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BMA: it it moves tax it, if it still moves ban it

By Angela Harbutt
July 13th, 2015 at 3:30 pm | 3 Comments | Posted in Uncategorized

In its latest attempt at extreme social engineering, the increasingly preposterous British Medical Association (the trade union for doctors and medical students) is today demanding a 20% tax on sugary drinks “to subsidise the cost of fruit and vegetables”.

What they don’t mention, but what Christopher Snowdon points out, is that:

“The BMA don’t mention that their soda tax will cost the public £1 billion a year, nor do they acknowledge that it would be deeply regressive. Indeed, they want to make it more even more regressive by taxing fizzy drinks (which are disproportionately purchased by people on low incomes) and use the money to subsidise fruit and vegetables (which are disproportionately purchased by people on high incomes). Nice.”

You may be surprised at that. Particularly when you consider that the BMA rejected a fat tax back in the summer of 2012 because:

“The idea of a fat tax on unhealthy food was rejected because it would have an unfair impact on people from a disadvantaged background.”

How is a tax on sugary drinks any different from a tax on fat? [Joined up  thinking ? I don’t think so]. But then again we should not be surprised at the lack of consistency in BMA proposals, or the absence of science-based thinking when it comes to its policies. This publicity-hungry, industry-hating trade union seems to have a policy of acting first and thinking afterwards.

This, after all, is the body that secretly awards its senior staff pay hikes of up to 137% – without bothering to inform its members. And a body that seems to have scant regard for the truth – with BMA spokespeople taking to the air to spout downright lies in support of their extreme views on ecigs and smoking.

That particular trait, of “massaging the facts” to suit the narrative, is displayed yet again today with its claims on sugar. As reported by Mr Snowdon:

“In the pages of The Guardian, their spokeswoman, Sheila Hollins, resorts to flat out lying…

“We know from experiences in other countries that taxation on unhealthy food and drinks can improve health outcomes, and the strongest evidence of effectiveness is for a tax on sugar-sweetened beverages.”

…..”[Mr Snowdon writes] the evidence on sugary drinks, in particular, is consistent in finding little, if any, change in patterns of consumption and no change at all in ‘health outcomes’, including obesity (see here and here for a summary).”

It is also the body that has consistently promoted a whole raft of policies which are potty at best and downright dangerous at worst. Here is a taster of some of its recent ludicrous proposals:

Ecigs – In December 2013 the BMA wrote to a number of football clubs urging them to end sponsorship deals with e-cigarette companies “smoking products” and to ban the use of e-cigarettes at their football grounds. [Err no e-cigs are not a “smoking product” – do at least get your facts right].

ECigs – The BMA has also been at the forefront of those demanding that all e-cigarettes are forced to be licensed medicinal product, and in the BMA’s 2014 annual meeting, it’s members called on governments to prohibit ‘vaping’ on e-cigarettes in public places where smoking is prohibited. [Hmm send them outside to smoke real cigarettes rather than vaping indoors – that will improve health [not].

Alcohol – In Jan 2015 the BMA demanded that politicians introduce a minimum unit price for alcohol. [Errm thought you were against regressive taxes? So middle classes can drink their French Chardonnay, but those on low incomes should be priced out of the market. This is prohibition for the working classes.]

Alcohol – In June 2015 the BMA called on all UK governments to introduce “clear and unambiguous” health warnings on alcohol. It also called on additional measures that “limit the affordability, availability and promotion of alcohol”. [Just to be clear will you restrict when I buy my alcohol from Ocado, or when they deliver it? Oh I forgot, you only wish to restrict those on low incomes from buying alcohol, not the middle classes with a credit card and an au pair at home to take delivery].

Alcohol – In June 1025 the Scottish BMA called on a ban on all alcohol advertising on television before 9pm “watershed”. [That might have worked in the 1970’s – but honestly.. in 2015?].

Alcohol – In July 2014 BMA in Northern Ireland called for a reduced hours of sale for alcohol. [Yep, let’s drive consumption out of pubs with responsible landlords and towards drinking in the home, because that is bound to work [not].

Smoking – In June 2015 – rather than vote FOR the legalisation of cannabis, the trade union voted for a BAN on the sale of all cigarettes to those born after 2000. Yes really, by 2030 you would” need ID to prove you were 31, not 30, to buy cigarettes”. [Well it was only a matter of time before they called for prohibition… Because that obviously works [not].

… that is to list but a few of BMA’s proposals. There are many more.

The BMA demand for a tax on sugar is yet another head-line grabbing, ill-thought through, plan, all too similar to those above: demonise industry; hit those on low incomes; tax where you can and ban where you can’t.  It is an archaic approach not fit for the 21st century.

It claims to want a comprehensive approach to “tackling obesity” and, it says, it sees  its role as “supporting the government and other stakeholders in taking action“. Sorry, but that claim rings hollow. You only have to read the foreword of the latest booklet to see the BMA’s primary objective – to end the relationship between Government and [one of the key stakeholders] industry.

“Addressing the commercial influences that have such a strong impact on diet will be key.”

“These range from the way unhealthy food and drink products are promoted and made widely available and affordable, to industry influence on the development of food and nutrition policies.”

“Without a stronger regulatory framework, commercial interests will continue to overshadow public health interests.”

“Many of these [measures] will not sit comfortably with the government’s approach to partnership working with industry.”

“My belief is that it is commercial interests that are excessively influencing people’s decisions about their diet.”

“How can we expect a child to develop normative behaviours about eating healthily when so many of the messages they are exposed to promote the opposite?

I don’t know which supermarket BMA bigwigs shop in, but when I go into a supermarket my problem is choice, not lack of it. Alongside normal coke I am offered Diet Coke [No sugar] “Coca Cola Zero” [No sugar] “Coca Cola Life” [Lower calorie sweetened using natural sources].. oh and “Caffeine Free” [also “lower calorie”]… and all with calorie content clearly shown on the tin.. if I care to look. I can also buy in a range of sizes from 150ml mini-cans, all the way up to 1.75 litre bottles, if I wish to limit portion size at any point.

And just in case that is not enough for you Coca Cola has, since 2012, reduced the average calories per litre in its sparkling drinks by 5.3% ; reduced the calorie and sugar content of Sprite, Dr Pepper, Fanta Fruit Twist and Glaceau Vitaminwater by more than 30% ; and increased its marketing budget in zero calorie colas by 52%. All as part of its “responsibility deal” with Government. I can also go to the Coca Cola calorie counter, where I see what exercise I can do to work of the calories in one can (11 minutes of squash or 32 minutes of pilates, (or if you prefer 19 minutes of stair climbing or 70 minutes of ironing) to work off 139 calorie can of normal Coca Cola.

Where is the praise from the BMA about how much has been achieved? How much of that would have been achieved if Government had opted to demonise the industry rather than working with it?

Moving away from all things fizzy, how much more could be achieved if this Government-industry relationship was extended to e-cigs and tobacco? Think of the public health advances that could be achieved if  Government worked with the tobacco industry on reduced risk products [such as PMI’s “heat not burn” products] rather than absurdly excluding them from an increasing number of conversations?

It is time for doctors to take back the BMA, sacking the self-serving fat cats at the top of this body, banging on like an old record about taxes and bans and little else. Surely they can see that the BMA is a fast-fossilizing dinosaur, desperately determined to remove all voices from the health debate except its own, regardless of the consequences. If they can’t see it, or won’t do anything about it, then public health is truly not safe in their hands.

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Why the 11th hour ASA u-turn?

By Angela Harbutt
July 30th, 2014 at 4:24 pm | 4 Comments | Posted in Quango

For those of you that don’t know, the Advertising Standards Authority (ASA) is a quasi-judicial authority, tasked with providing independent scrutiny of the marketing communications industry; specifically ensuring that advertising is not misleading, harmful or offensive.

The Chairman of the ASA is appointed by Advertising Standards Board of Finance (ASBOF) – who then appoints 12 Council members to preside over various cases put before them (frequently by members of the public complaining about advertisements they see). Council members are supposedly selected by the Chairman to reflect a diversity of background and experience. This of course only works if the Chairman does indeed appoint Council members who (a) genuinely reflect a wide range of views and experiences and (b) are completely impartial. The current Chairman is the beleaguered Lord Smith of Finsbury (out-going Chairman of the Environment Agency and former Labour Minister).

So what happens when the advertiser under investigation by the ASA is the Government, and too many of those on the ASA Council have various vested interests in keeping on side with government? Can the ASA realistically be relied upon to be blind status of the advertiser?

Perhaps not…

Back in January 2013 I submitted a complaint to the ASA regarding a Government “quit smoking” advert. The advert stated:

When you smoke the chemicals you inhale cause mutations in your body and mutations are how cancer starts. Every 15 cigarettes you smoke will cause a mutation.

I challenged the categorical statement that “every 15 cigarettes you smoke will cause a mutation”. The statement was based on an exploratory research paper which estimated that every 15 cigarettes smoked caused a mutation. It was based on a sample of one patient (yes one) whose smoking record was unknown and the paper did not take into account other factors that are known to affect mutation rates (e.g. ethnicity, age, environmental (background level of mutagenic chemicals) or lifestyle factors etc). No criticism of the study, it was fascinating insight into where genome research is heading. But the study did not provide evidence to back up the study. Nor did any other study. At best one other study (with a sample size of 21 patients – not much more than the average focus group) showed a range of estimated mutation rates, again with a long list of limitations attached to the estimates in this tiny sample.

Over the past 18 months the ASA has investigated the complaint thoroughly. As reported elsewhere, unsurprisingly, the ASA found on three separate occasions that the government advert was misleading and lacked substantiation. After the Department of Health had challenged the first two findings, the ASA brought in a cancer research expert to impartially review the evidence. Post review, it concluded, for a third time, that the advert was misleading and lacked substantiation. This recommendation was put to the ASA Council.

The ASA Council adjudication today however, overrules the findings of its own 18 month investigation, stating that the complaint is not upheld.  Given the consistency of the ASA rulings during the course of this investigation, why the dramatic last minute u-turn?

I can see only three possible reasons for the ASA Council adjudication.

Firstly the ASA Council were simply bamboozled by the science and talk of “peer-reviewed studies” (do people really not understand what that actually means?), lacking sufficient experience/ knowledge to differentiate between tiny incomplete exploratory studies producing estimates, and definitive studies providing robust evidence

Understandable perhaps, although you might have thought that if Council lacked the required experience it would have deferred to it’s own exhaustive investigation rather than overrule it.

Secondly, this quasi-judicial panel could not bring themselves to rule that government had misled the people, with all the ramifications for the long term future of the ASA (and/or themselves) that such a high-profile ruling might bring.

Or maybe it was ideological, and their views on smoking had a part to play. Perhaps they thought that no matter how unsubstantiated the government claim, the end justifies the means. To admit the government had lied on smoking (which it clearly did) would set back the cause for many years.

May be it was a bit of all of the above.

I do not know the ASA Council views on smoking, nor do I know if they actually had the competence to deal with the research data put before them, but I have do know something on the interests of some of the Council members.

Ray Gallagher, (according to the ASA website) has been advising the government “since 2006” as “broadcasting Specialist Adviser to the House of Commons Culture, Media and Sport Committee”.

Martin Narey is, according to his twitter account, also an advisor to Government, an appointment he is very pleased to have had recently renewed “I’m very pleased to be asked by Nicky Morgan to advise her on Adoption, Social Work Education and DCS support”. (You may also be interested to read his 2009 report on Social Mobility here – Page 68 states “Smokers in lower socio-economic groups consume more cigarettes than more affluent smokers and are more addicted. The strength of the addiction makes it harder for poorer people to quit…”).

Yet another Government advisor seated on the ASA Council is John Mayhead. The ASA website reports “Since 1999 he has been a non-exec at the Department for Transport and also chaired the Government Strategic Marketing Advisory Board which was responsible for the oversight of all Government marketing activity.”

You may be pleased to know that Hamish Pringle is not a Government advisor directly. Unfortunately he is Strategic Advisor at advertising agency 23Red. And guess which organisations feature prominently on 23Red’s client list … “Change for Life”, “Smokefree”, “Public Health England” and … “the Department of Health” (yes really).

He is not the only one whose clients include Government.

ASA Council member Anthony Earle Wilkes is the Managing Director of CETC Ltd, a specialist equal opportunity consultancy. His website states that he provides equality and training to organisations including regulatory authorities, local authorities and Government department & agencies. One wonders just how much the state accounts for his business income. Quite a bit one assumes given the nature of his business.

I could go on, but am waiting for the ASA to send me the “ASA Council Declaration of Interests” (curiously not on the ASA website) – and anyway I think you get the point.

I suppose it is possible that none of those listed above attended or, if they did attend, voted to over-rule the ASA executive on this Government advert – that information is not available to us. It is a regulatory body shrouded in mystery after all. We do not know who voted for and who against? We don’t know if it was a majority decision or unanimous? Or whether anyone abstained due to conflict of interest? All questions that cannot be answered.

And here is the problem, one that Arch Bishop Cranmer stated so well :

It is a question of impartiality, which matters profoundly in political processes where force and influence compete with manipulation and facts: if an organisation with quasi-judicial authority professes to be objective in its investigations, then its senior staff and officers must not only be impartial, they must also be seen to be impartial. There cannot be even the merest hint of a political agenda subverting that professed neutrality or corrupting the overriding commitment to fairness and justice.

Given the many Governmental connections past and present of those seated on the ASA Council, for Council to overrule the recommendations of its own investigation, with no explanation as to why, brings into question the very impartiality of the organisation – and therefore the whole process itself. Can people with such close links to Government really be relied upon to consider complaints against Government fairly? I think not.

At the very least you might expect the ASA adjudication to list members past and present links to Government at the end of the adjudication – for transparency sake at least.

An appeal on the ASA Council adjudication has been lodged with the ASA Independent Reviewer – Sir Hayden Phillips – who may decide to look at it and write a review. But even then his role appears to be only advisory – he can politely ask Council to reconsider its ruling – but it appears that this quasi-regulatory organisation cannot be forced to change its opinion, no matter how compelling the evidence: Given that Council members clearly believe they know better than their own staff, one assumes that they will also consider their views likewise superior to the Independent Reviewer.

This case has ramifications for us all. If the Government is not sanctioned for misleading the public in such a clear cut case, what else might it be allowed to say without fear of sanction? It does not bear thinking about. In the meantime we will wait to see what an appeal brings us – but what’s the betting it will this time next year before any decision is made?

DISCLAIMER: Across 2012 and 2013 Angela worked on the Forest campaign Handsoffourpacks opposing the introduction plain packaging of tobacco. She submitted the complaint to the ASA whilst working on that campaign.

READ ALSO: “At last, the ASA verdict on Forest complaint about DH “mutation” ad

UPDATE: For more information read “Spot the Difference: How the Advertising Standards Authority changed its tune

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Life imitating art

By Editor
June 9th, 2013 at 2:28 pm | 1 Comment | Posted in Uncategorized

H/T Here are three ideas for you….

  • Put all alcohol in plain packaging
  • Ban betting logos on sweatshirts
  • Print health warnings on the actual cigarettes

You might think these have been lifted from the latest indie spoof movie. Think again. These crackpot ideas are actually being put forward, for real, by those who “know best”. You see that is what happens when governments spend millions supporting so-called “charities” and institutions whose raison-d’etre is to come up with ideas that justify their existence (and their next round of funding). As for evidence? Forget it. All you need is to get some of your mates to fall in behind the idea, run a few more “studies”, get public health to back it and Bob’s your uncle, your almost there.

Click here to read more: (PS. We like the solution)

“Future generations will look back in wonder at how so many fruitcakes and monomaniacs came to wield influence in the foul years of the early twenty-first century. Sack the lot of them, abolish their grants, bulldoze their workplaces and pour salt on the land so that nothing ever grows there again.”

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Norman Lamb: Doh!

By Angela Harbutt


Only a short while ago Norman Lamb MP was one of our best. He stood up, and spoke out, on principle against needless government intrusion. A true poster boy for all those liberals amongst us who object to the nanny state telling adults how to live our lives.

Back in 2008, when the the Labour government suggested hiding cigarettes behind shutters in shops, Norman was one of the first to speak out. As Shadow Health Minister he rightly stated :

“This is the nanny state going too far.”

And he didn’t stop there. He also said

“This will hit small businesses with added costs while there is no clear evidence that it will actually reduce the number of young people smoking.”

And indeed he said this:

“The Government is obsessed with headline-grabbing gimmicks instead of tackling the real problems. Buying tobacco for children must be made a criminal offence. Ministers also need to clamp down on the shockingly high amount of tobacco that is smuggled illegally into this country.”

Where is that man we wonder? Roll on to 2013 and, when in a position to actually have an impact on the excesses of the nanny state, low and behold he pops up in the Guardian saying:

“As a liberal I would always defend someone’s right to smoke, if that’s what they choose to do. But, given we’re dealing here with a product that kills between 80,000 and 100,000 people a year, I think it’s legitimate for government to seek to control the marketing of that deadly product…”


Well, Norman, nothing has changed since 2008. Cigarettes are bad for you. Sure. But no more than they were in 2008, when you were against the display ban. Adults should be treated as adults – even when you are in power.

If ever there was a policy that was nothing more than a “headline-grabbing gimmick” (your words), banning coloured boxes must surely be it? What happened to your concern about the impact of policy gimmicks on small businesses? And why choose this point to ignore the 500,000 voters who registered their opposition to this policy during the consultation? Back in 2008 your concern was rightly focused on the black-market and proxy purchasing. Why, when in power, choose to support a policy that will make it actually easier and cheaper for organised crime to counterfeit cigarettes? You were against the tobacco display ban – but it was introduced anyway – why not at least wait to measure the effectiveness of that policy (and the ban on tobacco vending machines) before arguing for yet more legislation?

Picture courtesy of "Hands Off Our Packs"

Picture courtesy of “Hands Off Our Packs”

You say that:

“I think it would be a legacy for this government to have legislated on something which would be a landmark public health reform and to be out there in front in Europe.”

Great. If that’s the case [or indeed if it is, as it seems, just the usual politician’s desire to be “seen” to be doing something]  here are a few policies that may assist you in leaving a health legacy you can actually be proud of.


1. Clear the path for e-cigarettes. This revolution is leaving you behind. Hundreds of thousands are electing to choose this product – yet you waste your time on ruling what colour of boxes you think adults should look at – a campaign gimmick that is untried, untested and unwanted. If you want to be “out there in front of Europe” then let’s get as many e-cigarettes out there as possible. If you hadn’t noticed – they are working – unlike the tired, unimaginative and dangerous “more of the same” policies coming from those in tobacco control. Note that Chris Davies [Libdem] MEP seems to be way ahead of you [see “Politics at it should be done“]

2. Introduce a ban on proxy purchasing (your idea from 2008). Smoking is an adult pursuit. If your concern is children, then make it illegal to purchase cigarettes on behalf of minors.

3. And while you are at it, increase the penalties on those caught selling cigarettes to kids.

4. Act on counterfeiting. Fake cigarettes sell at half the price of UK duty paid cigarettes. Quite attractive to cash strapped youngsters don’t you think? They are sold to minors at school gates, car book sales and markets. They don’t ask for ID, and they don’t care who they sell to. Why not introduce some serious penalties for smuggling and counterfeiting?

That is just four for starters – and they really do start to look like a liberal legacy we can all be proud of.

PS: With great relief we note that education minister, David Laws, and the Home Office minister, Jeremy Browne are reported to remain firmly against this policy.

Seen elsewhere on this topic: “Norman Lamb:Perfect Example of the Genre” and “Open Minded?

Angela Harbutt is currently campaigning against the introduction of plain packaging of tobacco.

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New bounty on smokers helps GPs balance their books

By Guest
March 26th, 2013 at 9:41 am | 7 Comments | Posted in health

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!

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