Liberal Vision

Public health and public opinion

Interesting insight into British attitudes to public health policies going into 2015. Here’s a taster…

When asked explicitly whether they believe in personal responsibility or government intervention,  the British public strongly supports personal responsibility over ‘nanny state’ regulation.

70% agreed “Individuals should be responsible for their own lifestyle choices and the government should not interfere”.

Those opposing the ‘regulating and taxing high-calorie food and drink’ outnumber supporters by nearly 2 to 1 and there appears to be little appetite for further intervention in lifestyles. Only 2 in every 10 people thought that “there should be more government regulation to stop people making unhealthy lifestyle choices”.

Tellingly Lib Dem voters were almost always more likely to support government intervention and UKIP voters were almost always the most resistant. Lib Dem voters were consistently most likely to believe that taxes on cigarettes, air travel and all forms of alcohol were too low whereas UKIP voters were consistently the most likely to believe that these taxes were too high.

However, even amongst Lib Dem voters, higher taxes and financial incentives were supported by only a minority. And interestingly, half of all Lib Dem voters actually support the owners of pubs and private members clubs being allowed to have a private room for people to smoke in if they want to.

The findings come from a  ComRes Poll commissioned by the Institute of Economic Affairs. The fieldwork for the poll was carried out between 9th and 14th December 2014 with a representative sample of 4,135 adult British residents and provides interesting food for thought as we head toward May 7th… find out more here.

Tags: comres, health, Institute of Economic Affairs, lifestyle, polling

New bounty on smokers helps GPs balance their books

It is coming up to year end for GP practices and that of course means that they will all be diligently filling in reams of paperwork for the DH in order to secure maximum funding via the QOF. In the doctor’s business journal medeconomics Dr Gavin Jamie gives some top tips on how practices can maximise their points score.

According to Jamie:

It is that time of year when practices are polishing their data and preparing for the annual inspection on 31 March of their QOF achievement.

For many it is a matter of pride, and not simply financial necessity, to get the most points that they can. Here are my top tips.

The DH is now effectively offering GPs a bounty on every smoker they can identify and attempt to “reform”, so it is perhaps not surprising that third on his list of top tips for achieving the warm glow of satisfaction that only comes from a good dose of centralist bureaucracy is upping the practice’s smoking score.

TIP 3 Smoking

This has become more complicated with the need to offer smoking cessation advice or prescribe therapy to all smokers over age 15.

Due to the way that this is calculated, improved coding of people who have stopped smoking will enhance the advice indicator.

It really is worth making every contact count – even where patient just calls into reception or speaks to the practice by telephone.

If you are the sort of person who takes pride in this kind of exercise or if your practice just needs the money Dr Jamie recommends that you hassle people about their lifestyles at every possible opportunity.  I haven’t been anywhere near my practice because I am coming to hate the place. I wonder how many others feel the same and how long it will take for politicians to work out that this approach is counterproductive?

Surely even Dave can see that a system that encourages GPs to repeatedly annoy their patients is not a good thing. No doubt his DH advisors will claim to have “peer reviewed” evidence to the contrary and we can assume that it is the same advisors who tell him that minimum alcohol pricing will target alcoholics and that smoking bans have had dramatic immediate health effects. Surely at some point he will work out that these people are rather economical with the truth? Won’t he?

by Chris Oakley

This post is a followup to “The Department of Health is watching you!“

Tags: Department of health, GPs, health, Quality and Outcomes Framework, smoking

Is there a scandal brewing or just a big fat lie?

Serious questions are being asked today about Andrew Lansley’s stance on the consultation on the standardised (plain) packaging of tobacco.

Before the consultation was announced Health Secretary Andrew Lansley told the Times (13th Apri 2012l)  that the government did not work with tobacco companies as it wanted them to have “no business” in the UK. That set a few warning bells ringing.

Just a few days later, however, announcing the start of the consultation, his stance seemed to be more moderate. Andrew Lansley was insisting that his mind was “open” over proposals to strip cigarette packets of branding as a consultation on the plans was launched.

It is therefore surprising to find that the publicly funded pro-plain packs web site is claiming the Secretary of State is indeed, now at least, a supporter of plain packaging.

It is not clear when he became a supporter of plain packaging, but as this is a government funded body claiming it, I assume that is true? I am currently running the Hands of Our Packs campaign, opposing the introduction of plain packaging (no government money). I can’t imagine claiming that any Minister, health or otherwise, is against plain packaging, without checking with them first – no matter how many additional signatures it might draw into the campaign.

So I think that Andrew Lansley has some explaining to do? If he doesn’t then the campaign asserting that he has already made his mind up certainly does -particularly considering the source of its funding. It is all starting to look very curious indeed.

Angela Harbutt heads up the campaign Hands Off Our Packs. The campaign is funded by Forest – Freedom Organsiation for the Right to Enjoy Smoking Tobacco.

UPDATE:

A letter has now been sent to the Department of Health requesting a response to the following questions:

1. Is it appropriate for the Secretary of State for Health to be listed as a supporter of plain packs (by a campaign that receives public money) in the middle of a public consultation on the issue and before the DoH has published its report on the consultation?

2. What action will the DoH (or the Secretary of State) take on this matter?

Let’s see what the Department of Health has to say.

It is also interesting to note that two of the authors (including the lead investigator) of the Department of Health’s (emphasis own) “independent academic review of the existing evidence” relating to plain packaging are also listed on the plain packs protect web site as “supporters” of plain packs. The authors – Gerard Hastings and Linda Bauld are identified by the cmapign as being not quite so “independent” in their thinking as one might have hoped.

For more information and further updates go to the  “TAKING LIBERTIES” web site where the story is unfolding..

Tags: Andrew Lansley, consultation, health, open-minded, plain packaging, tobacco

Public Health Success?

If, as some campaigners would have us believe, obesity is more of a health risk than smoking, the data suggest that 50 years of massive investment in the public health industry have yielded very little in the way of overall risk reduction.

Source: Centers for Disease Control and Prevention – USA

I do not believe that the relationship between smoking and obesity rates is simple but this graph suggests that as a society we should at least consider taking a more holistic look at health issues.

For far too long now, health policy has been dictated by a dangerous combination of single issue campaigning and statistics based “evidence”.

People are not numbers, they do not conform to the rigid norms dictated by the public health industry and many will choose to accept certain health risks in pursuit of what they consider a more enjoyable if potentially shorter life.

I have no idea how much of the rise in obesity in the USA was fuelled by ex-smokers displacing one potentially harmful activity with another.  Similarly, campaigners have no idea whether trying to reduce young people’s access to tobacco and alcohol might lead to increased uptake of other substances that are potentially more acutely threatening to their health.

One thing that we do know, or should if we bothered to learn the lessons of history is that many public health interventions have had unintended negative consequences and the more illiberal and draconian the intervention then the greater the risk and impact of such consequences.

Chris Snowdon deals with this subject in some depth in his book The Art of Suppression. It is an informative well researched read for anyone interested in the reality behind the rhetoric.  Until I read it, amongst other things I was unaware that Heroin was originally promoted by the pharmaceutical industry as a non-addictive alternative to morphine.  Snowdon covers a range of issues including the disaster of alcohol prohibition in the 1920s, the EUs illogical ban on oral tobacco and the growth in designer drugs as a consequence of Ecstasy prohibition.

He questions why prohibitionist policies remain attractive to many in the light of their historic failure and concludes that “in the end, fear is more intoxicating than hope.”

By Chris Oakley. Chris has previously posted on Liberal Vision:  Smokers-State Aprroved hate and Intolerance is UK policy,   Alcohol is Old News – Minimum Pricing for Digestives is the “Next Logical Step” , Soviet Style Alcohol Suppression Campaign Called for By Public Health Activists , Alcohol Taxation: The truth, the whole truth and nothing but the truth , A Liberal Tolerant nation? and  What hope is there for liberty if truth becomes the plaything of political lobbyists.

Tags: Christopher Snowdon, health, obesity, smoking, The Art Of Suppression

Médecins sans frontières

Doctors just can’t help trying to save people, it seems.

The Academy of Medical Royal Colleges, which brings together the presidents of the Medical Royal Colleges and Faculties and so purports to represent nearly every doctor in the UK, is to lead a campaign to tackle rising levels of obesity.

One’s initial reaction might be to welcome a medical intervention aimed at combating something that kills as many as 30,000 people each year. But unfortunately, it is not a medical intervention that these doctors have planned.

My latest article on the IEA blog explains that the medical elite, having identified what it considers to be the end that society should pursue, is turning to the coercive power of the state to achieve that end.

Comments on the IEA blog, please.

 

Tags: fat, fat tax, health, tax