Thousands of elderly left suffering by ‘cruel and random’ eye surgery rationing
When vision in one of my eyes got blurry, I saw an ophthalmologist within a couple of weeks, had lots of tests in the week after that and had a new lens fitted a couple of weeks after that — in a trouble-free procedure that left me with no need for spectacles. But, like 40% of Australians, I have PRIVATE health insurance and went to private practitioners. The poor old Brits can’t afford that so just have to go blind
Thousands of elderly people are having to put up with deteriorating sight because they are denied cataract surgery on the NHS by ‘cruel and random’ rationing, campaigners warn.
Some health trusts offer the procedure only to patients whose sight is so poor it has led to them having a fall, research has found.
Nearly half of health trusts ration operations, with many turning patients away unless they can no longer drive, read or recognise their friends.
Around a third of over-65s suffer from cataracts, cloudy patches that form over the lens of the eye, causing blurred vision. In many cases, as the condition worsens, the only option is to have surgery to remove the cloudy lens and replace it with an artificial one. The procedure, which costs £930, is deemed to be one of the most effective in the NHS.
But researchers from Imperial College London have found 71 out of 151 Primary Care Trusts, which manage NHS budgets, had policies to restrict surgery. The study was published in the Journal of Health Services Research and Policy, and reported by the GP newspaper.
Steve Winyard, of the Royal National Institute of Blind People, said: ‘It’s indefensible and is leaving a lot of older people struggling to lead independent lives.
‘People should not have to live with a reduced quality of life because PCTs are using arbitrary criteria to determine whether they get to keep their sight.’
Andrew Gwynne, the shadow health minister, said: ‘Ministers have lost their grip on NHS finances and as a result we are seeing cruel and random rationing in the NHS.’
Lead researcher Sophie Coronini-Cronberg, of Imperial College London, said some restrictions were necessary as not all patients would benefit from cataract surgery and some would not want it [Really?? They want to go blind?].
But some patients whose sight could be improved were being refused the procedure.
GPs are given cash ‘bribes’ not to send patients to hospital… Practices promised up to £26,000 if they cut referrals
Totally perverse incentives. The ONLY incentive should be what is best for the health of the patient
Doctors are to be offered cash ‘bribes’ to slash the number of patients they send to hospital. GPs have been promised financial incentives of up to £26,000 for their surgery if they take certain measures to reduce referrals.
Every time a doctor sends a patient to hospital for a scan, consultation or operation, the local NHS trust is charged for the cost of their treatment. The trusts are trying to save money by urging GPs to cut the numbers of so-called ‘inappropriate’ referrals.
But leading doctors, including members of the British Medical Association, say it is ‘unethical’ to pay doctors for effectively withholding treatment.
Dr Laurence Buckman, chairman of the GP committee at the British Medical Association, said: ‘There is no way that paying doctors for withdrawing treatment is acceptable. ‘It produces obvious conflicts of interest. You cannot ever have the patient in front of you think that it’s in your interests not to treat them.
‘It’s not just me that thinks this – I’ve yet to find someone who thinks it’s a good idea. I don’t sense overall enthusiasm. ‘I’m very concerned that these schemes are happening.’
Under a scheme proposed by Harrow Primary Care Trust, in North West London, doctors have been promised up to £4 for every patient in their practice if they follow certain steps aimed at cutting referrals.
The amount of money each practice gets depends on the number of patients on its books and whether it meets all of the ‘referral’ targets that are set by the PCT. To get the full amount, practices must follow a number of steps, which include reducing their referrals by up to 10 per cent.
They must draw up lists giving details of the name of the patient referred, the reason they were sent to hospital and the GP who ordered it.
The practice must also nominate a GP to scrutinise every patient referral to hospital, to ensure they are ‘appropriate’. The scheme covers all referrals, ranging from patients sent for scans to rule out possible cancer to those needing to see a specialist for a hip or knee replacement.
If a practice meets all the criteria it will get £4 for every patient on its books. If it only fulfils some, it may get just £1 or £2 per patient.
An average-sized practice with 6,500 patients stands to earn a maximum of £26,000 extra, provided it meets all the targets.
Doctors could then decide to spend the money as they wished, on better facilities for the surgery or to increase their salaries, for example.
The number of referrals varies hugely between practices depending on whether the local NHS trust has policies to try to limit them, patients’ average age, and their illnesses. But a surgery with 6,500 patients is likely to send between 650 and 1,300 to hospital a year.
A spokesman for Harrow PCT said the proposals were still ‘under discussion’ and had not yet been implemented. The PCT also insisted the scheme was meant to be in patients’ ‘best interests’ and that they were trying to improve care while making the best use of NHS money.
Other trusts and clinical commissioning groups – organisations of GPs, which will in future be responsible for designing local health services – are also offering money to practices that cut referrals, although the rewards are not as high.
At Hardwick Clinical Commissioning Group, in Derbyshire, practices are offered 25p per patient, up to around £1,600 in total, if they cut referrals.
Luton PCT, in Bedfordshire, is also proposing to offer practices extra funding to cut referrals, though the details are still being drawn up.
A spokesman for Harrow PCT said: ‘This proposed scheme is about improving the clinical quality of referrals in the patient’s best interest. ‘The scheme is explicit in stating that patients must be referred where clinically appropriate at all times and that the process will ensure the best and most rapid treatment for that patient.’
Although the NHS has been protected from cuts to its budget, it has been ordered to make £20billion of savings by 2014 by running more efficiently.
Whitehall officials say the savings are necessary to ensure there is enough money to care for the increasing elderly population. But in the face of such stringent targets, many NHS trusts have resorted to trying to slash referrals, rationing certain treatments and cutting back on the number of staff.
Some trusts are trying to reduce spending by sending patients to other surgeries or clinics which offer scans or specialist services such as physiotherapy, rather than sending them to hospital, because it is cheaper.
A sad day when it takes a threat of mayhem to get civility out of the British military
After the guy complained to his local airforce base about overflights they reacted in a normal military way by increasing their harassment. That is a standard way of treating dissent in the military but it is totally inappropriate when dealing with the public.
I know an airforce guy who refused a deployment to a remote and unpleasant area of Australia — so they sent him to Afghanistan three times instead: perfectly normal and appropriate in a service environment but brainless otherwise
An angry businessman has threatened to raise a weather balloon above his land every day to stop a ‘gang of Hooray Henrys’ from Prince William’s RAF base thundering overhead in their planes.
John Arthur Jones, 62, said the aircraft roar over his estate up to 75 times a day, as low as 200ft and at speeds of around 400mph, instead of flying over empty fields.
He was so annoyed by the Hawk jets that he threatened to raise a balloon into their flight path every day from his property in Anglesey, North Wales, to deter the pilots.
The chartered surveyor said the planes from nearby RAF Valley, where the Duke of Cambridge works as a rescue pilot, were scaring children attending a nursery on his land at Parc Cefni, where he rents out property to businesses.
He repeatedly wrote to the base, asking in one letter: ‘Are our children being subjected, as some say in the village, to punishment by a gang of Hooray Henrys for daring to ask if they will fly over open fields instead of a children’s nursery?’
In another letter, he warned: ‘Since you have refused to send independent observers to Parc Cefni I will be arranging for a weather balloon to be raised daily at the corner of our property. It will be taken down each evening at midnight.’
Within 48 hours of the base receiving the balloon threat, police were dispatched to talk to him and said the RAF had become concerned for their safety and that of the public.
Mr Jones said he felt the response was ‘ridiculous’. ‘I told the policeman I was proposing to put one up because the planes were scaring the children,’ he said. ‘The safety aspect of this was my main concern and I was worried.
‘These planes are coming in at a speed of around 400mph and as they get to the edge of the property they open the throttle and give it a hell of a blast. ‘I had noticed that the jets were starting to fly much lower and far more regularly.
‘They were flying straight over us despite having the rest of the fields surrounding us, which are either empty or have cattle in.’
A spokesman for RAF Valley said: ‘We take our broader community responsibilities very seriously and we always strive to be a good neighbour, so we regret that Mr Jones has had cause to complain. ‘[Pilots] are instructed to try to avoid direct over-flight of the Parc Cefni children’s nursery whenever possible.’
Speaking of the response to the balloon threat, a police spokesman said: ‘North Wales Police classified the event as “precautionary” and deployed an officer to speak with the resident and clarify his intentions and advise of the possible dangers to air traffic and the local community. ‘An amicable conversation ensued during which time our concerns for safety to local residents and air traffic were expressed.’
Masters of cover-up: How the British Establishment closes ranks to protect its own and deny the people the truth
The illusion finally shatters. All his life, STEPHEN GLOVER (below) has believed in Britain’s great institutions. No more. The sad lesson of the Hillsborough disaster is how the Establishment — judges, police chiefs, civil servants — closes ranks to protect its own and deny the people the truth
Cover-up, lies, obfuscation and incompetence: these are the defects in the police and ambulance service revealed by this week’s damning report into the 1989 Hillsborough disaster in which 96 people died.
It has taken 23 long years to establish the shaming truth, which is that senior police officers manipulated evidence to hide police failings while attempting, with great success, to blacken the good name of the innocent people who needlessly perished.
Evil is a strong word, but some of the things the top brass of South Yorkshire Police are alleged to have done — the doctoring of 116 statements to remove criticisms of the force; the imputation of excessive alcohol consumption where none had taken place — would appear to warrant such a description.
Prosecutions and civil actions will doubtless follow as some of the guilty are finally brought to justice, and there will surely have to be a new inquest. At last everyone seems to be united in condemning the authorities.
Senior police officers and politicians beat their breasts. David Crompton, current chief constable of South Yorkshire Police, tells us his force is in a ‘very different place in 2012’, the implication being that what has happened could never happen again because the police have changed.
But couldn’t it? Have they? I wish I could believe it. Alas, I don’t. Hillsborough has been a classic institutional cover-up which has only been brought to our notice because of the heroic persistence of the relatives of those who died. The Establishment mindset — to hide wrong-doing and ineptitude and never say sorry until it is too late — has not altered.
As a young journalist I believed in the integrity and good sense of most of our institutions. Of course, there were bad apples and stupid mistakes, but there were enough good and honest people in charge to come clean and own up when things went badly wrong.
After a succession of scandals over recent years, it grieves me to say that I no longer believe this is true, and I don’t suppose it ever was. One episode after another has revealed a familiar and melancholy pattern of skulduggery and concealment.
Nearly all the institutions which I was taught to revere as a child have turned out to be self-serving, incompetent or dishonest — the police, Parliament, the Church, the civil service, government, the City and, I regret to say, some parts of the Press.
A dear and distinguished friend of mine blames the relentless media for hollowing out one institution after another, and lowering them in the public esteem. I’m afraid he’s wrong. The media have simply shone lights where they used not to be shone, and illuminated practices which all of us had hoped did not exist.
In a way, the most shocking thing about Hillsborough is that no one is really very surprised. The police have lost much of the respect they used to command. I was certainly brought up to trust them, and can remember throwing aside in disgust a book by George Orwell in which he doubted the decency of the police.
But maybe he was right. Of course, there are many brave and conscientious police officers. It’s their bosses I worry about — people like the then Metropolitan Police Commissioner Ian Blair, who tried to block an independent inquiry into the shooting in cold blood by one of his officers of the young Brazilian Jean Charles de Menezes in 2005.
Look at Parliament. When I was a boy, I believed there were few more honourable letters to have after your name than MP. Even when I was in the Commons press gallery 30 years ago I still looked up to parliamentarians, though I was beginning to learn they did not always tell the truth. That was long before the more recent MPs’ expenses scandal.
Of course many MPs were innocent of any fiddling, but just as many weren’t. In fact, 389 of them — more than half the Commons — were asked to pay back money to the taxpayer amounting to more than £1 million.
A hard core were straightforward crooks, and three MPs (and two peers) went to prison. But the majority were simply greedy, claiming for items they should have purchased themselves. It was depressing that some of the miscreants were privileged and supposedly gentlemanly Tory MPs who should have known better.
Have things improved? I’m not at all convinced they have. Recent figures show that in 2011/12 MPs’ expenses rose 26 per cent to £89.4 million, which is close to pre-scandal levels. First-class rail travel, supposed to be exceptional, is again becoming the norm. Fifty MPs have even been allowed to claim for expensive iPads. Why?
As with the police over Hillsborough, endemic wrong-doing among MPs remained secret for many years, and was ultimately exposed as a result of the efforts of outsiders, in this case the Press.
But it’s not just the institutions of the State that have let us down. As the son of a clergyman, I was brought up to believe that, come what may, the Church could be trusted. How wrong I was, and how saddened my father would have been to read about the cover-up of hundreds of paedophile cases in the Roman Catholic Church.
His own Church of England has also betrayed its congregations, albeit on a smaller scale. A recent internal report into the Diocese of Chichester disclosed a familiar picture of senior clergy being slow to act in sexual abuse cases, putting the Church’s reputation before the interests of children and their families. If you can’t trust a priest, whom can you trust?
Then there are the bankers. Some of them, such as the Royal Bank of Scotland’s disgraced former chief executive Fred Goodwin, showed recklessness and greed while behaving as if the banks were their own private property. Here it is hard to believe that their predecessors of 50 years ago were as rapacious and blindly egotistical.
Most of all, we have been disheartened by the lies and evasions of government. I believe that Tony Blair manipulated the evidence in taking this country to war against Iraq. It is perfectly true that most observers thought Saddam Hussein had weapons of mass destruction. What Blair did was to exaggerate the potency of weapons that turned out in any case to be fictitious.
His response to the growing case against him was a classic Establishment ruse — to appoint a friendly judge, in this instance Lord Hutton, and give him a narrow brief. Nine times out of ten a judge-led inquiry will obligingly come up with findings which suit the government of the day.
That was the case with Lord Hutton, though his implausible exoneration of Mr Blair may possibly be reversed by Sir John Chilcot’s inquiry, which has yet to deliver its verdict. This is being impeded by the Coalition’s refusal to allow it to publish relevant Cabinet papers. As ever, the Whitehall mandarins who stand behind every government live in fear of openness and candour.
British teacher fired for grabbing abusive boy, 16, who hurled a banana milkshake over him
A teacher has been sacked for grabbing a pupil who hurled a banana milkshake at him – despite neither the student or his parents complaining.
Robert Cox held the 16-year-old boy’s arms and pinned him to his chair after being soaked by the drink and suffering a torrent of abuse from the student.
Mr Cox said he feared the boy was about to throw the chair at him. After he let the teenager go, the pupil did pick up a chair and threw it, although not at Mr Cox.
The drama at Bemrose School in Derby was captured on CCTV and governors sacked Mr Cox.
At a tribunal hearing in Nottingham yesterday the 59-year-old said he had now been left ‘unemployable’ and has twice attempted suicide. He also said he feared youngsters’ behaviour was getting ‘out of control’.
Mr Cox, who claims he was unfairly dismissed, was sacked in response to the way he acted in the incident on March 4 last year, the tribunal heard.
Married Mr Cox’s 13-year teaching career has been ended by the episode.
He said: ‘It has had a huge impact on me. I can’t get another job now and our financial situation is dire, to say the least.
‘In all other public buildings you see posters saying abusive language and behaviour will not be tolerated.
‘That is not the case at Bemrose. ‘Instead, if you act within the school guidelines to protect yourself, to protect other students and to prevent an escalation of the situation, you are penalised.
‘Senior management at Bemrose don’t support staff in general at all.
‘Just before this incident, a meeting to discuss pupil behaviour and workload was called by the unions and we didn’t get past the topic of pupil behaviour because it is considered by the staff to be so bad.
‘I worry for my colleagues still there because the message this sends out is that if pupils threaten their teacher, the teacher is likely to be dismissed.’
Mr Cox said the pupil involved in abusing him was excluded for four days.
Governors ruled that he had used excessive force and had escalated rather than calmed the situation.
It was following a commotion in the school canteen when some boys were ‘acting up’ in front of another teacher.
Mr Cox told one of them, a year 11 pupil, to sit down, at which point the teenager launched into a tirade of verbal abuse and then threw his banana milkshake over him.
Mr Cox, who said he had never witnessed such an outburst before, held the boy by the arms and sat him in the seat.
He did that repeatedly every time the boy stood up because he said he feared the teenager was about to grab a chair and throw it at fellow pupils or a teacher if he did not restrain him.
When the school canteen emptied, the teenager did pick up a chair and threw it at an empty table.
Mr Cox, from Woodville, Derbyshire was suspended and, following a disciplinary hearing, was sacked after the panel concluded his actions had been inappropriate.
They did not believe the boy was about to throw a chair, having watched CCTV footage, and thought Mr Cox’s actions and words escalated, rather than calmed, the situation.
Mr Cox said: ‘The grainy CCTV footage from 50ft away did not show what I could see, I could see the look in the boy’s face and I thought he was going to grab a chair.’
Another member of staff who came to the canteen during the incident said Mr Cox was ‘fuming’.
Representing the school’s governing body, at the tribunal, Kathryn Duff said Mr Cox had ‘manhandled’ the boy and that the reason the teenager had thrown the chair was because he was ‘frustrated’ with the way Mr Cox had treated him.
The tribunal judge, who said he had sympathy with Mr Cox’s situation, is due to deliver his decision in writing in about two weeks.
Jo Ward, head teacher at Bemrose School, rejected Mr Cox’s allegations about poor pupil behaviour and a lack of involvement from senior managers.
She said: ‘The senior staff are very experienced and get involved with the children and we have got a very secure understanding of the school.
‘I would point you to the increase in our examination results. Children don’t perform like that if they are misbehaving – they can’t.’
She said a system was also in place to support staff who may be having problems in a classroom.
Failed, failed, failed: Blair said his priorities were education, education, education. But Labour billions did nothing to raise standards, says report
Billions of pounds poured into education under Labour resulted in ‘no improvements’ in standards, a major report revealed yesterday.
Despite Tony Blair declaring his priorities as ‘education, education, education’ when he swept to power in 1997, a huge increase in spending on schools led to ‘no improvement in student learning outcomes’, the report found.
In fact, the UK’s teenagers have slipped down world league tables in crucial subjects while the country’s schools have become among the most socially segregated across the world.
Britain’s immigrant children are clustered in the most disadvantaged schools, the report found.
Eighty per cent of students with an immigrant background attend schools with a ‘high concentration’ of children from similar families. Only Mexico, Estonia and Finland have higher levels, a study of 34 countries by the Organisation for Economic Co-operation and Development (OECD) found.
Primary school class sizes are bigger only in Turkey, Korea, Japan, Israel and Chile and rising numbers of young people have become Neets, ‘not in education, employment or training’.
The findings are a damning indictment of the former Labour government, suggesting their education policies have had little impact and taxpayers have failed to get value for money.
They come just a day after the National Union of Teachers and the NASUWT announced a ‘work to rule’, with staff sticking rigidly to six-and-a-half hour days, refusing all non-teaching duties and threatening strikes.
The OECD study – Education at a Glance – found that expenditure on UK primary and secondary schools and colleges as a percentage of GDP increased from 3.6 per cent in 1995 to 4.5 per cent in 2009, higher than the OECD average of 4.0 per cent.
At the same time, there has been ‘no improvement in student learning outcomes’, the report says.
Andreas Schleicher, deputy director for education at the OECD, said: ‘Spending in the UK has gone up really a lot and has not been reflected in changes to [exam] scores. You have seen huge effort on the part of Government and at the same time outcomes have been flat.’
Separate figures released by the Office for National Statistics have shown that Labour’s spending on education rose from £35.3billion in 2000 to £63.9billion in 2009.
The OECD monitors standards by administering its own tests in reading, maths and science for hundreds of thousands of 15-year-olds in up to 70 countries every three years.
The most recent results in 2010 revealed that the UK fell from 24th to 28th position in maths, 14th to 16th in science and 17th to 25th in reading.
The average class size in primary schools in 2010 was 25.8 pupils – above the OECD average of 21.3.
Meanwhile, the social make-up of UK schools poses ‘significant challenges’ for immigrant students and those from disadvantaged backgrounds, according to the OECD.
Some 79.8 per cent of immigrant students whose mothers are poorly educated – not achieving any qualifications beyond GCSE level – are concentrated in disadvantaged schools.
This is a higher proportion than any other OECD country. The average level is 55.9 per cent.
However, the situation is not limited to children with poorly educated mothers.
Some 42.5 per cent of immigrant students born to highly educated mothers – those who have a degree – are in disadvantaged schools.
This is also a higher proportion than any other country examined by researchers, with the average being 26.1 per cent. These figures relate to 2009.
Tory MP Chris Skidmore said yesterday: ‘Labour’s answer to falling educational standards was to throw more and more money at the problem.
‘This evidence demolishes that approach once and for all. It’s not how much you spend that counts, but what you spend it on.’
Not a grain of truth: Bread has been ‘demonised by TV nutritionists and is a vital part of our daily diet’
From hot buttered toast to the simple sandwich, bread was once the staple of the British diet.
But in recent years it has suffered from a serious image crisis and has become something of a health bogeyman, a food to be avoided and resisted.
Now nutrition scientists believe that most of the health alerts about consuming bread are myths.
Researchers at the British Nutrition Foundation said that people are instead going without vital vitamins and minerals that are contained in each loaf.
And they have dismissed 20 years of warnings that bread is responsible for a range of symptoms, including fatigue, stomach pain, bloating and headaches. They also dispute that wheat allergies are on the increase.
Lead researcher Dr Aine O’Connor said that despite a massive downturn in bread consumption, Britain’s obesity crisis is the biggest in Europe and continues to worsen.
She said that sliced white bread, in particular, had been unfairly ‘demonised’ by health campaigners and TV nutrition shows.
Dr O’Connor said that wheat allergies have not risen, but many people are are now incorrectly convinced they suffer from wheat intolerance or an allergy to gluten (the protein found in wheat).
‘Health professionals need to dispel the myths,’ she told The Sun. ‘Bread is an important source of nutrition.’
Sales of bread have been dropping since the 1970s. In 1974 the average Briton got through 2.2lb (1,029g) of bread a week, by last year it had fallen to 1½lb (700g).
A survey by the University of Portsmouth in 2010 found that one in five British adults believes they are allergic to a food, with most blaming wheat.
Meanwhile, low-carb diets such as Atkins and Dukan haven’t helped either – the claims that carbohydrates cause blood sugar levels to rise, preventing the body from burning fat, have put many off their lunchtime sandwich.
Yet despite this, bread is often the food people crave the most. Many dieters name their greatest weakness as toast in the morning or irresistible basket of warm rolls on the restaurant table.
Fizzy drink cleared as one of your five a day: Outcry as watchdog backs McDonald’s health claims
A children’s fizzy drink sold by McDonald’s has won the right to be labelled as one of the recommended five-a-day portions of fruit and vegetables, even though it contains around six teaspoons of sugar.
The fast-food giant has been cleared by the Advertising Standards Authority watchdog to put Fruitizz in the same category as eating an apple or a serving of broccoli.
The drink is a mixture of fruit juice concentrate – including grape, raspberry and lemon – with fizzy water, natural flavourings and the preservative potassium sorbate.
A small 250ml serving, which costs 89p, has 100 calories and 25g of sugar, which equates to around six teaspoons.
The high levels of sugar come from the fruit juice content. But the ASA said that the addition of natural flavourings and preservatives in the drink ‘did not negate the five-a-day benefits of that 150ml of fruit juice, providing the entire 250ml serving was consumed’.
The ASA made its decision after an investigation, which was launched in response to complaints about a McDonald’s TV commercial and an advert on the Mumsnet website.
A voiceover on the TV advert said: ‘Grape, apple, and raspberry juice with refreshing sparkling water. ‘Fruitizz is full of fruity bubbles with no added sugar, artificial colours or flavours. And it’s one of your child’s five a day.’
Malcolm Clark, of the Children’s Food Campaign, said the ASA ruling was evidence that the rules which define health claims around fruit and vegetables are not sufficiently strict.
He added: ‘McDonald’s is only doing what other companies do: exploiting the laxness surrounding the five-a-day claims regime for commercial benefit.
‘We are concerned that increasingly the five-a-day message – originally designed to tackle cancer and heart disease – is being used to promote junk foods, sometimes with very low fruit or vegetable content.
‘If the Government actually values the five-a-day claim and wants it to be a meaningful label that consumers can have confidence in, they need to re-issue and reinforce robust guidance restricting the five-a-day message to genuinely healthy foods.’
Dietitian Christina Merryfield, of London’s Bupa Cromwell Hospital, said: ‘Sugary drinks can encourage tooth decay and erosion and lead to weight gain. ‘Water is a much better option and milk is great because it is full of calcium and other vitamins and minerals.’
A McDonald’s spokesman said: ‘We welcome the ruling by the ASA. Fruitizz is a drink designed for the Happy Meal menu, served in a 250ml measure as standard and it is not marketed in any larger sizes.
‘In the development of Fruitizz we followed the five-a-day guidance provided by the Department of Health. ‘Fruitizz contains no added sugars, artificial colours or artificial flavours and all size servings provide one daily portion of fruit, as defined by the Department of Health.’