How many serious injuries and deaths does it take for a clear danger to become a public health issue?

Escalating dog attacks, on people and other dogs, must qualify now as a real and grave public health concern demanding tougher preventative measures? How many people killed by out-of-control dogs count as enough?

In the 11 months to February this year, 24,000 A&E visits in England were from dog attacks. In the last 19 months, 15 people have been killed by dogs in the UK. Five of these deaths involved children. We averaged three dog attack deaths a year for the 25 years before that.

Data doesn’t lie. This is only going to get worse.

Headlines of yet another death caused by a canine savaging barely shock now, signalling acceptance and familiarity has crept in, which is so wrong.

None of the killer dogs has been on the banned list of dangerous dogs, which is a huge red flag about the spiralling irresponsibility of dog ownership.

One commonality is, though, the relatively new breed, the American XL (extra-large – the clue is in the name) bully, legal in the UK despite being derived from pit bulls, which are illegal, and mixing about four other breeds.

Muscly and bulky with heavy bone structure, the breed is prey-focused and reactive. Its blocky head and strong jawline make it look like it’s bred to kill, quickly, within in a minute, apparently. Once in attack mode, an XL bully is hard to distract.

It’s unknown how many are in the UK, but breeding is escalating. In the wrong hands, they are lethal. The question must be asked - is there such a thing as the right hands for these dogs? Why would anyone have these dogs for benign reasons?

There will always be the self-declared dog ‘experts’ who say these beasts are the sweetest, softest, most gentle family pets with their babies and tiny children. But that feels like playing a game of catch with a live grenade.

It was an XL bully that killed 10-year-old Jack Lis. His mother, Claire Whitfield, says they are “lethal weapons” bred as status symbols, with puppies selling for as much as £10,000.

Ownership and extreme breeding of bullies are linked to organised crime gangs, obvs.

Jack’s mother wants them banned and other tough measures against irresponsible owners and breeders who see lucrative pickings from multiple litters of these animals.

A swelling public feeling agrees with her that irresponsible dog owners and breeders are reckless and so out of control the government must impose tougher penalties, now.

In the past five years, police records show a 34 per cent increase in dog attacks in England, costing the NHS tens of millions of unnecessary pounds. We averaged three dog attack deaths a year for the past 25 years. Last year there were 10, with up to seven related to the XL Bully. This is only going to get worse.

We’re in the grip of an epidemic of out-of-control dogs, not solely from unscrupulous breeders and owners, but also from the inept who bought dogs in lockdown because felt like a nice idea but are clueless about how to treat them, creating unsocialised dogs that react. No dog can be entirely predictable, but a trained dog is mostly controllable.

Any dog can be dangerous if it’s not trained properly, and its owners don’t understand dog behaviour.

The lockdown dog surge has created a monster. Proper dog training takes full-on commitment, skill and consistency, and is not easy. It is easy, though, to give up and leave a dog’s behaviour to chance and a fair wind.

Hereby lies the root of the 88% increase in hospital attendance with dog-related injuries, and steep rise in dogs attacking other dogs, with their hapless owners standing by incapable of calling their pet off.

The Dangerous dogs Act fails to protect the public from the real risk and is no longer fit for purpose.

Only this week, a man appealed for witnesses on social media after his dog was savagely attacked by two German Shepherd dogs. Their woman owner had given him a false name, address and phone details.

Dogs rarely attack without warning.

We need an urgent law review of punishment and what counts as a dangerous dog, stricter breeding rules and even resorting to licencing for responsible ownership because we’re failing to do it for ourselves.

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Junior doctors are striking again until tomorrow.

Alongside their campaign for more pay and better staffing, they should be calling for a name change.

Calling them junior doctors implies a lack of responsibility and experience, students, even. Calling them junior doctors is misleading at best, misrepresentative and dismissive at worst.

They are highly skilled dedicated lifesavers, who have paid for the skills themselves by student loans, owing tens of thousands of pounds to work ludicrously and irresponsibly long shifts when we all expect them to be at the top of their game every minute of their time on shift.

Any hospital doctor that is not a consultant counts as a junior doctor.

Like teachers, their strike is about more than money. It’s about conditions for those that receive their services – all of us and our children.

Who would blame any of them for heading to Australia or New Zealand – or across the sea to Ireland - after qualifying where they are treated, and valued, so much better.