Runaway British health bureaucracy reined in
NHS drugs rationing body NICE stripped of its other powers to act as nation’s lifestyle nanny
The ‘nannying’ health advice dished out by the NHS rationing body is being dramatically scaled back by ministers. The Government has asked the National Institute for Health and Clinical Excellence to stop working on guidance on six public health topics and ‘to put on hold’ work on a further 13.
Guidance from NICE that is still in the pipeline covering smoking, obesity, contraception and road safety is being axed or left in limbo amid questions about whether it constitutes value for money. NICE has also been told to abandon guidance on preventing road injuries in children and young people, and policies for smoke-free homes and cars.
Support for smokers buying nicotine replacement products and information on what can be done to combat trade in illicit tobacco products are also casualties of the plan to minimise the role of NICE.
Ministers have decided that six topics previously referred to NICE are ‘not appropriate for NICE guidance and should therefore be removed from the NICE work programme’.
The dramatic scaling back of the organisation’s workload – just nine out of 28 public health projects remain – follows the publication of the public health white paper Healthy Lives, Healthy People. In the document, the Government outlines new ‘responsibility deals’ it plans with business and the voluntary sector, in which voluntary targets to cut fat and salt are set by the industry to ‘nudge’ people into healthier choices.
But the heavy presence of food and drinks firms on committees overseeing the deals, including Kellogg’s, McDonald’s, and PepsiCo, has been widely criticised by doctors and public health experts.
Alan Maryon-Davis, honorary director of public health at King’s College London, who chairs the NICE public health topic consideration panel, said he was very disappointed by its shrinking public health portfolio. He told the British Medical Journal it was ‘a shame’ as a lot of work had been done.
Professor Maryon-Davis said: ‘It is a pity to take this work away from NICE, because it has a very good track record of producing evidence on which to build policy, something which is becoming even more important as local authorities and public health bodies are being asked to work together to improve public health.’
Five further pieces of guidance have been ‘put on hold’ until the results of separate government initiatives are known. These include advice on preventing obesity and contraceptive services for socially disadvantaged young people.
Ministers are ‘giving further consideration’ to another eight topics on which NICE has not yet started work. These include increasing fruit and vegetable supply to disadvantaged communities, identifying and treating overweight and obese children, healthy eating messages in the media, and providing smoking cessation services in hospitals for people with chronic conditions.
But Chris Daniel, policy analyst for the TaxPayers’ Alliance, said: ‘It is good news that spending on these wasteful projects has been scrapped. ‘We need to see money focused on cutting the burden on taxpayers and protecting frontline services, not new attempts to interfere in smokers’ lives and tell us what to eat. ‘We need to stop money being wasted like this in future on new projects, and stop these wasteful, nannying initiatives permanently.’
The changes to NICE’s role follow government plans to strip its powers to deny medicines to patients by bringing in a new method of paying for drugs in 2014. The Government’s aim is to increase availability and improve the value to the NHS.
A spokesman for the Department of Health said: ‘Our public health white paper, Healthy Lives, Healthy People, sets out a bold vision, announcing radical reforms to make wellness central to all we do – in health and across government. ‘NICE will continue to have an important role in developing robust, authoritative advice on public health interventions and we have made a few changes to some of the topics that NICE has been asked to produce guidance on.’
Professor Mike Kelly, director of the Centre for Public Health Excellence at NICE said: ‘The Coalition Government has major plans for the future of public health services. ‘We are glad that NICE’s evidence-based advice will continue to underpin future public health activity.’
Secret to a smooth hangover – honey on toast
If you are planning to overindulge this Christmas then it would be a good idea to stock up on bread and honey as well as booze. Scientists claim that the natural sweetener is a great way to help the body deal with the toxic effects of a hangover.
The Royal Society of Chemistry claim that the fructose in the honey – which is also found in golden syrup – is essential to help the body break down alcohol into harmless by-products.
The reason why hangovers are so painful is that alcohol is first broken down into acetaldehyde, a substance which is toxic to the body, claimed Dr John Emsley of the Royal Society. This is then converted – using fructose – into acetic acid which is then burned during the body’s normal metabolic process and broken down into carbon dioxide which is breathed out of the body. Serving the honey on toast adds potassium and sodium to the meal which is also helps the body cope with the alcohol.
Dr Emsley said: “The happiness comes from alcohol. The hangover comes from acetaldehyde. “This is the toxic chemical into which alcohol is converted by the body and it causes a throbbing headache, nausea, and maybe even vomiting. “The hangover disappears as the acetaldehyde is slowly converted to less toxic chemicals.”
Dr Emsley, author of the Consumer’s Good Chemical Guide, said that the time was the greatest healer of a hangover but there were also ways to minimise it. He said that drinking a glass of milk first, sticking to clear alcohols such as gin and mixing in the occasional soft drink were helpful as was sinking a pint of water before you go to bed.
He said: “The milk slows down the absorption of alcohol, which means there is less acetaldehyde for the body to deal with at any one time.
“Gin is alcohol twice purified by distillation and the botanical flavours it contains are mere traces. Avoid dark coloured drinks which contain natural chemicals that can adversely affect you.
“Alcohol increases water loss, hence the frequent trips to the loo. This dehydration makes a hangover worse, so moderate your drinking with a soft drink now and again, and drink a large glass of water before you go to sleep.”
He said that the traditional “hair of the dog” only worked if you have drank so much alcohol you suffer withdrawal symptoms, which suggests you are becoming addicted.
Why did the Met Office forecast a “mild winter”?
Asks Boris Johnson, Mayor of London, as he introduces his readers to a man who got it right
Do you remember? They said it would be mild and damp, and between one degree and one and a half degrees warmer than average. Well, I am now 46 and that means I have seen more winters than most people on this planet, and I can tell you that this one is a corker.
Never mind the record low attained in Northern Ireland this weekend. I can’t remember a time when so much snow has lain so thickly on the ground, and we haven’t even reached Christmas. And this is the third tough winter in a row. Is it really true that no one saw this coming?
Actually, they did. Allow me to introduce readers to Piers Corbyn, meteorologist and brother of my old chum, bearded leftie MP Jeremy. Piers Corbyn works in an undistinguished office in Borough High Street. He has no telescope or supercomputer. Armed only with a laptop, huge quantities of publicly available data and a first-class degree in astrophysics, he gets it right again and again.
Back in November, when the Met Office was still doing its “mild winter” schtick, Corbyn said it would be the coldest for 100 years. Indeed, it was back in May that he first predicted a snowy December, and he put his own money on a white Christmas about a month before the Met Office made any such forecast. He said that the Met Office would be wrong about last year’s mythical “barbecue summer”, and he was vindicated. He was closer to the truth about last winter, too.
He seems to get it right about 85 per cent of the time and serious business people – notably in farming – are starting to invest in his forecasts. In the eyes of many punters, he puts the taxpayer-funded Met Office to shame. How on earth does he do it? He studies the Sun.
He looks at the flow of particles from the Sun, and how they interact with the upper atmosphere, especially air currents such as the jet stream, and he looks at how the Moon and other factors influence those streaming particles.
He takes a snapshot of what the Sun is doing at any given moment, and then he looks back at the record to see when it last did something similar. Then he checks what the weather was like on Earth at the time – and he makes a prophecy.
I have not a clue whether his methods are sound or not. But when so many of his forecasts seem to come true, and when he seems to be so consistently ahead of the Met Office, I feel I want to know more. Piers Corbyn believes that the last three winters could be the harbinger of a mini ice age that could be upon us by 2035, and that it could start to be colder than at any time in the last 200 years. He goes on to speculate that a genuine ice age might then settle in, since an ice age is now cyclically overdue.
Is he barmy? Of course he may be just a fluke-artist. It may be just luck that he has apparently predicted recent weather patterns more accurately than government-sponsored scientists. Nothing he says, to my mind, disproves the view of the overwhelming majority of scientists, that our species is putting so much extra CO2 into the atmosphere that we must expect global warming.
The question is whether anthropogenic global warming is the exclusive or dominant fact that determines our climate, or whether Corbyn is also right to insist on the role of the Sun. Is it possible that everything we do is dwarfed by the moods of the star that gives life to the world? The Sun is incomparably vaster and more powerful than any work of man. We are forged from a few clods of solar dust. The Sun powers every plant and form of life, and one day the Sun will turn into a red giant and engulf us all. Then it will burn out. Then it will get very nippy indeed.
Shrinking British universities
There will be a freeze in university places next year and 10,000 fewer places the following year as the higher rate of tuition fees comes into force, the government has announced, meaning that hundreds of thousands will fail to get onto degree courses. David Willetts, the Universities and Science minister, said that teaching budgets would be slashed by almost £400 million, equivalent to 6% of the overall budget, next April, more than a year before fees rise to a maximum of £9,000.
The University and College Union (UCU) said the announcement was a “Christmas kick in the teeth for the sector” and warned that British universities face falling behind on the world stage. The union said the cuts, outlined in a grant letter to the Higher Education Funding Council for England (HEFCE), will force academic institutions to freeze staff pay and cut courses.
Mr Willetts said that “extremely challenging” public spending constraints meant that public expenditure costs had to be controlled by controlling student numbers. The fine on over-recruitment comes despite Mr Willetts’ criticism of a similar policy implemented by Labour last year, which he said at the time would add “real pressure” to the sector and was “very bad news” for Britain’s universities.
There has been a substantial rise in applications for places in 2011 as students battle to enter higher education before the new fee cap is introduced. At the end of November, applications were up by around 12% on the same period last year, meaning that some 235,000 people could be without places next autumn.
The grant letter, from Vince Cable, the Business Secretary, and Mr Willetts, said that total funding from loans and HEFCE grants would fall by around £600 million in 2011, from £9.8 billion to £9.2 billion. That figure will rise to £9.412 billion in 2012, when a larger proportion of the cash will be made up of Government loans to cover students’ tuition fees, to be repaid when they reach an income of £21,000 after graduation.
Teaching grants will be cut from £4.9 billion to £4.6 billion in 2011. This will drop to £3.8 billion in 2012, which will be offset by raised tuition fees. The figures are based on assumed average fees of £7,500 per year.
Ministers insisted that universities continue to receive “significant public funding”, with the total budget from Government grants and tuition fees rising from £9 billion to £10 billion by 2014. They suggested that in order to save money, universities collaborate “through greater sharing of research equipment and infrastructure”.
Mr Willetts said that despite the tough fiscal scene, institutions would be able to cope with the cuts and that in cash terms, there would be a “modest recovery” of funding going into universities in 2012, providing that they could attract the necessary number of students.
“We believe there is scope for efficiency savings within English universities and that they can handle cuts on this scale,” he said. “With the increase in revenues we expect universities to get from fees and loans, the aggregate effect could represent a rise in cash terms.” He said the rise in fees should create incentives to improve the quality of teaching.
Gareth Thomas MP, Labour’s Higher Education Spokesman criticised the government’s “triple whammy” imposed on universities – cuts in teaching funding, in research funding and in capital investment. He said: “Even within the terms of their own reckless approach to cutting the deficit such big cuts were not needed. Every other country in the G8 is increasing their higher education, science and research budgets despite their economic challenges.”
UCU general secretary, Sally Hunt, said the coalition’s Christmas message to the sector was “funding cuts, higher fees, fewer university places, a pay freeze and attacks on staff pensions”. She said: “After weeks of attacks on students and universities through budget cuts and increased tuition fees the coalition has delivered a real Christmas kick in the teeth to the sector by announcing these cuts to funding and student places and attacks on pay and conditions.
“The government seems to think that the sector will be able to deliver more for less and students will be happy to pay three times the price. “That is absolute madness, especially when we consider the increased spending on higher education in the vast majority of developed and developing countries around the world. “Put bluntly, by cutting funding and access to university, attacking staff pay and conditions and charging students record fees we are going to be left behind.”
Aaron Porter, NUS President, said that fines for over-recruiting would see hundreds of thousands of highly qualified students “missing out on places and being left between a hostile jobs market and tripled tuition fees if they dare to reapply”.