Woman's Hour - Education Secretary Bridget Phillipson, Anorexia legal case, Feminist yodelling

Episode Date: April 2, 2025

One manifesto pledge of the incoming Labour government was to provide over 3000 new nurseries in empty school classrooms in England. The first 300 of these will open by September and offer an average of 20 places each. Nuala McGovern speaks to Bridget Phillipson, Secretary of State for Education, about this announcement and also about the current state of provision and funding for children with special education needs.The family of a woman who is dangerously ill with anorexia is challenging a previous court decision which ruled she cannot be force fed. The family want the Court of Protection judge to make a new decision which would allow a hospital to act so that her life can be saved. We speak to the woman's aunt, and also hear from MIchelle Wright, who says she was in a similar position, on an end of life programme in a hospice, but who has now been recovered for 15 years and is speaking out for the first time. Plus we hear from law and philosophy academic Dr Camillia Kong who explains what will be considered as the Court makes its decisions in the patient’s ‘best interests’.Over the last few weeks Woman’s Hour has been talking to some of the writers who have been longlisted in the Women’s Prize for Fiction and Non-fiction this year. Well this morning, the shortlist for the fiction prize has just been announced. Nuala is joined by the author and Chair of Judges Kit de Waal.Echo vom Eierstock is Switzerland’s first feminist yodelling choir. Elena Kaiser is their founder and joins Nuala to discuss where her love of yodelling came from, and why she is challenging the make-up of traditional yodelling choirs and songs.

BBC Sounds music radio podcasts. Hello, this is Newland McGovern and you're listening to the woman's hour podcast. Hello. You're very welcome to the program. Well, in a moment, you will hear from the Secretary of State for Education, Bridget Phillipson, following her announcement of 300 new school based nurseries. But just how far will they go to plugging the gap in parts of the country called childcare deserts? Also the minister responds to criticism levelled out the government over the lack of send provision across schools in

England. Also today author and chair of judges Kit De Waal reveals the shortlist for this year's Women's Prize for Fiction. And we'll also hear from the family of a young woman who is severely ill with anorexia. Her family want a judge to overturn a previous court decision which ruled that the woman could not be force-fed. As you can imagine, it is a very complex case. If you want to get in touch with the programme about anything you hear, the number to text is 84844. On social media we're at BBC Woman's Hour or you can email us through our website. For a WhatsApp message or a voice note the number is 03700 100 444. Also today. Yodelling in Switzerland's first feminist yodelling choir.

It is all coming up in the next hour. But let me begin. You might remember there was a manifesto pledge of the incoming Labour government to provide over 3,000 new nurseries in empty school room classrooms in England. Well the first 300 of these will open by this September and offer an average of 20 places each. The government says these places for children aged nine months to four years will help parents get back to work and put more cash in their pockets. But critics argue that more funding needs to be invested in the staff to cover these places and also that it won't be enough to meet demand. I spoke to Brigid Philipson, the Secretary of State for Education, a

little earlier this morning and asked her who will benefit from these places. So the places that we're creating will be over 4,000 places by September, rising to 6,000. So we're investing 37 million pounds in 300 new or expanded school-based nurseries. That will make a really big difference to parents but critically it will make a really big difference to children because we know that you make the single biggest difference to children's life chances when they're young and that's why I've been clear as Secretary of State that early years is my number one priority and this is a promise I made to parents and a promise I'm keeping.

So you mentioned the places there but people might remember last year you did talk about 100,000 so that is a long way to go from 4,000 or 6,000 that number that you mentioned there as well. When do you expect to be able to hit that target? We're still going to get there, that's by the end of the parliament, that's over the course of the parliament, but today is the first step, an important first step because from September parents will be able to access expanded childcare entitlements which is incredibly important. We've put £8 billion into that this year. That's a record sum.

We do face big challenges as a country, as a government, where it comes to the public finances, but we have prioritised education and earlier spend in particular. But given that we're investing that money, we need to make sure we've got the places available. And critically, the plans I'm setting out today will see more places created in the North and in the Midlands where we see some of the biggest challenges in childcare deserts. Childcare deserts indeed that often

comes up when we speak to our listeners but they also talk about how do you get the staff that you need to work within these nurseries even if they are expanded? Absolutely, I mean early years is a fantastic place to work. We're putting more support in place in terms of training for staff because it's so important that they're well supported, that they get what they need and we're working with the sector to deliver the extra staff that we need for the expanded entitlement in September but the plans that we've set out today, the schools that have taken part in this, those who've bid to create

new places, had to set out a recruitment plan and how they will deliver the staff alongside that. So I'm confident that the schools we're announcing today will be able to deliver the places that are promised. Because when I've spoken to people that are involved they have quoted the minimum wage which is required, an increase in national insurance for example. They're really big obstacles to them retaining as well as actually recruiting the staff that is needed and it sounds to me like you're putting the onus on the schools to reach those solutions. Well we will of course work with schools, with nurseries, with childminders to make sure they've got the support they need especially

around training and development but we are putting a big level of investment into this area eight billion pounds it'll be this year but alongside that a real focus on making sure that we've got support in place for children from more disadvantaged backgrounds so the biggest ever boost to the early years pupil premium and alongside that an expansion grant of 75 million pounds to ahead of September to ensure that earlier settings are in the best possible place that they need to be to deliver on those expanded entitlements in September. And it will make such a big difference to parents, to children, to their life chances. I visited one of the

nurseries that's being announced today in Peterborough earlier this week and I met with Hannah who was dropping off her little boy, Niall. She's got two children already at the school so it's so convenient that she's able to drop off Niall at the school to get a really high quality early years education and she told me what a difference it had made, how her speech had really come on leaps and bounds, how he was so much more confident. And that nursery I'm visiting is now going to be able to massively expand the places that are available for local families in September and that will make a really big difference. And for Hannah I'm sure it does but you are confident that these nurseries will be able to recruit and retain the staff that they need. Yes I am and we're working

with the sector to deliver that but we do but alongside that I would just add I do recognise the need for wider reform particularly where it comes to issues around training, qualifications and the standing of the sector. Early years is where you make the biggest difference in children's life chances but I recognise that we've still got too big a gap between early years provision and some of the primary provision and how we bridge that. Well speaking of provision, you'll probably know on Woman's Error we've talked about SEND provision many times, that's Special Educational Needs and Disabilities. And on Monday we spoke to the actor Anna Maxwell Martin who very much

advocates on this issue and she believes that school exclusion is never the answer. She talked about attendance is not a condition, is that you need to actually look underneath why, the reasons why it's happening. It's quite something when you look at some of the figures of how exclusion and also suspensions has risen, particularly if we compare it with the pre-pandemic level. What do you want to say to Anna who has a child with special educational needs and very much feels the schools are not as inclusive as they should be? So I have followed closely the coverage that you've had on this topic.

It is an important topic for me, for the government, and it is a priority and we'll be setting out more later this year. A key principle of that will be around mainstream inclusion to Anna's point around ensuring that all schools are better able to support children with a wide range of needs. But alongside that, I've set out extra capital investment this year to create more specialist provision within mainstream schools. So what people will often call send units or resourced provision, where children with more complex needs who require additional support are able to go to, for example, their local primary school to be able to be with send units or resource provision where children with more complex needs who require additional support are able to go to, for example, their local primary school to be able to be with

their friends, their neighbours, but get the support they need in education terms. I've seen some fantastic examples across the country of where that's working really well, but we need to do a lot more of that. We need to do it in a much more strategic way. But we also need to ensure that there are specialist places for children who need them. The system isn't working at the moment you know I've heard from your program from your listeners how many parents have just lost confidence in the system and children are not getting the outcomes they deserve. Any reform that we will bring in terms of support for children with SEND will be rooted in their lives, their experiences

and delivering a brilliant education for children with SEND. Do you understand though the frustration that parents have that attendance is considered one of the core priorities by the Department of Education when it comes to what they're trying to achieve? Because they're saying in fact it's looking the wrong way at the issue. Attendance is important and I make no bones about that. I do recognize that for some children that can be more difficult. I know that many children experience challenges around mental health, that

there can be other challenges for children with SEND. It's why schools should be taking a support first approach, so working with families to understand what the problems and challenges are. But you know the impact on not being in school on a regular basis can be lifelong and the evidence that we've published as a department is that you're less likely to get good GCSEs at the end of your time at school and also you're actually less likely over the course of your life to earn as much. So these have long-standing, you know, long-standing kind of outcomes.

What I would add is that we have a responsibility as government, of course, to make sure that we are doing more to support children to be in school. Councils and others and the NHS who provide some of those critical services also need to be able to do more. But as parents, wherever we can, we should be making sure that our children are in school because it is so important and when they aren't in school it sadly does have an impact on other children's learning within the class because what teachers tell me is that they then sometimes have to cover all ground because children haven't been there for the lessons that they've been teaching. I mean I think what the parents

and some of the pupils, perhaps even the teachers, would say at this point is that the reason they're not in school is because that school isn't able to provide, because it doesn't have the funding required to be able to teach the children in the way that they need to be taught, to be able to give them more individual attention in whatever way it might be. This is complex. I do agree that there can be a range of reasons. Some children have other long-standing needs that mean that being at school can be more difficult and that's why it is important that we address mental health provision around the reform that we will bring on send. But what we often see

unfortunately is quite persistent levels of absence where we don't have some of those factors that are at play. And where we are saying to schools, we expect them to do more to support children, to make sure that they are regularly in school, because we see quite big variations, even between schools that serve similar communities with similar cohorts of young people.

And we're working with schools where those differences have opened up, so that they can learn from schools that are doing things well and we're putting in place the support that they need to do that to really improve on attendance rates but you know I completely understand that you know there can be acute pressures facing families and we're working hard as a government to resolve some of those wider pressures whether it's around temporary accommodation and homelessness, child poverty, access to mental health

support, that's all incredibly important too. The other word I keep hearing from people I discuss SEND with is that they want radical reform. When are you going to publish your white paper to reform the SEND system? We'll be setting out more detail later this year about the direction that we intend to take on reform. I think there is a line to tread here in that there is a recognition I believe from parents, from school leaders I've spoken to that the system that we have at the moment isn't working. The system that arose out of the reforms that took place over a decade

ago in 2014. We're not going to be able to overturn 10 years in a very short space of time and what I also hear from parents is that any reform that happens, they want to be a part of that and we will make sure that parents, that those with an interest in this area, that their voices are heard and understood as a part of that. But it's important that we get it right. There's always a balance in these areas to strike between the time something takes, but critically that actually it's the right reform. Yes, but there are children of course caught up in it at the moment and every

year it is so important and that is part of the impatience if we want to call it that or frustration with a non-specific time scale on these issues. You talk about balancing as well and I do want to talk about this because we spoke about earlier this week 10,000 extra school places for children with SEND in England which the government announced but on the same day a Guardian investigation revealed councils will overspend on SEND services by nearly 2 billion over the next year which then pushes their accumulated deficits if we look back to at least 5.2 billion by the end of March 2026. How are you going to balance those books?

Look, that's the challenge that we've inherited as a new government. But whilst I recognise the pressures that councils are under, my focus is on better life chances and a better education for children with SEND. That absolutely has to be the starting point. And I do recognise that the challenge that you pose around what needs to happen now versus what needs to happen into the future. Longer term reform does take time, we will set that out this year, but we are taking action in the here and now to make sure children with SEND are getting more support. Some more support around speech and language in our primary schools, which is a really

important area. The investment that we're putting in that you just talked about to create more places for children with SEND, particularly specialist places within mainstream, the progress that we're making around mental health support alongside that too. These are actions that we're getting on with right now and one of the very first things that I did on becoming Secretary of State for Education was to shake up the Department for Education. There hadn't been enough of a focus on SEND. It's dealt with as an entirely separate issue. I brought that right

into the heart of the approach that we're taking on schools because this is about inclusion overall so that all children, including those with additional needs or a range of needs, get a brilliant education. So excellence for all of our children, not just for some of our children. Do you think you will be able to balance the books when it comes to those deficits with SEND? We do need to bring that reform, not for the reasons that you've set out, but also I think critically because it's just not working for children and families.

And a part of that is how we can ensure that there are more places for children with SEND closer to home, because some of the pressures that you're talking about and that councils are facing is because often we are sending children with additional needs often who can be quite vulnerable, considerable distances to more expensive placements much further from home. Whereas in an ideal world I know what parents would want would be a brilliant local school where their child can be there with their friends. Sometimes you know for example one of the settings that I've seen setting for children with more complex autism, they have some of their time in a specialist provision but then where

they are able they can have break time and lunch time, take part in whole-school assemblies with the whole school community and the parents I spoke to at that school told me it had been life-changing for their children and they could now for the first time see what living an independent life might be like for their child into adulthood, because we talk about children in schools around SEND, that's important, but those children will emerge into the world and they need to be supported as adults as well. And I do hope maybe you'd come back and speak to our listeners and take their questions on SEND, for example, because I know there's such a hunger out there to engage with you

directly on these issues which we've just really skipped over and it'd be great to get into some more depth on them. One thing that is in the headlines today of course is tariffs. Be curious for your thoughts on this. They can significantly impact women-led businesses, potentially increasing costs disproportionately affecting women entrepreneurs. What is the government's Significantly tariffs impact women led businesses, potentially increasing costs, disproportionately affecting women entrepreneurs. What is the government's strategy with the impending possibility that US President Donald Trump will announce, sweeping taxes on goods that are imported? Our position as a government is that we don't think a trade war with the US would be in

anyone's interest. We obviously reserve all options and our position in terms of what action we might take but our focus at the moment is on negotiations around a wider economic deal with the US. Jonathan Reynolds, the business secretary, has been working incredibly hard in recent weeks and months with his counterparts in the US. That work is still continuing irrespective of what might or might not happen later on today around tariffs. The Education Secretary Brigid Philipson there thanks to her. Some of you listening have been getting in touch. Here's one message that came in, my daughter started school refusing at 13. I was not supported to get her back into school and was told mental health is not health by the school. The choice I was given was

boarding or her being kept in isolation in school 84844 if you'd like to get in touch and I do look forward to welcoming the Education Secretary onto Woman's Hour to answer your questions on SEND, Special Educational Needs and Disabilities. Now over the past few weeks Woman's Hour has been speaking to some of the writers who've been long listed in the Women's Prize for Fiction and also for Non--fiction this year. You might know the Women's Prize was founded 30 years ago so quite a legacy at this point. The shortlist for fiction prize, for fiction prize even, has been announced this

morning. I am joined by the author and chair of judges Kit Deval. Good morning Kit, welcome back. Good morning, it's great to be here. Shall we go through the six authors and their books who have made the shortlist? Yes. Do you want me to read them out? Yeah, go for it. Arya Aeba, Good Girl, Miranda July, All Fours, Sanam Mellugi, The Persians, Elizabeth Strout, Tell Me Everything, Yael Van de Vuden, The Safe Keep and Nusaiba Yunis Fundamentally. So there we have it, the six on the shortlist.

I know three of them have been on Woman's Hour actually in recent weeks. Sanaa Maloudji for The Persians, Elizabeth Strout, Tell Me Everything and Nusaiba Yunis Fundamentally if people want to go back and listen to those interviews BBC Sounds is the way to do it but oh my goodness kit what is that job like whittling the numbers down to six it's incredible I mean you start reading and you think I'll never do it and I'll never remember them all and you've got other people here that have got their opinions and I can honestly say I'm with the best group of women. You know, I mean, I'm the chair of the judges.

I've had nothing to do except chat, which is fabulous because it's my first love. And we have been through each book in turn. We've looked at the work, we've looked at what is being said and it's been a spicy, interesting, compassionate and completely informed conversation about literature and about women. I mean it's a joy. You talk about chat being your first love. I mean reading must be the second. How many books do you need to go through to get down to those six? I would say between 1800 something like that But you know

It's lovely. I mean you've got now an excuse I at least have an excuse to sit down and can't do the washing up can't do the washing Can't watch rubbish on the telly. I'm reading. That's like being handed a golden challenge to me. It's such a lovely way of thinking about it. Do you see any particular themes emerge when it comes to these novels? I talked about the 30 years, you know, and it has not that it's a fashion, but in the sense of do you see something that unites? Yes, I think there's definitely the sense that women are reclaiming their power, definitely, that women's journeys are just not, we're not able now to say this is what's going to happen to you

at 40, at 50, at 60 or 20 because the landscape that women operate in is so different. I think identities are a very very big thread that runs through these books, not just identity as the world sees us but as we see ourselves and I think there's a drive through all of these books to reclaim something that was lost or something that they've been battling with all their lives. You know, your words strike me. I'm thinking of an interview on Woman's Era that they did with Gloria Steinem, who is 90. And she said, you know, it was her birthday, actually.

And she was saying, you know, I don't have role models because there wasn't somebody at 90 who was forging that path that she was. So it's interesting that you say that about, you know, 30, 40, 50, whatever it might be as well. And I suppose age being part of identity in some ways. You were shortlisted for numerous awards for your debut novel, My Name is Leon. That was almost 10 years ago. What difference do you think it makes to an author? I know it's also individual, but to get on a list or on a short list? It's a shot in the arm. There's nothing like an objective assessment of your work. And especially when you're going up against authors that you love and respect and you're getting somewhere. Because you can always get your friend or your mom or your sister to say you're brilliant, of course you can. What you can't have is someone

that doesn't know you, doesn't know what you've put into this work and then they're saying this is good. It's the sort of thing that just keeps us going. In a world where there's a lot of rejection, as an author you experience a lot of rejection and here is just that time when you think actually I've done it. Your own new novel The Best of Everything is released next week in the midst of all this. I love that you're writing, you're chatting, you're reading and you're also writing. Tell us about your new book. New book's about a woman called Paulette who thinks she is overlooked. She has humble dreams, she wants to get married, she wants to have a baby, she wants to have a house.

And at the beginning of the book her love is lost and really the rest of the book is about her coming to terms with that and trying to carve out for herself through her kindness and generosity of spirit, a new life centered around this little boy that she has a close relationship with. Really interesting. Thank you for coming on, Kit. We'll speak to you again, no doubt. And just remind people we have featured half of the authors on the shortlist that Kit Deval was bringing us. And if you want to listen back to those interviews, BBC Sounds is a very good way to do it. Now the family of a 25-year-old woman who is dangerously ill with anorexia is trying

to get a judge to overturn a previous court decision which ruled the woman could not be forced fed using a feeding tube. The woman who is known as Patricia in the Court of Protection Proceedings so that she cannot be identified, says she does not want to die. Our reporter, Carolyn Atkinson, is here to explain more in this complex story. Also a very tragic case, Carolyn, welcome. It is, and also it's an unusual case in that a family is bringing this case to court as opposed to a hospital or a medical team. And in doing so, the family is challenging a previous decision

made by the Court of Protection which doctors involved with Patricia's care have had to comply with, otherwise they would be breaching the court order. So the case is being brought jointly by Patricia's mum and dad and by her aunt who I have been speaking with. Now, we aren't naming the aunt and her words are voiced up by an actor to protect her niece Patricia's identity. The aunt says it's a race against time because the judge at the last hearing in 2023 said Patricia was at imminent risk of death even then. Now, if you find anything in her interview upsetting and need some support then you please can go to the BBC Action Line which will be able to link you to organisations which can help. So Patricia's aunt says her niece was diagnosed with anorexia at 11 and

she's been in and out of eating disorder units ever since. She's currently in hospital. She is very, very frail, very fragile, a very severe anorexia nervosa patient. She's completely mobile. She's literally skin and bone, like a skeleton and nothing else. And her hair is falling out, although as she's increasing her, it's beginning to grow back again. She's very, very frail indeed. She's quite strong for somebody who can't walk, but she can't walk. She's in a wheelchair now.

And yes, just so, so frail. How is she still alive? We have no clue really. But she is. She's still fighting to live and desperately seeking help with her eating disorder. And before the hearing was being constantly turned down for eating disorder units because she was far too ill. The hospital would say that's simply because the Court of Protection made a ruling in 2023, didn't they, which prevented them from doing certain things. So in May 2023,

the judge decided that Patricia couldn't be tube-fed by force. So that's feeding with a nasogastric tube into her through her nose, so bypassing the need for her to have to eat. He had heard that Patricia had had numerous tube feeding attempts and Patricia had said that it caused her so much trauma and distress that she didn't want to be force fed again. And so he did a ruling that didn't allow her to be force fed with the tube anymore. And that's because he decided she didn't have capacity to make decisions about her medical treatment. Yes, so the decision in May 2023 was that she didn't have capacity for her treatment,

but she did have capacity to litigate. She was called a snow leopard. Apparently the reason they call them snow leopards is because it's quite rare to have the capacity to litigate yet not have capacity for treatment. But yes, he gave her the autonomy for her own treatment, which meant actually she had the autonomy for her treatment even though she didn't have capacity for her treatment. Patricia's view of this was that it meant that she could ask for the treatment that she wanted and felt that would do her good. But what it turned out, and this was clarified in another hearing

in October 2023, the judge confirmed that actually it was NG tubing, so force feeding or she died. So that decision was made and you now as a family, so you plus Patricia's mother and her father, are all bringing a case against the hospitals that are treating her and against Patricia herself. So why are you doing that? Because we have since discovered actually the safest way for Patricia to increase her weight is through tube feeding and we've given her lots of opportunity to volunteer for the tube feeding. She's declined, her health has declined quite significantly even since that hearing and she's obviously

not able to increase her calories on her own. Tube feeding is the safest way because if she goes into what they call re-feeding syndrome then they may need to get as many as four or even six thousand calories into her quite urgently. Now you and I couldn't eat that amount of calories of nutritious food. We would struggle to do that, but somebody with anorexia would struggle even more. And you know, we've done our research, we've seen that she can't do it on her own. So we've decided we've had to go to court. We really want her to volunteer to Tube and it may be with the threat of force feeding that we hope she volunteers.

We've certainly seen since the hearing started that she's tried an awful lot harder to increase her calories because she wants to avoid the force feeding. So, so yeah, our hope is that she will volunteer and it will be far less traumatic for her if she does that. You know, research shows, especially with eating disorders, that although you are very articulate and you know, she's studying for a degree in psychology, when it comes to actually eating there's a lack of capacity and ability to be able to do that. It's like a second brain is working in her and that eating capacity just isn't there. Can you describe how the anorexic brain works? How does it think differently to the standard brain? So I would describe it a bit like the film The Alien, where you have something growing

inside you that wants to control you and that eating disorder is the alien. And as your eating disorder gets worse and worse, the alien gets stronger and stronger and pushes out the Patricia brain and becomes the alien brain and it's very very strong when it comes to eating. It just fights really really hard for survival of the eating disorder. So your brain is sort of, it's almost as if it's sectioned off and an alien has taken over the eating side of it. Food is critical to life yet and anorexia brain doesn't seem to understand or comprehend that. And so are you saying then that the original judge was wrong?

I'm saying that he was given the wrong information. Patricia was deemed as untreatable in May and October of 2023. Now that's another thing that's been heavily disputed as we get to learn more and more about eating disorders. You know, people are recovering from really, really low BMIs. And there are examples of people who have overcome their eating disorder after 35 years. She's been looked at by consultants and none of her issues aren't reversible. She can reverse them as long as she's able to eat and, you know, the opportunity to lead a fulfilling life is very much there. And if refeeding is done

properly and done carefully, which sadly would include tube feeding, then her chances of survival are incredibly high. And what does she want to do with her life? Well, when she was doing her A-levels, she wanted to be a doctor. The anorexia though, she suffers heavily from anxiety as a result of the anorexia. So she was persuaded that perhaps being a doctor would be too stressful for her when she recovered. So she's decided now that she wants to be a midwife and she wants to go into third world countries and help babies being born and you know help young children survive really. But she also she says to me she wants to kiss, she wants to cuddle, she wants to have a normal life, she wants to travel when she recovers.

What is this doing to the family? My sister and her husband have lived with this since the age of 11. Her father has lost his job 18 months ago because he became full-time carer. Her mother, thankfully, her employers are really, really supportive. It's been really traumatic, especially as we've spent the last two years thinking that she will die any minute. And we've been battling to try and get her treatment and it's been quite stressful is to tame a word for it really. Patricia knows now doesn't she that you are bringing this case and she's extremely angry about that. Yes because she knows that we're pushing to get tube feeding brought back onto the agenda again.

We're really hoping though that she'll volunteer and we won't have to do all the restraints. Since she's realized that we're taking it back to court, she's increased her calories which over the couple of weeks is very dramatic actually for her. It's still a starvation diet. We're hoping that she will take it voluntarily because it'll be a lot less traumatic for her and also for the medical staff around her because it's not an easy thing for the medical staff to do when someone's resisting. The problem is that it's been used in the past as a punishment in some eating facility units, you know, if they

don't do as they're told, they're tube-fed. And so it's not treated in the same way that most medical procedures are. So how hopeful are you that the judge will rule in what you consider to be your favour, which you say would save Patricia's life? I'm really hoping that she will. I think she realizes how much Patricia wants to live. Patricia has shown to her how determined she is. Even if she has to be restrained,

science shows that trauma is fairly short-lived. And actually, most people who've recovered from anorexia when they've been very severe have said, yes, it was traumatic at the time, but it saved their life. And you know, Patricia has a lot to offer and she has a long life ahead of her. If we can get her over this and into normal weight.

So you're pinning everything on this judgment aren't you? We are. Her life depends on it. Our lives depend on it really because we fought so hard to get her some treatment. I don't know what we'll do if we fail. We want her to live. She wants to live. We need to win this case and we need to get a proper treatment. Otherwise we're going to lose a little angel. That was the testimony of the aunt of a 25 year old woman that we are calling Patricia, not her real name, who is dangerously ill with anorexia. I should say the aunt's words were voiced by an actor because we want to protect their identities. If you found anything you were hearing in that interview upsetting and need some support, please go to the

BBC Action Line which will be able to link you to organisations which can help with me is our reporter Carolyn Atkinson. Do we know what Patricia thinks about what she wants to happen? We heard she is angered there about these proceedings. Yes and we heard the aunt explaining some part of that but the family has actually shared with me some texts and emails from Patricia written very recently and which have been read out at the current court hearings. Now I've got one of them here. This one's from February 2025 and Patricia says I don't want to die, I want to go on holiday. I want to walk up mountains.

I want to swim in the sea. I want cuddles and kisses. I want to party and have fun. And in this email a month ago she pleads, my body will not continue forever. I can't keep surviving as I am for much longer and that terrifies me. Please, please, please, I'm begging everyone, can we up the ante?' So of course that may be very distressing for people to hear and of course the hope is that Patricia can recover despite being so ill for so long. And I've in fact been hearing from a woman, she's now in her 60s and she says she is proof that even severely ill people can and do recover. In the first interview she's ever done, Michelle Wright told me she had anorexia for more than three decades

and she was on end-of-life care in a hospice. I was in a very similar position. 16 years old was my first admission, which at that point I didn't realise I was, didn't even know what anorexia was. Didn't believe I was ill and I was sectioned into an adult psychiatric unit, which actually did a lot more harm than good. Did save my life initially, but did nothing to change my mindset because they didn't know how to treat me. So I was given insulin therapy and my weight forced up a little bit but on the first opportunity that I could get out and get away I did and

unfortunately that left me terrified of psychiatrists, terrified and so for 38 years I just had medical admissions with people I trusted. I found a doctor who would just patch me up. And from then on, bounced about, but was really told they doubted I'd recover because 38 years is a long time to have an eating disorder and not have proper eating disorder help in a proper unit. Eventually, my body started to give up and I actually ended up at a weight of a child and I ended up on end of life care in our local hospice.

I knew that I was going to die then. I'd become so fed up of the illness. By then I hated anorexia. Everything was black and white. There's no gray areas. You are terrified. And there's also a part of you terrified. If you're honest, you're terrified to let go of the illness because you don't know who you are without it. I wanted so much to get better, but believed I couldn't. And I was terrified, terrified of getting better as well, but I really wanted to get better.

But by that point doctors were telling me I couldn't so I tended to believe it and I just gave up. I felt there's no point I'm not going to get better I can't live with illness anymore either. It was miserable, really miserable by that point. And what sort of time scale was that over while you were going into this palliative pathway and this end of life care? Probably the last five or six years I went from being a very, very low weight to an unattainable weight, really ill, and just, I just gave up. I was virtually bed bound. I mean I'd lived with carers coming in to help to get me washed, changed, bathed,

everything. I couldn't function, I couldn't look after my home anymore, so my husband had to do everything. My children, I'd become just too ill to function basically by that point. Wasn't going out anymore, that was no life. So apart from being taken to daycare at the hospice at that point and then on a subsequent appointment at the hospice I was brought in for end-of-life care. Not being able to see my children grow up into, you know, young women broke my heart really. I think that was the thing that really hurt me the most. was that was the thing that really hurt me the most. So what happened that you went from being on end of life care in a hospice to starting to recover?

My husband brought me an email that a lady had happened to see my story. She was more or less the same age as me, had been ill for the same length of time as me, and she was now on the path to recovery. And when my husband brought that email up to me, that gave me a tiny glimmer of hope. If she'd been ill as long as I had, then how come she'd recovered? So my first thought was, I need to talk to her. I need to know if this is true. So we were put in touch and after speaking to her over several calls I felt I've got to give this a go. If there is hope I've got to try for my children I've got to try and do this. I was admitted into a specialised eating disorders unit,

spent just about a year there. The doctor did tell me that he thought at best I'd go in and probably just get a little bit stronger, but not actually get better. But I proved him wrong. I actually embraced recovery and continued to recover myself when I got home. And I've been recovered for 15 years. And I don't even think about food, weight, or anything like that anymore, it's really freeing. So it is possible. Why have you decided to speak out now? Because you've never spoken to anybody about this before. No, well, the thing is, after I'd got better,

I actually was fed up to the back teeth of eating disorders and I wanted to have a break from it. And it's only been over the last five years that I've felt I need to help other people, I need to show, and I've seen a lot more going on about people with anorexia being put on end of life care and palliative care, and I think that's a big mistake. I really do, because recovery is possible. Doctors need to rethink.

It doesn't matter how long you've been ill, you can recover. It's changing the mindset. And you haven't got cancer, you haven't got a heart problem, you haven't got something terminal. It's something you can recover from. So that's why I'm speaking out. all. It's something you can recover from. So that's why I'm speaking out. That was Michelle Wright who recovered from anorexia as you're hearing there and speaking for the first time about her experience to Carolyn Atkinson. Carolyn's here with us. Let's go back to Patricia's case. It goes to the Court of Protection next week. What could be some of the areas that the judge will consider? Well, one issue is that of autonomy and I've been speaking to Dr. Camilia

Kong from Queen Mary University in London. She's an expert in law and philosophy and she explains some of the issues which may be raised. So in the first decision she was found to lack capacity to make a decision about her treatment. However, the judge decided that it was in her best interest to not be force-fed and the reasoning behind this was that we needed to respect Patricia's autonomy and in that case it was seen to be a best interest decision where they did not actually force feed her and that she was not undergoing treatment any longer. So talk more about autonomy. Explain what autonomy really means in this situation. It's quite complicated because in some ways autonomy it doesn't fit very neatly in the framework of best interest

because in theory someone is making a decision on your behalf. For many people that's already contrary to autonomy. However, what we see happening in best interest decision-making is a desire to really honor the person's perspective and honor their wishes and their values and to try to consider this in the actual decision. So if we think about that first decision,

the way that the judge is actually respecting Patricia's autonomy is because she is refusing. She does not want to be force fed. She does not want to be undergoing treatment any longer. And so this is the judge actually honoring her subjective wishes in the first instance and her preferences and what she's expressing most strongly here. in the first instance and her preferences and what she's expressing most strongly here. The family are now challenging that decision and next week it goes back to court again. On what basis are they challenging the decision about autonomy in this new hearing? The notion of autonomy that was operating in the first decision is a really narrow and thin sense of how we actually respect a person's self-determination.

So we might have a narrow and wider interpretation of autonomy. A narrow interpretation is one where we just focus mainly on what the individual desires and prefers in those, what we express from moment to moment. So to use a mundane example, it might be that I choose to have coffee over tea, or I choose a film over this film. But the reason why autonomy is so important in our lives is because of a wider sense of why self-determination matters, because it's how we're making choices that reflect our deeper values, our deeper commitments, our deeper selves, and how we envisage the direction

of our lives. In this original judgment and probably in most mental capacity cases, autonomy is often understood in a very thin, narrow sense. And there's good reason for this because we have these kind of liberal intuitions in our society about we want to express our individual identity and we also want to make choices that are not interfered with. But we can see in the case of Patricia how these two interpretations of autonomy are conflicting because there is this strongly felt anorexic value to not be force fed and this is a very strongly felt desire. Yet she also has long standing values which are obstructed by her anorexia. So what we see in this particular judgment is where there are, there's a conflict of

our interpretation of autonomy. And so in the original case, we can see that there's quite a thin account of autonomy, but also we can see it in Patricia herself where she has a desire not to be force fed, where this desire to refuse treatment really tracks these strongly felt anorexic values. But she also has these long-standing commitments and values which are reflected in her desire to travel, the value that she places on education, about physical strength, about the desire not to die. It's a question about how we honor that in this best interest decision. To use this example of Patricia would be thinking about how this

anorexic compulsion to refuse treatment and food might not be tracking deeper values that she has about her life, about family, about relationality, about her identity and about the aspirations she has in future. And so what might that mean then? It might mean the decision to force feed. It might mean the decision to treat her against her will. The reason would be because it is trying to respect and promote Patricia's autonomy and her sense of self that goes beyond her anorexia. That was Dr.

Camilia Kong from Queen Mary University in London. Carolyn Atkinson is still here with me. Carolyn, you wanted to add a comment in reference to Michelle Wright, who we're hearing from previously, who recovered from anorexia. Yes, she said anorexia is not like cancer or a terminal illness or heart disease. But of course, eating disorders and anorexia is not like cancer or a terminal illness or heart disease but of course eating disorders and anorexia can damage the heart and other organs and anorexia does have the highest mortality rate of all mental illnesses.

Yes, that is a statistic which is very distressing. Again, I will refer people to the BBC Action Line if some of the issues that they have heard about affect them and there are links to support at the BBC's Action Line. Thank you very much Carolyn for bringing us that story and also of the family. I do want to let you know as well that we did contact two hospitals and the integrated care board that are involved in the woman we're calling Patricia's care and I want to read a little of what they said. One hospital told us this is an extremely complex case, which is currently with the Court of Protection

to provide a full final decision that will ensure clarity for Patricia and her family to identify the next steps in her treatment. Our clinical teams continue to work closely with Patricia, her family and all partner agencies. They also said that the trust is not permitted to impose treatment, including restrained feeding under that current court ruling. A second hospital and also the integrated care board gave us the same message,

which was while the proceedings are ongoing and we await the final decision, we will not be making any further comment. Thanks very much to Carolyn and all her guests speaking to Woman's Hour. I want to think about Easter for just a moment. Maybe you're thinking about it. Maybe you're clearing out some closets as you feel some spring weather. We're going to do a deep dive into clutter, the impact it has on our lives. And I want to hear from you. How do you feel about clutter? Do you feel overwhelmed? It's just part of the furniture at this stage. Maybe you've recently helped tackle someone else's stuff after a loss, that's when it happens sometimes, or maybe it's a big

move or a change, a transition, or maybe you wish you had more space to fill. Anyway, whether you have mastered the perfect technique to keep on top of everything or you're planning to tackle your drawers of doom over the bank holidays, I'd love to hear your thoughts, your experiences, your advice, your dilemmas. You can email us via the Womens Hour website. To text us it's 84844 on social media. It's at BBC Womens Hour. I need to move on to a little bit of yodelling.

Elena Kaiser had a lifelong love of yodeling, but got tired of the obstacles that were in her way as a woman wanting to yodel in a choir. So she set up Echo vom Eierstock, Switzerland's first feminist yodeling choir. Welcome to Woman's Hour. Hello. Good to have you with us. So Echo from the ovary is how I'm translating Echo vom Eierstock. Have I got that right? That is correct. If it's a literal translation,

because it is a Swiss term, it is quite hard to translate in any other language. Even in German, it doesn't have the same meaning. It has a double meaning in Swiss German. And I suppose part of that meaning is related to the fact this is the first feminist yodeling choir. What is so different about it from a traditional one? The difference is that we have decided to change texts in the songs to either rewrite them or write new ones or exchange some words with different words. And we'll talk about why that's necessary but first I think we need to give a

little bit of you in action. I know you're keen to point out that this is not a professional recording but let's give our audience a flavor. Beautiful. So we have, I can hear their women's voices that are there. How many are in your choir? We're about 50 women. Ranging ages? From, I'd say mid-twenties to seventy. And you talk about changing the lyrics. Why was that necessary to change from traditional Swiss yodeling songs?

Well, the songs, they come out of the tradition of late 19th century, early 20th century, when living in the Alps was being romanticized hopelessly, and it's a man's world, obviously, and everything that happens is because God made it happen, and women are portrayed as either, you know, just poor old ladies that are waiting for somebody to visit, or they're just temptresses or they're mean housewives that don't allow their husbands to go out at night. You do not ever hear about

texts that deal with issues that are actually commonplace nowadays. So you are changing the lyrics. So what are some of the issues that your songs jump into, delve into? Well, we deal with issues. We write about menopause, for instance, the song you just heard. We we texted it. I made it about menopause because we feel like we should sing about it. Well, tell me then, because obviously I was listening to it, but I couldn't understand the lyrics.

So what was I hearing? Well, we basically make it a joyful thing. Look forward to those years of change. The song is called A Plus 1.5 Degrees, and it starts out as a obviously climate change song, but it's meant to be the climate change within a woman's body. Ah. So they're quite clever lyrics I have to say and we wrote them ourselves so we're proud of them.

Yeah, of course. And who's doing the writing then? Obviously you, but you talk about these 50 women in the choir. Is it certain people are the songwriters? And for now, we took traditional songs that have no copyright on them anymore, that are old enough. Yes, quite a few years old. To change with copyright issues.

And we've had Swiss authors write new texts for us, but within the last six months, a year, a group has formed within the choir who's really talented. We found new talents who has been writing songs as well. So a couple of things. I know when you set it up, there was a backlash from some that just didn't want to see women yodeling. How did you deal with that? Not at all, actually. We just printed out those nasty emails and we gave it to everybody to read and laugh about it and we put it in the trash where it belongs. And do you feel the tide has changed since that time?

No, not really. No? It's just people aren't vocal about it. Because in Swiss culture, if you have nothing nice to say, say nothing at all. That's kind of our thing. So, I think most who don't like us after the first shock about a feminist yodel choir has subsided, they just choose to not say anything at all. Did you think it would be controversial?

Yes. We knew it wasn't going to be appreciated in every corner of the country, but that's okay. You know, we knew it was going to create a stir in the yodeling scene and that's fine. I understand there's a waiting list now to get into your choir. Yes, apparently we hit a nerve with women all across the country and, you know, we get asked so much. Women want to sing with us. I think we could form a whole other choir. Are you going to do that?

No, we don't have the capacity to do that. We're not professionals. We do this in our free time. We're all working people. This is supposed to be a fun hobby. we're all working people. This is supposed to be a fun hobby. Well, we've really had fun having you in, Elena Kaiser. Thank you so much for speaking to us about Switzerland's first feminist yodeling choir. And tomorrow, Dashiana Navaniagam will be here with you with Woman's Hour. That's all for today's Woman's Hour. Join us again next time. It's a parent's nightmare.

I said, oh, it's a boy. Join us again against time. I don't want this woman to leave this earth not knowing what happened to her son. The Gift from Radio 4, with me, Jenny Clemon. Listen now on BBC Sounds.