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BUSINESS LIVE: Cost-of-living crisis drives record Aldi UK sales

By Live Commentary

Updated: 03:25 EDT, 25 September 2023

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One million more patients attended A&E in the past year amid strikes, record waits for routine care and difficulties accessing a GP, figures show.

Health leaders say people have turned to emergency departments because it is one part of the NHS where they know the ‘lights are on’ and they will be seen.

But the surge in demand meant more patients waited longer than the target of four hours to be treated, admitted or discharged.

There were 25.34 million attendances at A&E in England in 2022/23, up 4 per cent from 24.37 million in 2021/22, according to NHS Digital.

Some 29.2 per cent of patients spent more than four hours in A&E in 2022/23, up from 23.3 per cent the year before.

Meanwhile, a record 1,789,130 patients spent over 12 hours in A&E – up 80 per cent in a year and up 491 per cent since 2020/21.

Patients in the poorest areas of the country are almost twice as likely to attend A&E as those in the wealthiest areas, the figures also show.

The figures were released yesterday as junior doctors walked out of hospital for the second day in a row. They are also due to strike again today.

The junior doctors provided emergency care on Wednesday but did not spare A&Es yesterday or today.

Almost 1million routine appointment and operations have been cancelled as a result of NHS industrial action since December, with waiting lists now at a record 7.7 million.

It has resulted in patients turning up to A&E in agony after facing delays to their care.

Matthew Taylor, chief executive of the NHS Confederation, which represents healthcare organisations, said: ‘A&Es have been under enormous pressure for years, with people naturally gravitating towards “where the lights are on” and where they know they will be seen in a relatively short time frame.

‘But it’s not just A&Es that are under pressure and that is the problem.

‘With general practice and primary care also facing huge demand, we know that patients may turn towards urgent and emergency care should they struggle to get a GP appointment at a time suitable to them.

‘As well as this we have an aging population with increasingly complex needs, a neglected and under resourced social care sector, and an elective care waiting list currently standing at 7.7m, all of which has consequences for A&Es which provide a safety net for the entire system.

‘For instance, many of those on waiting lists might develop complications to their condition and so seek help from urgent care.’

He added: ‘The data for last year shows the scale of the effects ever growing demand is having on A&E and on patients, with over 410,000 people waiting over half a day for admission, up from 98,000 the previous year, and this isn’t even from time of arrival, so a patient could’ve been waiting much longer.

‘But with too few staff, beds, or capacity and availability in alternative services, health leaders can only do so much.

‘This level of demand is unsustainable, so we need to see a greater focus on prevention and resourcing for community care to help relieve some pressure, keep patients healthy and out of hospital, and enable them to get care closer to home.’

Louise Ansari, chief executive of Healthwatch England, the patient watchdog, said: ‘People continue to wait many hours for care, often in crowded waiting rooms, with little or no information on when they will be seen.

‘However, people who received care for a life threatening illness or injury were still confident in the quality of care.

‘Undoubtedly, urgent and emergency services have been under unprecedented pressure for the last few years amid the pandemic, industrial action, record waiting times for hospital treatment and struggles to access GP care.

‘People will go to A&E if there is nowhere else to go, leading to increased treatment and care because they couldn’t get help sooner.’

Miriam Deakin, director of policy and strategy at NHS Providers, which represents NHS trusts, said: ‘These figures show trusts are working incredibly hard to respond to rising demand by seeing more patients than ever before.

‘This is remarkable given the relentless pressure on urgent and emergency care services and the wider sector.

‘However, demand continues to outstrip capacity, which means too many patients are having to wait longer for care and treatment.

‘Shortages of staff, beds and equipment, as well as the need for proper investment in the NHS estate, social care, and more preventative support, are putting the health service under an alarming level of stress.

‘Strikes are also piling on the pressure. By the end of this week, more than a million patients will have had their appointments and procedures pushed back due to industrial action.

‘This is incredibly distressing for all involved as trust leaders and their staff are unable to give patients the timely, high-quality care they deserve.’

More than 100 business leaders in New York City have penned an open letter calling on President Joe Biden to ‘take immediate action to better control the border’ and speed up the asylum and work authorization process for migrants.

The letter published on Monday was addressed to ‘President Biden and Congressional Leaders’ and backed New York Governor Kathy Hochul‘s recent plea for more federal resources to respond to the migrant influx. 

The letter comes as New York City has been overrun with 100,000 migrants, filling shelters and leaving many to sleep on the sidewalks throughout Manhattan.  

‘The New York business community is deeply concerned about the humanitarian crisis that has resulted from the continued flow of asylum-seekers into our country,’ the letter stated.

‘The situation is overwhelming the resources not only of the border region but of city and state governments across the nation,’ it added, noting that New York City alone has received more than 100,000 migrants whose ultimate asylum and work status remains unclear.

A White House official responded in a statement to DailyMail.com, saying the Biden administration ‘has led the largest expansion of lawful pathways to immigration in decades,’ and is ‘committed to building a humane, safe, and orderly immigration system’. 

Scroll down for the full letter 

Signatories of the recent open letter included Pfizer’s Albert Bourla, JPMorgan Chase CEO Jaime Dimon, Jeff Gennette of Macy’s and Goldman Sachs boss David Solomon. 

The letter backed Hochul’s recent plea for Biden to take urgent action to help her state absorb a surge of international migrants who have strained New York’s resources and filled homeless shelters.

‘In addition, there is a compelling need for expedited processing of asylum applications and work permits for those who meet federal eligibility standards,’ the letter added. 

‘Immigration policies and control of our country’s border are clearly a federal responsibility; state and local governments have no standing in this matter,’ the letter noted.

The White House official told DailyMail.com: ‘Those who arrive through those lawful pathways are immediately eligible to request an employment authorization document.’

The official noted the current process for asylum applications and employment authorization is set by law, which can only be changed by Congress, and noted: ‘The law establishes a 180-day waiting period to obtain a work authorization.’ 

A Department of Homeland Security spokesperson told DailyMail.com that DHS Secretary Alejandro Mayorkas had recently tasked ‘an expert team’ with assessing New York City’s migrant operations.

‘The team was impressed with the exceptional efforts by New York officials under the ongoing strain of accepting a large number of migrants and has provided recommendations for improvements, including data collection, case management, and increased communication with migrants on work authorizations,’ the spokesperson said. 

A federal official said the Biden administration had provided New York access to an FAA hangar at John F. Kennedy International Airport, which is being used to shelter 800 single males.

Eleven other federal sites across New York state are being reviewed as potential locations to shelter migrants, the person said. 

The migrant humanitarian crisis in New York, long seen as friendly to immigrants, is increasingly driving a wedge between local elected Democrats and the Biden administration. 

In a rare public address last week, Hochul said she sent the president a letter asking him to expedite work permits for migrants and provide financial resources to help care for the estimated 100,000 asylum seekers who have come to the state in the last year, mostly to New York City.

‘The reality is that we’ve managed thus far without substantive support from Washington, and despite the fact that this is a national, and indeed an inherently federal issue,’ Hochul said in a speech delivered in Albany. ‘But New York has shouldered this burden for far too long.’

The public plea came after months of private requests to the White House.

The central request of the governor’s letter was for the president to speed up the months-long bureaucratic process under which migrants can obtain work permits, and earn enough money to get off of public assistance.

‘Let them work,’ Hochul said, in remarks directed at the White House.

New York City Mayor Eric Adams, also a Democrat, has repeatedly made an identical demand.

New York has always prided itself on its ability to absorb waves of immigrants, but it has struggled to handle the thousands who have come over the past year, many on buses paid for by the state of Texas to rid itself of people entering the US across the southern border.

New York Democrats initially blamed Republican governors of southern states – such as Texas’ Greg Abbott and Florida’s Ron DeSantis – for the crisis, but have increasingly sought to characterize it is a national problem that should be solved by the federal government.

The situation has also provided Republicans in the state with a new political front from which to attack Democrats after an election year where the GOP made gains by criticizing liberals as slow to respond to concerns over crime.

‘Kathy Hochul´s solution after twiddling her thumbs after so many months is to write a strongly worded letter to Joe Biden? Come on, it´s not serious,’ said David Laska, New York Republican Party spokesperson.

The situation has also created tension between Democrats within the state. 

As New York City’s homeless shelter system became overwhelmed, and the cost of housing migrants in hotels and temporary shelters mounted, Adams began organizing bus trips of his own to take migrants to other parts of the state, to the frustration of officials in those communities.

Lawyers for Hochul and Adams have sparred in court over how best to house and expend resources to care for the migrants.

The state has earmarked up to $1.5 billion for its migrant response. Hochul asked Biden for financial assistance to help cover those costs and a projected $4.5 billion needed next year. 

In addition, the governor requested that the city and state be allowed to use federally-owned properties to house migrants.

New York City shelters have been at near capacity and officials have scrambled to set up temporary housing in hotels, recreational centers, school gyms and a hospital parking lot. The city is legally obligated to find shelter for anyone needing it.

Republicans are already seeing the response to this wave of migrants as an opportunity for campaigning in the 2024 election.

‘New Yorkers won’t forget what happened on Kathy Hochul’s watch,’ Laska said. 

‘They won’t forget that communities from all over the state have been strained beyond their ability to handle this influx of migrants and the real solution is to close the border.’

The city’s migrant situation has also led to clashes, such as on Sunday when protestors and counter-protestors battled outside Adams’ Gracie Mansion. 

 About half of the 100 people gathered were espousing messages demanding the shelters stop and the migrants be sent away, while others were counter-protesters who also denounced what they called the ‘white supremacist NYPD.’

Claims that the world is becoming ‘overpopulated’ have been in the zeitgeist for decades, but it’s a lack of new babies that really concerns experts in developed countries.

Japan announced this week that as many as a third of 18-year-old women may never have children due to a ‘sex recession’ that has plagued the country for decades.

One out of every 10 Japanese men in their 30s is still a virgin, and the country’s fertility rate has plummeted from 1.5 in 1992 to 1.34 births per woman in 2020.

The lack of babies being born is already having real-world impacts — Japan’s economy has stalled and caused the country to lose its place as an economic superpower. 

And experts warn the US is barreling towards the same fate, with fertility rates at a historic low and an increase in sexless relationships.

As well as having one of the lowest birth rates in the world, Japan also has one of the highest life expectancies, meaning it is left with a rapidly aging society, a shrinking workforce and fewer taxpayers.

Experts told DailyMail.com that America could be in store for a host of problems, such as a slump in economic growth and difficulties for retirement systems, if the birth rate does not pick up.

A baby boom in the mid-20th century saw the average woman in the US give birth to between three and four children. Today, that rate is just 1.6 — the lowest level recorded since data was first tracked in 1800. 

And there is ‘nothing in the data to suggest this trend is going to reverse itself anytime soon,’ Dr Phillip Levine, a professor of economics at Wellesley College in Massachusetts, told DailyMail.com.

He added that financial incentives — such as those promised in Japan for families with three or more children — are ‘unsuccessful’ at significantly raising a country’s birth rate, and we may have to ‘learn to live in a world in which the birth rate is low.’

In January 2023, Japan increased its financial incentives and offered 1m yen ($7,500) per child to families who moved out of greater Tokyo.

It topped an existing relocation fee of 300,000 yen ($2,000). It is too early to tell if it will make a lasting difference, but experts are not optimistic.

Dr Levine told DailyMail.com there will need to be economic reorganization to keep the country afloat, adding ‘jobs will be lost’ in manufacturing, construction and other fields and move into care and other services for the elderly.

This will ‘eventually have a damaging impact both on social cohesion and general wellbeing, and on economic dynamism’, he warned.

Dr Christopher Murray, a global health expert from the University of Washington, told DailyMail.com: ‘Since most purchases of real estate or consumer durables are in the working age adults, it will tend to put downward pressure on these types of assets.

‘In the long run, societies have to adapt to having more grandparents than grandchildren.

‘We are actually only just beginning to understand the myriad [of] challenges that sustained low fertility will have on societies.’

Previous research has revealed Americans are having far less sex than former generations.

A study from 2017 found that married or live-in couples had sex 16 fewer times per year in 2010-2014 compared to 2000-2004.

And couples had nine times more sex in 1995-1999 than they do now.

Experts have many theories as to why our interest in sex is dwindling – including porn addiction, lipido-sapping drugs like antidepressants, low testosterone levels among men, obesity and other factors.

Dr Stuart Fischer, an internal medicine physician in New York, told DailyMail.com that there needs to be a public mind shift where Americans start thinking about sex as a productive activity for the greater good and have more ‘goal-directed’ sex to increase the birth rate. 

In Japan, the falling birth rate has been attributed to a waning appetite for marriage and parenting and growing financial worries, leaving couples questioning whether they can afford children.

It is also due to a vicious cycle of fewer children who then have fewer children, said Takuya Hoshino, senior economist at Dai-ichi Life Research Institute.

As people have less children, they are able to spend more on each child than families have in the past. That drives up the average cost of raising a child for the broader population, putting some people off from having children, he said.

In the US, similar problems are blamed, as well as women prioritizing careers and the rise of fertility treatments, leaving many to think they can wait.

But Dr Levine said the evidence for these theories ‘isn’t really that great’ and admitted that researchers don’t have a ‘firm grasp’ on why American women are having fewer children.

‘States where housing costs are rising more or childcare costs are rising more don’t have birth rates that are falling more rapidly than other states,’ he said.

For example, Massachusetts has the most expensive childcare but has the fourth lowest fertility rate out of the states.

‘It doesn’t seem like it’s about the finances; it seems like it’s about what people want out of their lives.’

He said: ‘The Great Recession definitely started the ball rolling in the US and births are routinely linked to economic activity. 

‘But when the recession ended, births didn’t rebound, they just kept going down. So that clearly played a role at the beginning, but not an ongoing role because the recession did end.’

Instead, Dr Levine thinks the falling birth rate is likely due to ‘changing preferences, life goals and aspirations’ among women and their partners.

‘Marriage and childbearing may not be quite as much of a priority among more recent waves as young people, as they have been in the past,’ he said, but added that this is not ‘country-specific.’

An erosion of family values and religious principles might also be a factor, Dr Fischer said.

In Japan, the number of children has been falling for more than four decades, which is having a disastrous effect on GDP and productivity. 

Japan’s population of 126.15 million in 2020 is projected to fall to 87 million by 2070, according to the National Institute of Population and Social Security Research.

In China, the infamous one-child policy had catastrophic effects. Described as the worst policy in history, it caused China’s fertility rate to crash by more than half, from 5.8 births per woman in 1970 to 2.7 births per woman in 1979. 

And the effects are still being felt. Government data estimates showed China’s fertility rate dropped to a record low of 1.09 in 2022 — the lowest of any country with a population over 100 million.

A falling birth rate is detrimental to a country for several reasons. Fewer births means fewer workers, which has ‘implications for economic activity and economic growth,’ Dr Levine said.

‘It causes problems for retirement systems that are based on current workers paying benefits for current retirees,’ he said, as well as difficulties ‘funding and managing a school system.’

Dr Fischer agreed that the reasons for America’s falling birth rate are sociological.

‘People are more anxious than ever,’ he said. ‘People are in more desperate conditions; the economy is obviously very, very unstable. This is not the situation that would have occurred after winning a World War, let’s say, where you’re happy and you want to start a family. This is the antithesis of that.’

The rising cost of living has been a deterrent for people to start a family, Dr Fischer said.

He also noted how dating has changed over the years. ‘In the old days, that would be arranged marriages,’ he said.

Dr Fischer said the pandemic, technological advances, and increasing use of the internet have caused people to become ‘more insular.’

‘It’s easier to become isolated from society on the internet… and you don’t really want to go out because you’re depressed,’ he said, pointing to America’s growing mental health crisis, with one in five adults currently clinically depressed.

He added that rising obesity rates could be having an impact on fertility for both men and women.

‘When you have obese men, the balance of testosterone and estrogen isn’t correct, so there can be fertility problems,’ he said.

NHS crisis sparks boom in private health insurance: Aviva chief Amanda Blanc reports ‘very strong demand’ for cover

By John-Paul Ford Rojas

Published: 16:51 EDT, 16 August 2023 | Updated: 16:51 EDT, 16 August 2023

Some links in this article may be affiliate links. If you click on them we may earn a small commission. That helps us fund This Is Money, and keep it free to use. We do not write articles to promote products. We do not allow any commercial relationship to affect our editorial independence.

With higher taxes, rising interest rates and a cost-of-living squeeze, you’d be forgiven for wanting to escape it all.

Adam, in his late 40s, has come up with an inventive solution to escape the helter skelter of life – by booking himself on a three-year cruise.

In November he will set off on the trip of a lifetime from Istanbul, visiting places around the world from Shanghai to Montego Bay in a 1000 day adventure.

Speaking to MailOnline, he said that he had decided to take the trip following several setbacks, including a relationship breakdown and health problems.

He said: ‘I’ve been through a few life-changing events recently.

‘I sort of thought “I’ve had enough of this”.’

Cabins on Miray International’s MV Lara ship run by Life at Sea Cruises start at £60,000 per year including sights of seven world wonders.

But Adam argues that he can live at sea for three years for the same price that it would cost him to live at home.

He says when he first saw the offer he thought it might be a scam, when he found the offer while browsing online.

‘When I saw it I thought, is this a scam? Around the world for three years?’, he said.

With a tour of 382 places, Adam told MailOnline he was most eager to visit Deception and Half Moon Islands on Antarctica.

‘I’ve always dreamt of going to Antartica.’, he says.

‘If you were to do a trip on its own to Antarctica you would spend thousands.’, he said.

‘I was thinking I get to go to all these places including Antarctica.

‘And the other unique thing about this cruise is that we’re going to places that are hard to get to by plane.’ 

It won’t necessarily be one long holiday though: Adam is trying to arrange with his work to do his job onboard the ship in its designated business centre with high-speed internet.

He is also hoping to complete his dissertation for his Master’s in business administration onboard. 

But he joked that it would mean he wouldn’t need to commute or bother with food shopping.

‘I won’t have to go on Friday for a weekly shop.’, he said gleefully.

‘My bed gets made, my clothes get washed. 

‘They say you can do some yourself, but why would you?

‘Everything gets taken care of. It’s like living in a hotel.’

Onboard Adam will be pampered with a cooked breakfast each day, plus free soft drinks including tea and coffee and alcohol included with dinner.

There’s even entertainment, including live shows thrown in, and all housekeeping is taken care of. 

And as if that wasn’t enough, he can also enjoy the onboard gym and spa, and cinema.

He will also have access to medical consultations, but will have to pay extra for medicine and any treatment. 

But with over a thousand days at sea and not returning the UK until November 1 2026, will he get lonely?

No, says Adam, who lives at home on his own. He says his girlfriend can visit him on the ship four times a year for up to 30 days all included within his package, if they pay port fees and taxes.

The more than 1,200 passengers are also free to leave and rejoin the ship at different destinations if they wish to stay and explore somewhere for longer.

‘Residents, as we are called, are not tied to the ship. What I mean by this is that if we choose to go on some sort of land trip we are able to do so and meet the ship at another destination.’, says Adam.

‘And of course, if you have an emergency at home, say, you can disembark, go and do what you need, and rejoin the cruise later.’ 

With nearly everything included in his multi-year getaway, he even thinks he might make a saving compared to his everyday living costs.

According to the Office of National Statistics, the average UK household spends as much as £528.80 on food, energy, housing, transport and leisure activities – all adding up to £27,497.60 a year.

With higher gas and electricity bills in autumn and winter these costs are likely to rise.

Adam’s diesel car back in Bristol sets him back £9 each time he drives into the city’s low emission zone. 

But while cruising, Adam will be protected from Britain’s high inflation having paid a fixed cost for his trip.

He said: ‘Think about road taxes, shopping, bills.

‘Add into that the stealth taxes this government’s thrown in.’, he adds, ‘No wonder no one wants to earn anything, because everyone’s being thrown into higher tax brackets.

‘We just keep robbing people.’ , he concludes.

Cancer patients have told of having just months to live after facing long waits for treatment on the NHS.

Sufferers across England have been forced to endure delays of up to four months between vital checks, tests and treatments.

As a result, some say they are now dying prematurely, suffering depression and unable to plan for the future.

It comes as England’s burgeoning cancer crisis was today laid bare by MailOnline’s dossier of ‘disgraceful’ data.

The dire numbers – packaged into a searchable tool so you can see exactly how your NHS trust performs – come amid growing fears of a cancer timebomb.

Carol Fletcher

Carol Fletcher, from South Wales, had a routine screening appointment for breast cancer in June 2022.

The NHS offers the checks to women aged 50 to 71 every three years. It uses X-rays to look for cancers that are too small to see or feel.

It was not until eight weeks after her mammogram, that Carol was told there was something wrong.

She was then diagnosed with breast cancer and faced further waits for scans, tests, surgery and chemotherapy.

Carol told the BBC: ‘I was told that I might not get results back [quickly] after my mastectomy because they haven’t got enough pathologists, so there was another eight-week delay for chemotherapy.

‘I can’t plan for the future and it’s had a huge impact on my family.’

Kevin O’Hara

Kevin O’Hara, from County Durham, had a scan last November after a motorbike accident.

As well as showing that he had five broken ribs, a scan detected a shadow near one of his kidneys.

It was later diagnosed as kidney cancer.

Kevin was initially offered drugs to slow the growth of the tumour.

But medics informed him that he faced a three to four month wait for surgery.

He told the BBC: ‘Every day you are waiting and waiting and nothing changes.

‘I come home from work and go to the door and, when there’s no envelope that says NHS on the top, I just get so depressed.’

Charlotte Park

Charlotte Park, from North Yorkshire, booked GP appointment in June 2020 after finding a lump in her breast.

Her doctor made an urgent referral to her local breast clinic, which was supposed to see her within two weeks.

But when Charlotte called the clinic after not hearing from it, she was told there were delays due to a backlog.

She was eventually seen three-and-a-half weeks later — but only after going back to her GP who helped secure an earlier appointment. 

Scans showed she had an aggressive form of breast cancer. But it wasn’t until September that she began chemotherapy.

She is now in remission, which means there is no sign of cancer in her body. 

But she told the BBC: ‘It was so frustrating. I just felt like I was hitting my head against a brick wall. I felt under a massive amount of stress.

‘I thought I was going to die at one point. You worry so much when you are waiting. Sadly there are so many people out there is this position.’

Caroline Boulton 

Caroline Boulton, from Greater Manchester, was booked in for a mammogram — a routine breast cancer check — in March 2020.

But the appointment, and another for November 2020, were cancelled due to the Covid pandemic.

Then, in November 2021, she found a small pea-sized lump on her breast.

Caroline booked a GP appointment and was urgently referred to a specialist. 

However, she had to wait three weeks to see a consultant, rather than the two weeks set out in the NHS rule book.

By the time of her appointment, the lump had grown to the size of a tangerine.

Caroline was told it was a fast-growing cancer but that it would be an eight-week wait for surgery to remove her breast.

She then faced delays of four to eight weeks between each appointment and scan.

By the time she saw an oncologist, seven months after finding the lump, scans showed that the cancer had spread to her liver and there was no effective treatment available. 

Caroline said: ‘I’ve now got stage-four cancer that I shouldn’t have — and two years to live.’ 

In Dreams (Leeds Playhouse)

Verdict: It’s got it

Rating:

Annie Get Your Gun (Lavender Theatre, Epsom, Surrey)

Verdict: Scatter-shot Annie

Rating:

Roy Orbison was a rock’n’roll ventriloquist. It was incredible how little the Big O, as they called him, had to open his mouth to create that sonic boom.

It was as if the man had recently endured root-canal surgery — but could still, somehow, blow the wigs off an audience.

So the big challenge for the new Orbison jukebox musical, led by American actress and singer Lena Hall, was whether it could live up to that extraordinary voice.

Written by David West Read — the author of the Max Martin catalogue musical & Juliet — the show has all-too-transparent designs on our tear ducts. But as Orbison himself might have said of Hall and the cast’s mighty singing: they’ve got it.

Set in a New Mexico diner, it’s a midlife crisis of a musical: Hall’s long, tall, rock singer Kenna invites former band members to celebrate the Mexican Day Of The Dead with her, after she’s been diagnosed with cancer.

But however weird and tenuous the set-up may be, it’s just a pretext for songs ranging from I Drove All Night to Only The Lonely.

The emotional manipulation is cranked up with cascading drums and yearning guitar, typical of Orbison.

But ingeniously, West Read makes the songs fit the story seamlessly, as the friends gather to lament — and celebrate their lives with Kenna.

At its best, the production, directed by Luke Sheppard, has the atmosphere of a gig, with the silver-haired audience swaying and singing along.

Hall, as our skinny, gothic heroine who’s hit 40 and medical reality simultaneously, drives the show with a disdainful swagger — and one hell of a voice.

She is prone to running up and down the vocal scales at full tilt, but breaks up her mega-yodels with tender moments in songs such as Crying and Love Hurts. 

Light relief is provided by Oliver Tompsett as Ramsey, a former lover and the band’s Cockney drummer (who carries his sticks tucked down the back of his jeans, snug in his builder’s cleavage).

Also amusing (and note perfect) are Sian Reese-Williams and Noel Sullivan as former band members who are now on to their fifth child.

But Manuel Pacific is outstanding as the grief-stricken cafe owner, who matches Orbison’s vocal technique from top to bottom in the title number.

The most popular characters are (unsurprisingly) the least self-pitying: Alma Cuervo and Richard Trinder as the wise Spanish grandma and the personal injury lawyer, who get it on in a technically brilliant and hilarious rendition of Pretty Woman.

None of the pain here matches that of Orbison, who lost a wife and children of his own. But this is surely a moody, broody must for lovers of this rock’n’roll colossus. 

A jolly production of Annie Get Your Gun at the lavender-perfumed new open-air theatre in Epsom, Surrey, aims, according to director Simon Hardwick in the programme, to ‘challenge the status quo’ and inspire us to ’embrace the empowerment of women’. 

Happily, it’s more successful at providing a hearty night out, with barbecue and beer tent.

This is just as well, as on the night I attended, the audience at the 200-seater venue, attached to a green-belt garden centre, hailed from as far afield as Norfolk, Yorkshire, Cornwall — and even Australia.

One elderly lady came dressed as an Indian squaw in celebration of the cowboys and Native Americans themed show. And no one seemed in search of Hardwick’s socio- political enlightenment.

Irving Berlin’s Hicksville musical features toe-tapping classics of the genre from There’s No Business Like Show Business to Anything You Can Do (I Can Do Better).

As sharp-shootin’ cowgirl Annie Oakley, our 2018 Eurovision Song Contest entrant SuRie is hardly a feminist firebrand. More nanny than Annie, she could do with turbo-charging the whip-cracking attitude to bring Charlie McCullagh in line as chauvinist hunk Frank Butler.

But it’s a promisingly ambitious start in this new venue. Just come armed with blankets for the return of the traditional British summer.

Word-Play (Royal Court Theatre, London)

Verdict: Tricky

Rating:

Language is slippery stuff and has preoccupied playwrights from Shakespeare to Samuel Beckett. In Rabbiah Hussain’s tricky but tantalising new play, it’s seen as having viral qualities running through society in the wake of a Prime Minister’s gaffe. Who can she be thinking of?

The gaffe itself is not revealed, and the play itself is not concerned with traditional story telling.

Instead it’s a series of sketches traversing sundry locations and social situations. It starts in Downing Street, switches to a bus stop, goes on to alight on a ‘completely detached house in Highgate’ and, perhaps a little too predictably, winds up in a immigration detention centre — via a slew of other settings.

One of the more amusing (and comprehensible) scenes concerns the bovine public transport dictum ‘see it, say it, sorted’.

At another point a boyfriend (Issam Al Ghussain) wants to know why his politically correct girlfriend (Sirine Saba) calls him ‘different’.

Even salt levels in food can be construed as, if not racist, then culturally insensitive. Such is the paranoia of the society we have come to inherit.

But it’s also comic, and what’s clever and curious about Hussain’s play is the way it probes norms not everyone accepts. So we see a politician censored for using the word ‘weird’ on the radio. And there’s a playfulness in the way Hussain looks at how we use language on our phones, in personal relationships and in official situations.

The weirdness (if I may risk using that word) of the play’s non-linear structure is part of the point, but I’m not sure Hussain’s message requires this level of coding. There were periods in the 80-minute odyssey when I was completely lost.

Even so, Nimmo Ismail’s production, performed on office carpet tiles between a two-way mirror and a playground mural, always tantalises. It also has a lot of fun with words in ways that are all too uncommon on the modern stage, which is more concerned with policing language than enjoying it.

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By Miriam Kuepper

Published: 03:13 EDT, 24 June 2023 | Updated: 03:38 EDT, 24 June 2023

Alexandra Capelouto was found slumped over on her bed by her mother, Christine, two days before Christmas.

The 20-year-old sociology major at Arizona State University, who had returned home to Temecula, California on her winter break in 2019, had taken what she thought was a batch of oxycodone to help her sleep.

Instead, it was fentanyl, the deadly drug destroying lives across America. The man who sold it to her, Brandon Michael McDowell, 23, was jailed for nine years in February.

But Alexandra’s grieving father, Matt Capelouto, believes the state’s liberal lawmakers also ‘have blood on their hands’.

America’s fentanyl crisis was born in the mid-1990s, when pharmaceutical companies falsely claimed ‘revolutionary’ pills would put an end to chronic pain without addiction.

When regulators finally cracked down on that lie and the use of prescription opioids to treat chronic pain, addicts took to the streets in search of heroin, creating an unprecedented health crisis.

But by the mid 2010s, dealers began cutting other substances with fentanyl, which is much cheaper and around fifty times more potent than heroin.

In 2022, the drug caused around three quarters of roughly 110,000 overdose deaths, – meaning fentanyl is killing around 2,000 Americans a week. Of those, roughly 110 are Californians – approximately 5.5 percent. 

The crisis has ravaged many liberal states, creating deep divides within the Democratic Party on how to tackle it.

Matt Capelouto claims efforts by moderate state lawmakers to hold dealers to account are repeatedly blocked by a minority of ‘extreme, far-left’ Democrats who hold ‘too much power’.

In San Francisco, fatal overdoses are already up by 41 percent in the first three months of this year compared to the same period in 2022, with the vast majority of deaths involving fentanyl.

Even before the recent spike, the city had among the highest overdose rates of large US counties.

But its mayor, London Breed, is pumping $18.5million into opening three ‘safe consumption’ sites that critics say keep addicts hooked on drugs, instead of treating them.

And now liberal parents have had enough.

Middle class families who have seen their children’s lives destroyed by the state’s fentanyl crisis have told DailyMail.com that California’s drug laws are ‘insanity’ – keeping their loved ones in ‘bondage’ to their addiction while allowing dealers to act with impunity.

In many cases, victims are star students and athletes from the suburbs, creating a legion of enraged but educated parents challenging the liberal status quo on the war on drugs.

 ‘San Francisco keeps repeating the same mistakes’

Tanya Tilghman, 53, says she has been forced to ‘rethink’ her whole liberal worldview because ‘San Francisco has gone way too far left’.

What caused her to reevaluate?

It could have been the moment she was surrounded by 10 to 15 armed police officers while her fentanyl-crazed son held himself hostage in their family home.

Or the time she was laughed at by staff at the city’s ‘safe consumption’ site after she posed as a drug addict and told them she wanted to get clean.

But the final straw seems to be the city’s decision to pump millions of dollars into opening three more ‘wellness hubs’, despite having closed its first after a year because it wasn’t helping enough people into treatment.

Her son, Roman Vardanega, 23, became hooked on fentanyl after a long battle with drug abuse that began with Adderall in high school, which had been prescribed to treat his ADHD.

In between, he was also addicted to cocaine, heroin and meth, and ran out of a private Sacramento treatment center aged 19.

By the time his mother brought him back to San Francisco, fentanyl had become unavoidable for those living on the streets, as Roman now was.

The drug made him increasingly erratic and he would repeatedly break into Tanya’s home, prompting her to take out a restraining order.

Shortly after, Roman held himself hostage in her home and was taken into custody.

It was around this time that Tanya got wind of San Francisco’s Tenderloin Center, the safe consumption site that opened in January last year.

Mayor Breed had promoted it as a place that would help homeless people struggling with addiction get housing and treatment, so Tanya wanted to find out if it could help her son when he was out of custody.

But when she visited with a group of other mother’s, she heard music blaring and wanted a look inside.

She returned, posing as an addict, and told workers at the center she needed help to get off drugs.

‘They laughed at me,’ she said. ‘They told me they could help me to do drugs if I had my own.

‘I went inside and there was loud music. I could see people shooting up, smoking from pipes.

‘I saw people who were on the ground who looked like they were passed out. Staff didn’t seem to care.

‘I stayed there for a good 30 to 40 minutes, just to see if anyone was going to check on the people who were lying on the ground. Nobody was checking on them.

‘I was thinking: “If I would have brought my son there, there’s no way he would have wanted to get help”.’

The center closed in December after costing roughly $12million. While center staff reversed more than 300 overdoses, fewer than 1 percent of visits resulted in linkages to mental health or drug treatment.

Tanya is furious at Mayor Breed’s recent budget, which allocated millions more dollars to open three new centers.

‘If the Tenderloin Center was such a failure, why open new wellness hubs?’ she asks. ‘Just to call them that is insanity. Enabling people to do drugs, and then having them walk out of the facility high is a danger to the community and a danger to themselves.

‘San Francisco seems to keep repeating the same mistakes.’

A  one-stop shop for drugs

Jacqui Berlinn is similarly perplexed. Her son Corey, is an addict on the streets of San Francisco.

On the day Jacqui speaks to DailyMail.com, it is his 32nd birthday.

Last year, he also visited the Tenderloin Center for help with housing.

But he got only as far as getting a bottle of water before he spotted a friend in the waiting area and the pair ended up smoking fentanyl instead, his mother says.

‘He nodded off and never got seen because, of course, he was distracted by the drug use,’ Jacqui adds.

Corey has deteriorated so rapidly in the few years he has been on fentanyl that Jacqui has asked him if he could back on heroin.

‘It sounds crazy, but he actually stayed fairly healthy on heroin,’ she says. ‘Now he just looks awful. But he’s still there. He’s still very sweet and kind and has a sense of humor, but he’s more sad than he’s ever been.

‘He says he doesn’t want his life to be like this, but he doesn’t know how to get out of it.’

Just this week, Jacqui spoke with Corey about San Francisco’s approach to the crisis. ‘Even he said to me, “I don’t know what the mayor is doing”.

‘She is not helping addicts at all. Because they’re putting money into wellness hubs that give addicts everything they need in order to use, but they don’t help with getting people off drugs.

‘They allow people to use openly without consequence. They allow dealers to sell openly in front of police officers.’

Jacqui, along with other San Franciscan parents whose children have been stolen by fentanyl, have set up Mothers Against Drug Addiction & Deaths, a group that lobbies lawmakers for stricter penalties for dealers.

They have erected billboards blaming politicians for the drug crisis, including a ‘Welcome to Camp Fentanyl’ campaign calling for California Governor Gavin Newsom to shut down open-air drug markets, where dealers are allowed to sell drugs without fear of arrest.

The Tenderloin Center was situated directly across from the largest such market in San Francisco, where at least 100 drug dealers gather in the sunshine, creating what Jacqui describes as ‘a one-stop shop’ for drugs.

Addicts would buy their pills from the market and then pop across the plaza to the Tenderloin Center to take them.

To make matters worse, Corey has to walk through this scene to get to his methadone clinic.

‘They’re opposed to putting anybody behind bars’

While California does little to help addicts get off drugs, its lawmakers seem reluctant to punish those who supply them.

In April, Democrats struck down Alexandra’s Law, named after Matt’s daughter, which proposed strengthening penalties for dealers.

The proposed law would see convicted fentanyl dealers receive a warning from judges that would act as a precursor to a potential homicide charge if they then dealt drugs that killed someone.

The law was modeled on DUI legislation, which supporters claim has reduced instances of drink driving.

Despite bipartisan support, the bill failed to get past committee stage due to opposition from Democrat senators Scott Weiner, Nancy Skinner and Steven Bradford.

Tensions almost spilled over as the State Senate’s Public Safety Committee debated the bill, as angry parents yelled at lawmakers to hold dealers accountable.

Matt believes the Democrats opposed to the bill ‘willfully misled’ the public by arguing that the proposed law would prosecute dealers who weren’t aware their drugs were laced with fentanyl, with Wiener incorrectly suggesting that those who are caught drink driving after being spiked are not charged with an offense.

‘They’re opposed to putting anybody behind bars,’ he says. ‘They’ll come up with every excuse to make the victim the criminal.’

On Tuesday, state Republicans proposed a referendum on Alexandra’s Law to bypass the committee.

To go to a public vote, it will require two thirds of both the Assembly and the Senate to agree on it.

But Tanya believes the city’s entire attitude to drugs needs to change.

‘San Francisco has always been pro drugs,’ she says. ‘That dates back to the 60s and 70s. They still have the same message that it’s okay to use drugs.

‘But what they are failing to understand is that fentanyl has changed the entire drug outlook. We have so many more people dying, they’re cutting it in all different types of drugs.

‘I don’t understand that mentality. We’re in a city where we’re losing all of the major retail stores because of crime and because of all the drug dealing that’s going on.

‘Putting up more wellness hubs is going to attract more drug dealers and more people coming in and wanting to use drugs and crime is going to increase further.’

For Matt, it took four years to see the man who poisoned his daughter behind bars, but the anguish will never pass.

A year before the sentencing, his wife, Christine, was diagnosed with terminal breast cancer. She was told her disease was not genetic and was more than likely caused by grief.

As a final wish, the couple have just returned from a holiday to the Netherlands, visiting a family with whom Alexandra stayed on a school exchange.

Matt will continue campaigning for Alexandra’s legacy and that of his three surviving daughters, Skye, Brooke and Brittney.

‘Alex is my daughter in heaven now,’ he says. ‘Here I am, three and a half years later and probably not an hour goes by where I’m not thinking about her in some way.’