Category Archives: Cholesterol

Centenarian club: wealthiest investors expect to reach 100

More than half of of the world’s wealthiest investors expect to live to the age of 100, according to a survey.

UBS wealth management polled 5,000 high-net worth individuals (HNWIs), defined as having at least $ 1m in investable assets, across 10 countries including Germany, the UK, US and Taiwan, and found that 53% were confident of becoming centenarians. This is considerably higher than the 80-year life expectancy in most developed countries.

The UBS report, entitled The Century Club, concluded: “The idea of living a century was once confined to science fiction. But no longer. For the world’s wealthy, living a 100-year life is not an outcome they consider a mere possibility. It’s one they expect.”

The richest 1% own half the world’s wealth, according to a report by Credit Suisse in November, which highlighted the growing gap between the super-rich and the remainder of the globe’s population.

Numerous studies have provided evidence that wealth inequality is linked to health inequality. Last year, data compiled by the Department of Health showed that in the UK the gap between rich and poor in relation to “healthy life expectancy” – defined as a life free of disease or disability – had widened to almost 20 years.

A University of Washington study in the US in 2017 came to a similar conclusion on a “life expectancy gap” between affluent and poorer areas of at least 20 years.

Longevity expectations

Longevity expectations Photograph: UBS

UBS found that the outlook for longevity varies by country and wealth. Three-quarters of Germany’s wealthy elite anticipate reaching 100 while less than a third of HNWIs in the US believe they will live that long. In Switzerland, Mexico and Italy the figure is more than two-thirds. In the UK, nearly a third (32%) expect to reach the age of 100.

However, even the wealthy worry about having enough money to pay for healthcare when they are older, according to UBS. There is more appetite to work longer and to spend less today to save for tomorrow, amid concerns about how to pay for end of life care.

What per cent of your wealth would you sacrifice to guarantee an extra 10 years of healthy life?
What per cent of your wealth would you sacrifice to guarantee an extra 10 years of healthy life? Photograph: UBS

Healthcare costs are the greatest concern among those surveyed by UBS, with 52% worried about rising medical bills. In addition, 35% worry about having less wealth to pass on to their children, and 33% fret about being forced to work longer to maintain their lifestyle.

At the same time, nearly eight in 10 believe that work is important for their wellbeing. This belief is particularly strong in Asia (93% in Hong Kong), and in Switzerland (87%), but far less so in the US and the UK, where the figures are 52% and 59% respectively.

Giving while living is increasingly popular

Giving while living is increasingly popular Photograph: UBS

Nine in 10 say their health is more important than increasing their wealth and a similar number believe their wealth enables them to live a healthier life.

Those with more than $ 10m spend four times more on health than their less wealthy peers. Ultra-high net-worth individuals with $ 50m-plus claim they would part with nearly half their riches in exchange for an extra 10 years of healthy life. UAE investors are the most likely to sacrifice more while US investors are the least likely.

The longer they live, the quicker the wealthy are going to give away their riches; and the more likely they are to skip a generation and give wealth to their grandchildren rather than their children.

Nearly two in three plan to give away more of their wealth while they are still alive to see heirs enjoy it, especially in Switzerland but less so in Mexico and the US, where people worry about outliving their assets.

Patients with multiple conditions not getting best possible care, say experts

Millions of people in the UK and many more across the world are suffering from multiple long-term illnesses and may not be getting the best possible treatment from health services that focus on one disease at a time, say experts.

A team from the Academy of Medical Sciences in the UK says this is a growing problem and a huge potential burden on the NHS and other health services. “Clusters” of diseases are becoming more common, they say, such as type 2 diabetes, high blood pressure, osteoarthritis, depression and chronic obstructive pulmonary disease of the lungs.

Specialised hospital doctors treat each one of these conditions individually. Patients may have one problem treated and then have to wait months to see a different specialist for another condition. The experts are calling for a greater role for the GP, who can look at the whole person, but needs more time than a 10 minute consultation.

Prof Stephen MacMahon, principal director of the George Institute for Global Health and chair of the Academy’s steering group on multimorbidity said the best evidence on the numbers came from Australia, but there was no reason to think other countries would be different. “Among Australians seeing a general practitioner, half have two diseases or more, a third have three or more and 10% have six diseases or more,” he said. “This is not a small problem.”

In the UK a study published in 2016 showed that the numbers of patients over the age of 50 with multiple conditions rose over the decade from 2002/3 from 31.7% to 43%. The Royal College of GPs said its own analysis has shown that the number of people living with more than one serious, long-term condition in the UK will increase by nearly one million to 9.1 million by 2025.

These people are more likely to die early, be hospitalised, suffer disability and have a poor quality of life, said the Academy. They could be on dozens of pills each day, raising the chances of interactions and side-effects.

“If you have multiple conditions, any one of those conditions is likely not to be treated as well as it might be of you were treated for one condition alone,” MacMahon said.

Mental and physical conditions go hand in hand, say the experts. Heart disease patients may have depression. People with dementia may develop other physical illnesses. There were links between depression and heart attacks. People with depression were more likely to smoke – or not give up smoking – and more likely to become obese, said Martin Prince, professor of epidemiological psychiatry at King’s College London. People with mental health conditions were less likely to adhere to their medication.

The experts say there is not enough evidence to know why there is such an increase in multiple conditions and call for more research, but an ageing population and the effects of modern lifestyles in obesity and alcohol and smoking-related disease must all play a part.

The most dramatic surge around the world has been in type 2 diabetes, which is obesity-related. The numbers are projected to reach 630 million, said Melanie Davies, professor of diabetes medicine at the University of Leicester. “That is nearly one in every 10 people on the planet,” she said.

Those people often had other health problems. “Under the age of 65, you have a mean of three long-term conditions. Over-65 you have seven other conditions.” She is now seeing many young people with a disease that was almost unheard of in their age group 20 years ago. Now there are 500 children with type 2 diabetes in the UK.

Many of those young people had other conditions as well. “We need to rethink how we deliver care,” she said, involving pharmacists for their multiple drugs as well as social workers and care co-ordinators.

Prof Helen Stokes-Lampard, chair of the Royal College of GPs said: “GPs play a major role in looking after patients living with multimorbidities, but often find ourselves coming up against barriers to their care. A lack of research, as this study highlights, into the extent of the crisis is one; another is understanding how best to treat patients living with both physical and psychological conditions – and having access to the most appropriate services to manage this in the community.”

Britain’s use of contaminated blood was no ‘tragedy’ – it was a scandal | Simon Hattenstone

In two weeks’ time Sir Brian Langstaff will take up his post as chair of the public inquiry into contaminated blood and contaminated blood products. Today, World Haemophilia Day, is the perfect occasion to remind Langstaff what the thousands of haemophiliac victims need from this inquiry if they are to get justice.

In the 1970s and 1980s more than 4,600 haemophiliacs contracted HIV or hepatitis C after being infected by contaminated blood-clotting products. Much of the blood had been imported on the cheap from US prisons, and taken from high-risk donors (sex workers, drug addicts and alcoholics) who were paid for their blood. As early as 1975, the TV programme World in Action exposed the fact that the NHS was buying this blood and that it had led to a hepatitis epidemic among haemophiliacs. This was before HIV and Aids had been diagnosed.

That year, David Owen, the then Labour health secretary, promised Britain would become self-sufficient in blood products to ensure vulnerable patients were put at minimal risk. But this never happened. By the mid-80s, the government was still buying the deadly blood from Arkansas prisons, despite the fact that the US Food and Drug Administration had banned its sale in America in 1983.

In 1983 Dr NS Galbraith, founding director of the Communicable Disease Surveillance Centre in England and Wales, wrote to the Department of Health and Social Security, saying: “All blood products made from blood donated in the US after 1978 should be withdrawn from use until the risk of Aids transmission by these products has been clarified.” But they were not withdrawn. The Department of Health considered his advice “premature”. Six months later, the then minister of state for health, Kenneth Clarke, told the House of Commons: “There is no conclusive evidence that Aids is transmitted by blood products.”

The government prefers to refer it as the contaminated blood “tragedy”, but make no mistake: this is a scandal. (In a further diminution, the inquiry is now into “infected” rather than “contaminated” blood, as it was initially). Tragedy, as victims and loved ones point out, suggests there is no one to blame. This could not be further from the truth. Last year, the former health secretary Andy Burnham said, in his final speech in the Commons, that the use of contaminated blood was a “criminal cover-up on an industrial scale” and threatened to pass his evidence to the police if the government did not act. Three months later, in July 2017, a public inquiry was announced. This is the third inquiry into contaminated blood in Britain, but the other two have been dismissed by campaign groups as a whitewash.

So what do victims want from the public inquiry (the terms of reference for which have yet to be defined)? First, it must discover exactly how this happened and why it was covered up for so long. Those affected need legal aid to ensure they can fully participate in the inquiry, and there must be compensation without further delay for lost incomes and lost lives.

By the early 1980s, government experts knew that those receiving Factor VIII (and less commonly Factor IX) blood-clotting products were at risk of HIV infection. Medical experts recommended that the products underwent heat treatment to kill infection-causing viruses, but implementation was delayed because of the expense. Even after it had been introduced, unheated Factor VIII product was given to patients in A&E departments of hospitals.

Campaign groups such as Tainted Blood believe haemophiliacs were used as human guinea pigs in contravention of the Nuremberg Code created at the end of the second world war, which states that “nobody will be experimented on medically without their consent”.

Initially the heated blood products were tested on chimpanzees, but this proved too expensive. As early as January 1982 haemophilia expert Prof Arthur Bloom wrote to the country’s haemophilia centres telling them new preparations of Factor VIII were going to be processed through heat treatment, saying it was vital to discover how much infectivity had been reduced with the new heat-treated products: “The most clearcut way of doing this is by administering those concentrates to patients requiring treatment who have not been previously exposed to large pool concentrates.” These patients were known as pups – previously untreated patients.

None of them knew they were pups. Colin Smith, a haemophiliac who was infected with HIV and hepatitis C, died at the age of seven weighing 13 pounds. After his death, his parents, Jan and Colin Sr, discovered in his notes that he was one of Bloom’s pups. “All these materials carry the risk of hepatitis … but this is something haemophiliacs have to accept,” Bloom wrote. Yet the Smiths were never told of this risk.

Factor VIII concentrate was only supposed to be given for life-threatening bleeds. After his death, Colin’s parents discovered he had been treated with Factor VIII after hitting his head “without any evidence of intracranial bleeding” and for a swollen finger. His parents not only had to suffer the heartbreak of their son’s painful death, but also the humiliation of being ostracised by their community – Aids was painted on the side of their house in six-foot letters. They ended up moving home.

Before the Factor VIII product was introduced, haemophiliacs had been treated with a product called cryoprecipitate. It was cumbersome and involved visits to the hospital, but it was safe and effective. The minutes from the 1983 annual meeting of the UK Haemophilia Centres Directors state that Dr Margaret Chisholm raised the issue of “patients refusing to take up commercial Factor VIII because of the Aids scare” and asked “whether the directors could revert to using cryoprecipitate for home therapy”.

According to the minutes Bloom, by then chair of the UK Haemophilia Centre Doctors’ Organisation, responded that “there was no need for this switch to occur on the basis that there was no proof that commercial concentrates were the cause of Aids”. If he had listened to Chisholm many lives could have been saved. In one special school, Treloar College, 89 children were infected with HIV or hepatitis B and C from 1975 onwards. Only 16 are alive today.

There are other issues for the inquiry to consider – not least the attitude of some medical experts, civil servants and politicians who appeared to regard haemophiliacs as little more than a financial burden. In one memo from 1985 a government official wrote “those who are already doomed will generate savings which more than cover the cost of testing blood donations”.

The contaminated blood scandal was not confined to Britain. In France the former health secretary was found guilty of manslaughter but not jailed. In Japan senior health officials were jailed for negligence. Jan and Colin Smith believe their son was killed by the state, and they want the public inquiry to tell them how. But for them that is just the start. They will not be satisfied until those responsible face criminal charges.

Simon Hattenstone is a features writer for the Guardian

Love Island and other shows ‘encourage teenagers to smoke’

Contestants’ cigarette habits in the reality TV show Love Island and Winston Churchill’s cigars in the Oscar-winning film Darkest Hour inspire children to take up smoking, anti-tobacco campaigners have warned MPs.

Action on Smoking and Health (Ash) and the UK Centre for Tobacco and Alcohol Studies said children in the UK are still exposed to significant amounts of on-screen smoking. They cited a rise in smoking in Oscar-nominated films and research that showed cigarettes appeared in Love Island every five minutes on average with the Lucky Strike brand appearing 16 times.

This year, 86% of Oscar-nominated films contained someone smoking, up from 60% four years ago, the groups told the Commons science and technology select committee. Just over half of the nominated actors depicted smokers, the highest level in several years, research found.

Given Love Island’s popularity with young people, last summer’s series left 47m “gross impressions” of smoking on children under 16, the campaigners told the MPs in a submission to the parliamentary inquiry into the impact of social media and screen use on young people’s health.

The campaigners want the communications regulator, Ofcom, and the British Board of Film Classification to monitor youth exposure to depictions of tobacco use on screen, to discourage any depictions of tobacco use and require broadcasters or cinemas to run anti-smoking ads during presentations that feature smoking.

Smoking is banned in UK advertising, but not in programmes. Craig Lawson, a dumped Love Island contestant, told the Sun last year that every islander was given at least 20 cigarettes a day by producers, if they wanted them.

“Ofcom and the BBFC, which regulate these sectors, need to take the necessary steps to warn parents of the risks and protect our children from the harmful effects of tobacco imagery,” said Deborah Arnott, the chief executive of Ash.

Arnott said that while Churchill was a famous cigar smoker and to show him smoking was justified, the majority of the smoking roles on biographical films were taken by fictional characters who the film-makers had chosen to show smoking.

However, the pro-smokers’ group Forest said Ash was mounting “an attack on artistic freedom” and claimed there was “no significant evidence that smoking on TV or film encourages teenagers to smoke”.

Ash responded that multiple academic studies had proved causality and said Forest was funded by the Tobacco Manufacturers’ Association.

Forest is supported by companies including British American Tobacco, which makes Lucky Strike and Camel cigarettes.

The submission to MPs includes figures from Cancer Research UK, showing that between 2014 and 2016 about 127,000 children a year started smoking for the first time. That research shows more than 60% of those who try smoking become regular smokers.

“The introduction of standardised packaging of tobacco products, backed up the complete ban on advertising, leaves smoking in the entertainment media as the main way smoking is promoted to children,” said George Butterworth, a senior policy manager at Cancer Research UK.

I’ve been an NHS doctor for five years. The Home Office wants to deport me

A year ago I had a stable job working as a trainee GP in Greater Manchester and was due to qualify in February this year. I was in a relationship, had my own car and everything was great.

But for the last eight months my life has been a living hell.

My troubles began towards the end of last year when I applied for indefinite leave to remain in the UK. I am from Singapore. I was five months away from qualifying as a GP and had studied medicine at Manchester University, starting as a doctor in the NHS in 2012.

I booked an appointment and paid for it before my visa ran out. I thought that was fine. In reality, the application is made when you attend the appointment, by which time my visa had been invalid for 18 days. I was refused residency for that reason, and since then it’s been a battle to reverse the decision. An immigration judge ruled that it “would not be proportionate” to remove me; the Home Office lodged an appeal. My lawyer told me on Friday morning it is reconsidering my original application.

Everything flies in the face of common sense. NHS England is paying £100m to recruitment agencies to get GPs to work in England and here I am, five months away from becoming a GP, and I’m being kicked out. Meanwhile, demand in the NHS is rising and GP numbers are falling.

I haven’t been allowed to work since the initial appointment. When I was told, my first thought was: “What am I going to do about all the patients I’ve booked next week? Who is going to see them?”

I’m not entitled to benefits so I’ve been living off my savings and help from my parents.

My mental health has deteriorated. There have been days when I’ve woken at 5am, my heart racing, and thought: “What should I do? Are they going to deport me? Am I going to be detained?” It was constantly on my mind. It placed a lot of strain on my relationship, which has now ended, party because of the stress.

I chose general practice because I like having the time to sit with patients and build up a relationship

Everything has ground to a halt. It takes a lot to be resilient and say I’m going to carry on regardless of what happens. If I can’t finish my training, everything will have been for nothing. I would have to go to another country – Singapore or Australia – and start over again as a trainee.

I’ve loved the UK since I visited as a child. When it came to university, my mind was set on the UK. I chose general practice because I like having the time to sit with patients and build up a relationship. It’s always nice to see what happens to them.

I remember learning about the NHS at school in Singapore. It’s this massive institution that takes care of you from when you’re born to your very last days. You always have to pay something for healthcare in Singapore. The NHS is amazing – it is unimaginable in other countries to have a system that gives you what you need, when you need it. I’m so proud to have worked for it.

I feel I have a personal debt to the NHS. It has invested in me – it costs hundreds of thousands of pounds to train a GP (pdf) from medical school through to qualification. Some of that I’ve paid for but I’m immensely grateful. I really want to be able to contribute and give back to the NHS.

Dr Ong has started a petition asking the Home Office to reconsider

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs

Liverpool protest held over withdrawal of Alfie Evans’ life support

The parents of a seriously ill boy at the centre of a life-support treatment battle are to mount another legal challenge.

Tom Evans, 21, and Kate James, 20, are preparing to ask court of appeal judges to allow 23-month-old Alfie Evans to continue to receive treatment.

The latest legal challenge, set for Monday, came after hundreds of demonstrators gathered outside a hospital in Liverpool to protest against the decision to turn off the baby’s life support.

The demonstration, which closed roads around Alder Hey hospital on Thursday night, was to challenge a high court judge who ruled that further treatment would harm Alfie’s future dignity.

On Wednesday the high court judge, Mr Justice Hayden, endorsed an end-of-life care plan for Alfie drawn up by specialists. The judge described Alfie’s life as “profoundly unfair” but accepted medical evidence that showed further treatment was futile.

Alfie Evans.

Alfie Evans. Photograph: PA

Alfie’s parents, who are from Liverpool, have already lost fights in the high court, court of appeal, supreme court and European court of human rights.

But on Friday appeal court officials confirmed to the Guardian that another hearing had been listed for Monday.

Appeal court officials told Press Association that an appeal court judge had decided that Alfie should continue to receive treatment pending Monday’s hearing.

Legal advisers representing the couple said they will ask judges to overturn at least one decision made by Hayden on Wednesday.

The protest outside Alder Hey began after Tom Evans said in an emotional Facebook video that he had an air ambulance on standby to fly his son for treatment in Rome but that police prevented him from taking Alfie out of the hospital.

Footage posted online showed Alfie’s parents receiving huge applause as they joined the significant crowd of protesters who were chanting Alfie’s name.

Liverpool protest held over withdrawal of Alfie Evans’ life support

A video posted on Facebook showed Alfie’s father filming his son in the hospital and holding a letter he said stated he had the right to leave with his child. The words “Christian Legal Centre” can be seen at the top of the letter.

“I have documentation that says I have the right to take my son out of the hospital. I have the right to take my son out of this hospital,” he says in the video. Evans said the documentation proved he was allowed to leave legally, and that he had removed the duty of care and given it to their air ambulance company.

“Alder Hey have phoned the police to stop me from taking my son out of the hospital. This is my son. Look at my healthy, healthy young boy who is undiagnosed, who is certainly not dying,” he said.

During the clip of about two and a half minutes he also encouraged people to come to the hospital to stand outside and “tell them to release our son” in a “quiet protest”.

He added: “They have phoned the police over a child … Look how innocent the boy is, look at him, he lies there eagerly waiting for his trip home. How can this come to this?”

Merseyside police said the protest was peaceful but “did cause significant traffic disruption and inconvenience for other people trying to access the hospital”.

Alder Hey said the protest causedsignificant disruption and paid tribute to its staff who “worked tirelessly under extremely difficult conditions to manage the implications of the disruption”.

Alfie is in a semi-vegetative state and has a degenerative neurological condition that has never been definitively diagnosed by doctors.

As a GP I’m not holding out on antibiotics because I’m a sadist | Elizabeth Oliver

I have two shortcuts in my medical software for this time of year.

Flu 1

“Has had joint aches, fever, vomiting, sore eyes and throat for three days. Now dry cough, severe fatigue. Feels like hit by bus. Usually fit and well. Looks terrible.”

I enter the specific features of their misery. Then comes my other shortcut.

Flu 2

“Advised regular paracetamol, ibuprofen. Rest, Netflix. Return in 72 hours if ongoing fever, develops chest pain, shortness of breath or heavily productive cough. Frequent hand washing. Avoid small babies, elderly and public transport. Advised recovery can take a month. Advised consider vaccination next year.”

Friends, the time is upon us. GPs are lining up the stethoscope, thermometer and tongue depressor on their desks. There will be at least eight people a day for the next four months who will roll in and say they have the flu, and they need something to “get it gone” by tomorrow, because they have canteen duty, or three kids, or they’re flying to Madrid. In the interest of my vocal cords, let’s clear up a few things.

  1. People will say that because they feel so awful, they must need antibacterials. But a virus and a bacteria are not opposite ends of the same spectrum of illness. They are totally different organisms. Antibiotics target the cell membrane of bacteria. Viruses do not have a cell membrane. They are not a cell. They are a piece of genetic code with some protein. I feel bad for you, son, but doctors aren’t holding out on you because they’re sadists. When you take antibiotics for influenza, the virus skips around between your dying hoards of healthy gut bacteria, laughing maniacally and breaking everything, like a toddler loose in a supermarket.
  2. Among the influenza, there will be at least five times as many people who get the “common cold.” A snotty nose and feeling a bit fuzzy is not “the flu.” Influenza (flu) is that thing you had that time – if you could have made your brain work, you would have worried you were dying. Some of you cried. Some of you called an ambulance. You remember it forever and recount the tale at family get-togethers. The common cold viruses cause some of the same symptoms as influenza, but are nowhere near as deadly, or unpleasant.
  3. Nothing will “get it gone.” If you see a doctor within the first few days of an influenza-like illness, you can invest in antiviral treatment (around $ 50), which may slightly lessen the severity. But to be honest, waiting out influenza is like dealing with the ATO, or being stuck in an elevator. Patient, calm, vigilant suffering is the order of the day.
  4. The vaccine is a gamble. It’s redeveloped seasonally, and last year the virus pulled a Jason Bourne and mutated after vaccine production had started. The vaccine was therefore misdirected, and we had twice the average number of cases. But for me, the odds are a no-brainer especially with everyone coughing in my face. Last year at least 3,000 Australians died of influenza, including healthy young adults and children. None died of the vaccine. I like it so much I have two – one in May and one in August, for the late comers.

If you’re sick and worried, see a doctor. “Just a virus” is about the stupidest phrase ever. (HIV is just a virus. Other strong performers include polio, Ebola, rabies, smallpox and herpes.) Influenza can be incredibly dangerous, as evidenced by the tragic deaths last season. Your doctor’s job is to assess how your body is handling the virus and whether you’re heading off road and need extra help in hospital. Other sneaky infections hide in the wave of influenza, and while they examine you, your GP is thinking about meningitis, measles, true bacterial lung infections and similar bad-ass rarities.

So if you’re sick, come on in. Just put on a mask in the waiting room. And understand that the doctor who writes you a script for antibiotics after 30 seconds is giving you what you think you need (as well as thrush and irritable bowel), therefore ensuring future business and saving themselves time. The doctor who elicits your particular cluster of symptoms, considers your medical history, examines you for signs of impending doom and writes you a medical certificate is doing the right thing by you and the people around you.

Elizabeth Oliver is a practicing GP and RACGP fellow. She blogs at That Lady Doctor

Majority of voters back tax rises to bolster NHS

Voters are ready by nearly two to one to pay more tax to bolster the NHS. A large face-to-face survey carried out before the winter crisis struck the health service in November has recorded the biggest-ever shift of opinion on the issue.

The survey, by the respected British Social Attitudes research centre, has recorded a jump from 41% support for higher taxes in 2014 to 61% at the end of last year. An even higher proportion, nearly nine in 10 people, thought there was a funding crisis.

It also found a matching rise in opinions about the quality of NHS care, with nearly three times as many saying healthcare was declining, with most expecting it to get worse still. Only a fifth thought the standard of care would improve.

Theresa May has promised higher funding for the health service, but not until after a spending review this autumn. At current estimates, the NHS in England alone will be £900m in deficit by the end of this year, and Jeremy Hunt, the health and social care secretary, is calling for a 10-year pay settlement as part of a push for a significant increase in spending.

An unprecedented cross-party alliance of senior MPs, including the chair of the health committee, Dr Sarah Wollaston, has asked for NHS funding to be taken out of politics.

“We call on the government to act with urgency and to take a whole system approach to the funding of the NHS, social care and public health. On behalf of all those who rely on services, we need to break down the political barriers and agree a way forward,” they said.

In an unusual move, the appeal, which was launched at the end of March, was backed by Sir Nick Macpherson, the former permanent secretary at the Treasury, who supports a dedicated NHS tax.

More than half of Conservative voters who took part in the survey backed a tax rise to pay for the NHS, up from 33% in 2014. Support among Labour party voters stood at 68% in 2017.

Costly medicines and pus in milk: a Brexit trade deal that’ll make you sick | Nick Dearden

The British public is already scared about a trade deal with the US. They don’t care for chickens washed in chlorine, nor for cows stuffed with hormones. But this week, an epic US document setting out the barriers to foreign trade it would like to remove shows that these concerns are just the tip of the iceberg.

Not only do the 400-plus pages detail a stomach-churning list of foods the US would like to import into Britain – more pus in your milk and more pesticides on your vegetables – but they also uncover the US government’s distaste for the way the EU regulates big pharmaceutical corporations generally. The US would certainly ask us to strip away these regulations as part of a post-Brexit trade deal, which in turn poses a direct threat to NHS budgets and our ability to get our hands on life-saving medicines in the future.

So a US trade deal could be both bad for our health, and bad for helping us get better again. In its report, the US government is clear that it hates the EU’s food policies. It wants to export chlorinated chicken (meat rinsed in antimicrobial wash as an alternative to keeping and killing animals in healthy conditions), and meat from animals stuffed with hormones, steroids, ractopamine, and endocrine disrupters (chemicals that mess with animals’ hormones and can cause cancer and birth defects).

The list goes on, with the US unhappy about the EU’s “cautious” approach to approving genetically modified goods, chemical flavourings in food and the amount of pesticide residue allowed in fruits and nuts. They even think the amount of “somatic cells” allowed in milk in the EU is too restrictive. The US allows more white blood cells in milk than anywhere else in the world, even though this often indicates infection in the cow.

The US argues that this is a matter of customer choice. But that’s disingenuous, both because importing this food will inevitably drive down standards here, and because, as we discover in the document, the US dislikes the sort of food labelling that allows the consumer to make an informed choice.

If all of this is starting to make you feel queasy, it gets worse when you look at the “treatment” side of the equation. Medicines in the US are vastly more expensive than they are in Europe. So it’s little wonder that the US, batting for big pharma, disagrees with the (still very moderate) limitations many European governments place on pharmaceutical corporations.

For starters, the US complains that there is “a lack of meaningful stakeholder input” into these policies. In turn this creates “uncertainty and unpredictability” and can “undermine incentives to market and innovate further”.

Shelves with medicines

‘It’s little wonder that the US, batting for big pharma, disagrees with limitations on pharmaceutical corporations.’ Photograph: Alamy Stock Photo

In Britain, for instance, the NHS has some limited power to negotiate the price of medicines. It also has a framework for what is and isn’t “value for money”. None of this is to the taste of the US administration. Indeed, it even has a problem with the (again very limited) transparency the EU forces on pharmaceutical corporations to disclose drug trial dates. Drug trials are notoriously opaque, with vital information routinely withheld from the public, making it harder to scrutinise prices or even the real efficacy of medicines.

This is the same agenda that the US has been pursuing in other trade deals. The American campaign group Public Citizen shows how the US routinely pushes for greater monopoly rights for pharmaceutical companies in trade deals. On the government’s list are demands to make it easier to renew patents on medicines, allow an even greater degree of corporate control over clinical test data, grant new patents on biological medicines (including many new cancer treatments) and give corporations a greater say in healthcare policy.

All of this amounts to a simple reality: if the US successfully pushes through these top-line demands in a trade deal with the UK, the NHS would either have to spend more money on drugs each year, or more patients would be denied access to those drugs.

The secretive US-UK trade working group, led by the trade secretary, Liam Fox, met two weeks ago. We are not allowed to know much about the talks, but we do know that “services, investment, intellectual property rights and enforcement, regulatory issues” were discussed. That means: all of the above. Changes in regulatory standards on food and healthcare will be the price Trump charges for a trade deal with the UK. And we know that Fox himself has few qualms about lower food standards.

A whopping 82% of Brits would rather not have a trade deal with the US than sacrifice decent food standards

So public attention is urgently needed here. But there is some good news too. First, Fox is wildly out of step with the British public. An opinion poll released over the weekend shows that a whopping 82% of Brits would rather not have a trade deal with the US than sacrifice decent food standards. Only 8% would put a trade deal first.

Second, the trade bill, shelved for the time being as Theresa May fears losing a vote on the customs union, will have to return to parliament soon. MPs must take this opportunity to vote for powers to properly scrutinise the trade secretary and to have the right to stop trade deals they don’t like. The stakes couldn’t be higher. If we don’t want to give in to Trump’s trade demands, we must make trade policy democratic.

Nick Dearden is director of Global Justice Now

Competitive eater taken to hospital after eating world’s hottest chilli pepper

A man who took part in a chilli pepper eating contest ended up with more than he bargained for when he took on the hottest pepper in the world.

After eating a Carolina Reaper pepper, the 34-year-old started dry heaving before developing a pain in his neck that turned into a series of thunderclap headaches: sudden and severe episodes of excruciating pain that peak within a minute.

The Carolina Reaper, which can top 2.2m on the Scoville heat scale, was the world’s hottest pepper at the time of the incident in 2016 – although new breeds called Pepper X and Dragon’s Breath have since reportedly surpassed it.

The details, published in the journal BMJ Case Reports, reveal the pain was so terrible the man had to go to a hospital emergency room.

“[A thunderclap headache] lasts for a few minutes and it might be associated with dry-heaving, nausea, vomiting – and then it gets better on its own. But it keeps coming back,” said Dr Kulothungan Gunasekaran of the Henry Ford Health System in Detroit, a co-author of the report, adding that thunderclap headaches can be caused by a number of problems including bleeding inside the brain or blood clots.

CT and MRI scans of the man’s brain were taken but showed nothing out of the ordinary. What’s more, the man did not report having any speech or vision problems.

But when the medical team tried another type of CT scan designed to look at the blood vessels in the brain, they had a surprise. A number of arteries in the brain had narrowed, and as a result the team decided it was a condition known as reversible cerebral vasoconstriction syndrome (RCVS), which probably caused the thunderclap headache. The diagnosis was backed up by a scan five weeks later showing the arteries had returned to normal. In rare cases, said Gunasekaran, RCVS can cause a stroke.

While such narrowing of the blood vessels can be triggered by certain medications or drugs, the team found nothing of the sort when they screened the man’s urine. Instead, they say, it is likely the Carolina Reaper was to blame.

It’s not the first time chilli peppers have triggered serious repercussions.

“Actually, when we were looking at the literature we found a couple of cases similar to our case,” said Gunasekaran.

Weight-loss pills made from another type of chilli pepper are believed to have caused a heart attack in a 25-year-old man by triggering a sudden narrowing of the coronary artery, and a 33-year-old man died from a heart attack after eating a super-hot sauce he had cooked up from homegrown chillies.

In 2016 a 47-year-old man had a brush with death after he tore his oesophagus by retching and straining after eating pureed ghost pepper.