Almost a quarter of children needing community care services in England are waiting over a year for treatment, with 1 in 15 waiting two years, an analysis by two healthcare think tanks has found.1The Nuffield Trust and the Health Foundation said the “unacceptable” figures were placing children’s health and life chances at risk and should serve as a “wake-up call” for the government. The think tanks said their findings, published on 16 October, showed that many young people with disabilities and developmental problems faced potentially damaging delays to treatment.Failing to tackle the problem could derail ambitions laid out in the NHS’s 10 year plan to move more care out of hospitals into the community, they warned.2Community health services see and treat more than two million patients each month in England, with more than eight million care contacts, accounting for around 13% of all daily activity in the NHS.In July 2025...

The report on surrogacy presented to the United Nations General Assembly in October by special rapporteur Reem Alsalem concludes that “The practice of surrogacy is characterized by exploitation and violence against women and children, including girls”.1 Its key recommendation is to eradicate all forms of surrogacy around the world. Alsalem’s report has, predictably, prompted highly polarised responses, with some commentators welcoming its conclusions, and others responding with outrage.234Two things need to be said here. Firstly, Alsalem is the UN special rapporteur on violence against women and girls, and the report is entitled “The different manifestations of violence against women and girls in the context of surrogacy.” The report therefore takes a particular viewpoint and is not intended as an objective survey of the global surrogacy landscape. Secondly, although the special rapporteur can make recommendations, the UN is under no obligation to accept them. This report is therefore a prompt for...

The World Health Organization has been forced to cut dozens of staff in Europe over the past few weeks, as the US withdrawal continues to hit the agency hard.Speaking at the World Vaccine Congress Europe in Amsterdam on 15 October, Robb Butler, WHO Europe’s director of the division of communicable diseases, environment, and health, said 32 staff had been cut from his division in the past three weeks. “We’ve taken a very heavy hit. The politicisation of health is a very raw and real thing in the WHO European region at the moment,” he said.The Trump administration withdrew from WHO in January,1 saying that the UN agency had mishandled major international health crises. The US had previously contributed around 18% of WHO’s funding.Between January and July this year WHO reduced its staff by 221, according to Health Policy Watch, from 9452 to 9231.2 In March WHO said it would have...

The BMJ editorial on declining childhood vaccine uptake in England is both sobering and timely.1 The authors rightly highlight fragmentation, austerity, and service delivery barriers, but they linger within the boundaries of traditional paradigms. I urge a more radical, systemic response—one that dares to reframe the entire vaccine ecosystem in the UK.First, it is time to recognise that our current model—a patchwork of institutional silos, short term funding, and legacy outreach—is not simply strained but obsolete. Instead of incremental tweaks, let’s pilot “vaccine broker” hubs: hyperlocal, interdisciplinary teams embedded in schools, community centres, and pharmacies. These hubs would not just deliver immunisations but also build authentic relationships with families—leveraging data science to predict hesitancy, tailor outreach, and triage barriers in real time.2Second, digital transformation remains underused. Although reminders and portals exist, the future lies in intelligent scheduling and artificial intelligence (AI) driven nudges embedded into the everyday digital footprint of...