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The marketing pitches are bold and arriving fast: Invest opioid settlement dollars in a lasso-like device to help police detain people without Tasers or pepper spray. Pour money into psychedelics, electrical stimulation devices, and other experimental treatments for addiction. Fund research into new, supposedly abuse-deterrent opioids and splurge on expensive, brand-name naloxone.

This story also ran on Fortune. It can be republished for free. More from This InvestigationPayback: Tracking the Opioid Settlement Cash

Opioid manufacturers and distributors are paying more than $54 billion in restitution to settle lawsuits about their role in the overdose epidemic, with little oversight on how the money is spent. Were tracking how state and local governments use or misuse the cash.Read More

These pitches land daily in the inboxes of state and local officials in charge of distributing more than $50 billion from settlements in opioid lawsuits.

The money is coming from an array of companies that made, sold, or distributed prescription painkillers, including Johnson & Johnson, AmerisourceBergen, and Walgreens. Thousands of state and local governments sued the companies for aggressively promoting and distributing opioid medications, fueling an epidemic that progressed to heroin and fentanyl and has killed more than half a million Americans. The settlement money, arriving over nearly two decades, is meant to remediate the effects of that corporate behavior.

But as the dollars land in government coffers more than $4.3 billion as of early November a swarm of private, public, nonprofit, and for-profit entities are eyeing the gold rush. Some people fear that corporations, in particular with their flashy products, robust marketing budgets, and hunger for profits will now gobble up the windfall meant to rectify it.

They see a cash cow, said JK Costello, director of behavioral health consulting for the Steadman Group, a firm that is being paid to help local governments administer the settlements in Colorado, Kansas, Oregon, and Virginia. Everyone is interested.

Costello receives multiple emails a week from businesses and nonprofits seeking guidance on how to apply for the funds. To keep up with the influx, he has developed a standard response: Thanks, but we cant respond to individual requests, so heres a link to your localitys website, public meeting schedule, or application portal. Email Sign-Up

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KFF Health News obtained email records in eight states that show health departments, sheriffs offices, and councils overseeing settlement funds are receiving a similar deluge of messages. In the emails, marketing specialists offer phone calls, informational presentations, and meetings with their companies.

Alabama Attorney General Steve Marshall recently sent a letter reminding local officials to vet organizations that reach out. I am sure that many of you have already been approached by a variety of vendors seeking funding for opioid initiatives, he wrote. Please proceed with caution.

Of course, not all marketing efforts should prompt concern. Emails and calls are one way people in power learn about innovative products and services. The countrys addiction crisis is too large for the public sector to tame alone, and many stakeholders agree that partnering with industry is crucial. After all, pharmaceutical companies manufacture medications to treat opioid addiction. Corporations run treatment facilities and telehealth services.

Its unrealistic and even harmful to say we dont want any money going to any private companies, said Kristen Pendergrass, vice president of state policy at Shatterproof, a national nonprofit focused on addiction.

The key, agree public health and policy experts, is to critically evaluate products or services to see if they are necessary, evidence-based, and sustainable instead of flocking to companies with the best marketing.

Otherwise, you end up with lots of shiny objects, Costello said. Carolyn Williams lost her 47-year-old son, Haison Akiem Williams, to an overdose in February. She wants settlement funds to support services she thinks could have kept him alive: mental health treatment, case management, and housing. In June, she spoke at a protest outside a Drug Enforcement Administration building in Arlington, Virginia, where people called for an end to a criminal justice approach to addiction.(Aneri Pattani/KFF Health News)

And, ultimately, failure to do due diligence could leave some jurisdictions holding an empty bag.

Take North Carolina. In 2022, state lawmakers allotted $1.85 million of settlement funds for a pilot project using the first FDA-approved app for opioid use disorder, developed by Pear Therapeutics. There were high hopes the app would help people stay in treatment longer.

But less than a year later, Pear Therapeutics filed for bankruptcy.

The state hadnt paid the company yet, so the money isn’t lost, according to the North Carolina Department of Health and Human Services. But the department and lawmakers have not decided what to do with those dollars next.

$1 Million for Drug Disposal Pouches

Jason Sundby, CEO of Verde Environmental Technologies, said the Deterra pouches his company sells are a low-cost way to prevent expensive addictions.

Customers place their unused medications in a Deterra pouch and add water, deactivating the drugs before tossing them, ensuring they cannot be used even if fished out of the trash. A medium Deterra pouch costs $3.89 and holds 45 pills.

The goal is to get these drugs out of people’s homes before they can be misused, diverted, and people start down the path of needing treatment or naloxone or emergency room visits, Sundby said.

Sundbys company ran an ad about spending settlement dollars on its product in a National Association of Counties newsletter and featured similar information online. The Deterra website prominently features opioid settlement funds as a potential funding stream to purchase drug disposal pouches. Several other companies have taken similar approaches, urging consumers to consider applying opioid settlement funds to their products. (KFF Health News screenshot of https://deterrasystem.com/resources/funding/ on Nov. 21, 2023)

It may be paying off, as Deterra is set to receive $1 million in settlement funds from the health department in Delaware County, Pennsylvania, and $12,000 from the sheriffs office in Henry County, Iowa. The company also has partnerships with St. Croix and Milwaukee counties in Wisconsin, and is working on a deal in Connecticut.

Several other companies with similar products have also used their product sites to urge jurisdictions to consider the settlements as a funding stream and theyre seeing early success.

DisposeRx makes a drug deactivation product its version costs about a dollar each and received $144,000 in South Carolina for mailing 134,000 disposal packets to a program that educated high school football players, coaches, and parents about addiction.

SafeRx makes $3 pill bottles with a locking code to store medications and was awarded $189,000 by South Carolinas opioid settlement council to work with the Greenville County Sheriffs Office and local prevention groups. It also won smaller awards from Weld and Custer counties in Colorado.

None of the companies said they are dependent on opioid settlements to sustain their business long-term. But the funds provide a temporary boost. In a 2022 presentation to prospective investors, SafeRx called the opioid settlements a growth catalyst.

Critics of such investments say the products are not worthwhile. Todays crisis of fatal overdoses is largely driven by illicit fentanyl. Even if studies suggest the companies products make people more likely to safely store and dispose of medications, thats unlikely to stem the record levels of deaths seen in recent years.

The plausible mechanism by which they would even be able to reduce overdoseis a mystery because prescription medications are not driving overdose, said Tricia Christensen, policy director with the nonprofit Community Education Group, which is tracking settlement spending across Appalachia.

Safe storage and disposal can be accomplished with a locking cabinet and toilet, she said. The FDA lists opioids on its flush list for disposal and says there is no evidence that low levels of the medicines that end up in rivers harm human health.

But Milton Cohen, CEO of SafeRxs parent company, Caring Closures International, said keeping prescription medicines secure addresses the root of the epidemic. Fentanyl kills, but often where people start, where water is coming into the boat still, is the medicine cabinet, he said. We can bail all we want, but the right thing to do is to plug the hole first. SafeRx has been awarded $189,000 in opioid settlement funds in South Carolina to work with the Greenville County Sheriffs Office and local prevention groups.(Caring Closures International)

Products to secure and dispose of drugs also provide an opportunity for education and destigmatization, said Melissa Lyon, director of the Delaware County Health Department in Pennsylvania. The county will be mailing Deterra pouches and postcards about preventing addiction to three-quarters of its residents.

The Deterra pouch is to me a direct correlation to the overprescribing that came from pharmaceutical companies aggressive marketing, she added. Since the settlement money is to compensate for that, this is a good use of the funds.

Tools for Law Enforcement That Superheroes Would Envy

Other businesses making pitches for settlement funds have a less clear relationship to opioids.

Wrap Technologies creates tools for law enforcement to reduce lethal uses of force. Its chief product, the BolaWrap, shoots a 7-foot Kevlar tether more than a dozen feet through the air until it wraps around a persons limbs or torso almost like Wonder Womans Lasso of Truth. Brownwood, Texas, has spent about $15,000 of opioid settlement funds to buy nine BolaWrap devices.(Wrap Technologies)

Terry Nichols, director of business development for the company, said the BolaWrap can be used as an alternative to Tasers or pepper spray when officers need to detain someone experiencing a mental health crisis or committing crimes related to their addiction, like burglary.

If you want to be more humane in the way you treat people in substance use disorder and crisis, this is an option, he said.

The company posts body camera footage of officers using BolaWrap on YouTube and says that out of 192 field reports of its use, about 75% of situations were resolved without additional use of force.

When officers de-escalate situations, people are less likely to end up in jail, Nichols said. And diverting people from the criminal justice system is among the suggested investments in opioid settlement agreements.

That argument convinced the city of Brownwood, Texas, where Nichols was police chief until 2019. It has spent about $15,000 of opioid settlement funds to buy nine BolaWrap devices.

Our goal is to avoid using force when a citizen is in need, said James Fuller, assistant police chief in Brownwood. If were going to take someone to get help, the last thing we want to do is poke holes in them with a Taser.

After Brownwoods purchase, Wrap Technologies issued a press release in which CEO Kevin Mullins encouraged more law enforcement agencies to take the opportunity afforded by the opioid settlement funds to empower their officers. The company has also sent a two-page document to police departments explaining how settlement funds can be used to buy BolaWraps.

Language from that document appeared nearly word-for-word in a briefing sheet given to Brownwood City Council before the BolaWrap purchase. The council voted unanimously in favor.

But the process hasnt been as smooth elsewhere. In Hawthorne, California, the police department planned to buy 80 BolaWrap devices using opioid settlement funds. It paid its first installment of about $25,000 in June. However, it was later informed by the state Department of Health Care Services that the BolaWrap is not an allowable use of these dollars.

Bola Wraps will not be purchased with the Settlement Funds in the future, Hawthorne City Clerk Dayna Williams-Hunter wrote in an email.

Carolyn Williams, a member of the advocacy group Vocal-TX, said she doesnt see how the devices will address the overdose crisis in Texas or elsewhere.

Her son Haison Akiem Williams dealt with mental health and addiction issues for years. Without insurance, he couldnt afford rehab. When he sought case management services, there was a three-month wait, she said. Police charged him with misdemeanors but never connected him to care, she said. Share Your Story

Do you have concerns about how your state or locality is using the opioid settlement funds? Are they doing something effective that other places should replicate? Tell us here.Share Your Story

In February, he died of an overdose at age 47. His mother misses how he used to make her laugh by calling her Ms. Carol.

She wants settlement funds to support services she thinks could have kept him alive: mental health treatment, case management, and housing. BolaWrap doesnt make that list.

Its heartbreaking to see what the government is doing with this money, she said. Putting it in places they really don’t need it.

Aneri Pattani: apattani@kff.org, @aneripattani Related Topics Multimedia Public Health States Alabama California Colorado Connecticut Investigation Iowa North Carolina Opioid Settlements Opioids Pennsylvania South Carolina Texas Wisconsin Contact Us Submit a Story Tip

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Stephen Graham on how the rise of incel culture influenced new Netflix show Adolescence

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Stephen Graham on how the rise of incel culture influenced new Netflix show Adolescence

Stephen Graham says the rise of “misogynistic tendencies” is concerning and we’re “all accountable to an extent” to finding a solution.

His new limited series Adolescence looks at the impact of social media on children and the accessibility to radicalised views online.

Speaking to Sky News, Graham says there was a certain moment for him that inspired him to create the show.

Stephen Graham as Eddie Miller in Adolescence. Pic: Netflix
Image:
Stephen Graham as Eddie Miller in Adolescence. Pic: Netflix

“I read an article about a young girl who was stabbed to death by a young boy, and then a few months later, on the news there was a young girl who, again, had been brutally stabbed to death by a young boy in a completely different part of the country.

“If I’m really honest with you, that hurt my heart and I just thought, why? Why does this kind of thing happen? What is this society? Why have we reached this point where this kind of thing is happening? What was the reason?”

The four-part drama, he says, doesn’t have the answer but instead holds a mirror up to society asking how can the growing presence of incel culture be quashed?

“You look at it and you see that we’re kind of all accountable to an extent. There’s failings within the school system, there’s situations where the education system can look at this, look at what’s happened with that kind of rise in these misogynistic tendencies.

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“The society as a whole can look at this, parents obviously can look at this, and the government in many ways.”

What is the term incel?

Derived from the phrase “involuntarily celibate”, an incel culture in its simplest is someone who deems themselves unable to find a romantic partner despite desiring one.

A more radicalised sub-culture of incels has surfaced online in recent years which includes individuals who dislike feminism and believe that women have become too sexually selective.

They believe men are the superior sex and men have the right to objectify and criticise women as a result.

Influencers like Andrew Tate have been connected to the growing corner of the internet in which young boys are being radicalised from the certain viewpoint.

Ashely Walters as Detective Inspector Bascombe in Adolescence. Pic: Netflix
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Ashley Walters as Detective Inspector Bascombe in Adolescence. Pic: Netflix

Actor Ashley Walters, who stars alongside Graham in the series, says reading into the existence of the misogynistic group came as a bit of a shock and it worries him about the world children are growing up in.

“I’d seen bits of the Andrew Tate stuff kind of popping up online or whatever, but I never really delved into it. And for me, this was the first real experience.

He adds: “I do sometimes feel sorry for [kids]. When I was growing up, I was in a bubble. I didn’t have a clue what was going on in the States and other parts of the world.

“It was just kind of in my little area that I grew up in with my family… I wasn’t seeing Bentleys and designer clothes and all of this stuff. It’s like I was happy with what I had. And now you’re exposed to everything. It’s no wonder that kids mentally grow up quicker.”

Read more from Sky News:
Who is the real Belle Gibson?
Meet the Eurovision hopefuls who sing their trollers’ insults

The Top Boy actor believes it can be hard for young boys to talk about their emotions.

“It’s really important that we have these conversations and we make it normal to have discussions just like women and young girls do about feelings and whatever they’re going through.

“That was one of the big reasons why I wanted to be a part of this conversation that we’re creating, because I’m a strong advocate for, as a man, being vulnerable, crying in front of my friends, and just saying how I feel.

“It’s even difficult for me at times, so I can’t imagine how young men are at the moment… everything that’s going on around social media in their lives, how difficult it is for them to start this conversation.”

‘This government needs to do something’

Co-creator and writer Jack Thorne agrees and says the government should step in and guide children and their parents to the correct use of social media.

“I think this government needs to do something. And there’s a private members’ bill going through the Commons on Friday that has been watered down quite extensively by this government because they’re frightened of big tech.

“And we need to be having conversations like Australia’s having conversations, whether they’re actually putting in legislation about restricting social media access.

“We need to be having those conversations in this country and we’re not. And if we don’t have these conversations, it is going to get worse.”

Fatima Bojang as Jade. Pic: Netflix
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Fatima Bojang as Jade in Adolescence. Pic: Netflix

He adds: “Doing this show I spent a lot of time in a lot of dark places. I saw where the web went and where the web goes. And it’s not about Andrew Tate. Andrew Tate is the shorthand for adults.

“There’s much worse stuff out there. And it teaches kids a logic… that makes sense of the world for them in a really distorted and ugly way. And unless we look at that and talk about that, things are only going to get worse.”

A government spokesperson said: “We are committed to keeping young people safe online.

“Starting next week, Ofcom can begin enforcing the Online Safety Act’s illegal content duties, targeting the most harmful material.

“By summer, children will be protected from harmful content, and platforms must take steps to ensure age-appropriate experiences online.

“These protections will act as the foundation and our priority is implementing them quickly and effectively.

“We also know there will be more to do and have already acted, including commissioning a study to assess current research on the impact of social media and smartphones, strengthening the evidence base on their impact on children’s wellbeing.

“This will enable us to swiftly consider all options to inform our next steps in the safety of children online.”

Adolescence is out on Netflix on 13 April.

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Reform UK’s Andrea Jenkyns says Nigel Farage’s row with Rupert Lowe was ‘clearly a big falling out’ – but insists it will ‘blow over’

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Reform UK's Andrea Jenkyns says Nigel Farage's row with Rupert Lowe was 'clearly a big falling out' - but insists it will 'blow over'

Reform UK’s most senior woman has told Sky News the Rupert Lowe row “doesn’t look great” and she doesn’t “want to see it in the news any more days”. 

Dame Andrea Jenkyns, who defected to Reform last year, accepted it was “clearly a big falling out” but suggested these spats do not always cut through to the public.

She insisted she was concentrating on winning as she looks to become the party’s first ever mayor in May.

In an interview with Sky News, Dame Andrea also spoke for the first time about her experience of domestic abuse, denying Reform has a “woman problem” but accepted “we need to start talking more about issues, what women are interested in”.

Having lost her seat as a Conservative in the 2024 election, Dame Andrea briefly quit politics only to return earlier this year as Reform’s newest recruit.

She is now standing as the party’s candidate to become the first Greater Lincolnshire mayor, in a race that psephologists think could be Reform’s best hope of turning itself from a party of protest into one that is governing.

That’s because Reform is on the march in Lincolnshire, which is a key battleground between the Conservatives and Reform in the local and mayoral elections in May.

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Richard Tice, Reform’s deputy leader, took the Conservative seat of Boston and Skegness in the last election as Reform came second in a further two of the county’s eight constituencies.

Andrea Jenkyns spoke to Sky News' Beth Rigby
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Dame Andrea spoke to Sky News’ Beth Rigby

This farming country has long been part of the patchwork of Conservative England and it is in these heartlands that Reform hopes it can land a significant blow to its political rivals in the coming weeks.

“It’s a worry,” admits one Labour insider who doesn’t much relish the prospect of having to deal with a newly minted Reform party mayor should Dame Andrea win in May against Labour candidate Jason Stockwood, the Conservative Rob Waltham and independent Marianne Overton.

There is also the Lincolnshire council race, which Reform is targeting. All 70 seats are up for grabs and the Conservatives, which have a 38-seat majority, are defending 53 seats. The only way is up for Reform here, while the Conservatives, who have held this council for 10 of the past 13 elections, are bracing for a drubbing.

Tories say Jenkyns is from Yorkshire

The Conservatives make the point that they have a “strong local candidate who is born and bred in Lincolnshire, whereas Dame Andrea is from Yorkshire” when I ask them about the race.

“We are fighting hard, we have a proven track record of delivery in charge of local services whereas Reform aren’t tried and tested,” the Conservatives said.

“And if they’re anything like Reform nationally, who don’t turn up on important votes, then they won’t show up for people locally.”

Dame Andrea is still based in Yorkshire where she used to be an MP, as this is where her son attends school. But she rents a place in Lincolnshire and has vowed to move to the county should she win the mayoralty.

She also points out that she grew up in Lincolnshire and was a local councillor before moving to Yorkshire after her shock victory over Ed Balls in the 2015 general election.

Read more:
Rupert Lowe consulting lawyers over libel action
Police launch investigation into Rupert Lowe over ‘verbal threats’

Andrea Jenkyns with farmers
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Dame Andrea is hoping to become Reform’s first mayor

‘Fed up’ farmers eyeing Reform

When we meet her on the road in Lincolnshire, she takes us to meet some farmers whose livelihoods are under intense pressure – be it over local flooding and flood defences or changes to inheritance tax and farming subsidies that are affecting their farms.

There is little love for Labour in the gathering of farmers, who in the main seem to be lapsed Conservative voters that are now eyeing Reform, as a number of them tell me how they are fed up with how the Environment Agency and local politicians are running their area.

“We’re fed up with all of them,” said one farmer.

“We just want some action. As farmers we know drainage is so important, we just want to get it sorted.”

They are also alarmed and anxious about the inheritance tax changes introduced by Labour and are pressing for carve-outs for small farms handed down from generation to generation amid fears they will have to sell up to pay the inheritance tax bills.

But the troubles at the top of Reform hadn’t gone unnoticed by this group. Unprompted, one of the farmers raised the row between the suspended Reform MP Rupert Lowe and the party leadership, telling Dame Andrea that while he “really likes Reform” he doesn’t much like what he’s seeing at the moment.

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Reform UK row explained

‘Spat looks worse because Reform is small’

The farmer said: “I don’t follow politics avidly. But I just look and say [Rupert Lowe] is full of common sense and I really like him and I don’t know what’s happened, but it looks from outside [he has been] chucked under the bus.

“And I’m like, am I getting second thoughts about Reform? I don’t know what’s gone on, but it concerns me about what’s going on with Reform.”

Dame Andrea tries to downplay it and says the “spat” looks worse because it’s a smaller party.

“To me it’s about the movement, the right policies, to carry on. What is the alternative? This will blow over and Reform will keep getting strong,” she said.

Can Jenkyns and Farage co-exist?

Dame Andrea would clearly like the infighting to stop, but it raises questions for me about how she will fit into this very male-dominated party, in which all four MPs are male, with Dame Andrea the only senior woman beyond the former Conservative minister Ann Widdicombe.

She is, like Nigel Farage, a disrupter – Dame Andrea was one of the first Tories to call for Theresa May and Rishi Sunak to stand down, and a conviction politician who fervently backed Boris Johnson and Brexit.

If she does win this mayoral race she will be a big personality in Reform alongside Farage, which leaves me wondering if they can co-exist in a party already at war.

Andrea Jenkyns
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Dame Andrea says she doesn’t think the party has a ‘woman problem’

Jenkyns was in an abusive relationship

Reform does struggle with female voters, with fewer women voting for the party against all age cohorts, young to old. Dame Andrea tells me she doesn’t think the party has a “woman problem”, but she does think it needs to talk about more issues that she thinks women are interested in, citing education, special educational needs and mental health.

When I raise the matter of violence against women and how the party has handled revelations that one of its own MPs was jailed in a youth detention centre as a teenager for assaulting his girlfriend, Dame Andrea reveals to me she has been in an abusive relationship.

“I know how it can break you. I know how you sort of start losing your identity. So I’ve been on that side,” she said.

“And I’ve also helped constituents to fight against this, so it matters, we need to do more in society because whether it’s men or women, one is too much in my view.”

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Out on the campaign trail, even in the Labour territory of Lincoln where Hamish Falconer is the local MP, Dame Andrea gets a warm welcome. She tells me she thinks she can win it: “I might be living in blind hope here. But I’ve got that feeling.”

This corner of England has become a test bed for Reform to see if it can turn from a party of protest into one that has a shot at governing in the form of a regional mayor.

If Reform can succeed in that – what might come next? It would be a remarkable comeback for Dame Andrea and a remarkable victory for Reform too.

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Labour MPs and officials briefing against work and pensions secretary should ‘shut up’, Baroness Harman says

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Labour MPs and officials briefing against work and pensions secretary should 'shut up', Baroness Harman says

Labour MPs and officials briefing against work and pensions secretary Liz Kendall should “shut up”, Harriet Harman has said.

The Labour peer told Beth Rigby on Sky News’ Electoral Dysfunction podcast Labour needed to “pull together” rather than descend into infighting.

Ms Kendall said on Thursday she was “determined to fix the broken benefits system” ahead of announcing “radical welfare reforms” next week.

Ministers have been priming Labour MPs and the public for cuts to a ballooning welfare bill since the start of the year.

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Baroness Harriet Harman said people criticising Liz Kendall should ‘shut up’

Asked what she thought of briefings against Ms Kendall as welfare cuts loom, Baroness Harman said: “I hate those sorts of briefings.

“I don’t think anybody should be briefing against Labour ministers who are trying to implement the manifesto.

“You know, she is incredibly competent and leads a really dedicated team. So I think they should just shut up and pull together.”

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Work and Pensions Secretary Liz Kendall. Pic: PA
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Work and Pensions Secretary Liz Kendall. Pic: PA

More and more Labour MPs have publicly criticised the impending benefit cuts, with many concerned they will hit people with disabilities the most.

Downing Street has taken the unusual step of calling all 404 Labour MPs into Number 10 over Wednesday and Thursday for briefings on the changes ahead of the details being released next week.

Baroness Harman said she thinks Ms Kendall is a “rising star” and is “absolutely certain” the PM and chancellor will stand behind her.

Read more:
What welfare cuts could be announced?

Labour MPs criticise benefit cuts

The peer was social security secretary – the equivalent of Ms Kendall’s job now – at the start of Tony Blair’s first term after Labour’s 1997 landslide win.

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‘Government’s plan to cut welfare is terrifying’

She was forced to defend benefit cuts just after they came to power and said there are “lots of parallels between what we were trying to do then, and what the government is trying to do now”.

However, she said the difference is, in 1997 she was making the argument for welfare cuts to help single parents into work by herself, but Ms Kendall is being backed by Rachel Reeves and Sir Keir Starmer.

Never miss an episode of Electoral Dysfunction wherever you get your podcasts.

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