. And what they do is they check, they search them. They sometimes do drug tests on the children or with parental permission. And going to the police is almost the very last resort when we're talking about fee-paying schools. The school that Chalky attended was not a fee-paying school. It's a mainstream school.

And I think that's really important here. We're talking about race, we're talking about class. There are certain children that are being targeted by the police. And they, unfortunately, because of their race and class, the police feel they're able to treat them in these ways. Yeah, that was one of the concerns brought up by the Children's Commissioner when she said that race perhaps is playing a part in this. What do you think is the reason for the majority of these children, the 650 between 2018 and 2020, being of black heritage? What do I make of it? What's the reason behind it? What's the reason behind it? I think it takes me back to structural racism, institutional racism. What's the reason behind it? And before that, in 1984, the Scarman Report, which both of which, despite being almost decades apart, seek to undermine that there is any racial inequality.

And I think that is what is at the heart of this, that the police do operate with serious racial prejudice, that they operate with archaic views about black people, fundamentally. Let's be clear here. And I think that is what is at the heart of this. And it hasn't been dealt with. The institutional racism that the McPherson report mentioned has not been dealt with. Well, of course, the Met Police aren't here to represent themselves and to counteract your claims, but they do say that they've made changes

since these figures have been released. And even before that, off the back of the child Q case coming to light. They've made changes to the policies when it comes to children being strip searched. Are you happy with that response? Not really, because when we're thinking about these strip searches where there's no appropriate adult in place or no supervision, as the guidelines say they should and the policies say they should, you can revise policies as much as you want. But if in practice, if the people who are conducting the searches, the officers are not applying those policies, they're just mere words on paper. They're not, you know, they're not being brought to life. They're not, you know, they're not being brought to life.

They're not being practiced in the spirit of the policy. So I don't take that as an adequate response to this. How much do you worry about your own children? Incredibly. And that's why I have decided to be a school governor at the school that my kids attend. I am there to be a symbol of a listening ear and a critical friend to the school and to make sure that my face as a black woman is present on

the governing board and ensure that if there is ever a situation concerning race, that there will be somebody conscious there who is willing to hold the school to account, hold the, you know, whatever needs to be brought to, you know, forward and to be discussed openly and honestly, that I will be able to do that or try to. Well, as I mentioned before, the Metropolitan Police declined our invite to come on the programme this morning, but they did send us a statement in which they say that work is progressing at pace to ensure children subject to intrusive searches are dealt with appropriately and respectfully. We recognise the significant impact such searches can have. We have already made changes and continue to work hard to balance the policing need for this type of search with the considerable impact it can have on young people. Now, I know as well, Jacqueline, that you're also working with the City of London Police Force, which operate differently to the Met.

They're not part of the same police structure. But working with them so closely, what are you hoping to achieve? I suppose the issues that the Met Police have come under, you're hoping that that doesn't happen with the City of London Police Force. Absolutely. I'm hoping through my involvement in that group, the IASG, that we will be able to advise and really scrutinise the way in which they operate, how they conduct searches. I was born at a time when SUS laws were, you know, were being assessed for their veracity. Just explain what SUS laws are, sorry. So SUS laws come from the Vagrancy Act, basically.

And it's a shortened version of suspected person. And essentially, these are the ways in which through sus law, sorry, so stop and search, black people in particular, were being criminalized at a far higher rate in the 1980 of these strip searches and various other forms of police brutality. And so for me, it's important that we have a watchful eye on what's going on and how it's being practiced. And I just wanted to say one more thing about strip searches. In Hackney, over the same period as the Child Q case, so 2020 to 2021, there were 29 further searches conducted conducted by local police officers and 25 of them were done to children and of those 25 searches 22 of them that's 88 percent were negative with an outcome of no further action um so what that tells us is that there's an inherent problem that children who should never end up in the presence of police are ending up there, regardless of their proximity to drug use or not.

And as I said earlier, because of their race and their class fundamentally. Yeah, that's clearly something as well that the Children's Commissioner brought up in the fact that some of the cases don't lead to any further action after these children are strip searched. Celestina and Jacqueline, thank you for coming into Woman's Hour this morning.

Much appreciated. Thank you. Now it's the end of an era. Peggy from The Archers is retiring at 103 years old. Well, actually, it's the actor playing Peggy who's hanging up the mic, and that's June Spencer. She's played Peggy since 1951. Her last appearance was in yesterday's Omnibus edition. Camilla the Duchess of Cornwall was a

big fan of Peggy's calling her a true national treasure who has been part of my life and millions of others for as long as I can remember. With me now is Felicity Finch who's played Ruth Archer for over 30 years so has known June for a very long time indeed. Haven't you Felicity Finch, who's played Ruth Archer for over 30 years, so has known June for a very long time indeed. Haven't you, Felicity? Good morning. Did you know that June was going to retire before you heard last night's edition? I heard very recently that she was going to retire. But what I didn't realise was when I was listening, I listened to yesterday's Omnibook to catch up on the week,

and I didn't realise until this morning that the scenes that I heard yesterday were June's last scenes that she was recording. I was so shocked, and I feel quite, I have to say, I feel emotional about that, that I won't actually see June in studio again, and that's quite difficult yeah I can imagine after working for so many years with each other how are the rest of the Archers team reacting well we have a whatsapp group and this morning my phone hasn't stopped pinging so

people just say oh my god I didn't realize you know that yesterday was the last episode we'd hear and what an inspiration she is what a role model is you know to have somebody that you know I think one of the really strong things about the Alpachers program is the multi-generational aspect you know the huge cross-section of characters from very young, in fact, two babies just been born, right through to, you know, the older members of the cast. And that is so important. So, you know, somebody like June is, you know, she really is an inspiration. I mean, she's lived through the different changes in, you know, throughout the century, let alone the, you know, Archer's life, the way it has changed over the years.

Well, tell us, what's her secret? You've worked with her. How has she managed to keep on going to past the 100? I honestly don't know. She just has, you can, you know, I remember when I first saw her, when I first started in the programme, back, you know, as I said, over 30 years ago in 1987, she struck me as being a cross between,

when I looked at her, a cross between the queen and a prima ballerina. She has that amazing poise, that amazing, you know, natural, innate stature. And I think, you know, I think it's that how she's lasted so, you know, wanted to be in the program for so long is that obviously she's kept her health,

which has been brilliant. We know you have to travel to Birmingham to do the Archer Archers you're not doing it on your doorstep you know she lives um you know on the other side of London but uh I think it's that she you know it means so much to her radio being an actress it's her you know it's her identity it's what her passion the program you know what happens you're growing you're growing with the character so as June has grown older so Peggy has grown older and vice versa and I think just that you know what happens to your character over the years and what you bring to that is is always um um fulfilling um you know it never ceases to be fulfilling playing a character that you're going

on that journey with your character right through to the you know the end of your life and the end of the character's life and that doesn't sound morbid at all no no of course not but she has so many fans doesn't she including some from the royal family well yes i mean camilla is a is a huge fan and we actually attended um an event at count's house earlier this year and some people said it was difficult to tell who was the greater royalty because june was actually sitting in a chair and so many people just you know were going and chatting with her taking the food and generally making sure, you know, very chuffed that she was able to be there. Yeah, Camilla is a great fan of The Archers and, you know, somebody like June. Well, it's been wonderful to have you on, Felicity, and pay tribute to the magnificent actress that she is.

Thank you so much for coming on. Felicity Finch there, taking us through an incredible career that she's had. And to retire at 103 is absolutely exceptional. And I asked you, our listeners, whether there are any people out there, any women that you know, or maybe you're a woman yourself who has gone on to take on a hobby later in life or perhaps do daredevil stunts. And quite a few of you have got in touch someone here has texted in to say i worked for the nhs until i was 79 i am still self-employed now aged 80 that is absolutely brilliant someone else has said i'm an event florist and was bench trained by a florist 22 years ago. She turned 80 in June and is still arranging flowers.

Do continue to keep in touch with us. You can text, you can email, you can even WhatsApp us now as well. Now Listener Week begins on the 22nd of August. It's the week when you're in charge and you decide the agenda and the topics you want us to explore here on Women's Hour. So if there's something you're dying for us to discuss or someone you'd love to hear on the programme, do get in touch now via the website bbc.co.uk forward slash Women's Hour. You can text Women's Hour on 84844. Text will be charged at your standard message rate. On social media, it's at BBC Women's Hour, or as always, you can email us through our website. Now, the Women's Health Strategy was announced in the past month,

and you'll remember it was very widely discussed here on Women's Hour. The National Institute for Health and Care Excellence, or NICE, is one of the agencies whose job it is to carry out that strategy. Dr. Sam Roberts is the new chief executive and took up that post back in February. Before joining NICE, she was managing director of health and care at insurance company Legal & General. She began her career in clinical practice and spent some time working as a junior doctor in a London hospital.

Good morning to you, Sam. Thank you for coming into the studio. Good morning. Six months into the job then, have you been able to achieve what you wanted to achieve in that time? It's a work of a moment. Well, I think NICE's job is twofold. One, getting the best care to patients fast, and two, ensuring the best value for your taxes. So that's the work of a lifetime. I suppose the question for us today is, you know, what's our role in the women's health

strategy and how do we think we're doing on that? So there's a couple of things we need to do. One, make sure that when new technologies or medicines come our way that benefit women, that we're able to make kind of decisions about those quickly and in the best interests of society. So I think we're doing pretty well on that so far. 15 of the last breast cancer medicines that we've seen have all been approved since 2018. So I think that's pretty good. Two is we need to be constantly looking where there's new evidence on health issues that are important to women and constantly updating our clinical guidelines, which kind of describe to the NHS how women should be cared for. So we're looking at menopause and fertility at the moment.

So has the recent Women's Health Strategy changed your priorities and changed the way NICE works? I think it's a continuum of an ongoing discussion. So it's been great because it's meant that we've worked very closely with the Department of Health on our priorities. We've potentially worked a little bit closer on research needs. So for example, an important issue for women like the use of testosterone in menopause is something where there's just not enough research for us to write guidance on. So we've worked really closely with the Department of Health to commission research in much quicker time than I think would normally be the case. So it's that sort of thing. It's an acceleration of a journey we've all been on for a while. So you mentioned a couple of issues that you'll be looking at in

terms of women's health. Go into a bit more detail about those. What specific health conditions will you be looking at? Yeah, so the way we do it is actually women's health is one of our most active areas. So we've got a suite of guidelines that we look at and we constantly speak to patients, clinicians, look at the medical research to say, where's something new coming up? And then the minute we see something new coming up, we commission a new guideline or we look at the new medicine. So the specific areas we're looking at at the moment on the guideline side are menopause and fertility. Okay and what specifically are you looking at? How does it work when you write up these guidelines? What are you looking for and what are you hoping to achieve? Yeah so what we're hoping to achieve is that we communicate

what's best practice to the NHS, to clinicians, patients, managers, so that those services can be commissioned and they can be put into practice. So how do we do that? Well, we scan through all the literature. We do, because what we're trying to figure out is what works and what is good value for taxpayer money. So we scan through all the literature, we do all the analyses about what's good value and what isn't. We involve patients and clinicians and others who work in the service in independent committees who look at all the evidence and then they make a decision.

And based on the decision, we write it up into advice that is available on our website and used to kind of describe the care that the NHS should be providing. It's thorough, isn't it? It takes a long time to produce these guidelines. Yeah, so we're always balancing kind of rigour, transparency, independence. Those things are our hallmark and we're never going to move away from them. With speed, it's important to patients to get access to care as fast as possible. And we really learned a lot during COVID with this. So historically, our guidelines had taken maybe two to three years sometimes to draft

because of all the work I've described that goes into them. But during COVID, we realized we can't wait that long. So our first COVID guideline, I think, took less than a couple of months to develop. So we've taken that learning now and we're saying, how can we take kind of the COVID magic and move that into some of our other guidelines and a medicine's approval work? So that's one area that NICE deals with in writing up guidelines. But another area is whether or not to approve drugs. Now, two cancer drugs have recently been recommended by NICE. Tell us about those.

And the evidence suggests that for one of those drugs, it gave women with breast cancer more time, but the drug was rejected back in April. What can you tell us? Yeah, so when a medicine comes to us, we look at two things. Does it work? And is it good value for your taxes? So there's an analogy here, which is like if you were to go and buy a car and you went to the dealership and all the performance data was there, all the independent assessments, all the driver's experiences were all collected in one place and you got a good price,

well, you could buy the car straight away, right? And so it's the same with us. If we get a good price, all the evidence we need to say yes, then we can say yes pretty quickly. But if like when you're at the car dealership, it's not a price that you can afford, all the data's not in one place, you're still waiting for the experts to give some advice on what the car's like to drive, then you may have to go back to the dealership a couple of times until you're comfortable that this is the car you want. But in the meantime, people are having shorter lives, are passing away. How do you deal with what's at stake here? Because these are life and death decisions you're making, even if you don't have all the information straight away yeah absolutely so the um what we need to balance is that we know that this medicine works because that's i mean that that has

got severe consequences should we not get that decision right and secondly that it is good value for taxes so those um those days and weeks where we ask for more information we really balance the are we worried that by asking for more information we're delaying unnecessarily versus actually we need that information because it's absolutely crucial that we make the right decision for patients around the country. And I mean, judging by your career background, you're very aware of the fact that this is life and death. You worked as a junior doctor in the 90s, didn't you? But you described it as one of the scariest jobs you've ever had. Has that influenced the way you make

decisions now that you're in this job and now that you're in health management? Yeah, absolutely. And I think it's scary because as you say, these are life and death decisions and there's a sense of urgency every day in healthcare that I think we feel it nice. We know those decisions are impacting patients, carers, clinicians every single day. But what else is good about having studied medicine is you're very steeped in the science, in knowing that you have to be certain and rigorous and transparent and independent in your assessment. And so it's that kind of balance of the urgency, but also the rigor and the independence that I think NICE aims to embody. How do you deal with it on a personal level? Making those life and death decisions?

Yeah. So, I mean, it's always tough to have that responsibility. And what I think, the way I deal with it is looking at it from the perspective of society as a whole you know we are a taxpayer-funded health system if we cannot get you good value for your taxes society as a whole is going to be worse off for it if we can't get the majority of patients fast access to medicines then patients as a whole are going to be worst off. So we kind of see ourselves as the custodian of the NHS and patients as a whole. And that's the thing. That is, and that must be a tough thing to weigh up for you on a daily. Now, there's a report in today's newspapers claiming the NHS is running short on childbirth pain relief.

Epidural kits and the drug that women are offered as an alternative are in short supply. Drug shortages seem to be quite a common occurrence. Would you agree? What's holding up supply? There's also been some kind of shortages when it comes to HRT treatments as well. What is holding up the supply? What's the problem here? Oh, I'm afraid you found me in an area which is not my remit, which is kind of the supply chain for medicines and other areas. So that's really an area that the Department of Health looks at. Our role is more about figuring out what is the best care that is good value for your taxes. Yeah. And that's a big part of it, isn it because the NHS under more pressure than ever to save money and that impacts your choices that you make. Does it

impact it to the point where you can't make the decisions you want to make perhaps? No it actually doesn't. So our decision criteria aren't really affected month by month by the financial situation of the NHS. What we do do, however, is we're acutely aware of staffing shortages, etc. So we're constantly scanning for where are their technologies which are best for patients, good value for taxes, and perhaps put less pressure on the NHS. So a good example of that is something like a continuous glucose monitor, which we approved last week, which, you know, gives patients more control over their glucose, means they see the NHS more, less, and it's good value for your taxes, and they live and patients live longer and healthier lives. So there are kind of solutions that we're constantly scanning for where you can get kind of the best for everybody. Yeah, I'm seeing more and more about this in the press with, you know,

there's talk of robots one day being able to diagnose this at some point, which for me is a bit of a scary thought. Dr. Sam Roberts, thank you very much for coming on the program. Dr. Sam Roberts, they're the new chief executive of NICE. Thanks for having me. Now, how does it feel to reach the age your mum was when she died? Well, our reporter Jo Morris talked to three women whose stories are different, but who all feel that the age their mum passed away has shaped their lives. First, Rachel, who lives in Devon with her family. Even people who know her really well don't know about a feeling she's been keeping secret. My mum died very suddenly.

She had a stroke. My mum died very soon after her 40th birthday. So it was like two weeks later. So there was a big sort of celebration of this special age. And I can remember when we went to see relatives after she died, you know, people sort of making more of that sort of saying, oh, you know, 40 is supposed to be where life begins sort of thing. So that age has really, really stuck. It's been really significant. It's just felt like a bit of a deadline, really. I've never talked about it.

And therefore, because I haven't talked about it, I assumed it wasn't an issue for anyone else. I've never heard this mentioned before. And I thought it was just me being a bit neurotic, really. Somewhere along the way, in losing my mum at the age of 40, that decision in my head was like, right, that's my timeline then. That's what I'm working towards. I never expected to make it to 40. I shouldn't laugh at the end of that. Why are you laughing?

I don't know. Why are you laughing? Because it does sound bonkers. It does sound bonkers. And how Why are you laughing? Because it does sound bonkers. It does sound bonkers. And how old are you now? I'm 14 now. You've just reached the same age. Yeah.

Yeah, there's a lot of comparison going on between what I'm doing now and how she may have felt when she was that age. Because as a child, you don't think of your mother and what she goes through, you just think of her as a mum. Where's my dinner? Yeah, exactly. So, yeah, there's a lot now of sort of just, you know,

that empathy of where she would have been in her life. So how have you been feeling? Very reflective, I suppose, about being a mum and bringing up a family and prioritising a family. There's just a bit of paranoia really that things could just end very suddenly. I could tell my husband was worried about it. My dad's mentioned it before. What have they both said?

My dad was like, oh I'd be really pleased once you get past 40. I was like, oh thanks dad. When did he say that to you? I don't know, he said it on a couple of occasions when you were young or no sort of 30s and my husband's heard it and he's like oh you know that's that's worried him you know I was 12 years old and then suddenly she's just gone life is just completely flipped on its head nothing is what you thought it was going to be and nothing is all the parameters are taken away and personally I just felt very much on my own

you know that's no sort of disrespect to the rest of my family it was my approach of sort of dealing with it was to just be very independent and just to get on there's that sort of instinctiveness there and survival. But somewhere along the way, it was, yeah, I'm going to get on with life and I know that life is going to finish just as my mum's life finished and that makes perfect sense in my head. What was your mum like? Her name was Angela. She was creative.

She would make our clothes, sewing, knitting. She was working part-time, so I'm the youngest of four and I was creative. She would make our clothes, sewing, knitting. She was working part-time, so I'm the youngest of four and I was 12. So, you know, all the children were probably off to school and a bit more independent. I think it was just giving her a bit more time just to focus on some things that she liked to do. She was a really good cook, always cooked amazing dinners and roast dinners. You know, that was a huge part of our family, was to all eat together. And I don't have many pictures of my mum around. I don't really have family pictures up.

This was a typical after-dinner shot. My mum's probably thinking, oh, I just would like to relax for two seconds, and I've got my arms all around her, which is very much what my children do to me now. I'm just like, OK, can I just have five minutes? The old, like, they pretend they're giving you a massage, but it's a sort of intense squeeze.

Exactly, yeah. So she's trying to relax with what looks like a cup of coffee and a Bailey's on the side and the ashtray is there as well. It's taken quite a while ago before we decorated, so the lovely old curtains. So this is back in our family home. That was just life, you family home that was just life you know that was just I don't think I'm good at looking at photos because it's kind of like you didn't know what was gonna happen then you didn't know what was coming so that's quite sad in a way as well she's not done her hair life is busy bringing up four kids and

a dog and the house and there's something very special about life just being ordinary and no big dramas, the security of just having your family around. And that's what I really love for my children now. And I suppose that's what I fear most for my children now is that their world will be rocked in some way. It's a very strong feeling that you've had continually over the years. Yeah, but not consciously. Can you remember when you first had that particular feeling?

When I was waiting for the ambulance to arrive, when my mum died, that's a really vivid memory. And I think it was in that time that I decided this was it for me. I had this sort of thought in my head of being older and chatting to someone and saying, oh, yeah, my mum died when she was 14. She wasn't dead at this point. We'd just found her at home, but she wasn't actually dead.

And I think that was me sort of deciding then that that was how life was going to be and that was how life was going to be for me. It's really odd. You know, I had my first son when I was 35. Deep down, you can't sort of shift that ticking time is not on your side and time's running out the amazing thing in that is that you see the absolute absolute beauty in life and the world you know sort of moving to Devon was part of that just wanting to celebrate everything that is fantastic in in the world and in the environment and in nature you almost feel that intensely because you feel it's going to be

taken away so it's a good feeling but it's very closely followed by a fear really you know being frightened being frightened. So after your mum died did you talk about it at all in the family? Not really no I just remember going to the hospital and my grandparents arriving that was my mum's parents and and just bursting into tears I just remember crying as soon as I saw them and I think that was the moment where I don't know if it was directly said but it was kind of like hold yourself together you know not in a not in an aggressive way or in a bad way but it's like you know take a deep breath. And I don't think I've sort of stopped holding it in since then, really.

Friends who have lost people recently, it's so lovely and joyous to talk about their memories. And it's such a positive way to be. But it's kind of like, how do I bring my mum into conversations with people now, you know? And it's not a natural thing to do. And if I do, then I do just find it very emotional emotional so I tend to just sort of back that away really so what's this here what have you got here ah this is my very subtle cardigan that my mum knitted which now you've got to bear in mind that I was probably about 10 and this would fit me now, I think. I love that. Bright pink mohair.

Yeah, with some highly contrasting roses on. I think when I was at university, I probably wore it then. It's just a very special thing that I like to have and I don't hold on to much to do with my mum, but it might have been one of the last things she knitted. Does it smell of anything? It's just got a slight must to it. Despite being nicely kept under the bed in a box, it's still got that nice...

Do you remember her making it for you? I remember she was incredible at watching television and knitting at the same time and not dropping a stitch. If you need to remember your mum, are there certain things you do? A bit of Barbra Streisand, always, yeah you did you love barbara streisand a particular barbara streisand song guilty probably can you remember her yeah honestly it's just her. I don't know. I think it's a combination of just that time,

70s dresses and, yeah, the 80s perms. You know, it's all very much Babs. Yeah. I always remember her doing the housework with headphones on. She had a Walkman. So was it a surprise when you made it to your 40th birthday then, Rachel? It was, yeah, it was. And it was a really odd thing to actually think,

oh, I'd better do something. And I was so quiet about telling people I was going to be 40. It didn't feel like having a big party. I think there was still a bit of a, like, oh, I don't know, this could all go terribly wrong at the last minute. So what did you do on your 40th birthday? We went out for lunch, my two brothers and sister, my dad. So it was understated, but it was special.

Did you tell them how you were feeling? No. No. It's only since thinking about talking today I mentioned it to my sister that I was doing it and yeah bizarrely now however many years on she was saying the same thing I reached 40 I didn't die and that's when I really started to see myself as as me and think wait a minute I'm not my mum I'm not my mum and that you know actually saying that so I'm not my mum and thinking why have I never said that to myself before that is actually quite freeing and exciting it's not a scary feeling dare I look to you know being 41 42 43 and but I'm quite excited by the fact that there is no road map.

I think it's a very freeing feeling. Has it made you feel less lonely reaching out? Yeah, it has. It has. I've sent messages to friends who have lost their mum and I opened up a conversation with them about it and, again, been completely surprised that they've had similar feelings. It really does feel like being back in the world again. It feels like there's nothing bad that can come out of talking about it more.

It's not going to be an easy conversation to have with my family and to actually pick up the phone and say, you know, hey, should we have a chat? It's going to be huge. I love it. I love a bit of Babs a bit babsy yeah she is my connection that was rachel talking to our reporter joe morris now i'm really happy to say that you are absolutely loving our new whatsapp number so many of you have been getting in touch about the women that you know doing things in later life. Cass has WhatsAppped in to say, my mum has joined me on a new career path at the age of 80.

Together, we've started a micro greens farm during lockdown. It's transformed her life. Louise has written in to say, I have huge admiration for my mum who took up a second career going to uni, getting her degree in psychology at 52. She's now 83 and still working at the request of referrals. Do continue to get in touch with us on WhatsApp via text, email as well via our website at bbc.co.uk forward slash women's hour.

So incredible women there, but how about the incredible women at the Commonwealth Games? It actually ends today and what a couple of weeks it's been. England have come second after Australia in the medals table. Scotland were sixth, Wales eighth and Northern Ireland tenth. Across all the sports, there's been so much success for the home nation's women. From Ailish McColgan winning the 10,000 metre gold, then Silva last night for the 5,000 metres.

What about weightlifter Emily Campbell winning gold as well for England? And Rosie Eccles won boxing gold for Wales at light middleweight. It's been such an inspirational Games to follow, hasn't it? Yesterday, the England women's hockey team won gold for the first time at the Commonwealth Games beating Australia in the final. Captain Holly Pern-Webb said they took their inspiration from the England women's football team. We were all watching the game as a team in the village last Sunday. Women's sport in in this country has just escalated hugely over the past few years and especially women's team sports and we're just so pleased all of them.

So let's talk more about the success of the home nation's women who better to give us the lowdown than Jeanette Kwachi who's a former British athlete now BBC broadcaster good morning Jeanette morning Jess how are you yeah I'm doing really well I've been absolutely loving watching listening reading all about these women in so many sports over the last couple of weeks. What have been your standout moments, though? So many standout moments. I've got the privileged position of being track side at the Athletics, which was absolutely mind blowing for all six days of it. It ended yesterday. Ailish McColgan, definitely a standout as she was on the second night of the athletics where she won that 10,000

meters in a race that was just absolutely phenomenal especially the final lap and I think what made it sweeter for Eilish was that her mum of course Liz McColgan who's synonymous with distance running in this country was also there and she'd won it previously 36 years ago so to see her daughter do the same thing as a coach was amazing but as a mum I can only imagine was just such a proud moment so Ailish was fantastic. Katarina Johnson-Thompson's been brilliant at the track as well she was brilliant she retained her gold medal that she won on the Gold Coast four years ago so it's just brilliant to sit here and just watch these women in awe they're absolutely

fantastic it's been brilliant I've been really blessed you got to interview Ailish as well after she won yeah and it was it was interesting because Ailish is a character she you know she's such a proud Scottish woman you know you rarely get the emotion from her like that she she just goes out and gets the job done but you could just see how much it meant to her in the week to pick up that medal in the 10k that gold and then yesterday again in the silver and she actually said on air that you know it just feels like a bit of a dream and she came over and she was just completely overwhelmed by the level of support that she's been receiving and recognition because of course it's a home games and like I say a proud Scott who's worked really really hard to get to

this point so it was a joy to talk to her after and for Wales in terms of their boxing heritage we all know about that at the Commonwealth Games and a gold for Rosie Eccles what a win isn't that just brilliant Rosie Eccles gold for Wales and I'm a big boxing fan and more so women's boxing because at the moment what we are seeing with women's boxing is that there are pathways so what Rosie Eccles has been able to do is really show that she's got the grit and determination to try her hand at amateur boxing and then actually as time moves on she could step up to the professional game and we see a lot of women at the moment who have been able to do it that way Katie Taylor

Caroline Dubois just a couple of boxers to name a few who've gone through an Olympic or Commonwealth pathway into professional boxing. So Rosie Eccles now joins a really, a really strong list of women who potentially could go and do that. So that will just put her in such good stead for later on in her career. And hockey gold for England's women, their first gold at a Commonwealth Games. Finally, it's really interesting when you're when you're working on the games um to try and keep an eye out on everything else that's happening around you and uh for them to be able to get that golden hockey their first ever um commonwealth gold is interesting because of course we we all

know them for their 2016 um rio gold and that was team gb so it's a different bit of a setup actually so really really nice to know that as a home nation that England can walk away with their heads held high especially as they are essentially transitioning from the old squads into the new squads but the one person that has remained a constant is of course their goalkeeper Maddy Hinch who's just so amazing and when you have someone like that that crosses over across a couple of teams, then she's got all the experience to bring forward and take on to the new players. So it's just it's amazing that they've been able to do it and it will give them so much confidence.

And you've highlighted so many examples there of sports women doing incredible things. I mean, this feels like a moment, Jeanette, like an important moment for women's sport. After we saw the Lionesses win the European final at Wembley. Do you feel as though this is a positive time for women's sport after we saw the Lionesses win the European final at Wembley. Do you feel as though this is a positive time for women's sport? You know, Jess, you and I, I think, you know, kind of having our sports backgrounds in terms of what we do. I totally agree. I genuinely believe that we're on the cusp of something really, really great. We saw a huge turning point, a bit of a shift, actually, with the women's football. And it was just so emotional to kind of see that a lot of people's hard work up until that point has finally started to be recognized and I've always been a big advocate of giving women the same platform as men to be able

to perform on because when you do that it's essentially you can't ignore the greatness that's in front of you and it's just being able to allow women to express themselves on the pitch in the pool on the track on the courses wherever they think you know their talents lie and just allow that to happen and for people to be inspired by that and it's sport at the end of the day you know I think that some of us majority of people in society have an emotional connection to that whether it's man or a woman that's playing so I'd like to see that more and more people are really really invested in in what a lot of our British women are doing in the field of play. Yeah, it's such an exciting time. Jeanette, thank you very much. Enjoy the final day of the Games. Thank you all for listening.

I'll see you tomorrow. And that's all for today's Woman's Hour. Join us again next time. Hi, I'm Andy Oliver, and I'd like to tell you all about my Radio 4 series One Dish. It's all about why you love that one dish, the one that you could eat over and over again without ever getting tired of it. Each week a very special guest will bring their favourite food to my table and will be unpacking the history of it and food psychologist Kimberley Wilson is on hand to talk us through the science bit what food reminds you of your child what's your favorite place to go for dinner what do you have for sunday lunch what's your favorite dessert you say plantain or plantain what food would you take with you to a desert island what's your favorite type of chili oil what do you have for breakfast

what's the best pasta so if you're the sort of person who's already planning what you're having for lunch while you're eating breakfast, then this podcast is going to be right up your street. That's One Dish with me, Andy Oliver. Listen now on BBC Sounds. I'm Sarah Treleaven, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies. I started like warning everybody.

Every doula that I know. It was fake. No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story, settle in.

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