Category Archives: Cholesterol

Cannabis drug cuts seizures in children with severe epilepsy in trial

A new drug derived from cannabis has been shown to reduce the convulsive seizures experienced by children with a severe form of epilepsy by nearly a half – and in a small number, stop them altogether.

Doctors involved in the trials say the drug could change the lives of thousands of children for whom there is little treatment, and might also help children and adults with more common forms of epilepsy.

Dravet syndrome, which affects one in 40,000 children in the UK, can cause life-threatening convulsions several times a day. The trial at Great Ormond Street children’s hospital in London and centres in the US and Europe was launched because some parents desperate to help their children told of improvements after giving them cannabis derivatives bought on the internet.

“There was a lot of interest on the internet three to four years ago,” said Prof Helen Cross, a consultant in paediatric neurology at Great Ormond Street. That led to the trial of a carefully formulated pharmaceutical form of cannabidiol with virtually no THC (tetrahydrocannabinol), which is responsible for psychoactive effects.

“This is cannabidiol. It is not the oils that are available over the internet and the results cannot be ascribed to that,” she said. “Families should not be feeling this is something they should be able to get [for themselves]. This is a pharmaceutical product.”

The trial involved 120 children, aged two to 18, with an average age of nine. They were randomly assigned to take either cannabidiol in liquid form twice a day or a placebo. Neither the families nor the doctors knew which children were getting the active drug.

On average, the seizures experienced by the children were reduced by nearly 40% and 43% of those taking cannabidiol saw their seizures cut by half. Three children – 5% – stopped having seizures altogether. There were side-effects, which included drowsiness, fatigue, diarrhoea and reduced appetite – but these are similar to those caused by other epilepsy drugs.

The drug is not a cure, however. Cross said seizures returned in those who had stopped the drug. Children would probably be on the medication for life.

There is a need for more and better epilepsy drugs. A third of people with epilepsy do not respond to those that exist. Doctors think cannabidiol may work in at least some of those cases too, although the reason it works in the case of Dravet syndrome is unclear. “I have to say we don’t know,” said Cross. But asked whether it could be effective in other children and adults, she said, “Probably, yes.”

In young women, there has been concern over the drug sodium valproate, which can cause birth defects. Women and girls who may get pregnant are faced with deciding whether to stop taking a drug that may successfully keep their epilepsy under control.

Cross said cannabidiol may also prove to be an option for them, although trials would need to be done.

The results of the trial are published in the New England Journal of Medicine. In a commentary in the journal, Samuel Berkovic, from the Epilepsy Research Centre of the University of Melbourne, called medicinal cannabis “a hot-button issue in the treatment of epilepsy”, after anecdotal reports in the media of “spectacular results, coupled with the allure of using a ‘natural’ compound and long-held beliefs surrounding its recreational use”.

The trial was the beginning of solid evidence for the use of cannabinoids in epilepsy, but more research was needed, he said.

GW Pharmaceuticals, which makes the drug, will apply for a licence to the authorities in the US and Europe. If it is approved, the National Institute for Health and Care Excellence will have to assess the drug for cost-effectiveness before it can be used in the NHS.

Cannabis drug cuts seizures in children with severe epilepsy in trial

A new drug derived from cannabis has been shown to reduce the convulsive seizures experienced by children with a severe form of epilepsy by nearly a half – and in a small number, stop them altogether.

Doctors involved in the trials say the drug could change the lives of thousands of children for whom there is little treatment, and might also help children and adults with more common forms of epilepsy.

Dravet syndrome, which affects one in 40,000 children in the UK, can cause life-threatening convulsions several times a day. The trial at Great Ormond Street children’s hospital in London and centres in the US and Europe was launched because some parents desperate to help their children told of improvements after giving them cannabis derivatives bought on the internet.

“There was a lot of interest on the internet three to four years ago,” said Prof Helen Cross, a consultant in paediatric neurology at Great Ormond Street. That led to the trial of a carefully formulated pharmaceutical form of cannabidiol with virtually no THC (tetrahydrocannabinol), which is responsible for psychoactive effects.

“This is cannabidiol. It is not the oils that are available over the internet and the results cannot be ascribed to that,” she said. “Families should not be feeling this is something they should be able to get [for themselves]. This is a pharmaceutical product.”

The trial involved 120 children, aged two to 18, with an average age of nine. They were randomly assigned to take either cannabidiol in liquid form twice a day or a placebo. Neither the families nor the doctors knew which children were getting the active drug.

On average, the seizures experienced by the children were reduced by nearly 40% and 43% of those taking cannabidiol saw their seizures cut by half. Three children – 5% – stopped having seizures altogether. There were side-effects, which included drowsiness, fatigue, diarrhoea and reduced appetite – but these are similar to those caused by other epilepsy drugs.

The drug is not a cure, however. Cross said seizures returned in those who had stopped the drug. Children would probably be on the medication for life.

There is a need for more and better epilepsy drugs. A third of people with epilepsy do not respond to those that exist. Doctors think cannabidiol may work in at least some of those cases too, although the reason it works in the case of Dravet syndrome is unclear. “I have to say we don’t know,” said Cross. But asked whether it could be effective in other children and adults, she said, “Probably, yes.”

In young women, there has been concern over the drug sodium valproate, which can cause birth defects. Women and girls who may get pregnant are faced with deciding whether to stop taking a drug that may successfully keep their epilepsy under control.

Cross said cannabidiol may also prove to be an option for them, although trials would need to be done.

The results of the trial are published in the New England Journal of Medicine. In a commentary in the journal, Samuel Berkovic, from the Epilepsy Research Centre of the University of Melbourne, called medicinal cannabis “a hot-button issue in the treatment of epilepsy”, after anecdotal reports in the media of “spectacular results, coupled with the allure of using a ‘natural’ compound and long-held beliefs surrounding its recreational use”.

The trial was the beginning of solid evidence for the use of cannabinoids in epilepsy, but more research was needed, he said.

GW Pharmaceuticals, which makes the drug, will apply for a licence to the authorities in the US and Europe. If it is approved, the National Institute for Health and Care Excellence will have to assess the drug for cost-effectiveness before it can be used in the NHS.

Nurse job interview tips: top nine questions and answers

Compassion and communication, respect and resilience, accountability and adaptability – a good nurse possesses a daunting set of qualities. If you’re newly qualified, how can you convince employers you have what it takes?

We asked those responsible for hiring band five nurses to tell us how they identify the right candidates. Here, they reveal some of the most common interview questions, as well as tips on how to answer them.

Why do you want this job?

The first question is usually broad. Candidates shouldn’t go into lots of detail but obviously shouldn’t give an answer that’s too short. If they’re newly qualified, they should think about what brought them into nursing in the first place. Why that specific branch of nursing … did they work there on a placement?
Wendy Preston, head of nursing practice, Royal College of Nursing

Why do you think you’re a good nurse and how can you evidence this?

They have got to show integrity and honesty, and also courage – we want to know they’re going to be a good advocate for their patients. They need to show they work according to the values of the six Cs – care, compassion, competence, communication, courage and commitment.We incorporate scenario question during the interview that will assess a nurse’s integrity. For example: “If you witnessed a nurse administering an incorrect drug, what would you do?” We ask for examples and to provide evidence from their career to date. Their answer will show their thinking processes and whether they know the right procedures to follow.We also understand the value of a happy team, so we want someone who can demonstrate they work well in a team and have a positive, can-do attitude. We want enthusiasm to shine through – you can see when someone’s energised by the work they do.
Ann Duncan, matron, Royal Marsden hospital, London

What does compassionate care mean to you and how do you deliver it?

I’m looking for someone who wants to care. I can teach you any skill, with help from my team, but caring and compassion is inherent. Answers often include kindness, empathy, treating the person as I would want myself or my family to be treated, listening to what it is the patient perceives as the problem and addressing that issue (often different from the clinical issues requiring nursing care).
Jo Thomas, director of nursing and quality, Queen Victoria hospital, Sussex

It is often good to ask a nurse if there has been a time they felt they were unable to give compassionate care and explore their answers. This can give us a good insight at interview. Examples staff have given include exhaustion, abnormally busy, low morale, poor skill mix/staffing levels, poor teamwork, challenging or abusive patients or relatives. Clearly we do not want this to be the norm for a nurse but understand there may be barriers to giving compassionate care all the time. We are looking for honesty and self-awareness. It is important to listen to what they say and how they say it.

Ann Duncan, matron, Royal Marsden hospital, London

How have you dealt with conflict in the past?

Interviewers are looking to see that the nurse can de-escalate a situation, that they know some basic conflict resolution strategies – such as taking people away from the area, sitting them down, finding out the root of the problem – and that they know when they need to escalate to a senior member of staff.
Wendy Preston, head of nursing practice, Royal College of Nursing

What makes a good shift?

We want to hear about the delivery of safe, effective care, and we want it to be documented and evidenced. We don’t want them to believe that high numbers of staff always equates to the best care. Some days, you will be short, but that doesn’t mean they are the worst shifts. It’s good when they say they know the importance of breaks and having catch-up time with staff.
Ann Duncan, matron, Royal Marsden hospital, London

There’s usually a question on resilience. We have to bear in mind that retention of staff is difficult and we want to encourage nurses to stay in the profession. Interviewers will want to know how they manage their time, cope with stress, stay hydrated. The best answer would be about work-life balance.
Wendy Preston, head of nursing practice, Royal College of Nursing

What are you most proud of in your nursing career to date?

Even though some of them have been student nurses they will have moments they are proud of, and we ask them to give an example of when they went above and beyond for a patient. We want to hear a personal story and we want them to be illustrating that they are kind, caring and compassionate, and that they are prepared to do everything they possibly can to ensure safe and effective care.

The stories can vary from nurse to nurse, but we will be able to hear and see if a nurse has genuine pride in their work, and we’ll gain an understanding of what is important to them.
Ann Duncan, matron, Royal Marsden hospital, London

Tell us about a mistake you have been involved with

Often they will talk about someone else’s mistake, not theirs. It’s good if they talk about their mistake, what they’ve learned from it, what they’d do differently, how they have changed their practice, how they have worked with others to change their practice. Interviewers will be looking for how they use evidence in their practice and how they learn from things.
Wendy Preston, head of nursing practice, Royal College of Nursing

What would others say about you in three words?

This is an end-of-interview question. I’m looking for someone who is self-aware, but also whether the three-word description matches the answers and examples they have given to the other questions. Some answers I’ve had in the past include loyal, compassionate and fair; genuine, caring and professional; equitable, passionate and reliable.

The point of the question is to assess how effective the individual is in seeking feedback and reflection, and whether they can articulate this in single words. Being able to answer can demonstrate that you have the insight and maturity to seek the opinions of others. A follow-up question, depending on the seniority of the role, might be: have you changed your practice as a result of feedback from others?
Jo Thomas, director of nursing and quality, Queen Victoria hospital, Sussex

Do you have any questions for us?

Often people are flummoxed and say no, but it’s good to be prepared with a couple of questions. A good question to ask, if it hasn’t come up, is about what kind of preceptorship programme, or learning and development, can they offer. If you have got any holidays booked, this is the time to say it.
Wendy Preston, head of nursing practice, Royal College of Nursing

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WHO elects first ever African director-general after tense vote

The World Health Organisation has its first ever director-general from Africa, after the election of Dr Tedros Adhanom Ghebreyesus, the former Ethiopian health minister.

Dr Tedros, as he is known, beat the British candidate, Dr David Nabarro, after three tense rounds of voting on Tuesday. Third was Pakistan’s Dr Sania Nishtar. The decision by member states came at the World Health Assembly in Geneva after a fraught campaign.

Dr Tedros was well-regarded, particularly by aid donors, for his stewardship of health in the Ethiopian government from 2005 to 2012. In the latter stages of the campaign, however, there were allegations about the human rights record and lack of transparency of the government of which he was a member. One US academic accused him of trying to hide a cholera epidemic that occurred in Ethiopia on his watch.

Dr Nabarro’s pitch for power rested on his long career at the UN, where he has played a trouble-shooting role in a number of epidemics. He promised reform of the WHO, which was strongly criticised around the world for failing to respond quickly enough to the Ebola epidemic in west Africa. Nabarro was sent in to boost the response by the UN Secretary General, then Ban Ki-moon. Later he chaired the advisory committee set up by the outgoing WHO Director General Margaret Chan, which put in place a blueprint for reform.

The campaign to lead the WHO has been long and hard fought. It began with the nominations of six candidates in September last year. The first one to fall by the wayside in January, when the WHO’s executive board selected the finalists, was the Hungarian former health minister Dr Miklós Szócska, followed swiftly by Italy’s Dr Flavia Bustreo and France’s Professor Philippe Douste-Blazy.

The candidates crisscrossed the world, seeking to win the votes of member states. For the first time, they debated together on public platforms and set out their manifesto commitments in online videos. But in spite of the greater transparency, there were allegations of dirty tricks behind the scenes.

The stakes were particularly high in the wake of the scandal that engulfed the WHO during the Ebola epidemic in west Africa. Investigations revealed that officials in the Africa regional office and also in the Geneva headquarters had not wanted to upset the governments of the three affected countries, Sierra Leone, Liberia and Guinea by declaring an epidemic. There were calls from some for the abolition of the WHO and the creation of a more effective body.

The new director-general will have not only the reform agenda but also a struggle for more financial stability to contend with. Member states have been reluctant to give the UN organisation core funding and much of its income has been tied to specific projects, giving it less flexibility.

Dr Jeremy Farrar, director of the Wellcome Trust, said: “I’m pleased to extend my congratulations to Dr Tedros on his appointment to the most important job in global health. As someone who has worked tirelessly to reform health systems in Ethiopia and across Africa, he will bring great insight and the political leadership necessary to restore trust in the WHO at a critical moment in its history.

“Tedros’s predecessor has done much to improve the WHO’s response to epidemics in the wake of the Ebola crisis of 2014/15, but there is more to be done. Tedros has the power to herald a new era in how the world prepares for and responds to epidemics, including building partnerships, strengthening public health systems, and developing new vaccines and therapies that are available to all who need them.”

Christy Turlington: ‘The closest I’ve come to death? The birth of my daughter’

Born in California, Christy Turlington Burns, 48, was scouted to be a model at 14 and went on to become one of the original supermodels. After suffering a postpartum haemorrhage in 2003, she took a masters in public health and set up non-profit organisation Every Mother Counts, addressing global maternal health. The charity has partnered with Toms shoes. She is married to actor Ed Burns, has two children and lives in New York.

When were you happiest?
Before kids, when I was 13 or so, on the back of my horse, running at full speed in an open pasture. Post kids, happiness happens often, but in more subtle ways. I now prefer the word “content”.

What is your greatest fear?
I don’t fear anything but fear itself. Fear makes humans behave inhumanely.

What is your earliest memory?
I have a collage of memories beginning around age four: my first walk alone to a store or to school, and early trips to Central America with my mom to visit her family.

Which living person do you most admire, and why?
A midwife named Jennie Joseph. She is a tireless activist for women, family health and equal access to quality maternity care.

What is the trait you most deplore in yourself?
I sometimes set unreasonably high expectations of myself and those around me.

What was your most embarrassing moment?
There are too many to name, but none of them keeps me up at night.

What makes you unhappy?
Government policy decisions that negatively impact the health and wellbeing of women and families.

What do you most dislike about your appearance?
Having to talk about it.

Who would play you in the film of your life?
The world does not need a film about my life.

What is the worst thing anyone’s said to you?
A boyfriend once told me there was always going to be someone smarter, funnier and prettier than me, which at the time felt pretty mean, but it was true.

To whom would you most like to say sorry, and why?
To strangers. Living in New York, I see individuals every day who are invisible to so many. I want to say sorry that so many of us think their pain and suffering is not our own.

What was the best kiss of your life?
The first kiss from my husband and every one since.

What has been your biggest disappointment?
My father’s death before my marriage, and motherhood.

If you could edit your past, what would you change?
I might speed up a few details, but wouldn’t change anything, other than my dad still being here.

How do you relax?
Yoga, running, recreational reading.

What is the closest you’ve come to death?
The birth of my daughter.

What keeps you awake at night?
The fact that at least 300,000 women die every year from pregnancy and childbirth-related issues that are largely preventable.

What is the most important lesson life has taught you?
That I am more than I thought I was.

How would you like to be remembered?
As someone who didn’t waste a minute.

How Alzheimer’s took my brilliant dad, Lord Goodhart, in increments

There can’t be many people who realise their dad has Alzheimer’s from listening to the Today programme. But six years ago, hearing my brilliant and erudite father, the Liberal Democrat peer Lord Goodhart, stumbling and pausing through his interview with John Humphrys, I knew something was very wrong. Not that being reduced to a stuttering wreck by Humphrys is necessarily a sign of dementia – if it were, we’d have very few senior politicians left – but that sort of thing didn’t happen to my dad. He was calm, clear-thinking, unflustered and always in full possession of the facts. He knew his onions. He was that frowned-on creature these days – an expert.

If that sounds braggadocious, well, yeah. It is. But my dad died in January, and I feel like bragging about him. He was the kind of man who deserves to be bragged about, although it is the last thing he would have dreamed of doing himself – he was modest to a fault.

That was the last of many appearances on Today – someone in an office somewhere on Portland Place would have quietly put a red “x” through his name, another poor old fellow watching helplessly as his marbles gradually rolled out of reach. Although Dad didn’t officially stand down from the House of Lords until later, in many ways, that interview marked the end of a long and distinguished career of public service.

It was a career that encompassed a successful legal practice, as well as chairing the human rights organisation Justice, and travelling overseas, as far afield as Kashmir and Sri Lanka,to report on human rights violations. He wrote the constitution for both the SDP and the Liberal Democrats. In 1997, he was made a lord, and promptly set about trying to put himself out of a job by campaigning for a largely elected second chamber. As the Lib Dem shadow lord chancellor, he was steadfast in his assertion that the war in Iraq was illegal, just as he was unequivocal that there was never any justification for torture. He was – to my mind – on the right side of every argument. But then, don’t most kids think that about their dad?

Lord Goodhart canvassing.


Lord Goodhart canvassing.

For us – my sisters, my mother and me – the door closing on Dad’s career marked the beginning of a new era: one that was by turns agonising, baffling, heartbreaking and, I must confess, comedic. Alzheimer’s affects everyone differently, including those around them – but the ability to laugh at its quirks and peculiarities sustained us all in the darkest times.

For almost 50 years of married life, Dad got up in the morning and brought Mum a cup of tea in bed. This came to a rather abrupt halt the morning her cup of tea consisted of orange juice, milk, and some potted shrimps all stirred together. My mother demurred, though Dad consumed his with alacrity and chided her for being fussy. At times like that, it is easier to laugh than to cry.

On another occasion, two years ago, Dad took me and my wife to the opera. An opera devotee, it was his last visit: as the lights went down for act three of a rather lengthy German comic opera, he called out in despair, “Oh God.” A few minutes later, he heckled (I suspect a first for the rarefied audience): “Get on with it!” My wife and I, being of reasonably sound mind, were inclined to agree. That was also the evening Dad looked at his diary, which he did every five minutes, for reassurance, and read “To opera with Benjie.” Then he looked up at me. “Are you Benjie?”


He also cast off some of his inhibitions. He would happily sit and hold hands, and began calling me darling

That’s what it’s like, though, watching someone you love journey down Alzheimer’s meandering path: a series of minor heartbreaks. You lose them by increments. First, they are struggling to cope with the finer points of policy on Radio 4. Then they can’t remember the word for rain, so say “water falling from the sky”. Then they can’t go to the bank, because they try to use their diary in the cashpoint machine. Then they can’t go out alone. Then they forget your name, and how to use a spoon, until finally they don’t even recognise your face, and can’t really walk, and have forgotten the word not just for rain, but for wife and daughter and son and bed and everything else. It takes seconds to read, but years to happen.

It was worst of all for my mum. She had spent pretty much all of her adult life being dazzled by a man of towering intellect. I mean, obviously she wasn’t permanently dazzled – sometimes she was just bloody annoyed, as he reloaded the dishwasher to his exact specifications, or took her round yet another Renaissance church – but she loved his brilliant mind. He was the only man I ever saw who would consistently do better in Mastermind on people’s specialised subjects than they would. She watched it all slip away, and watched my strong, brave, independent, free-thinking father become an uncomfortable, ill-at-ease figure who followed her from room-to-room, checking and re-checking his diary for reassurance. What results, inevitably, is not just grief, but irritation, guilt, and (entirely unnecessary) self-abasement.

In the autumn of 2015, Dad went into a nursing home. By now, his dementia was progressing rapidly. We had been told that we would all know when it was time to find a home for him, and so it proved. Oddly, and against all my preconceptions, I developed a marked fondness for the place. Dad was beautifully looked after, and I think found a measure of contentment there that none of us had expected. Perhaps being removed from his old life allowed him to come to terms more easily with his new reality.

To my delight, he also cast off some of the inhibitions that are a feature of so many men of his generation. He would happily sit and hold hands, and began calling me darling. Of course, this was in part because he had forgotten my name but, still, I enjoyed it. He even developed an unlikely fondness for You’ve Been Framed!. (I also once found him with the Daily Mail in his room, at which point we knew things were bad.)

Those last months of Dad’s life were not without their consolations, and one superseded them all: Alzheimer’s cushioned my dad from some political realities that would have broken his heart, if not his resolve. The annihilation of the Lib Dems at the 2015 general election left a vacuum at the centre of British politics just when the party was needed the most. As a half-American who cherished his transatlantic roots, he would have despised everything that President Trump represents. As an enthusiastic European, he would have abhorred Brexit. And as a thinker and intellectual, he would have loathed the wilful misinformation and visceral insularity that both campaigns embodied. But as the world he had fought for with such passion and zeal turned to dust, he was in the garden of the care home, happily counting the aeroplanes that passed overhead.

On Dad’s death certificate, the cause of death, along with Alzheimer’s, is urosepsis. If he is looking down now from the great debating chamber in the sky (which, as a lifelong humanist, would come as some surprise to him), he would insist that the word was missing an “e” at the beginning. And then he’d laugh.

On the morning that Dad died, my mum, my sisters and I were there with him, along with the saintly carer, Cathy, who had looked after my parents through their darkest times. In the care home, they placed a series of blue paper butterflies on Dad’s door, to let others know that some privacy was needed in his room as the end neared. It was a simple and deeply moving gesture, heightened by the fact that Dad had always loved, and could instantly identify, all types of butterfly.

An hour after he had died, peacefully and in the presence of people who loved him as he deserved, the night shift staff came in and whispered their quiet goodbyes to Dad. Then the day shift came in and did the same. When they spoke to us, many were in tears, and every one of them mentioned how polite, courteous and kind he was, and how fond they had been of him. My dad had hung on to his warmth and decency, even when everything else had left him. It was just another in a long, long list of reasons to be proud of him.

Coca-Cola’s ‘health by stealth’ wheeze is sneaky. But if it works so be it | Gaby Hinsliff

It had been a long day. I was knackered, and frankly not concentrating. Which is how I managed recently to bake a plum cake and forget to put the sugar in. The damn thing was already cooked and cooling by the time the penny dropped, so there was little option but to keep quiet and dish it up. But surprisingly, plates were licked clean. It tasted fine, if a little drier than usual. And yes, there is a point to this tedious domestic mishap, which is that Coca-Cola just did something similar to millions of its customers, in a move that has interesting implications for the debate over public health and the nanny state.

The soft drinks giant started by silently reducing the calories in Sprite. People didn’t seem to mind, so two weeks ago it secretly cut the sugar in Fanta by a third, and again sales held perfectly steady. So much for all the outraged spluttering over government plans to introduce a levy on sugary drinks next year – the reason Coca-Cola changed its recipes, since both drinks will now escape the tax – and how it would ruin much-loved brands. People literally didn’t notice.

There is admittedly something mildly disconcerting about the concept of “health by stealth” – although health is, in this case, a relative term. The acid in fizzy drinks is still no friend to teeth, and swapping sugar for other sweeteners does nothing to discourage the craving for sweetness. Who knows? In a few years we may all be panicking instead about some unforeseen side-effect of stevia, the natural plant-based sweetener substituted in Sprite. But it remains a rare example of a company fooling its customers into better choices, not worse ones – for once. They’re treating us like children. This is, after all, the equivalent of smuggling hated vegetables into pasta sauce and brazenly liquidising the evidence. But then, there’s nothing like a public health intervention for provoking a national tantrum.

Andy Burnham was accused of waging war on parents only four years ago for promising that a future Labour government would act to reduce sugar in cereals such as Frosties. Last year, when George Osborne finally unveiled plans for a tax on sweetened drinks, libertarian Tories were outraged.

Yet in a few years’ time we’ll surely look back and wonder what the fuss was about, for such is the way of health and safety interventions, from the ban on smoking in public places to the introduction of compulsory seatbelts. Outrage turns to grudging acceptance, before mellowing into surprise that things were ever any different.


If you announce you’re lowering fat, sugar or salt, then consumers glumly assume the result will be thin and joyless

It seems genuinely astonishing now that until 31 people died in the King’s Cross station fire in 1987, which was started by a dropped cigarette, nobody seemed to think smoking on the tube was a problem. My son boggles at the idea that back in the 1970s, kids would travel piled on top of each other in the backseat of a car or rolling around in the boot. But it still requires political courage to get past the initial wall of resistance, which is constructed of corporate inertia plus kneejerk irritation among consumers at being told what to do. Legislation can obviously overcome the former, but what’s less often noted is that it can also prompt imaginative responses to the latter.

Once, food manufacturers who made their products healthier would shout it from the rooftops, but increasingly they’re learning to do it on the sly. If you announce that you’re lowering fat, sugar or salt then consumers glumly assume the result will be thin and joyless; since so much of eating is about anticipation, that may be exactly how it tastes to them. But do it quietly and – as any slapdash home cook will know – you can get away with murder. Even in baking, which does depend on measuring ingredients accurately, it’s the ratio of fat to flour and liquids that seems crucial to the chemistry, rather than the sugar. A diabetic friend was advised by nurses that most recipes will still work even if you halve the sugar – which is roughly what I did by accident, since the plum cake recipe I screwed up still contained honey, fruit and golden syrup – at least so long as you don’t tell. Sneaky?

Coca-Cola’s ‘health by stealth’ wheeze is sneaky. But if it works so be it | Gaby Hinsliff

It had been a long day. I was knackered, and frankly not concentrating. Which is how I managed recently to bake a plum cake and forget to put the sugar in. The damn thing was already cooked and cooling by the time the penny dropped, so there was little option but to keep quiet and dish it up. But surprisingly, plates were licked clean. It tasted fine, if a little drier than usual. And yes, there is a point to this tedious domestic mishap, which is that Coca-Cola just did something similar to millions of its customers, in a move that has interesting implications for the debate over public health and the nanny state.

The soft drinks giant started by silently reducing the calories in Sprite. People didn’t seem to mind, so two weeks ago it secretly cut the sugar in Fanta by a third, and again sales held perfectly steady. So much for all the outraged spluttering over government plans to introduce a levy on sugary drinks next year – the reason Coca-Cola changed its recipes, since both drinks will now escape the tax – and how it would ruin much-loved brands. People literally didn’t notice.

There is admittedly something mildly disconcerting about the concept of “health by stealth” – although health is, in this case, a relative term. The acid in fizzy drinks is still no friend to teeth, and swapping sugar for other sweeteners does nothing to discourage the craving for sweetness. Who knows? In a few years we may all be panicking instead about some unforeseen side-effect of stevia, the natural plant-based sweetener substituted in Sprite. But it remains a rare example of a company fooling its customers into better choices, not worse ones – for once. They’re treating us like children. This is, after all, the equivalent of smuggling hated vegetables into pasta sauce and brazenly liquidising the evidence. But then, there’s nothing like a public health intervention for provoking a national tantrum.

Andy Burnham was accused of waging war on parents only four years ago for promising that a future Labour government would act to reduce sugar in cereals such as Frosties. Last year, when George Osborne finally unveiled plans for a tax on sweetened drinks, libertarian Tories were outraged.

Yet in a few years’ time we’ll surely look back and wonder what the fuss was about, for such is the way of health and safety interventions, from the ban on smoking in public places to the introduction of compulsory seatbelts. Outrage turns to grudging acceptance, before mellowing into surprise that things were ever any different.


If you announce you’re lowering fat, sugar or salt, then consumers glumly assume the result will be thin and joyless

It seems genuinely astonishing now that until 31 people died in the King’s Cross station fire in 1987, which was started by a dropped cigarette, nobody seemed to think smoking on the tube was a problem. My son boggles at the idea that back in the 1970s, kids would travel piled on top of each other in the backseat of a car or rolling around in the boot. But it still requires political courage to get past the initial wall of resistance, which is constructed of corporate inertia plus kneejerk irritation among consumers at being told what to do. Legislation can obviously overcome the former, but what’s less often noted is that it can also prompt imaginative responses to the latter.

Once, food manufacturers who made their products healthier would shout it from the rooftops, but increasingly they’re learning to do it on the sly. If you announce that you’re lowering fat, sugar or salt then consumers glumly assume the result will be thin and joyless; since so much of eating is about anticipation, that may be exactly how it tastes to them. But do it quietly and – as any slapdash home cook will know – you can get away with murder. Even in baking, which does depend on measuring ingredients accurately, it’s the ratio of fat to flour and liquids that seems crucial to the chemistry, rather than the sugar. A diabetic friend was advised by nurses that most recipes will still work even if you halve the sugar – which is roughly what I did by accident, since the plum cake recipe I screwed up still contained honey, fruit and golden syrup – at least so long as you don’t tell. Sneaky?

Doctors’ leaders accuse ministers of ‘callous disregard’ for the NHS

Ministers are guilty of “callous disregard” of the NHS and have put its funding into “deep freeze”, doctors’ leaders claim in a sharply worded attack on the Conservatives’ stewardship of the health service. The government must plug “the enormous funding gap” in healthcare spending between Britain and other major European countries, the British Medical Association says.

Dr Chand Nagpaul, chair of the BMA’s GPs committee, is to tell a conference of family doctors on Thursday that the NHS “has been paralysed by the vote for the UK to leave the European Union”.

“Far from the pledged investment of an extra £350m per week, audaciously plastered on double decker buses, the reality is we’ve been cheated with the opposite: a deep-freeze in NHS spend, continued savage austerity cuts, and with politicians turning a blind eye to the spiralling pressures affecting the entire health and social care system, in which even the 18-week target, laid down in the NHS constitution, is being allowed to be breached,” Nagpaul will say.

In addition, GP services are under such pressure and beset by such serious understaffing that they are “on the brink of collapse”.

Norman Lamb, the Liberal Democrats’ health spokesman, said: “Instead of £350m a week for the NHS, under the Conservatives we’ve seen the health service being gradually run into the ground. The NHS cannot take five years of a Conservative landslide that would give Theresa May free rein to cut services further at your local hospital.”

Meanwhile, the Health Foundation thinktank has warned the prime minister that the operation and future of the NHS and the social care system are at risk because of serious and deepening staff shortages.

Urgent action is needed, the thinktank says, because 900 people a day are quitting as social care workers, too few new recruits are joining the sector, and the workforce is struggling, with 80,000 vacancies.

Corbyn’s inspiring manifesto takes me back to Labour 1945 blueprint for hope | Harry Leslie Smith

It was at Bradford University on Tuesday that Jeremy Corbyn unveiled the Labour party’s election manifesto. In the grand hall, Corbyn spoke to an enthusiastic gathering of students and party faithful about the concrete plans Labour has to transform Britain into a country where the many will prosper instead of the few. Corbyn spoke about the need to properly fund the NHS, provide free tuition to students, end the blight of zero-hours contracts, and raise the living wage to £10 an hour.

For me, a man who was born and bred in the harsh poverty of Britain after the first world war, it was inspiring. But what moved me most was the venue he chose to announce this manifesto of equality and fairness – because Bradford University is built on ground that, in my youth, was a site of great suffering and death.

You see, within the boundaries of what is now the university campus, my boyhood dreams and idealism were crushed under the cruel weight of austerity during the Great Depression. When I was young, this was not a place where one’s future was made but where it was condemned. The grounds that now hold this university contained a slum, and hope never penetrated its dark, enveloping canopy of destitution.

My family arrived in the neighbourhood that once covered this well-maintained university as penniless and jobless economic migrants from Barnsley in 1929. Then, it was an endless, warren-like landscape of dilapidated houses that nestled in cul-de-sacs where no one expected to enjoy either a decent or a long life because there was no welfare state or NHS. If hard luck struck, all that was available was poor relief, which paid a mean weekly stipend that guaranteed either starvation or homelessness.

My family couldn’t survive on poor relief, so we ended up living cheek by jowl in a doss house with a multitude of other desperate characters. Like us, all of them had been washed up on its doorstep like the flotsam that crashes on to a desolate beach after a terrible tempest. Soldiers from the first world war who had been promised a land fit for heroes by lying politicians resided in the doss where my family kipped. During the day, they still tried to hold themselves up bravely.

Like my dad, these Tommies looked for work in a city whose factories had been hushed by the collapse of the world’s economies. But at night when they tried to sleep, weary from unemployment and PTSD, I’d hear their cries of terror because their dreams had sent them back into battle at Ypres or the Somme.

As for me, my childhood was a nightmare of indentured servitude and malnutrition. At bedtime, my sister and I would huddle together for warmth on a piss-stained flock mattress on an unlit garret floor. We would try to quell the gnawing in our stomachs by wondering what our king had eaten for his tea that evening.

Even while playing, my boyhood was never blissful. In this part of Bradford I was always reminded that death for the poor is miserable, brutal and lonely: from open windows, I heard the inhuman howls of cancer sufferers dying in agony because poverty denied them the dignity of morphine.

But all of that changed in 1945 when, at the end of the second world war, the Labour party fought a general election on a manifesto that promised the creation of the NHS, affordable education, an end to that era’s housing crisis and fair conditions for all workers. The Labour party’s 2017 election manifesto echoes the sentiments found in Labour’s 1945 manifesto that inspired my generation to build a just society.


I can tell you as a very old man: I am afraid for the future of ordinary people in Britain

When I remember all the pain and sadness that once populated the part of Bradford that now houses its university, I can’t think of a better tribute to all those whose lives were blighted by the Great Depression than for Labour to have unfurled its manifesto here for the nation to see.

But I fear that the 2017 manifesto, no matter how just and how right for our times, may not catch the wind it needs to help this country sail forward to hope and prosperity because we have forgotten the hardships, tragedies and triumphs of my generation. It’s sad for me to ponder how on Remembrance Sunday people speak solemnly about their commitment to never forgetting those who fell in war, while those uncountable lives that were cut short because of economic injustice throughout the early part of the 20th century are forgotten.

I can tell you, as a very old man, that I am afraid for the future of ordinary people in Britain. Because by the time the next general election is scheduled, in 2022, most of those from my generation, who have survived for so long, will be dead or incapacitated. No one then may be left alive to remember the profound suffering, the hardship, the sorrow and the eventual victory all those nameless, ordinary people achieved in 1945 with election of a Labour government.

Forgetting them, and the lessons your parents or grandparents taught you from their lives about how to overcome austerity and build a proper and just society, will condemn you to something far worse than I experienced growing up.