title: National Health Service (England)

text: The population of England is ageing, which has led to an increase in health demand and funding. From 2011 to 2018, the population of England increased by about 6%. The number of patients admitted to hospital in an emergency went up by 15%.  There were 542,435 emergency hospital admissions in England in October 2018, 5.8% more than in October 2017. Health spending in England is expected to rise from £112 billion in 2009/10 to £127 billion in 2019/20 (in real terms), and spending per head will increase by 3.5%.


title: National Health Service (England)

text: However, according to the Institute for Fiscal Studies (IFS), compared to the increase necessary to keep up with a rising population that is also ageing, spending will fall by 1.3% from 2009–10 to 2019–20. George Stoye, senior research economist of the IFS, and said the annual increases since 2009-10 were "the lowest rate of increase over any similar period since the mid-1950s, since when the long-run annual growth rate has been 4.1%".<ref name="Guardian3/5/2017"></ref> This has led to cuts to some services, despite the overall increase in funding. In 2017, funding increased by 1.3% while demand rose by 5%. Ted Baker, Chief Inspector of Hospitals has said that the NHS is still running the model it had in the 1960s and 1970s and has not modernised due to lack of investment. The British Medical Association (BMA) has called for £10bn more annually for the NHS to get in line with what other advanced European nations spend on health. In June 2018 ahead of the NHS' 70th Anniversary then Prime Minister Theresa May announced extra funding for the NHS worth an average real terms increase of 3.4% a year, reaching £20.5 billion extra in 2023/24.


title: National Health Service (England)

text: From 2003 to 2013 the principal fundholders in the NHS system were the primary care trusts (PCTs), that commissioned healthcare from NHS trusts, GPs and private providers. PCTs disbursed funds to them on an agreed tariff or contract basis, on guidelines set out by the Department of Health. The PCTs budget from the Department of Health was calculated on a formula basis relating to population and specific local needs. They were supposed to "break even" – that is, not show a deficit on their budgets at the end of the financial year. Failure to meet financial objectives could result in the dismissal and replacement of a trust's board of directors, although such dismissals are enormously expensive for the NHS.


title: National Health Service (England)

text: From April 2013 a new system was established as a result of the Health and Social Care Act 2012. The NHS budget is largely in the hands of a new body, NHS England. NHS England commissions specialist services and primary care. Acute services and community care are commissioned by local clinical commissioning groups (CCGs) led by GPs. From April 2021 all CCGs have become part of Integrated Care Systems.


title: National Health Service (England)

text: This means that people generally do not pay anything for their doctor visits, nursing services, surgical procedures or appliances, consumables such as medications and bandages, plasters, medical tests, and investigations, x-rays, CT or MRI scans or other diagnostic services. Hospital inpatient and outpatient services are free, both medical and mental health services. Funding for these services is provided through general taxation and not a specific tax.


title: National Health Service (England)

text: Because the NHS is not funded by a contributory insurance scheme in the ordinary sense and most patients pay nothing for their treatment there is thus no billing to the treated person nor to any insurer or sickness fund as is common in many other countries. This saves hugely on administration costs that might otherwise involve complex consumable tracking and usage procedures at the patient level and concomitant invoicing, reconciliation and bad debt processing.


title: National Health Service (England)

text: the NHS prescription charge in England was £9 for each quantity of medicine (which contrasts with Scotland, Wales and Northern Ireland where items prescribed on the NHS are free). People over sixty, children under sixteen (or under nineteen if in full-time education), patients with certain medical conditions, and those with low incomes, are exempt from paying. Those who require repeated prescriptions may purchase a single-charge pre-payment certificate that allows unlimited prescriptions during its period of validity. The charge is the same regardless of the actual cost of the medicine, but higher charges apply to medical appliances. Pharmacies or other dispensing contractors are reimbursed for the cost of the medicines through NHS Prescription Services, a division of the NHS Business Services Authority. For more details of prescription charges, see Prescription charges.


title: National Health Service (England)

text: The high and rising costs of some medicines, especially some types of cancer treatment, means that prescriptions can present a heavy burden to the primary care trusts, whose limited budgets include responsibility for the difference between medicine costs and the fixed prescription charge. This has led to disputes whether some expensive drugs (e.g., Herceptin) should be prescribed by the NHS.


title: National Health Service (England)

text: The position of dentistry within the NHS has been contested frequently. At the inception of the NHS, three branches of dental service were established: local health authority dental service; general practitioner service; and hospital dental service. Dental treatment was initially free at the point of use; however charges were introduced in 1951 for dentures – leading to the resignation of the architect of the NHS and Minister for Labour, Aneurin Bevan in March 1951 – and in 1952 for other treatments.


title: National Health Service (England)

text: Dentists are private contractors to the NHS, which means practitioners must purchase and maintain the practice premises, equip the surgery, and hire staff in order to provide an NHS dental service. The contract between the NHS and dentists determines what work is provided for under the NHS, payments to dentists, and charges to patients. The contract is regularly revised – in 2003, the Government announced major changes to NHS dentistry, giving Primary Care Trusts (PCTs) responsibility for commissioning NHS dental services in response to local needs, and using NHS contracts to influence where dental practices were located, and in 2006 a new contract was introduced following Department of Health recommendations on how to cash limit NHS primary care dentistry. Professional bodies such as the British Dental Association have complained that the 2006 contract changes introduced a remuneration system which fails to incentivise disease prevention, leading to declining patient outcomes, and that radical reform was needed.


title: National Health Service (England)

text: NHS dentistry charges were: £20.60 for an examination; £56.30 for a filling or extraction; and £244.30 for more complex procedures such as crowns, dentures or bridges. As of 2007, less than half of dentists' income came from treating patients under NHS coverage; about 52% of dentists' income was from treating private patients.


title: National Health Service (England)

text: From 1 April 2007 the NHS Sight Test Fee (in England) was £19.32, and there were 13.1 million NHS sight tests carried out in the UK.


title: National Health Service (England)

text: For those who qualify through need, the sight test is free, and a voucher system is employed to pay for or reduce the cost of lenses. There is a free spectacles frame and most opticians keep a selection of low-cost items. For those who already receive certain means-tested benefits, or who otherwise qualify, participating opticians use tables to find the amount of the subsidy.


title: National Health Service (England)

text: Under older legislation (mainly the Road Traffic Act 1930) a hospital treating the victims of a road traffic accident was entitled to limited compensation (under the 1930 Act before any amendment, up to £25 per person treated) from the insurers of driver(s) of the vehicle(s) involved, but were not compelled to do so and often did not do so; the charge was in turn covered by the then legally required element of those drivers' motor vehicle insurance (commonly known as "Road Traffic Act insurance" when a driver held only that amount of insurance). As the initial bill went to the driver rather than the insurer, even when a charge was imposed it was often not passed on to the liable insurer. It was common to take no further action in such cases, as there was no practical financial incentive (and often a financial disincentive due to potential legal costs) for individual hospitals to do so.


title: National Health Service (England)

text: The Road Traffic (NHS Charges) Act 1999 introduced a standard national scheme for recovery of costs using a tariff based on a single charge for out-patient treatment or a daily charge for in-patient treatment; these charges again ultimately fell upon insurers. This scheme did not however fully cover the costs of treatment in serious cases.


title: National Health Service (England)

text: Since January 2007, the NHS has a duty to claim back the cost of treatment, and for ambulance services, for those who have been paid personal injury compensation. In the last year of the scheme immediately preceding 2007, over £128 million was reclaimed.


title: National Health Service (England)

text: From April 2019 £725 is payable for outpatient treatment, £891 per day for inpatient treatment and £219 per ambulance journey.


title: National Health Service (England)

text: Car parking charges are a minor source of revenue for the NHS, with most hospitals deriving about 0.25% of their budget from them. The level of fees is controlled individually by each trust. In 2006 car park fees contributed £78 million towards hospital budgets. Patient groups are opposed to such charges. (This contrasts with Scotland where car park charges were mostly scrapped from the beginning of 2009 and with Wales where car park charges were scrapped at the end of 2011.)


title: National Health Service (England)

text: There are over 300 official NHS charities in England and Wales. Collectively, they hold assets in excess of £2 billion and have an annual income in excess of £300 million. Some NHS charities have their own independent board of trustees whilst in other cases the relevant NHS trust acts as a corporate trustee. Charitable funds are typically used for medical research, larger items of medical equipment, aesthetic and environmental improvements, or services that increase patient comfort.


title: National Health Service (England)

text: In addition to official NHS charities, many other charities raise funds that are spent through the NHS, particularly in connection with medical research and capital appeals.


title: National Health Service (England)

text: Regional lotteries were also common for fundraising, and in 1988, a National Health Service Lottery was approved by the government, before being found illegal. The idea continued to become the National Lottery.


title: National Health Service (England)

text: Although the NHS routinely outsources the equipment and products that it uses and dentistry, eye care, pharmacy and most GP practices are provided by the private sector, the outsourcing of hospital health care has always been controversial. The involvement of private companies regularly draws the suspicion of NHS staff, the media and the public.


title: National Health Service (England)

text: Outsourcing and privatisation has increased in recent years, with NHS spending to the private sector rose from £4.1 billion in 2009–10 to £8.7 billion in 2015–16. The King's Fund's January 2015 report on the Coalition Government's 2012 reforms concluded that while marketisation had increased, claims of mass privatisation were exaggerated. Private firms provide services in areas such as community service, general practise and mental health care. An article in "The Independent" suggested that the private sector tends to choose to deliver the services that are the most profitable, additionally because the private sector does not have intensive care facilities if things go wrong.


title: National Health Service (England)

text: Sustainability and transformation plans were produced during 2016 as a method of dealing with the service's financial problems. These plans appear to involve loss of services and are highly controversial. The plans are possibly the most far reaching change to health services for decades and the plans should contribute to redesigning care to manage increased patient demand. Some A&E units will close, concentrating hospital care in fewer places.<ref name="BBC17/11/2016"></ref> Nearly two thirds of senior doctors fear the plans will worsen patient care.


title: National Health Service (England)

text: Consultation will start over cost saving, streamlining and some service reduction in the National Health Service. The streamlining will lead to ward closures including psychiatric ward closures and reduction in the number of beds in many areas among other changes. There is concern that hospital beds are being closed without increased community provision.


title: National Health Service (England)

text: Sally Gainsbury of the Nuffield Trust think tank said many current transformation plans involve shifting or closing services. Gainsbury added, "Our research finds that, in a lot of these kinds of reconfigurations, you don't save very much money – all that happens is the patient has to go to the next hospital down the road. They're more inconvenienced... but it rarely saves the money that's needed." By contrast, NHS England claims that the plans bring joined-up care closer to home. Senior Liberal Democrat MP Norman Lamb accepted that the review made sense in principle but stated: "It would be scandalous if the government simply hoped to use these plans as an excuse to cut services and starve the NHS of the funding it desperately needs. While it is important that the NHS becomes more efficient and sustainable for future generations, redesign of care models will only get us so far – and no experts believe the Conservative doctrine that an extra £8bn funding by 2020 will be anywhere near enough."


title: National Health Service (England)

text: In an independent review in 2016 by Robert Francis, it was concluded that some staff in England felt unable or unwilling to raise concerns about standards of care due to fear or low expectations, and that some staff who raised concerns had bad experiences and suffered unjustifiable consequences which the report described as "shocking". There is a culture of bullying towards those who raise concerns. This response may consist of placing the whistleblower on performance review, providing no assistance to them, starting a review process that can take months or years, possibly leading to mental health problems, and bullying and victimisation by other staff. This process rarely ended with being redeployed in an organisation, instead resulting in retirement, dismissal, or alternative employment.


title: National Health Service (England)

text: An issue identified by the report was the use of "gagging clauses" involved in settlements surrounding the termination of employment of those who whistleblow. While the report found that all the contracts were legal, it noted that the language used was often complicated and legalistic, a culture of fear deterred public interest disclosures even when they were not in breach of contract, and that the terms were often unnecessarily restrictive, for example by making the existence of the agreement confidential.


title: National Health Service (England)

text: Surgeon Peter Duffy wrote about his experiences of whistleblowing following an avoidable death in an independently published book, "Whistle In the Wind".


title: National Health Service (England)

text: The 1980s saw the introduction of modern management processes ("General Management") in the NHS to replace the previous system of consensus management. This was outlined in the Griffiths Report of 1983.


title: National Health Service (England)

text: This recommended the appointment of general managers in the NHS with whom responsibility should lie. The report also recommended that clinicians be better involved in management. Financial pressures continued to place strain on the NHS. In 1987, an additional £101 million was provided by the government to the NHS. In 1988 Prime Minister Margaret Thatcher announced a review of the NHS. From this review in 1989 two white papers "Working for Patients" and "Caring for People" were produced. These outlined the introduction of what was termed the "internal market", which was to shape the structure and organisation of health services for most of the next decade.


title: National Health Service (England)

text: In England, the National Health Service and Community Care Act 1990 defined this "internal market", whereby health authorities ceased to run hospitals but "purchased" care from their own or other authorities' hospitals. Certain GPs became "fund holders" and were able to purchase care for their patients. The "providers" became independent trusts, which encouraged competition but also increased local differences. Increasing competition may have been statistically associated with poor patient outcomes.


title: National Health Service (England)

text: These innovations, especially the "fund holder" option, were condemned at the time by the Labour Party. Opposition to what was claimed to be the Conservative intention to privatise the NHS became a major feature of Labour's election campaigns.


title: National Health Service (England)

text: Labour came to power in 1997 with the promise to remove the "internal market" and abolish fundholding. However, in his second term Blair renounced this direction. He pursued measures to strengthen the internal market as part of his plan to "modernise" the NHS.


title: National Health Service (England)

text: A number of factors drove these reforms; they include the rising costs of medical technology and medicines, the desire to improve standards and "patient choice", an ageing population, and a desire to contain government expenditure. (Since the National Health Services in Wales, Scotland and Northern Ireland are not controlled by the UK government, these reforms have increased the differences between the National Health Services in different parts of the United Kingdom. See NHS Wales and NHS Scotland for descriptions of their developments).


title: National Health Service (England)

text: Reforms included (amongst other actions) the laying down of detailed service standards, strict financial budgeting, revised job specifications, reintroduction of "fundholding" (under the description "practice-based commissioning"), closure of surplus facilities and emphasis on rigorous clinical and corporate governance. Some new services were developed to help manage demand, including NHS Direct. The Agenda for Change agreement aimed to provide harmonised pay and career progression. These changes have given rise to controversy within the medical professions, the news media and the public. The British Medical Association in a 2009 document on Independent Sector Treatment Centres (ISTCs) urged the government to restore the NHS to a service based on public provision, not private ownership; co-operation, not competition; integration, not fragmentation; and public service, not private profits.


title: National Health Service (England)

text: The Blair government, whilst leaving services free at point of use, encouraged outsourcing of medical services and support to the private sector. Under the Private Finance Initiative, an increasing number of hospitals were built (or rebuilt) by private sector consortia; hospitals may have both medical services such as ISTCs and non-medical services such as catering provided under long-term contracts by the private sector. A study by a consultancy company for the Department of Health shows that every £200 million spent on privately financed hospitals will result in the loss of 1000 doctors and nurses. The first PFI hospitals contain some 28 per cent fewer beds than the ones they replaced.


title: National Health Service (England)

text: The NHS was also required to take on pro-active socially "directive" policies, for example, in respect of smoking and obesity.


title: National Health Service (England)

text: In the 1980s and 90s, NHS IT spent money on several failed IT projects. The Wessex project, in the 1980s, attempted to standardise IT systems across a regional health authority. The London Ambulance Service was to be a computer-aided dispatch system. Read code was an attempt to develop a new electronic language of health, later scheduled to be replaced by SNOMED CT.


title: National Health Service (England)

text: The NHS Information Authority (NHSIA) was established by an Act of Parliament in 1999 with the goal to bring together four NHS IT and Information bodies (NHS Telecoms, Family Health Service (FHS), NHS Centre for Coding and Classification (CCC) and NHS Information Management Group (IMG)) to work together to deliver IT infrastructure and information solutions to the NHS in England. A 2002 plan was for NHSIA to implement four national IT projects: Basic infrastructure, Electronic records, Electronic prescribing, and Electronic booking, modelled after the large NHS Direct tele-nurse and healthcare website program. The NHSIA functions were divided into other organisations by April 2005.


title: National Health Service (England)

text: In 2002, the NHS National Programme for IT (NPfIT) was announced by the Department of Health. It was widely seen as a failure, and blamed for delaying the implementation of IT in the service. Even in 2020 it appeared most of the 1.38 million NHS computers were still using Windows 7, which was released in 2009, and additional support had to be arranged by Microsoft until 14 January 2021 before the migration to Windows 10 could be completed. NHSX, the organisation set up to manage NHS information technology was supervising the migration, and has the power to impose sanctions on laggards.


title: National Health Service (England)

text: Despite problems with internal IT programmes, the NHS has broken new ground in providing health information to the public via the internet. In June 2007 <nowiki>www.nhs.uk</nowiki> was relaunched under the banner "NHS Choices" as a comprehensive health information service for the public now known simply as "The NHS Website".


title: National Health Service (England)

text: In a break with the norm for government sites, www.nhs.uk allows users to add public comments giving their views on individual hospitals and to add comments to the articles it carries. It also enables users to compare hospitals for treatment via a "scorecard". In April 2009 it became the first official site to publish hospital death rates (Hospital Standardised Mortality Rates) for the whole of England. Its "Behind the Headlines" daily health news analysis service, which critically appraises media stories and the science behind them, was declared Best Innovation in Medical Communication in the prestigious BMJ Group Awards 2009. and in a 2015 case study was found to provide highly accurate and detailed information when compared to other sources


title: National Health Service (England)

text: In 2012, NHS England launched the NHS Apps Library, listing apps that had been reviewed by clinicians.


title: National Health Service (England)

text: In 2018, the NHS announced they would abandon the name NHS Choices, and in future, call the site the "NHS website". This coincided with the launch of the NHS app.


title: National Health Service (England)

text: Eleven of the NHS hospitals in the West London Cancer Network were linked using the IOCOM Grid System in 2009. This helped increase collaboration and meeting attendance and even improved clinical decisions.


title: National Health Service (England)

text: Twenty-one different electronic systems were used in the NHS in England to record data on patients in 2019. These systems do not communicate well with each other so there is a risk doctors treating a patient will not know everything they need to know to treat the patient effectively. There were 11 million patient interactions out of 121 million where information from a previous visit could not be accessed. Half the Trusts using Electronic Medical Records used one of three systems and at least those three should be able to share information. A tenth of Trusts used multiple systems in the same hospital. Leigh Warren who participated in the research said, "Hospitals and GPs often don't have the right information about the right patient in the right place at the right time. This can lead to errors and accidents that can threaten patients' lives."


title: National Health Service (England)

text: In February 2022 Sajid Javid declared that at least 90% of NHS trusts should have electronic patient record systems by the end of 2023 and that the remaining 10% of trusts without them must be in the implementation phase by December 2023. He wants 80% of social care providers to have a digital record in place by March 2024. He also said he wanted 75% of adults in England to have downloaded the NHS App by March 2024.


title: National Health Service (England)

text: Information on millions of NHS patients in England was sold to international pharmaceutical companies, in the US and other nations for research, adding to concerns over USA ambitions to access remunerative parts of the NHS after Brexit. There is concern over lack of transparency and clarity over the data and how it is used. Phil Booth of medConfidential , campaigning for privacy of health data, said: "Patients should know how their data is used. There should be no surprises. While legitimate research for public health benefit is to be encouraged, it must always be consensual, safe and properly transparent. Do patients know – have they even been told by the one in seven GP practices across England that pass on their clinical details – that their medical histories are being sold to multinational pharma companies in the US and around the world?"


title: National Health Service (England)

text: Waiting times for routine surgery have fallen substantially since 2000. As of July 2019, the median wait for planned care in England is under 8 weeks. The number of people waiting over 12 months has fallen from over 200,000 in the 1980s to under 2000 in 2019. However the number of patients on the waiting list has risen recently as constrained funding, hospital beds and staffing growth has not kept up with increasing patient need.


title: National Health Service (England)

text: Smoking is the greatest cause of avoidable illness and death in England, and costs the NHS £2.5 billion a year and the economy £11bn. Public Health England (PHE) states that one in four hospital patients smoke tobacco products, higher than the proportion in the general population, and smoking causes 96,000 deaths per year in England and twenty times the number of smoking related illnesses. PHE wants hospitals to help smokers quit. Few patients who smoke are referred to a hospital or community based cessation programme. During their hospital stay, over a quarter of patients were not asked if they smoke and nearly three quarters of smokers were not asked if they wanted to stop. PHE states smoking patients should be offered specialised help to stop and nicotine replacement therapy. Frank Ryan, a psychologist said, "It's really about refocusing our efforts and motivating our service users and staff to quit. And of course, whatever investment we make in smoking cessation programmes, there's a payback many times more in terms of the health benefits and even factors such as attendance at work, because it's workers who smoke [who] tend to have more absent spells from work." The numbers of smokers getting help to quit has fallen due to cuts in funding for smoking cessation care, though the National Institute for Health and Care Excellence recommends such help.


title: National Health Service (England)

text: A 2016 survey by Ipsos MORI found that the NHS tops the list of "things that makes us most proud to be British" at 48%. An independent survey conducted in 2004 found that users of the NHS often expressed very high levels of satisfaction about their personal experience of the medical services. Of hospital inpatients, 92% said they were satisfied with their treatment; 87% of GP users were satisfied with their GP; 87% of hospital outpatients were satisfied with the service they received; and 70% of Accident and Emergency department users reported being satisfied. Despite this some patients complain about being unable to see a GP at once when they feel their condition requires prompt attention. When asked whether they agreed with the question "My local NHS is providing me with a good service" 67% of those surveyed agreed with it, and 51% agreed with the statement "The NHS is providing a good service." The reason for this disparity between personal experience and overall perceptions is not clear; however, researchers at King's College London found high-profile media spectacles may function as part of a wider 'blame business', in which the media, lawyers and regulators have vested interests. The survey found that most people believe that the national press is generally critical of the service (64% reporting it as being critical compared to just 13% saying the national press is favourable), and also that the national press is the least reliable source of information (50% rating it not very or not at all reliable, compared to 36% believing the press was reliable) . Newspapers were reported as being less favourable and also less reliable than the broadcast media. The most reliable sources of information were considered leaflets from GPs and information from friends (both 77% reported as reliable) and medical professionals (75% considered reliable).


title: National Health Service (England)

text: There are many regulatory bodies with a role in the NHS, both government-based (e.g., Department of Health and Social Care, General Medical Council, Nursing and Midwifery Council),and non-governmental-based (e.g., Royal Colleges). Independent accreditation groups exist within the UK, such as the public sector Trent Accreditation Scheme and the private sector CHKS.


title: National Health Service (England)

text: With respect to assessing, maintaining and improving the quality of healthcare, in common with many other developed countries, the UK government has separated the roles of suppliers of healthcare and assessors of the quality of its delivery. Quality is assessed by independent bodies such as the Healthcare Commission according to standards set by the Department of Health and the National Institute for Health and Clinical Excellence (NICE). Responsibility for assessing quality transferred to the Care Quality Commission in April 2009.


title: National Health Service (England)

text: 700 hospital patients suffered harm in serious incidents due to treatment delays in part of 2015–16, 1,027 hospital patients suffered similar harm in 2016-17 and this rose to 1,515 in 2017–18. Norman Lamb blames understaffing. NHS Improvement stated during 2017-18 the NHS was short of 93,000 staff, which included 10,000 doctors and 37,000 nurses.


title: National Health Service (England)

text: In 2014 the Nuffield Trust and the Health Foundation produced a report comparing the performance of the NHS in the four countries of the UK since devolution in 1999. They included data for the North East of England as an area more similar to the devolved areas than the rest of England. They found that there was little evidence that any one country was moving ahead of the others consistently across the available indicators of performance. There had been improvements in all four countries in life expectancy and in rates of mortality amenable to health care. Despite the hotly contested policy differences between the four countries there was little evidence, where there was comparable data, of any significant differences in outcomes. The authors also complained about the increasingly limited set of comparable data on the four health systems of the UK. Medical school places are set to increase by 25% from 2018.


title: National Health Service (England)

text: A report from Public Health England's Neurology Intelligence Network based on hospital outpatient data for 2012–13 showed that there was significant variation in access to services by clinical commissioning group. In some places there was no access at all to consultant neurologists or nurses. The number of new consultant adult neurology outpatient appointments varied between 2,531 per 100,000 resident population in Camden to 165 per 100,000 in Doncaster.


title: National Health Service (England)

text: Following the start of COVID-19 pandemic, there was a dramatic increase in the backlog of people waiting for treatment. The BMI said "the backlog in secondary care consists of the care that the NHS would normally have delivered but which was disrupted as COVID-19 impacted service delivery". In December 2022 over 7 million people were on a hospital waiting list in England, 1 in 8 English people. Many had waited for months. This was the largest number since the start of records. 37,837 patients waited over 12 hours for hospital admission after it had been decided to admit them in November 2022, 255% more than in 2021 and 3,303% more than in November 2019.


title: National Health Service (England)

text: The NHS provides mental health services free of charge, but normally requires a referral from a GP first. Services that do not need a referral include psychological therapies through the Improving Access to Psychological Therapies initiative, and treatment for those with drug and alcohol problems. The NHS also provides online services that help patients find the resources most relevant to their needs.


title: Mokele-mbembe

text: In cryptozoology, the Mokele-mbembe (also written as "Mokèlé-mbèmbé"), Lingala for "one who stops the flow of rivers", is a water-dwelling entity that supposedly lives in the Congo River Basin, sometimes described as a living creature, sometimes as a spirit. Those that allegedly saw the entity describe it as a large quadrupedal herbivore with smooth skin, a long neck and a single tooth, sometimes said to be a horn.


title: Mokele-mbembe

text: In early to mid 20th century, the entity would become a point of focus among adherents of the pseudoscience of cryptozoology, and young Earth creationism, resulting in numerous expeditions led by cryptozoologists and funded by young Earth creationists and other groups with the objective to find evidence that invalidates or contradicts the scientific consensus regarding evolution. Paleontologist Donald Prothero remarks that "the quest for Mokele-Mbembe... is part of the effort by creationists to overthrow the theory of evolution and teaching of science by any means possible". Additionally, Prothero observes that "The only people looking for mokele-mbembe are creationist ministers, not wildlife biologists."


title: Mokele-mbembe

text: Historian Edward Guimont has argued that the mokele-mbembe myth grows out of earlier pseudohistorical claims about Great Zimbabwe, and in turn influenced the later reptilian conspiracy theory.


title: Mokele-mbembe

text: The first description of the mokele-mbembe as an apatosaurus-like creature was in 1909, in "Beasts and Men", the autobiography of famed big-game hunter Carl Hagenbeck. He claimed to have heard from two independent sources about a creature living in Rhodesia, or modern day Zimbabwe, which was described to them by natives as "half elephant, half dragon." Naturalist Joseph Menges had also told Hagenbeck about similar stories. Hagenbeck speculated that "it can only be some kind of dinosaur, seemingly akin to the "Brontosaurus"." Another of Hagenbeck's sources, Hans Schomburgk, asserted that while at Lake Bangweulu, he noted a lack of hippopotami; his native guides informed him of a large hippo-killing creature that lived in Lake Bangweulu; however, as noted below, Schomburgk thought that native testimony was sometimes unreliable.


title: Mokele-mbembe

text: Tales of entities like mokele-mbembe, living saurians walking around the African rain forest, are not rare; there have been multiple tales of large, smooth-skinned quadrupeds with long necks that fed on large prey still living in central Africa. It was only after the description of the mokele-mbembe surfaced that the rest of the world started interpreting those legends as possessing a dinosaur-like body structure. A notable example would be the emela-ntouka, an elephant-sized creature that shares a lot of similarities with the mokele-mbembe. It is described as having smooth skin, a strong and muscular tail, and a "horn" or "tooth". Another similar creature, the "jago-nini", was described by Alfred Aloysius Smith, who had worked for a British trading company in what is now Gabon in the late 1800s, who briefly mentions it in his 1927 memoir.


title: Mokele-mbembe

text: Reports of entities described to be dinosaur-like in Africa caused a minor sensation in the mass media, and newspapers in Europe and North America carried many articles on the subject in the early 1910s; some took the reports at face value, while others were more skeptical. It is notable that Western Europe and the Americas were going through a pop cultural interest in dinosaurs, of which the Brontosaurus was one of the most popular. This could have contributed to both the reports as well as the tendency for newspapers to claim the reported beast was a sauropod.


title: Mokele-mbembe

text: According to German adventurer Lt. Paul Gratz's account from 1911:The crocodile is found only in very isolated specimens in Lake Bangweulu, except in the mouths of the large rivers at the north. In the swamp lives the "nsanga", much feared by the natives, a degenerate saurian which one might well confuse with the crocodile were it not that its skin has no scales and its toes are armed with claws. I did not succeed in shooting a "nsanga", but on the island of Mbawala I came by some strips of its skin.


title: Mokele-mbembe

text: Another report comes from German Captain , as described by Willy Ley in the book "The Lungfish and the Unicorn" (1941). Von Stein was ordered to conduct a survey of German colonies in what is now Cameroon in 1913. He heard stories of an enormous reptile called "Mokele-mbembe" alleged to live in the jungles, and included a description in his official report. According to Ley, "von Stein worded his report with utmost caution," knowing it might be seen as unbelievable. Nonetheless, von Stein thought the tales were credible: trusted native guides had related the tales to him, and the stories were related to him by independent sources, yet featured many of the same details. Though von Stein's report was never formally published, Ley quoted von Stein as writing:


title: Mokele-mbembe

text: The animal is said to be of a brownish-gray color with a smooth skin, its size is approximately that of an elephant; at least that of a hippopotamus. It is said to have a long and very flexible neck and only one tooth but a very long one; "some say it is a horn". A few spoke about a long, muscular tail like that of an alligator. Canoes coming near it are said to be doomed; the animal is said to attack the vessels at once and to kill the crews but without eating the bodies. The creature is said to live in the caves that have been washed out by the river in the clay of its shores at sharp bends. It is said to climb the shores even at daytime in search of food; its diet is said to be entirely vegetable. This feature disagrees with a possible explanation as a myth. The preferred plant was shown to me, it is a kind of liana with large white blossoms, with a milky sap and apple-like fruits. At the Ssombo River I was shown a path said to have been made by this animal in order to get at its food. The path was fresh and there were plants of the described type nearby. But since there were too many tracks of elephants, hippos, and other large mammals it was impossible to make out a particular spoor with any amount of certainty.


title: Mokele-mbembe

text: In 2001, BBC broadcast in the TV series "Congo" a collective interview with a group of BiAka pygmies, who identified the mokele-mbembe as a rhinoceros while looking at an illustrated manual of wildlife. Neither species of African rhinoceros is common in the Congo Basin, and the mokele-mbembe may be a mixture of mythology and folk memory from a time when rhinoceroses were found in the area.


title: Mokele-mbembe

text: In 2016, a travel documentary crew from South Africa made a documentary about searching for mokele-mbembe, which they later sold to Discovery Africa. The team spent roughly four weeks in the Likuoala swamp region visiting various Aka (pygmy) villages, collecting stories of the creature's existence. They point out the difficulty of differentiating between mokele-mbembe's metaphysical and physical existence. They interviewed people who believed in its presence, others stated it died at least a decade ago.


title: Mokele-mbembe

text: In 2018, Lensgreve of Knuthenborg, Adam Christoffer Knuth, along with a film crew from Danish Radio and a DNA scientist, traveled to Lake Tele in Congo, in search of the mokele-mbembe. They did not find the dinosaur. However they found a new green algae.


title: Mokele-mbembe

text: The mokele-mbembe's existence has been highly questioned since its publication: the lack of physical evidence and the conflicting witnesses have made the existence of the entity doubted by the astounding majority of scientists and historians. The most reasonable and agreed upon explanation is that the mokele-mbembe is a legend based on the black rhinoceros, a species once common to central Africa, where the stories of the mokele-mbembe originated. The absence of this evidence, despite several centuries of Western contact with the region, numerous expeditions in search of the animal, and periodic aerial and satellite surveillance, all of which have detected elephants and other large animals - but no sauropods - all argue against the existence of mokele-mbembe.


title: Sour Tour

text: The Sour Tour was the debut concert tour by American singer-songwriter and actress Olivia Rodrigo in support of her debut studio album, "Sour" (2021). It began on April 5, 2022 in Portland, Oregon, with shows across North America and Europe. It concluded in London on July 7, comprising 48 shows. Gracie Abrams, Holly Humberstone, Chappell Roan, and Baby Queen served as opening acts.


title: Sour Tour

text: In July 2021, "Billboard" reported that the singer would be unable to embark on a tour until next year due to her television commitments and her contract with Disney. An official concert cycle was announced through social media on December 6, with tickets going on sale four days later.


title: Sour Tour

text: Tickets for the tour went on sale December 10 for fans who were chosen for "Verified Fan" registration. Tickets sold out in minutes, although many attributed this to ticket scalpers, with some tickets being listed on secondhand sites for more than $9,000 within minutes of tickets going on sale. Many fans and media outlets criticized the choosing of smaller venues over arenas, citing it as the reason many fans were unable to secure tickets. Rodrigo defended her decision to perform at smaller venues, telling the "Los Angeles Times" "I don’t think I should skip any steps" and assuring fans "there will be more tours in the future."


title: Sour Tour

text: This set list was representative of the show on April 5, 2022, in Portland. It was not representative of all concerts for the duration of the tour.


title: Muse discography

text: The discography of Muse, an English rock band, consists of nine studio albums, two live albums, one compilation album, one box set, five extended plays (EPs), 44 singles, two video albums, 61 music videos and four other appearances. Formed in Teignmouth, Devon in 1994, the band signed with Taste Media before releasing their debut album "Showbiz" in 1999. The album was a success across Europe, and in the UK reached number 29 on the UK Albums Chart, as well as being certified platinum by the British Phonographic Industry (BPI). Five singles were released from "Showbiz", with final release "Unintended" the band's first to reach the top 20 on the UK Singles Chart. Muse released their second album "Origin of Symmetry" in 2001, which reached number 3 on the UK Albums Chart and was certified double platinum by the BPI. The album's first three singles, "Plug In Baby", "New Born" and "Bliss", all reached the UK top 25.


title: Muse discography

text: In 2002 the band released their first live video album "", alongside the tie-in compilation album "Hullabaloo Soundtrack". The video reached number 2 on the UK Music Video Chart, while the soundtrack album reached number 10 on the UK Albums Chart. The group's third studio album "Absolution", issued on East West Records, was released in 2003 and was the band's first release to top the UK Albums Chart. The album only reached number 103 on the US "Billboard" 200, but has been certified platinum by the Recording Industry Association of America (RIAA). "Time Is Running Out" was the band's first single to reach the UK Singles Chart top ten, peaking at number 8. "Absolution Tour", a live video filmed on the "Absolution" promotional cycle, reached number 9 on the UK Music Video Chart.


title: Muse discography

text: After founding their own label, Helium-3, and signing with Warner Bros. Records, Muse released "Black Holes and Revelations" in 2006. The album was a commercial success, topping several albums charts and reaching the top ten on the "Billboard" 200. Lead single "Supermassive Black Hole" is the band's most successful on the UK Singles Chart to date, peaking at number 4. The band's first live album "HAARP" was released in 2008, reaching number 2 on the UK Albums Chart. "The Resistance" followed in 2009, topping several countries' album charts for the first time, as well as reaching number 3 in the US. The first single from the album, "Uprising", was the band's first to reach the top 40 on the "Billboard" Hot 100, as well as their fourth to reach the top ten in the UK. Muse have continued to enjoy high levels of commercial success in recent years – "The 2nd Law" and "Drones" both topped the UK Albums Chart, while the latter was the group's first release to reach number one on the "Billboard" 200.


title: Lookism (manhwa)

text: Lookism is a South Korean webtoon written and illustrated by Park Tae-joon. The webtoon was first published weekly on Naver Webtoon in November 2014. Its story revolves around a high-school student who can switch between two bodies: one fat and ugly, and the other fit and handsome. A Korean animated series adaptation by Studio Mir was released globally on Netflix in December 2022.


title: Lookism (manhwa)

text: Park Hyung Seok is an unpopular and bullied high-school student who is looked down on by his fellow student for his obesity. Bullied and harassed every day by a delinquent, he takes out his anger verbally on his mother and asks for a school transfer. Resolving to run away from his problems and start anew, he moves to Seoul and plans to attend a new high school. A few nights before he begins school, however, he receives a new body that is tall, muscular, and handsome. When one body is in use, the other falls asleep; he can switch bodies by waking up the sleeping one.


title: Lookism (manhwa)

text: His days are split between the two bodies: the handsome one for the daytime, and the original for the night. As Daniel Park (Park Hyung Seok) lives with two bodies, he begins to see how much the world discriminates against people considered unattractive or different. He experiences discrimination and hates for his original body, kindness, and special treatment of others. His new body makes him a social-media influencer, a trainee for an entertainment company, and a clothing model. At night, however, Daniel's dream life becomes a harsh reality when he returns to his original body.


title: Lookism (manhwa)

text: Daniel Park is a naïve high-school student who is bullied by Logan Lee. Before transferring to Jae Won High School to escape the bullying, he awakens with a slimmer, more-attractive body next to his chubby one. With his new body, he makes friends and learns about the world and himself from a new perspective.


title: Lookism (manhwa)

text: Vasco has a reputation of being a Robin Hood-like figure, defending the weak and bullied. A childhood friend of Jace Park, he leads Burn Knucklesa gang which punishes bullies and other wrongdoers. Despite his tough exterior, he is sweet and seeks the friendship of those he considers good.


title: Lookism (manhwa)

text: Zack Lee is a boxer who was aggressive towards everyone except his childhood friend, Mira Kim, whom he loves. Mira dislikes violence, so Zack stops bullying and becomes more patient. They are friends with Johan Seong.


title: Lookism (manhwa)

text: Mira Kim is compassionate, patient and observant, and sees the good in everyone. Johan Seong and Zack Lee were in love with her.


title: Lookism (manhwa)

text: Zoe Park is a beautiful girl who tried to use charm to get what she wanted. After Daniel's original body saves her from a stalker, however, she develops feelings for him.


title: Lookism (manhwa)

text: Crystal Choi, daughter of the HNH company chairman, also has two bodies. First an overweight student who transfers to the fashion department of Daniel's school, she lives in her original body during the day. Her different treatment leads her to believe that the world judges those with a different appearance unkindly. Crystal sees the handsome Daniel as an egotistical bully (based on his looks), and prefers the other Daniel's personality.


title: Lookism (manhwa)

text: Daniel's single mother is an old, hardworking, and patient woman. After seeing Logan bully Daniel, and Daniel yelling at her, she transfers him to Jae Won High School. She works twice as hard to enable Daniel to attend J High, folding and selling empty boxes and working part-time waiting tables. More than anything, she wants Daniel to be happy. As he matures, Daniel begins to appreciate and help his mother.


title: Lookism (manhwa)

text: Jace, the second-in-command of the Burn Knuckles, is a childhood friend of Vasco and helped Vasco overcome his fear of needles.


title: Lookism (manhwa)

text: A short, plump student and an aspiring rapper who was bullied by others and rejected by producers. When he meets and collaborates with Daniel, he gains confidence, begins streaming on TV and becomes famous.


title: Lookism (manhwa)

text: Bullied at J High until Daniel takes him under his wing, he is obsessed with power and societal standards. Jiho shows signs of an inferiority complex, and goes to juvenile prison for the attempted murders of Daniel Park and James Gong. He becomes mentally ill in prison, and is influenced by Jake Kim. He dies after a fight with Daniel.


title: Lookism (manhwa)

text: A big, strong character who bullied Daniel Park in his former school; after Daniel moved to Seoul, Logan did too. Daniel stands up to Logan in his original body, and they reach an uneasy truce. Logan is expelled after assaulting his advisor.


title: Lookism (manhwa)

text: Arrogant, he says he is better than everyone else and dislikes Daniel and Duke. He fears losing his sunglasses, and loses control when they are removed; this is later explained by his polycoria in one eye.


title: Lookism (manhwa)

text: The webtoon's main theme is lookism: bias based on a person's physical appearance. Daniel, the main character, is an overweight, unattractive student who is bullied until his appearance changes. Other themes include gangs, extortion, animal hoarding, cults, body shaming, anti-social behaviours, stalking, body positivity, rape, and attempted murder.


title: Lookism (manhwa)

text: Daniel's design was inspired by model Park Hyung-seok. Jay Hong's design was inspired by model Hong Jae-yeol; DG was inspired by G-Dragon; Oliver Jang's design was inspired by Jang Dongwoo, ARU by singer IU, and Vasco/Euntae Lee was inspired by a rapper whose former stage name was Vasco. The manhwa was created by Park Tae-joon, also a model.


title: Lookism (manhwa)

text: Tencent produced 外貌至上主义 ("Wàimào Zhìshàng Zhǔyì"), a 38-episode Chinese television series based on "Lookism", in 2019. The Chinese series starred Lomon, Wayne Zhang, Wang Zi Xuan and Dino Lee.


title: Lookism (manhwa)

text: A Korean animated series adaptation by Studio Mir titled "외모지상주의" "/" was announced during Netflix's "Tudum" virtual event on September 25, 2022. The series is directed by Kwang Il Han, with Dae Woo Lee doing art and Kyung-Hoon Han composing the music. It was originally set to be released worldwide on Netflix on November 4, 2022, but was delayed to December 8 due to the Seoul Halloween crowd crush. Ateez performed the series' theme song "Like That".


title: Avignon Papacy

text: The Avignon Papacy was the period from 1309 to 1376 during which seven successive popes resided in Avignon – at the time within the Kingdom of Arles, part of the Holy Roman Empire; now part of France – rather than in Rome. The situation arose from the conflict between the papacy and the French crown, culminating in the death of Pope Boniface VIII after his arrest and maltreatment by Philip IV of France. Following the further death of Pope Benedict XI, Philip forced a deadlocked conclave to elect the French Clement V as pope in 1305. Clement refused to move to Rome, and in 1309 he moved his court to the papal enclave at Avignon, where it remained for the next 67 years. This absence from Rome is sometimes referred to as the "Babylonian captivity of the Papacy".


title: Avignon Papacy

text: A total of seven popes reigned at Avignon, all French, and all under the influence of the French Crown. In 1376, Gregory XI abandoned Avignon and moved his court to Rome, arriving in January 1377. After Gregory's death in 1378, deteriorating relations between his successor Urban VI and a faction of cardinals gave rise to the Western Schism. This started a second line of Avignon popes, subsequently regarded as illegitimate. The last Avignon antipope, Benedict XIII, lost most of his support in 1398, including that of France. After five years besieged by the French, he fled to Perpignan in 1403. The schism ended in 1417 at the Council of Constance.


title: Avignon Papacy

text: Among the popes who resided in Avignon, subsequent Catholic historiography grants legitimacy to these:


title: Avignon Papacy

text: Benedict XIII was succeeded by three antipopes, who had little or no public following, and were not resident at Avignon:


title: Avignon Papacy

text: The period from 1378 to 1417, when there were rival claimants to the title of pope, is referred to as the "Western Schism" or "the great controversy of the antipopes" by some Catholic scholars and "the second great schism" by many secular and Protestant historians. Parties within the Catholic Church were divided in their allegiance among the various claimants to the office of pope. The Council of Constance finally resolved the controversy in 1417 when the election of Pope Martin V was accepted by all.


title: Avignon Papacy

text: Avignon and the small enclave to the east ("Comtat Venaissin") remained part of the Papal States until 1791 when, under pressure from French Revolutionaries, they were absorbed by the short-lived revolutionary Kingdom of France (1791–92), which, in turn, was abolished in favor of the French First Republic the following year.


title: Avignon Papacy

text: The papacy in the Late Middle Ages played a major temporal role in addition to its spiritual role. The conflict between the Pope and the Holy Roman Emperor was fundamentally a dispute over which of them was the leader of Christendom in secular matters. In the early 14th century, the papacy was well past the prime of its secular rule – its importance had peaked in the 12th and 13th centuries. The success of the early Crusades added greatly to the prestige of the Popes as secular leaders of Christendom, with monarchs like those of England, France, and even the Holy Roman Emperor merely acting as marshals for the popes and leading "their" armies. One exception was Frederick II, Holy Roman Emperor, who was twice excommunicated by the Pope during a Crusade. Frederick II ignored this and was moderately successful in the Holy Land.


title: Avignon Papacy

text: King Philip IV of France wanted to use the finances of the Church to pay for his war with the English. Pope Boniface VIII protested, leading to a feud.


title: Avignon Papacy

text: This state of affairs culminated in the unbridled declaration of papal supremacy, "Unam sanctam", in November 1302. In that papal bull, Pope Boniface VIII decreed that "it is necessary to salvation that every human creature be subject to the Roman pontiff." This was directed primarily to King Phillip IV of France who responded by saying, "Your venerable conceitedness may know that we are nobody's vassal in temporal matters."


title: Avignon Papacy

text: In 1303 AD, Pope Boniface VIII followed up with a bull that would excommunicate the king of France and put an interdict over all France. Before this was finalized, Italian allies of the King of France broke into the papal residence and beat Pope Boniface VIII. He died shortly thereafter. Nicholas Boccasini was elected as his successor and took the name Pope Benedict XI. He absolved King Phillip IV and his subjects of their actions against Pope Boniface VIII, though the culprits who assaulted Boniface were excommunicated and ordered to appear before a pontifical tribunal. Benedict XI died within eight months of being elected to the papacy. After eleven months, Bertrand de Got, a Frenchman and a personal friend of King Phillip IV, was elected as pope and took the name Pope Clement V.


title: Avignon Papacy

text: Beginning with Clement V, elected 1305, all popes during the Avignon papacy were French. However, this makes French influence seem greater than it was. Southern France (Occitania) at that time had a culture quite independent from Northern France, where most of the advisers to the King of France were based. The Kingdom of Arles was not yet part of France at that time, formally a part of the Holy Roman Empire. The literature produced by the troubadours in the Languedoc is unique and strongly distinct from that of Royal circles in the north. Even in terms of religion, the South produced its own variety of Christianity, Catharism, which was ultimately declared heretical. The movement was fueled in no small part by the strong sense of independence in the South even though the region had been severely weakened during the Albigensian Crusade a hundred years before. By the time of the Avignon Papacy, the power of the French King in this region was uncontested, although still not legally binding.


title: Avignon Papacy

text: A stronger impact was made by the move of the Roman Curia from Rome to Poitiers in France in 1305, and then to Avignon in 1309. Following the impasse during the previous conclave, and to escape from the infighting of the powerful Roman families that had produced earlier Popes, such as the Colonna and Orsini families, the Catholic Church looked for a safer place and found it in Avignon, which was surrounded by the lands of the papal fief of Comtat Venaissin. Formally it was part of Arles, but in reality it was under the influence of the French king.


title: Avignon Papacy

text: During its time in Avignon, the papacy adopted many features of the Royal court: the life-style of its cardinals was more reminiscent of princes than clerics; more and more French cardinals, often relatives of the ruling pope, took key positions; and the proximity of French troops was a constant reminder of where secular power lay, with the memory of Pope Boniface VIII still fresh.


title: Avignon Papacy

text: The temporal role of the Catholic Church increased the pressure upon the papal court to emulate the governmental practices and procedures of secular courts. The Catholic Church successfully reorganised and centralized its administration under Clement V and John XXII. The papacy now directly controlled the appointments of benefices, abandoning the customary election process that traditionally allotted this considerable income.


title: Avignon Papacy

text: Many other forms of payment brought riches to the Holy See and its cardinals: tithes, a ten-percent tax on church property; annates, the income of the first year after filling a position such as a bishopric; special taxes for crusades that never took place; and many forms of dispensation, from the entering of benefices without basic qualifications like literacy for newly appointed priests to the request of a converted Jew to visit his unconverted parents. Popes such as John XXII, Benedict XII, and Clement VI reportedly spent fortunes on expensive wardrobes, and silver and gold plates were used at banquets.


title: Avignon Papacy

text: Overall the public life of leading church members began to resemble the lives of princes rather than members of the clergy. This splendor and corruption at the head of the Church found its way to the lower ranks: when a bishop had to pay up to a year's income for gaining a benefice, he sought ways of raising this money from his new office. This was taken to extremes by the pardoners who sold absolutions for all kinds of sins. While pardoners were hated but popularly regarded as helpful to redeem one's soul, the friars who were commonly regarded as failing to follow the Church's moral commandments by ignoring their vows of chastity and poverty and were despised. This sentiment strengthened movements calling for a return to absolute poverty, relinquishment of all personal and ecclesiastical belongings, and preaching as the Lord and his disciples had.


title: Avignon Papacy

text: For the Catholic Church, an institution embedded in the secular structure and its focus on property, this was a dangerous development, and beginning in the early 14th century most of these movements were declared heretical. These included the Fraticelli and Waldensian movements in Italy and the Hussites in Bohemia (inspired by John Wycliffe in England). Furthermore, the display of wealth by the upper ranks of the church, which contrasted with the common expectation of poverty and strict adherence to principles, was used by enemies of the papacy to raise charges against the popes; King Philip of France employed this strategy, as did Louis IV, Holy Roman Emperor. In his conflict with the latter, Pope John XXII excommunicated two leading philosophers, Marsilius of Padua and William of Ockham, who were outspoken critics of the papacy, and who had found refuge with Louis IV in Munich. In response, William charged the pope with seventy errors and seven heresies.


title: Avignon Papacy

text: The proceedings against the Knights Templar in the Council of Vienne are representative of this time, reflecting the various powers and their relationships. In 1314 the collegium at Vienne convened to make a ruling concerning the Templars. The council, overall unconvinced about the guilt of the order as a whole, was unlikely to condemn the entire order based on the scarce evidence brought forward. Exerting massive pressure in order to gain part of the substantial funds of the Order, the King managed to get the ruling he wanted, and Pope Clement V ordered by decree the suppression of the order.


title: Avignon Papacy

text: In the cathedral of Saint Maurice in Vienne, the King of France and his son, the King of Navarre, were sitting next to him when he issued the decree. Under pain of excommunication, no one was allowed to speak at that occasion except when asked by the Pope. The Templars who appeared in Vienne to defend their order were not allowed to present their case—the cardinals of the collegium originally ruled that they should be allowed to raise a defense, but the arrival of the King of France in Vienne put pressure on the collegium, and that decision was revoked.


title: Avignon Papacy

text: After the arrest of the Bishop of Pamiers by Philip IV of France in 1301, Pope Boniface VIII issued the bull "Salvator Mundi", retracting all privileges granted to the French king by previous popes, and a few weeks later "Ausculta fili" with charges against the king, summoning him before a council to Rome. In a bold assertion of papal sovereignty, Boniface declared that "God has placed us over the Kings and Kingdoms."


title: Avignon Papacy

text: In response, Philip wrote "Your venerable conceitedness may know, that we are nobody's vassal in temporal matters," and called for a meeting of the Estates General, a council of the lords of France, who had supported his position. The King of France issued charges of sodomy, simony, sorcery, and heresy against the pope and summoned him before the council. The pope's response was the strongest affirmation to date of papal sovereignty. In "Unam sanctam" (November 18, 1302), he decreed that "it is necessary to salvation that every human creature be subject to the Roman pontiff."


title: Avignon Papacy

text: He was preparing a bull that would excommunicate the King of France and put the interdict over France when in September 1303, William Nogaret, the strongest critic of the papacy in the French inner circle, led a delegation to Rome, with intentionally loose orders by the king to bring the pope, if necessary by force, before a council to rule on the charges brought against him. Nogaret coordinated with the cardinals of the Colonna family, long-standing rivals against whom the pope had even preached a crusade earlier in his papacy. In 1303 French and Italian troops attacked the pope in Anagni, his home town, and arrested him. He was freed three days later by the population of Anagni. Boniface VIII, then 68 years of age, was deeply shattered by this attack on his own person and died a few weeks later.


title: Avignon Papacy

text: In reaction to the intransigence of Popes like Boniface VIII, the French tightened their influence under the papacy, eventually reducing the Popes to puppets and stacking the Papal court with French clerics.


title: Avignon Papacy

text: The death of Pope Boniface VIII deprived the papacy of its most able politician who could stand against the secular power of the king of France. After the conciliatory papacy of Benedict XI (1303–04), Pope Clement V (1305–1314) became the next pontiff. He was born in Gascony, in southern France, but was not directly connected to the French court. He owed his election to the French clerics. He decided against moving to Rome and established his court in Avignon. In this situation of dependency on powerful neighbours in France, three principles characterized the politics of Clement V: the suppression of heretic movements (such as the Cathars in southern France); the reorganization of the internal administration of the church; and the preservation of an untainted image of the church as the sole instrument of God's will on earth.


title: Avignon Papacy

text: The latter was directly challenged by Philippe IV when he demanded a posthumous trial of his former adversary, the late Boniface VIII, for alleged heresy. Phillipe exerted strong influence on the cardinals of the collegium, and compliance with his demand could mean a severe blow to the church's authority. Much of Clement's politics was designed to avoid such a blow, which he finally did (persuading Phillipe to leave the trial to the Council of Vienne, where it lapsed). However, the price was concessions on various fronts; despite strong personal doubts, Clement supported Phillipe's proceedings against the Templars, and he personally ruled to suppress the order.


title: Avignon Papacy

text: One important issue during the papacy of Pope John XXII (born Jacques Duèze in Cahors, and previously archbishop in Avignon) was his conflict with Louis IV, Holy Roman Emperor, who denied the sole authority of the Pope to crown the Emperor. Louis followed the example of Philippe IV, and summoned the nobles of Germany to back his position. Marsilius of Padua justified secular supremacy in the territory of the Holy Roman Empire. This conflict with the Emperor, often fought out in expensive wars, drove the papacy even more into the arms of the French king.


title: Avignon Papacy

text: Pope Benedict XII (1334–1342), born Jaques Fournier in Pamiers, was previously active in the inquisition against the Cathar movement. In contrast to the rather bloody picture of the Inquisition in general, he was reported to be very careful about the souls of the examined, taking a lot of time in the proceedings. His interest in pacifying southern France was also motivation for mediating between the King of France and the King of England, before the outbreak of the Hundred Years' War.


title: Avignon Papacy

text: Under Pope Clement VI (1342–1352) the French interests started dominating the papacy. Clement VI had been Archbishop of Rouen and adviser to Philippe IV before, so his links to the French court were much stronger than those of his predecessors. At some point he even financed French war efforts out of his own pockets. He reportedly loved luxurious wardrobe and under his rule the extravagant life style in Avignon reached new heights.


title: Avignon Papacy

text: Clement VI was also pope during the Black Death, the epidemic that swept through Europe between 1347 and 1350 and is believed to have killed about one-third of Europe's population. Also during his reign, in 1348, the Avignon papacy bought the city of Avignon from the Angevins.


title: Avignon Papacy

text: Pope Innocent VI (1352–1362), born Etienne Aubert, was less partisan than Clement VI. He was keen on establishing peace between France and England, having worked to this end in papal delegations in 1345 and 1348. His gaunt appearance and austere manners commanded higher respect in the eyes of nobles at both sides of the conflict. However, he was also indecisive and impressionable, already an old man when being elected Pope. In this situation, the King of France managed to influence the papacy, although papal legates played key roles in various attempts to stop the conflict.


title: Avignon Papacy

text: Most notably in 1353 the Bishop of Porto, Guy de Boulogne, tried to set up a conference. After initial successful talks the effort failed, largely due to the mistrust from the English side over Guy's strong ties with the French court. In a letter Innocent VI himself wrote to the Duke of Lancaster: "Although we were born in France and although for that and other reasons we hold the realm of France in special affection, yet in working for peace we have put aside our private prejudices and tried to serve the interests of everyone."


title: Avignon Papacy

text: With Pope Urban V (1362–1370), the control by Charles V of France of the papacy became more direct. Urban V himself is described as the most austere of the Avignon popes after Benedict XII and probably the most spiritual of all. However, he was not a strategist and made substantial concessions to the French crown especially in finances, a crucial issue during the war with England. In 1369 Pope Urban V supported the marriage of Philip the Bold of the Duchy of Burgundy and Margaret III, Countess of Flanders, rather than giving dispensation to one of Edward III of England's sons to marry Margaret. This clearly showed the partisanship of the papacy; correspondingly, the respect for the church dropped.


title: Avignon Papacy

text: The most influential decision in the reign of Pope Gregory XI (1370–1378) was the return to Rome, beginning on 13 September 1376 and ending with his arrival on 17 January 1377. Although the Pope was French born and still under strong influence by the French King, the increasing conflict between factions friendly and hostile to the Pope posed a threat to the papal lands and to the allegiance of Rome itself. When the papacy established an embargo against grain exports during a food scarcity 1374 and 1375, Florence organized several cities into a league against the papacy: Milan, Bologna, Perugia, Pisa, Lucca and Genoa.


title: Avignon Papacy

text: The papal legate, Robert of Geneva, a relative of the House of Savoy, pursued a particularly ruthless policy against the league to re-establish control over these cities. He convinced Pope Gregory to hire Breton mercenaries. To quell an uprising of the inhabitants of Cesena he hired John Hawkwood and had the majority of the people massacred (between 2,500 and 3,500 people were reported dead). Following such events opposition against the papacy strengthened.


title: Avignon Papacy

text: Florence came in open conflict with the Pope, a conflict called "the war of the eight saints" in reference to the eight Florentine councilors who were chosen to orchestrate the conflict. The entire city of Florence was excommunicated and as reply the forwarding of clerical taxes was stopped. Trade was seriously hampered and both sides had to find a solution. In his decision about returning to Rome, the Pope was also under the influence of Catherine of Siena, later canonized, who preached for a return to Rome.


title: Avignon Papacy

text: This resolution was short-lived when, having returned the papal court to Rome, Pope Gregory XI died. A conclave met and elected an Italian pope, Urban VI. Pope Urban alienated the French cardinals, who held a second conclave electing one of their own, Robert of Geneva, who took the name Clement VII, to succeed Gregory XI, thus beginning a second line of Avignon popes. Clement VII and his successors are not regarded as legitimate, and are referred to as antipopes by the Catholic Church. This situation, known as the Western Schism, persisted from 1378 until the ecumenical Council of Constance (1414–1418) resolved the question of papal succession and declared the French conclave of 1378 to be invalid. A new Pope, Pope Martin V, was elected in 1417; other claimants to succeed to the line of the Avignon Popes (though not resident at Avignon) continued until c. 1437.


title: Avignon Papacy

text: The period has been called the "Babylonian captivity" of the popes. When and where this term originated is uncertain although it may have sprung from Petrarch, who in a letter to a friend (1340–1353) written during his stay at Avignon, described Avignon of that time as the "Babylon of the west", referring to the worldly practices of the church hierarchy. The nickname is polemical, in referring to the claim by critics that the prosperity of the church at that time was accompanied by a profound compromise of the papacy's spiritual integrity, especially in the alleged subordination of the powers of the Church to the ambitions of the French kings. As noted, the "captivity" of the popes at Avignon lasted about the same amount of time as the exile of the Jews in Babylon, making the analogy convenient and rhetorically potent. The Avignon papacy has been and is often today depicted as being totally dependent on the French kings, and sometimes as even being treacherous to its spiritual role and its heritage in Rome.


title: Avignon Papacy

text: Almost a century and a half later, Protestant reformer Martin Luther wrote his treatise "On the Babylonian Captivity of the Church" (1520), but he claimed it had nothing to do with the Western Schism or papacy in Avignon.


title: Avignon Papacy

text: The relationship between the papacy and France changed drastically over the course of the 14th century. Starting with open conflict between Pope Boniface VIII and King Philip IV of France, it turned to cooperation from 1305 to 1342, and finally to a papacy under strong influence by the French throne up to 1378. Such partisanship of the papacy was one of the reasons for the dropping esteem for the institution, which in turn was one of the reasons for the schism from 1378 to 1417.


title: Avignon Papacy

text: In the period of the Schism, the power struggle in the papacy became a battlefield of the major powers, with France supporting the antipopes in Avignon and England supporting the popes in Rome. At the end of the century, still in the state of schism, the papacy had lost most of its direct political power, and the nation states of France and England were established as two of the main powers in Europe.


title: Armand Duplantis

text: Armand Gustav "Mondo" Duplantis (born 10 November 1999) is an American-born Swedish pole vaulter, the current world outdoor and indoor record holder ( and ), the current Olympic and World outdoor and indoor champion, the current European outdoor and indoor champion, and the current Diamond League champion. He won the silver medal at the 2019 World Athletics Championships. Duplantis is a two-time European champion from 2018, when he set current world under-20 record, and from 2022. Indoors, he is 2022 World Indoor Championship and 2021 European Indoor Championship gold medallist.


title: Armand Duplantis

text: Duplantis won gold as a 15-year-old at the 2015 World Youth Championships. A year later, he placed third at the World U20 Championships. In 2017, he took the European U20 title, and the following year, World U20 title. Duplantis is also a two-time Diamond League champion.


title: Armand Duplantis

text: Both European Athletics and World Athletics Male Rising Star of the Year in 2018, two years later he was voted World Athletics World Male Athlete of the Year. For his 2022 season, which saw him breaking world records three times, becoming World indoor and outdoor champion as well as European and Diamond League champion, and clearing six-metre-plus 22 times, Duplantis was crowned both European and World Male Athlete of the Year.


title: Armand Duplantis

text: Duplantis was born into an athletic family; his American father, Greg Duplantis, who is of Cajun and Finnish descents, is a former pole vaulter with a personal best of , while his Swedish mother Helena (née Hedlund) is a former heptathlete and volleyball player. His two older brothers, Andreas and Antoine, and his younger sister, Johanna, also took up sports; Andreas represented Sweden as a pole vaulter at the 2009 World Youth Championships and 2012 World Junior Championships, while Antoine dropped pole vault for baseball in high school before heading to Louisiana State University where he became the team's career hits leader in 2019.


title: Armand Duplantis

text: While growing up in an English-speaking household, Duplantis learned adequate Swedish as his second language. Encouraged by his mother, Duplantis took extensive lessons over Skype in order to improve his fluency and by 2020 he felt that he understood native, and faster, speech much better than he had done in the past. His mother claimed at the same time that while Duplantis felt shy about speaking Swedish in public, he was very happy to do so in private, where there was less pressure. By 2021, after winning the Olympic gold, his knowledge of the language had improved to the point that he felt comfortable doing full Swedish-speaking interviews. In the past, Duplantis has lamented that improving his Swedish has been somewhat hampered by the high level of English skills in Sweden, which has led to native speakers preferring to speak English when talking with him.


title: Armand Duplantis

text: After winning the Jerringpriset as the most popular athlete in Sweden in 2020, Duplantis expressed relief that the Swedish public had accepted and embraced him. During said Olympics, Duplantis also stated that his older brother having great experiences representing Sweden at a youth level and his love for Sweden as a child made his choice very easy but that he also feels a strong bond to Lafayette. Duplantis usually divides his year between winters in Louisiana and summers in Uppsala in Sweden, adapted for when the two climates offer the best possibilities for training. With Duplantis' mother Helena being raised in Avesta, the municipality raised a pole vault bar beside the gigantic Dala horse monument to showcase the height of his world record, something that made Duplantis "break down in tears" over the significance of what he had accomplished when he heard about it.


title: Armand Duplantis

text: Duplantis first tried pole vaulting as a three-year-old at the family's home in Lafayette, Louisiana, and took to the event rapidly; he set his first age group world best at age seven, and his jump of as a 10-year-old surpassed the previous world bests for ages 11 and 12 as well. , he holds the world best in all age groups from age seven to age 12; he held the age 13 record until it was broken in May 2015.


title: Armand Duplantis

text: In 2015, his freshman year at Lafayette High School, Duplantis set national freshman records both indoors and outdoors and was named Gatorade Louisiana Boys Track & Field Athlete of the Year. As a citizen of both the United States and Sweden, Duplantis could have chosen to vault for either country internationally; in June 2015 it was announced that he had selected Sweden. Duplantis represented Sweden for the first time at the 2015 World Youth Championships in Cali, Colombia; he won gold on countback with a first-attempt clearance of 5.30 m (17 ft  in), improving his personal best by two centimeters and setting a new championship record.


title: Armand Duplantis

text: Duplantis cleared at a high school meet in Baton Rouge on 6 February 2016, setting a new age-16 world best, world indoor youth best and national high school indoor record; he was the first high school athlete to vault 18 feet indoors. Emmanouil Karalis of Greece, the same age as Duplantis, broke his world marks with a vault only one week later.


title: Armand Duplantis

text: On 11 February 2017, at the Millrose Games, Duplantis jumped to set the World Indoor Junior Record. That mark was ratified by IAAF. A month later he improved to in the same facility at the New Balance National Scholastic Championships. That mark was not ratified due to incorrect peg lengths being used. On 1 April 2017, Duplantis jumped 5.90 m at the Nike Clyde Littlefield Texas Relays, improving his personal record and setting a new World Junior Record. The jump also became a Swedish senior record by . While the IAAF recognized the record with Duplantis representing Sweden, on 2 December 2017, USATF also ratified Duplantis' mark as the American Junior record.


title: Armand Duplantis

text: Duplantis began his 2018 season by improving upon the World Indoor Junior Record by jumping at the Pole Vault Summit in Reno, Nevada. He later improved his indoor record to and reached at the 2018 European Athletics Championships. The vault ranked him tied as the fifth-best pole vaulter in history and tied for the second-best outdoors.


title: Armand Duplantis

text: Duplantis placed 2nd at the 2019 IAAF World Championships in Doha, Qatar, clearing on his third attempt.


title: Armand Duplantis

text: On 4 February, Duplantis cleared indoors at his first competition of the season. He followed that up with three attempts at a new world record of . On his second attempt, he cleared the bar but brushed it off with his arm on the way back down.


title: Armand Duplantis

text: On 8 February, Duplantis broke Renaud Lavillenie's almost-six-year-old world record with a jump of in Toruń, Poland. A week later, on 15 February in Glasgow, he increased the record by another centimetre to .


title: Armand Duplantis

text: On 19 February, Duplantis won the Meeting Hauts de France Pas de Calais by clearing , after which he made three unsuccessful attempts at the new world record height of . A few days later, on 23 February, Duplantis won the All Star Perche in Clermont-Ferrand by clearing in his last indoor competition for the season, which ended with new unsuccessful attempts at . On 14 July, he received a scholarship from Swedish Crown Princess Victoria.


title: Armand Duplantis

text: On 17 September at the Rome Golden Gala Pietro Mennea Diamond League, Duplantis broke Sergey Bubka's outdoor world best of , with a second-attempt clearance of . Note that the IAAF does not recognize the indoor and outdoor pole vault as separate events; Duplantis already held the world record at from his indoor clearance in February 2020.


title: Armand Duplantis

text: On 1 December, he was awarded the Svenska Dagbladet Gold Medal for "the most significant Swedish sports achievement of the year".


title: Armand Duplantis

text: On 6 March, Duplantis competed at the 2021 European Indoor Championships. He was the overwhelming favourite to win the title after the late withdrawal of Renaud Lavillenie with injury. Duplantis was still tested by Piotr Lisek and Lavillenie's younger brother Valentin, who went on to claim bronze and silver respectively — the latter with a personal best. Duplantis however set a new championship record of before making three unsuccessful attempts at , his second narrowly missing the world record.


title: Armand Duplantis

text: At the one-year delayed 2020 Summer Olympics in Tokyo, Duplantis won a gold medal when he cleared a height of on his first effort, and afterwards got very close to beating his own world record. Silver medalist Chris Nilsen was full of praise for the winner. He compared the competition against Duplantis that evening as being a regular footballer "trying to emulate Lionel Messi or Cristiano Ronaldo" and that his superiority over the world's best pole vaulters was "impressive and ridiculous".


title: Armand Duplantis

text: On 7 March, he beat his own world record by jumping at the Belgrade Indoor Meeting. Two weeks later, at the 2022 World Athletics Indoor Championships in Belgrade, he won the gold medal. At the same time, he broke his world record yet again, by jumping .


title: Armand Duplantis

text: On 24 July he broke his own world record yet again, at the 2022 World Athletics Championships in Eugene by recording a jump of .


title: Ulster loyalism

text: Ulster loyalism is a strand of Ulster unionism associated with working class Ulster Protestants in Northern Ireland. Like other unionists, loyalists support the continued existence of Northern Ireland within the United Kingdom, and oppose a united Ireland. Unlike other strands of unionism, loyalism has been described as an ethnic nationalism of Ulster Protestants and "a variation of British nationalism". Loyalists are often said to have a conditional loyalty to the British state so long as it defends their interests. They see themselves as loyal primarily to the Protestant British monarchy rather than to British governments and institutions, while Garret FitzGerald argued they are loyal to 'Ulster' over 'the Union'. A small minority of loyalists have called for an independent Ulster Protestant state, believing they cannot rely on British governments to support them (see Ulster nationalism). The term 'loyalism' is usually associated with paramilitarism.


title: Ulster loyalism

text: Ulster loyalism emerged in the late 19th century, in reaction to the Irish Home Rule movement and the rise of Irish nationalism. Although Ireland had a Catholic majority who wanted self-government, the province of Ulster had a Protestant and unionist majority, largely due to the Plantation of Ulster. Although not all unionists were Protestant or from Ulster, loyalism emphasised Ulster Protestant heritage. During the Home Rule Crisis (1912–14), loyalists founded the paramilitary Ulster Volunteers to prevent Ulster becoming part of a self-governing Ireland. This was followed by the Irish War of Independence (1919–21) and partition of Ireland: most of Ireland became an independent state, while most of Ulster remained within the United Kingdom as the self-governing territory of Northern Ireland. During partition, communal violence raged between loyalists and Irish nationalists in Belfast, and loyalists attacked the Catholic minority in retaliation for Irish republican activity.


title: Ulster loyalism

text: Northern Ireland's unionist governments were accused of discrimination against Catholics and Irish nationalists. Loyalists opposed the Catholic civil rights movement, accusing it of being a republican front. This unrest led to the Troubles (1969–98). During the conflict, loyalist paramilitaries such as the Ulster Volunteer Force (UVF) and Ulster Defence Association (UDA) often attacked Catholics in retaliation for republican paramilitary actions. Loyalists undertook major protest campaigns against the 1973 Sunningdale Agreement and 1985 Anglo-Irish Agreement. The paramilitaries called ceasefires in 1994 and their representatives were involved in negotiating the 1998 Good Friday Agreement. Since the Agreement, loyalists have been involved in protests against perceived threats to their cultural identity. Sections of the loyalist paramilitaries have attacked Catholics, taken part in loyalist feuds, and withdrawn their support for the Agreement, although their campaigns have not resumed.


title: Ulster loyalism

text: In Northern Ireland there is a tradition of loyalist Protestant marching bands. There are hundreds of such bands who hold numerous parades each year. The yearly Eleventh Night (11 July) bonfires and The Twelfth (12 July) parades are associated with loyalism.


title: Ulster loyalism

text: The term "loyalist" was first used in Irish politics in the 1790s to refer to Protestants who opposed Catholic Emancipation and Irish independence from Great Britain.


title: Ulster loyalism

text: Ulster loyalism emerged in the late 19th century, in response to the Irish Home Rule movement and the rise of Irish nationalism. At the time, all of Ireland was part of the United Kingdom. Although the island had a Catholic majority who wanted self-government, the northern province of Ulster had a Protestant majority who wanted to maintain a close union with Britain, a political tradition called Unionism. This was largely due to the Plantation of the province. Eastern Ulster was also more industrialised and dependent on trade with Britain than most other parts of Ireland. Although not all Unionists were Protestant or from Ulster, loyalism emphasised Ulster Protestant heritage. It began as a self-determination movement of Ulster Protestants, who did not want to become part of a self-governing Ireland dominated by Catholic Irish nationalists.


title: Ulster loyalism

text: The British government's introduction of the Third Home Rule Bill in 1912 sparked the Home Rule Crisis. Ulster unionists signed the Ulster Covenant, pledging to oppose Irish home rule by any means. They founded a large paramilitary force, the Ulster Volunteers, threatening to violently resist the authority of any Irish government over Ulster. The Ulster Volunteers smuggled thousands of rifles and rounds of ammunition into Ulster from Imperial Germany. In response, Irish nationalists founded the Irish Volunteers to ensure home rule was implemented. Home rule was postponed by the outbreak of the First World War in 1914. Both loyalists and nationalists fought in the war, with many Ulster Volunteers joining the 36th (Ulster) Division.


title: Ulster loyalism

text: By the end of the war, most Irish nationalists wanted full independence. After winning most Irish seats in the 1918 general election, Irish republicans declared an Irish Republic, leading to the Irish War of Independence between the Irish Republican Army (IRA) and British forces. Meanwhile, the Fourth Home Rule Bill passed through the British parliament in 1920. It would partition Ireland into two self-governing polities within the UK: a Protestant-majority Northern Ireland, and a Catholic-majority Southern Ireland. During 1920–22, in what became Northern Ireland, partition was accompanied by violence both in defence of and against partition. Belfast saw "savage and unprecedented" communal violence, mainly between Protestant loyalist and Catholic nationalist civilians. Loyalists attacked the Catholic minority in reprisal for IRA actions. Thousands of Catholics and "disloyal" Protestants were driven from their jobs, and there were mass burnings of Catholic homes and businesses in Lisburn and Banbridge. More than 500 were killed in Northern Ireland during partition and more than 10,000 became refugees, most of them Catholics.


title: Ulster loyalism

text: In 1926, about 33.5% of the Northern Ireland population was Roman Catholic, with 62.2% belonging to the three major Protestant denominations (Presbyterian 31.3%, Church of Ireland 27%, Methodist 3.9%).


title: Ulster loyalism

text: The Unionist governments of Northern Ireland were accused of discrimination against the Irish nationalist and Catholic minority. A non-violent campaign to end discrimination began in the late 1960s. This civil rights campaign was opposed by loyalists, who accused it of being a republican front. Loyalist opposition was led primarily by Ian Paisley, a Protestant fundamentalist preacher. They held counter-protests, attacked civil rights marches, and put pressure on moderate unionists. Loyalist militants carried out false flag bombings that were blamed on republicans and civil rights activists. This unrest led to the August 1969 riots. Irish nationalists/republicans clashed with both police and with loyalists, who burned hundreds of Catholic homes and businesses. The riots led to the deployment of British troops and are often seen as the beginning of the Troubles.


title: Ulster loyalism

text: The beginning of the Troubles saw a revival of loyalist paramilitaries, notably the Ulster Volunteer Force (UVF) and Ulster Defence Association (UDA). Their stated goals were to defend Protestant areas, to fight those they saw as "enemies of Ulster" (namely republicans), and thwart any step towards Irish unification. The Provisional Irish Republican Army waged a paramilitary campaign to force a British withdrawal from Northern Ireland. Loyalist paramilitaries attacked the Catholic community as alleged retaliation for IRA actions, and the vast majority of their victims were random Catholic civilians. During the Troubles there were incidents where some local British soldiers and police colluded with loyalist paramilitaries, such as the attacks by the Glenanne group.


title: Ulster loyalism

text: Signed in 1973, the Sunningdale Agreement sought to end the conflict by establishing power-sharing government between unionists and Irish nationalists, and ensuring greater co-operation with the Republic of Ireland. In protest, loyalists organized the Ulster Workers' Council strike in May 1974. It was enforced by loyalist paramilitaries and brought large parts of Northern Ireland to a standstill. During the strike, loyalists detonated a series of car bombs in Dublin and Monaghan, in the Republic. This killed 34 civilians, making it the deadliest attack of the Troubles. The strike brought down the agreement and power-sharing government.


title: Ulster loyalism

text: Loyalists were involved in the major protest campaign against the 1985 Anglo-Irish Agreement. They saw it as a breach of sovereignty, because it gave the Republic an advisory role in some Northern Ireland affairs. The many street protests led to loyalist clashes with the Royal Ulster Constabulary (RUC), whom loyalists accused of enforcing the Agreement and betraying the Protestant community. This caused a rift between loyalists and the police, and there were numerous loyalist attacks on police officers' homes during the protests.


title: Ulster loyalism

text: From the late 1980s, there was a rise in loyalist paramilitary violence, partly due to anger over the Anglo-Irish Agreement. It also resulted from loyalist groups being re-armed with weapons smuggled from South Africa, overseen by British Intelligence agent Brian Nelson. From 1992 to 1994, loyalists carried out more killings than republicans. The deadliest attacks during this period were the Greysteel massacre by the UDA and Loughinisland massacre by the UVF.


title: Ulster loyalism

text: The main loyalist paramilitary groups called a ceasefire in 1994, shortly after the Provisional IRA's ceasefire and beginning of the Northern Ireland peace process. This ceasefire came under strain during the Drumcree dispute of the mid-to-late 1990s. The Protestant Orange Order was blocked from marching its traditional route through the Catholic part of Portadown. Catholic residents held mass protests against the yearly march, seeing it as triumphalist and supremacist, forcing police to halt the march. Loyalists saw this as an assault on Ulster Protestant traditions, and held violent protests throughout Northern Ireland. In Portadown, thousands of loyalists attacked lines of police and soldiers guarding the Catholic district. A new UVF splinter group, the Loyalist Volunteer Force (LVF), attacked Catholics over a two-year period before calling a ceasefire.


title: Ulster loyalism

text: Loyalist representatives had helped negotiate the Good Friday Agreement of 1998, and it was backed by the UVF-linked Progressive Unionist Party and UDA-linked Ulster Democratic Party. However, wider loyalist support for the Agreement was tenuous from the outset, and these parties received many fewer votes than the main unionist parties: the pro-Agreement UUP and anti-Agreement DUP.


title: Ulster loyalism

text: Since the Agreement, loyalist paramilitaries have been involved in riots, feuds between loyalist groups, organized crime, vigilantism such as punishment shootings, and racist attacks. Some UDA and LVF brigades broke the ceasefire and attacked Catholics under the name Red Hand Defenders, but the paramilitary campaigns did not resume.


title: Ulster loyalism

text: The 2001 Holy Cross protests drew world-wide condemnation as loyalists were shown hurling abuse and missiles, some explosive, others containing excrement, at very young Catholic schoolchildren and parents. Loyalist residents picketed the school in protest at alleged sectarianism from Catholics in the area. Many other loyalist protests and riots have been sparked by restrictions on Orange marches, such as the 2005 Whiterock riots. The widespread loyalist flag protests and riots of 2012–13 followed Belfast City Council voting to limit the flying of the Union Flag from council buildings. Loyalists saw it as an "attack on their cultural identity".