Nanny state bans cigarette vending machines

The nanny state banned in England cigarette vending machines over the weekend. The Department of Health said the ban had been introduced to prevent under-age sales to children and to support adults who were trying to quit.

The rest of the UK is expected to implement a similar ban next year.

Some pub landlords say it is a further threat to a livelihood that has already been damaged by the smoking ban.

But Cancer Research and the British Heart Foundation have welcomed the move.

According to the Department of Health, nearly all adult smokers started smoking before they turned 18.  Of the children who regularly smoke, 11% buy their cigarettes from vending machines.

It is also estimated that 35 million cigarettes are sold illegally through vending machines to children every year.

Under the new rules, pub landlords will still be able to sell cigarettes from behind the bar but they must ensure all tobacco advertising on vending machines is removed. Any person found guilty of displaying cigarette adverts on a vending machine could face imprisonment for up to six months, a fine of £5,000, or both.

Health Secretary Andrew Lansley said smoking was “one of the biggest and most stubborn challenges in public health”, with more than eight million people in England still smoking, causing more than 80,000 deaths each year.

He said: “Cigarette vending machines are often unsupervised, making it easy for children to purchase cigarettes from them.

“The ban on cigarette sales from vending machines will protect children by making cigarettes less accessible to them – we want to do everything we can to encourage young people not to start smoking in the first place.”

Jo Butcher, the National Children’s Bureau’s programme director of health and wellbeing, welcomed the ban and said a person’s lifetime smoking or non-smoking behaviour was “heavily influenced” by decisions in their adolescence.

“Children and young people tell us that external influences make it even more difficult for them to choose healthier lifestyles.

“It’s essential that we create environments that improve health and tobacco legislation is an important part of public health protection and promotion,” she said.
Protection

Charities have also welcomed the ban.

Betty McBride, director of policy and communications at the British Heart Foundation, said thousands of children at risk of this “deadly addiction” regularly got tobacco from vending machines, “which conveniently don’t ask them to prove their age”.

“These children are often blissfully unaware of the damage smoking does to their health and, by the time they realise, they’re hooked.

“Scrapping these machines cuts off an easy source of tobacco for existing young smokers and makes it harder for a new generation to start.

“We’re encouraging landlords to remove machines completely now so they – and any left-over branding – don’t act as dusty old adverts for tobacco,” she said.

Eileen Streets, director of tobacco control at the Roy Castle Lung Cancer Foundation, said she hoped the ban would play a “significant part in stopping many children becoming the next generation of lung cancer victims”.

Jean King, of Cancer Research UK, added: “Tobacco kills half of all long-term users and is responsible for one in four cancer deaths.

“Cancer Research UK is determined to protect children from tobacco marketing and through our Out of Sight Out of Mind campaign we are continuing to work for legislation to introduce plain packaging for cigarettes.”

But the British Beer and Pub Association described the ban as “an unnecessary measure”.

A spokesman said the machines were there for the convenience of adult customers, and that the association did not believe they played a role in childhood smoking.

Although cigarettes can be sold by bar staff, the spokesman said many pubs would not opt to introduce that, as it raised issues about having a “high-value” item behind the bar and interfered with serving drinks.

Other measures to protect young people from the dangers of smoking are also on the way.

In April 2012, large retailers in England and Scotland will have to get rid of all tobacco displays. Small shops will be expected to comply from April 2015.

Wales and Northern Ireland plan to implement similar regulations.

The government is also due to begin a public consultation before the end of the year on whether to introduce plain packaging for cigarettes in order to lessen their marketing appeal to young people, help make health warnings more effective and help reduce the number of smokers.

Nanny state wants to ban the Great British Fryup Breakfast

Nanny state government targets are putting the great British Breakfast under threat. For many, a plate of bacon, sausage and eggs makes the perfect start to a buzy day.

But Government nanny state targets are about to put the great British breakfast under threat.

Butchers and other food retailers say health diktats to reduce salt levels could ruin the taste of some of our favourite dishes, with producers of bacon and sausages facing the greatest difficulties.

More than 60 food firms and supermarkets have pledged to meet salt reduction targets agreed by the Coalition.

But as the deadline grows closer, they fear compromising the familiar tastes valued by customers unless extra additives are introduced. They also fear risking safety, because of the role of salt as a preservative.

Some independent butchers have said they have no intention of changing cherished recipes to meet the demands of the “salt police”.

At least 80 per cent of sausages sold in Britain currently fall short of the government’s 2012 target, which allows 1.13g of salt per 100g of food. Popular brands such as Richmond contain twice that amount.

Own brand packs of bacon on sale at Sainsbury’s, Tesco and Waitrose all contain more salt than the future 2.88g per 100g limit for bacon.

Andrea Martinez-Inchausti, Deputy Food Director for the British Retail Consortium (BRC) said it was “pointless” to put huge efforts into reducing salt if only left consumers adding large amounts themselves at the dinner table.

“Our members have made fantastic progress reducing the levels of salt in food in recent years,” she said. “In some cases we’ve come as far as we can without help from science. If salt is reduced further there’s a danger that products will no longer taste the way customers want them to.”

The BRC and the Food and Drink Federation have drawn up a list of eight foods for which it is proving difficult to reduce salt content without losing flavour or risking safety. In addition to bacon and sausages, the list also includes soft cheeses, cakes, and sauces such as pesto.

Research will be conducted from next month to see if any new processes or ingredients can be found to overcome the problems.

In total, 62 retailers and manufacturers, including Sainsbury’s, Tesco, Marks & Spencer, Waitrose and Asda have pledged to meet dozens of salt reduction targets by next year.

Their promises were part of a ‘public health responsibility deal’ set by the Coalition before it handed responsibility for nutrition policies from the Food Standards Agency (FSA) to the Department of Health.

It is aimed at helping consumers follow health advice to limit their salt intake to 6g a day, in order to prevent high blood pressure that can lead to strokes and heart disease.

Previous targets, brought in last year, have provoked a backlash from fans of HP sauce who said their favourite brand had been left tasting “bland” and “disgusting” after a drastic cut in salt content.

The sauce used to contain 2.1g of salt per 100g, as well as malt vinegar, molasses, dates and tamarind, but the content was reduced to 1.3g to meet last year’s targets.

Internal FSA documents, dated May 2009, state: “Maintaining product binding and succulence in sausages has proved challenging whilst reducing levels of sodium.”

It says some reductions had been achieved, though they fell well short of next year’s commitment.

The same analysis warns of the difficulties of attaining an even dispersal of salt in bacon, and the impact of laws restricting the use of nitrates as a preservative.

Maureen Strong, nutrition manager for the British Pig Executive, said: “When the work first started on these targets, it was led by statisticians, not microbiologists.

“Research showed that the initial targets they drew up would have caused a rise in salmonella, botulism and E.coli.

“They have been altered since then, and we have all tried to work together, but some of the targets for next year are nigh on impossible – at least without too great a compromise.”

She added: “If you want to reduce the salt in sausages, that often means a whole lot more additives. I don’t know if that is what customers are asking for.”

Those most affected by the changes are food suppliers to major retailers. Independent butchers not signed up to the responsibility deal do not have to meet hit the targets, but some feel failure to meet the new standards could be viewed badly by health-conscious customers.

Mick Norkett, founder of the East London Sausage Company, based in Walthamstow, said he would try to meet next year’s targets.

“We do our best to keep the levels low, but salt is a preservative, and in sausages, it is in the skins as well as the sausage meat,” he said.

“If you are having a fry up, and trying to be keep salt levels down, I think the best thing is to stop adding salt at the table, and to avoid slathering on ketchups and beans that are packed full of the stuff.”

Mr Norkett, a butcher for almost 40 years, said reaching the targets would be more difficult for supermarkets that need a long shelf life for their products.

Stuart Higginson, from Grange-over-Sands, Cumbria, has run his butchers with his wife Pauline for 28 years.

His sausages meet current Government limits of 1.4g per 100g, which came in last year, but he is not prepared to sacrifice flavour in order to meet next year’s demands.

Mr Higginson, 61, from said: “I’ve never had anyone come in and ask for sausages or bacon with less salt in them.

“I think the government are overdoing this; most of us don’t have bacon and sausages every day, and we want to get some enjoyment from our food when we eat it, not just eat to live.”

New drug could help obese patients lose tenth of their weight in just one month

A new drug which destroys blood supply to fatty tissue could help people lose a tenth of their body weight in just one month, a study indicates. Obese rhesus monkeys lost on average 11 per cent of their body weight after four weeks of the experimental treatment.

Body mass index (BMI) and waistline also were reduced, while all three measures were unchanged in untreated control monkeys.

Imaging studies also showed a substantial decrease in body fat among treated animals.

A research team led by scientists at The University of Texas MD Anderson Cancer Centre carried out the study.

Co-senior author Professor Renata Pasqualini, at the David H. Koch Centre for Applied Research of Genitourinary Cancers, said: “Development of this compound for human use would provide a non-surgical way to actually reduce accumulated white fat, in contrast to current weight-loss drugs that attempt to control appetite or prevent absorption of dietary fat.”

She said previous attempts to treat obesity have predominantly focused on drugs aimed at suppressing appetite or increasing metabolism, but these efforts have been hampered by their toxic side-effects.

The MD Anderson group designed a new drug, which includes a homing agent that binds to a protein on the surface of fat-supporting blood vessels and a synthetic peptide that triggers cell death.

Their blood supply gone, fat cells are reabsorbed and metabolised.

Co-senior author Professor Wadih Arap, said: “Obesity is a major risk factor for developing cancer, roughly the equivalent of tobacco use, and both are potentially reversible.”

In earlier preclinical research, obese mice lost about 30 per cent of their body weight with the drug, now called Adipotide.

The drug acts on white adipose tissue, the scientific name for the unhealthy type of fat that accumulates under the skin and around the abdomen, and is a disease and mortality predictor.

Prof Pasqualini said: “Most drugs against obesity fail in transition between rodents and primates.  We’re greatly encouraged to see substantial weight loss in a primate model of obesity that closely matches the human condition.”

The primate model also shares other physiological features associated with human obesity, such as metabolic syndrome, characterised by an increased resistance to insulin, which can lead to the development of type 2 diabetes and cardiovascular disease.

Adipotide-treated monkeys showed marked improvements in insulin resistance – using about 50 per cent less insulin after treatment.

Now the research team are preparing for a clinical trial in which obese prostate cancer patients would receive daily injections of Adipotide for 28 consecutive days.

Prof Arap said: “The question is, will their prostate cancer become better if we can reduce their body weight and the associated health risks?”

He said some prostate cancer treatments, such as hormone therapy, cause weight gain.

Greater weight can lead to arthritis, which in turn causes inactivity that leads to more weight gain.

Fat cells also secrete growth hormones that cancer cells thrive on.

Weight, BMI and abdominal circumference all continued to drop for three weeks after treatment ended before turning back up during the eighth week of the study.

Treated monkeys’ abdominal fat levels fell by 27 per cent during the study. Fat levels increased slightly in the control group.

Lean monkeys did not lose weight in a separate study to test for potential effects of the drug in non-obese animals, indicating that the drug’s effect may be selective for obese subjects.

Monkeys in the studies remained bright and alert throughout, interacting with caretakers and demonstrating no signs of nausea or food avoidance.

This is potentially an important finding since unpleasant side-effects have limited the use of approved drugs that reduce fat absorption in the intestines.

The principal side effects were noted in the kidneys.

Study first author Dr Kirstin Barnhart, a veterinary clinical pathologist said: “The renal effect was dose-dependent, predictable and reversible.”

NHS 111 health direct number- 1 in 8 calls unanswered

One in eight calls to the NHS’s new non emergency health direct phone number are going unanswered, amid reports people are having to wait over half an hour. Ministers want 111 to be the only number people need to call in England, “if you urgently need medical help or advice but it’s not a life threatening situation”.

But a pilot in four areas – Luton, County Durham and Darlington, Lincolnshire, and Nottingham – is highlighting worrying problems.

Official statistics show that in September, 12 per cent of calls went unanswered.

Across the four areas there were 33,707 calls to the service.

The Department of Health expects 12 million calls a year to the free 111 number in England, based on scaling up that figure.

Writing on the NHS’s own web page about the 111 number, one caller expressed frustration at being unable to get through despite waiting 35 minutes.

“All I wanted was a bit of advice. I now need to go to work and have had no help from anyone,” the caller wrote. “I had the sense to take pain killers myself, hope this new service gets better.”

A month ago Andrew Lansley, the Health Secretary, announced that 111 would be rolled out nationwide by April 2013, abolishing the concept of “out-of-hours” care. It is also meant to encompass NHS Direct.

The Department of Health claimed the September statistics showed an “encouraging picture”.

A spokesman said: “Lessons learned from the pilots will ensure that when the service is rolled out nationally it will provide people with a first class service.”

He added: “We know that unanswered calls are usually callers who get through to the NHS 111 message and hang up. This could be because they wanted to speak to their GP practice, but it was still in the ‘out of hours’ period and they were therefore transferred to NHS 111.

“This figure does not mean patients are receiving a poor service.”

A spokesman for NHS Direct echoed this, saying the vast majority of the 12 per cent of unanswered calls were of people who chose to hang up, after learning they were being put through to the 111 service when they wanted to speak directly to their GP.

NHS hospitals crippled by labour’s PFI scheme

Patient care is under threat at more than 60 NHS hospitals which are “on the brink of financial collapse” because of costly private finance initiative schemes the Health Secretary warns. Andrew Lansley says he has been contacted by 22 health service trusts which claim their “clinical and financial stability” is being undermined by the costs of the contracts, which the Labour government used extensively to fund public sector projects.

The trusts in jeopardy include Barts and the London, Oxford Radcliffe, North Bristol, St Helens and Knowsley, and Portsmouth.

Between them the trusts run more than 60 hospitals which care for 12 million patients.

There is already evidence that waiting lists for non–urgent operations have begun to rise as hospitals delay treatment to save money. Adding to this are growing fears over the impact of the financial crisis on care this winter.

Under the PFI deals, a private contractor builds a hospital or school. It owns the building for up to 35 years, and during this period the public sector must pay interest and repay the cost of construction, as well as paying the contractor to maintain the building.

However, the total cost of the deals is often far more than the value of the assets. As a result, Mr Lansley says, the 22 trusts “cannot afford” to pay for their schemes, which in total are worth more than £5.4billion, because the required payments have risen sharply in the wake of the recession.

Mr Lansley said: “Over the last year, we’ve been working to expose the mess Labour left us with, and the truth is that some hospitals have been landed with PFI deals they simply cannot afford.

“Like the economy, Labour has brought some parts of the NHS to the brink of financial collapse. Tough solutions may be needed for these problems, but we’ll help the NHS overcome them. We will not make the sick pay for Labour’s debt crisis.”

He said hospitals would not be allowed to collapse financially.

“There are many hospitals that are well run, do not have a legacy of debt and do have projects which are perfectly sustainable. My point is that we have looked since the election and are working together with individual trusts to arrive at a place where they are financially, and in terms of the quality of their services, sustainable for the future. We can only do that if we work closely with them,” he said.

“This is about making very clear that we are not only working on unsustainable PFIs, but also working with legacy debt that the NHS has been left with, working on the IT programmes which were on an unsustainable scale of contractual commitments that didn’t meet the need of the NHS’s customers.

“Across the board, we have to tackle Labour’s legacy of poor value formoney and debt.”

Over the next few weeks, Department of Health officials and executives at the 22 trusts will develop detailed plans for dealing with the crisis. Their proposals are expected to include significant cost–cutting and the renegotiation of PFI contracts.

Money will also be moved from NHS trusts that are in better financial shape to cover the debt costs at those that are struggling. However, officials are braced for the need to use Whitehall funds to bail out some hospitals.

Among the trusts which have contacted Mr Lansley to inform him of their severe financial problems are several London institutions, including South London Healthcare, Barking, Havering and Redbridge, and North Middlesex.

Outside the capital, other trusts to have approached the health department include Wye Valley, Worcester Acute Hospitals, Mid Yorkshire, and Walsall.

After the general election last year, Mr Lansley ordered officials to establish why some NHS hospitals were under–performing. The health department is assessing the financial position of every hospital. It is understood that the PFI costs have emerged as a leading factor in poor patient care in some areas.

The Health Secretary decided to disclose the list of hospitals in difficulty and is expected to announce the rescue plans for each trust next month.

Taxpayers are having to pay more than £200 billion for schools, hospitals and other projects whose capital value is little more than £50 billion.

In one example, a hospital in Bromley, south east London, will ultimately cost the NHS £1.2 billion, more than 10 times what it is worth. Another hospital was charged £52,000 for maintenance that cost £750. The annual cost of the schemes is almost £400 for each household.

The public payments for PFI deals are typically linked to inflation and therefore the cost to taxpayers has increased by up to a third since the beginning of the credit crisis, according to the National Audit Office. Last month, MPs on the Treasury select committee effectively called for a moratorium on new PFI projects, which it said were “like a drug” as the costs were not apparent at the outset.

George Osborne, the Chancellor, has tightened the rules on the deals.

Earlier this year, John Healey, the shadow health secretary, admitted in an interview that Labour ministers had failed when negotiating the multi–million pound schemes for hospitals.

“There is definitely a case for saying we were poor at PFI, poor at negotiating PFI contracts at the outset,” he said.

Companies who run PFI schemes boast profit margins of up to 71 per cent on the projects, but have come under growing pressure from MPs and ministers to return some of their “windfall profits”.

NHS Hospitals failing to report serious safety incidents

NHS Hospitals are breaking the law by failing to report incidents that result in severe harm to patients a charity has warned. Peter Walsh, chief executive of the charity Action Against Medical Accidents (AvMA), said many were failing to own up to such incidents despite a law that had been in force since April 2010, requiring them to do so.

He was commenting on National Patient Safety Agency (NPSA) figures, showing an 8.5 per cent increase in the total number of reported incidents in the NHS in England, between April to September 2010 and October to March 2011.

The vast majority of such incidents result in “no harm” (69 per cent), “low harm” (24), or “moderate harm” (six).

However, one per cent result in “death or severe harm”. Since April 2010, health trusts have had to report these incidents.

Between the two most recent six-monthly periods for which data are available, the number of such reported incidents rose by 13 per cent – from 4,358 to 5,012.

While significant, Mr Walsh believed if all trusts were reporting as they should, the rise would be larger still.

He said: “Given that there was a new set of rules that came in, in April 2010, that made it a statutory requirement for trusts to report incidents that cause severe harm or death, we would have expected a bigger increase.

“So we think some trusts might be holding back on reporting incidents that caused severe harm.”

He added: “We think work is needed looking at why trusts do not seem to be reporting at a rate we would expect.”

Individual cases that were known through clinical negligence claims should be checked back, to see if trusts had reported them to the NPSA, he recommended.

A spokesman for the NPSA said that overall new figures reflected an improving culture of reporting incidents in NHS trusts.

Sarndrah Horsfall, chief executive of the NPSA, said: “Identifying patient safety incidents and ensuring they are reported and analysed is at the heart of reducing risk in healthcare.

“NHS organisations should use the data and review the tools, guidance and support available to them. This will ensure patient safety incidents continue to be reported and learned from, strengthening the patient safety culture across all levels of the NHS.”