Health | ukwatch.net

Foreign Bodies

Ellie Keen — Sat, 12 Jul 2008 17:13:27 +0000

As Schnews Investigates Dictated Racism in the NHS

As the NHS sinks into a privatised pay-as-you-go American style health system, SchNEWS has decided to take an overdue look at the state of NHS Plcs’ treatment of foreigners who have the misfortune to get sick over here. They’re having their right to health taken away from underneath them by a swathe of new laws being passed.

Despite free healthcare for all being enshrined in the NHS charter, overseas visitors’ access to treatment has been systematically attacked since 1989, when the Tories brought in the first charges for foreigners. Neo-labour has (as always) smoothly stepped in where they left off, further tightening the noose. The latest piece of legislation was passed in 2007.

Thanks to the efforts of successive tightfisted and racist regimes, overseas visitors (anyone who’s been resident in the UK for less than a year) will only be treated when it’s absolutely necessary. For any treatment deemed not immediately necessary they must cough up or go home (not exactly an enticing offer for someone whose fled from persecution and poverty back home).

Whether it’s an attempt to save money or (more likely) pandering to tabloid induced fear of ‘health tourists’ comin’ over ‘ere and swamping ‘our’ NHS (not that foreigners would ever come over here to work in the NHS), the logic of the system simply doesn’t add up. If it’s ‘not immediately necessary’ to provide a patient with drugs to hold a heart condition at bay, before not too long it’ll be necessary to pay for open heart surgery to save his or her life, at a massively higher cost (about £10,000 for open heart surgery versus a few hundred quid for a GP visit and some drugs). It’s nice to know though that if a ‘chargeable’ foetus is delivered in a UK hospital, it is not charged, just its mother.

The latest Neo-Labour wheeze to squeeze the poor and the brown out of their fundamental rights is the new post of NHS Private and Overseas Patients Co-ordinator’. These staff are the attack dogs of this latest approach to maltreatment. They function as NHS debt collectors, who’s job it is to go bed to bed hunting down foreigners and making them pay or turfing them out of the country. These jobs are being advertised around the country- government diktat is that every NHS trust must have one.

Things are a little better in GP’s surgeries, where doctors can operate with a greater degree of freedom than within the over-bureaucratised NHS. Luckily as GPs are self employed it’s at their discretion to accept any person, including overseas visitors, to be fully registered as an NHS patient or as a temporary resident. Because nurses at a GP’s Practice are employed by them and not the NHS Trust, they’re exempt from the laws as well. Unfortunately not many of them seem to know this. However, GPs should know that any random generosity on their part will extend no further than their surgery. For example if the GP wanted to send them for an x-ray, the patient would have to pay up.

In a bizarre twist of government logic, the 65 page document detailing who is and isn’t eligible for free treatment is big on avoiding discrimination. The most important principle (according to the document) is all patients should treated as foreign until proven innocent, not just people who appear foreign (ie funny accents and dark skin). Theoretically, everyone who goes to hospital should be asked “Have you lived in the UK for the past 12 months?” and “Can you show you have the right to live here?” Anyone who has enough foresight to bring their proof they have lived legally in UK for 12 months before treatment should be OK. Of not expect a visit from the NHS debt chaser.

These new laws are compounding the lack of access to health of the poor, immigrant communities that are a micro third-world in large British cities, replete with developing country-style diseases such as tuberculosis and hepatitis. In Tower Hamlets (poor and multi-ethnic London borough) the rate of TB infection is eight times the national average.

Bucking the trend, the French-based NGO ‘Médecins du Monde’ set up a clinic, ‘Project London’ in Bethnal Green two years ago. MdM broke away from the more famous Medicine Sans Frontiers, and, like its larger parent organisation, is more used to working in slums and refugee camps than a scant few miles from one of the world’s financial centres.

Staffed entirely by volunteers, Project London aims to help the immigrant poor access medical services- assisting them to overcome language and cultural barriers. More than three quarters just needed help to register with a GP, and in 85% of cases they were able to get them registered. This suggests that if staff on the front desk aren’t deliberately excluding people are too scared to seek help or no-one can actually work out who is and who isn’t entitled to care.

The Médecins du Monde style is the basic ethos of health workers- good old fashioned humanistic philosophy. Inside hospitals doctors and nurses are having to lie, cheat and break rules in order to protect the rights of patients, having to work against what amounts to an NHS anti-immigrant secret police.

As the UN Special Rappotuer Paul Hunt puts it: “The right to health applies to everyone, regardless of Immigration status…Governments are required to ‘refrain from denying or limiting equal access’ to health services for all persons including ‘illegal immigrants’.”

The ‘Project:London’ clinic is found at:
Praxis, Pott Street, London E2 0EF.
Tube: Bethnal Green, Bus: D3, 8, 106, 254, 388
Tel: 0208 1236614/07974 616852

Open every Monday, Wednesday and Friday between 1pm – 5pm No appointment necessary. (No admission after 4.30pm)
www.medecinsdumonde.org.uk

Along for Fluoride

Ellie Keen — Sun, 22 Jun 2008 19:55:48 +0000

AS BRITAINS FACE MASS MEDICATION OF TOXIC WATER ADDITIVE

If you knew that someone was putting poison into your water supply, what would you do? Call the authorities? Well don’t bother cos it’s the government wot’s doing it!

If you live in the West Midlands or the North East, the chances are that you already have a fluoridated water supply – and comments earlier this year from Health Secretary Alan Johnson made it clear that he is keen to see this toxic industrial waste added to everyone else’s water as soon as possible. Why? He believes that it is a ‘key means of tackling tooth decay’ – despite the fact that no scientific evidence bears this out, and much other evidence has emerged linking fluoride ingestion to bone deficiencies, cancer, joint pain, skin rash, damage to thyroid glands and even IQ deficits.

So what’s going on? Well, Alan Johnston has swallowed the arguments put forward by the dental and pharmaceutical lobbying groups, all of which have been exported here from the US where, since the 1940s, they have managed to get over 70% of water fluoridated. It’s just science they say – fluoride was shown in the mid-1930’s to have a beneficial effect on the incidence of children’s tooth decay, so why not add it at source and protect everyone’s teeth without them having to do a thing?

But this mass medication argument has more holes in than my sugar-addled teeth. Number one is obviously, er, mass medication? Unknown dosage level (everyone’s water consumption is different) and without the patients’ consent? Since when was that normal practice? You don’t forcefeed people aspirin because one of them may be experiencing a headache… it’s illogical and wasteful – not to mention people’s rights to refuse medication.

In fact, a dip in the scientific fluoride literature is like diving into a very muddy pool, reminiscent of the ‘smoking is not really bad for you’ or ‘climate change isn’t really happening’ debates of recent decades. This alone should be ringing the alarm bells. Many studies do suggest that ‘topical’ application of fluoride, i.e. applying it to the teeth directly by way of toothpaste etc does have some beneficial effect on cavity rates, although these don’t attempt to separate out all the other factors which may play a part in tooth health, like diet, or attempt to discover other ways of achieving the same benefits. While fluoride is proven (and accepted by all) to cause dental fluorosis (pitted or mottled tooth enamel) – now widespread in American mouths – little high quality study has been done on other side effects like bone deterioration or cancers, which may mean a slightly healthier smile is far outweighed by a shorter diseased life.

And the story with applying the fluoride by drinking it in water is even cloudier. There is no unequivocal proof that it works. In fact, since large parts of America started sipping it in the 1950s, numerous studies have shown that, all else being equal, tooth decay rates for fluoridated and non-fluoridated water areas are, er, exactly the same – or in some cases even higher in fluoridated areas! This has led to nearly all of Europe long since abandoning the practice – but it seems that governments in the UK (10% fluoridated) and Ireland (72%) just can’t resist the persuasive American connection.

If you were of a slightly cynical mind (who us?!), it would almost seem that nobody at the top wants to hear any evidence contradicting the fluoride dogma. The approved studies are designed (and funded) purely to decide whether adding fluoride for teeth can be considered ‘a good thing’. This is the result demanded by big business eager to turn an expensive-to-get-rid-of toxic industrial waste product (left over in pesticide production, aluminium processing and nuclear uranium enriching, amongst other things) into a ‘miracle’ health ingredient to be boxed up, re-branded and sold back in small amounts to the general public in return for a handsome profit. Well you can see their logic. Two birds with one stone and profits up. No wonder that the many more recent long term-studies and peer-reviews of past data showing no provable benefits (and many possible negatives) are swiftly discredited or ignored.

CLOSE TO THE BONE

And there are other (presumably weakened, deteriorating) skeletons in the closet. In 1997, two American journalists dug out previously classified documents revealing how fluoride policy and research was shaped by atom bomb making at the end of the Second World War. The first court cases against the government from people affected by living near to the bomb making facilities were not for the effects of radiation, but for damage to crops from fluoride pollution.

The secret ‘Manhattan Project’ memos – the group of government and industrial capitalists running the development of the nuclear option – show that they knew about the problems and commissioned pro-fluoride research merely to help fight these and future possible court cases. Despite editorial approval and full referencing, the damning article was dropped by the Christian Science Monitor and never widely published.

Despite Birmingham and other areas’ water being contaminated, no new UK regions have joined them since the mid 1980s when the rollout was put on hold. But the threat is back. In 1993, despite no demand, the government passed an act giving regional strategic health authorities (SHA) the power to compel water to be fluoridated. It must have been frustrating for them and their corporate sponsors that, to date, not one of them has done so. So it seems like a whole new round of propaganda and pressure is about to be applied. Anti-fluoride action groups have sprung up around the country (see www.hampshireagainstfluoridation.blogspot.com and www.freewebs.com/keepwatersafe for example) who are working to try and ensure that nobody else is unwillingly force-fed this harmful toxic poison for no health benefit. As recent studies in China and Mexico have shown a link between fluoride consumption and lower IQ scores, maybe they’re just out to keep us all dumb…?

There’s tons more info to get yer teeth into at www.freewebs.com/keepwatersafe and www.fluoridealert.org

NHS strike looms as GMB reject pay deal

tim — Fri, 06 Jun 2008 14:37:52 +0000

Published online 31/05/08

A threat of industrial action across the NHS intensified yesterday when health workers in the GMB union voted by an overwhelming majority to reject the three-year pay deal offered by the government.

If their decision is confirmed by the 450,000 NHS workers in Unison next week, the government may be forced to abandon its attempt to reach a long-term settlement.

In those circumstances Johnson has warned that he would be obliged by the Treasury to cut the pay increase that staff are banking on getting this year. Such a move would be likely to provoke a wave of hostility across the NHS, including overtime bans that could derail ministers’ plans to cut waiting times for patients.

GMB members, representing 25,000 NHS staff in England and Wales, rejected the deal by more than 96% in a ballot with high turnout. The offer was worth 8% over three years, with 2.75% paid immediately this year – the best terms available in the public sector in the current pay round though still way below inflation, amounting to a cut in real wages. Ambulance workers, porters and cleaners in Unite had already voted to reject the deal by a majority of six to one. This week the Royal College of Midwives said a consultation of members found 99. 7% were opposed.

The GMB, which represents ambulance crews, porters, catering staff, ancillary workers, blood collection, nursing assistants and practitioners, cleaners, laboratory workers, drivers and maintenance staff, said it would seek a meeting with Johnson. Dame Karlene Davis, general secretary of the Royal College of Midwives, said this week: “Given the outlook for the economy in future years, acceptance of the three-year deal would represent a vote for a real terms pay cut.”

Unison and the Royal College of Nursing negotiated the deal on behalf of the smaller NHS unions and were expected to recommend it. But the Unison leadership failed to win a majority on its health executive. The RCN is poised to accept the three-year deal.

This represents the stirring of health workers as part of the wider movement of unrest amongst public sector workers with the threat of strike action also coming from civil servants, refuse collectors, teachers, academic staff, local government and others.

10 reasons why organic can feed the world

tim — Thu, 05 Jun 2008 20:47:12 +0000

1. Yield

Switching to organic farming would have different effects according to where in the world you live and how you currently farm.

Studies show that the less-industrialised world stands to benefit the most. In southern Brazil, maize and wheat yields doubled on farms that changed to green manures and nitrogenfixing leguminous vegetables instead of chemical fertilisers.1 In Mexico, coffee-growers who chose to move to fully organic production methods saw increases of 50 per cent in the weight of beans they harvested. In fact, in an analysis of more than 286 organic conversions in 57 countries, the average yield increase was found to be an impressive 64 per cent.2

The situation is more complex in the industrialised world, where farms are large, intensive facilities, and opinions are divided on how organic yields would compare.

Research by the University of Essex in 1999 found that, although yields on US farms that converted to organic initially dropped by between 10 and 15 per cent, they soon recovered, and the farms became more productive than their all-chemical counterparts.3 In the UK, however, a study by the Elm Farm Research Centre predicted that a national transition to all-organic farming would see cereal, rapeseed and sugar beet yields fall by between 30 and 60 per cent.4 Even the Soil Association admits that, on average in the UK, organic yields are 30 per cent lower than non-organic.

So can we hope to feed ourselves organically in the British Isles and Northern Europe? An analysis by former Ecologist editor Simon Fairlie in The Land journal suggests that we can, but only if we are prepared to rethink our diet and farming practices.5 In Fairlie’s scenario, each of the UK’s 60 million citizens could have organic cereals, potatoes, sugar, vegetables and fruit, fish, pork, chicken and beef, as well as wool and flax for clothes and biomass crops for heating. To achieve this we’d each have to cut down to around 230g of beef (½lb), compared to an average of 630g (1½lb) today, 252g of pork/bacon, 210g of chicken and just under 4kg (9lb) of dairy produce each week – considerably more than the country enjoyed in 1945. We would probably need to supplement our diet with homegrown vegetables, save our food scraps as livestock feed and reform the sewage system to use our waste as an organic fertiliser.

2. Energy

Currently, we use around 10 calories of fossil energy to produce one calorie of food energy. In a fuel-scarce future, which experts think could arrive as early as 2012, such numbers simply won’t stack up. Studies by the Department for Environment, Food and Rural affairs over the past three years have shown that, on average, organically grown crops use 25 per cent less energy than their chemical cousins. Certain crops achieve even better reductions,including organic leeks (58 per cent less energy) and broccoli (49 per cent less energy). When these savings are combined with stringent energy conservation and local distribution and consumption (such as organic box schemes), energy-use dwindles to a fraction of that needed for an intensive, centralised food system. A study by the University of Surrey shows that food from Tolhurst Organic Produce, a smallholding in Berkshire, which supplies 400 households with vegetable boxes, uses 90 per cent less energy than if non-organic produce had been delivered and bought in a supermarket.

Far from being simply ‘energy-lite’, however, organic farms have the potential to become self-sufficient in energy – or even to become energy exporters. The ‘Dream Farm’ model, first proposed by Mauritius-born agroscientist George Chan, sees farms feeding manure and waste from livestock and crops into biodigesters, which convert it into a methane-rich gas to be used for creating heat and electricity. The residue from these biodigesters is a crumbly, nutrient-rich fertiliser, which can be spread on soil to increase crop yields or further digested by algae and used as a fish or animal feed.

3. Greenhouse gas emissions and climate change

Despite organic farming’s low-energy methods, it is not in reducing demand for power that the techniques stand to make the biggest savings in greenhouse gas emissions.

The production of ammonium nitrate fertiliser, which is indispensable to conventional farming, produces vast quantities of nitrous oxide – a greenhouse gas with a global warming potential some 320 times greater than that of CO2. In fact, the production of one tonne of ammonium nitrate creates 6.7 tonnes of greenhouse gases (CO²e), and was responsible for around 10 per cent of all industrial greenhouse gas emissions in Europe in 2003.6

The techniques used in organic agriculture to enhance soil fertility in turn encourage crops to develop deeper roots, which increase the amount of organic matter in the soil, locking up carbon underground and keeping it out of the atmosphere. The opposite happens in conventional farming: high quantities of artificially supplied nutrients encourage quick growth and shallow roots. A study published in 1995 in the journal Ecological Applications found that levels of carbon in the soils of organic farms in California were as much as 28 per cent higher as a result.7 And research by the Rodale Institute shows that if the US were to convert all its corn and soybean fields to organic methods, the amount of carbon that could be stored in the soil would equal 73 per cent of the country’s (would-be) Kyoto targets for CO² reduction.8

Organic farming might also go some way towards salvaging the reputation of the cow, demonised in 2007 as a major source of methane at both ends of its digestive tract. There’s no doubt that this is a problem: estimates put global methane emissions from ruminant livestock at around 80 million tonnes a year,9 equivalent to around two billion tonnes of CO²,10 or close to the annual CO² output of Russia and the UK combined.11 But by changing the pasturage on which animals graze to legumes such as clover or birdsfoot trefoil (often grown anyway by organic farmers to improve soil nitrogen content), scientists at the Institute of Grassland and Environmental Research believe that methane emissions could be cut dramatically. Because the leguminous foliage is more digestible, bacteria in the cow’s gut are less able to turn the fodder into methane. Cows also seem naturally to prefer eating birdsfoot trefoil to ordinary grass.

4. Water use

Agriculture is officially the most thirsty industry on the planet, consuming a staggering 72 per cent of all global freshwater at a time when the UN says 80 per cent of our water supplies are being overexploited.12,13

This hasn’t always been the case. Traditionally, agricultural crops were restricted to those areas best suited to their physiology, with drought-tolerant species grown in the tropics and water-demanding crops in temperate regions.14 Global trade throughout the second half of the last century led to a worldwide production of grains dominated by a handful of high-yielding cereal crops, notably wheat, maize and rice. These thirsty cereals – the ‘big three’ – now account for more than half of the world’s plant-based calories and 85 per cent of total grain production.15

Organic agriculture is different. Due to its emphasis on healthy soil structure, organic farming avoids many of the problems associated with compaction, erosion, salinisation and soil degradation, which are prevalent in intensive systems.16 Organic manures and green mulches are applied even before the crop is sown, leading to a process known as ‘mineralisation’ – literally the fixing of minerals in the soil. Mineralised organic matter, conspicuously absent from synthetic fertilisers, is one of the essential ingredients required physically and chemically to hold water on the land.

Organic management also uses crop rotations, undersowing and mixed cropping to provide the soil with near-continuous cover. By contrast, conventional farm soils may be left uncovered for extended periods prior to sowing, and again following the harvest, leaving essential organic matter fully exposed to erosion by rain, wind and sunlight. In the US, a 25-year Rodale Institute experiment on climatic extremes found that, due to improved soil structure, organic systems consistently achieve higher yields during periods both of drought and flooding.17

5. Localisation

The globalisation of our food supply, which gives us Peruvian apples in June and Spanish lettuces in February, has seen our food reduced to a commodity in an increasingly volatile global marketplace. Although year-round availability makes for good marketing in the eyes of the biggest retailers, the costs to the environment are immense.

Friends of the Earth estimates that the average meal in the UK travels 1,000 miles from plot to plate.18 In 2005, Defra released a comprehensive report on food miles in the UK, which valued the direct environmental, social and economic costs of food transport in Britain at £9 billion each year. In addition, food transport accounted for more than 30 billion vehicle kilometres, 25 per cent of all HGV journeys and 19 million tonnes of carbon dioxide emissions in 2002 alone.19

The organic movement was born out of a commitment to provide local food for local people, and so it is logical that organic marketing encourages localisation through veg boxes, farm shops and stalls. Between 2005 and 2006, organic sales made through direct marketing outlets such as these increased by 53 per cent, from £95 to £146 million, more than double the sales growth experienced by the major supermarkets.20 As we enter an age of unprecedented food insecurity, it is essential that our consumption reflects not only what is desirable, but also what is ultimately sustainable. While the ‘organic’ label itself may inevitably be hijacked, ‘organic and local’ represents a solution with which the global players can simply never compete.

6. Pesticides

It is a shocking testimony to the power of the agrochemical industry that in the 45 years since Rachel Carson published her pesticide warning Silent Spring, the number of commercially available synthetic pesticides has risen from 22 to more than 450.21

According to the World Health Organization there are an estimated 20,000 accidental deaths worldwide each year from pesticide exposure and poisoning.22 More than 31 million kilograms of pesticide were applied to UK crops alone in 2005, 0.5 kilograms for every person in the country.23 A spiralling dependence on pesticides throughout recent decades has resulted in a catalogue of repercussions, including pest resistance, disease susceptibility, loss of natural biological controls and reduced nutrient-cycling.24

Organic farmers, on the other hand, believe that a healthy plant grown in a healthy soil will ultimately be more resistant to pest damage. Organic systems encourage a variety of natural methods to enhance soil and plant health, in turn reducing incidences of pests, weeds and disease.

First and foremost, because organic plants grow comparatively slower than conventional varieties they have thicker cell walls, which provide a tougher natural barrier to pests. Rotations or ‘break-crops’, which are central to organic production, also provide a physical obstacle to pest and disease lifecycles by removing crops from a given plot for extended periods.25 Organic systems also rely heavily on a rich agro-ecosystem in which many agricultural pests can be controlled by their natural predators.

Inevitably, however, there are times when pestilence attacks are especially prolonged or virulent, and here permitted pesticides may be used. The use of organic pesticides is heavily regulated and the International Federation of Organic Agriculture Movements (IFOAM) requires specific criteria to be met before pesticide applications can be justified.26

There are in fact only four active ingredients permitted for use on organic crops: copper fungicides, restricted largely to potatoes and occasionally orchards; sulphur, used to control additional elements of fungal diseases; Retenone, a naturally occurring plant extract, and soft soap, derived from potassium soap and used to control aphids. Herbicides are entirely prohibited.

7. Ecosystem impact

Farmland accounts for 70 per cent of UK land mass, making it the single most influential enterprise affecting our wildlife.27 Incentives offered for intensification under the Common Agricultural Policy are largely responsible for negative ecosystem impacts over recent years. Since 1962, farmland bird numbers have declined by an average of 30 per cent. During the same period more than 192,000 kilometres of hedgerows have been removed, while 45 per cent of our ancient woodland has been converted to cropland.28

By contrast, organic farms actively encourage biodiversity in order to maintain soil fertility and aid natural pest control. Mixed farming systems ensure that a diversity of food and nesting sites are available throughout the year, compared with conventional farms where autumn sow crops leave little winter vegetation available.29

Organic production systems are designed to respect the balance observed in our natural ecosystems. It is widely accepted that controlling or suppressing one element of wildlife, even if it is a pest, will have unpredictable impacts on the rest of the food chain. Instead, organic producers regard a healthy ecosystem as essential to a healthy farm, rather than a barrier to production.

In 2005, a report by English Nature and the RSPB on the impacts of organic farming on biodiversity reviewed more than 70 independent studies of flora, invertebrates, birds and mammals within organic and conventional farming systems. It concluded that biodiversity is enhanced at every level of the food chain under organic management practices, from soil micro-biota right through to farmland birds and the largest mammals.30

8. Nutritional benefits

While an all-organic farming system might mean we’d have to make do with slightly less food than we’re used to, research shows that we can rest assured it would be better for us.

In 2001, a study in the Journal of Complementary Medicine found that organic crops contained higher levels of 21 essential nutrients than their conventionally grown counterparts, including iron, magnesium, phosphorus and vitamin C. The organic crops also contained lower levels of nitrates, which can be toxic to the body.31

Other studies have found significantly higher levels of vitamins – as well as polyphenols and antioxidants – in organic fruit and veg, all of which are thought to play a role in cancer-prevention within the body.32

Scientists have also been able to work out why organic farming produces more nutritious food. Avoiding chemical fertiliser reduces nitrates levels in the food; better quality soil increases the availability of trace minerals, and reduced levels of pesticides mean that the plants’ own immune systems grow stronger, producing higher levels ofantioxidants. Slower rates of growth also mean that organic food frequently contains higher levels of dry mass, meaning that fruit and vegetables are less pumped up with water and so contain more nutrients by weight than intensively grown crops do.33

Milk from organically fed cows has been found to contain higher levels of nutrients in six separate studies, including omega-3 fatty acids, vitamin E, and beta-carotene, all of which can help prevent cancer. One experiment discovered that levels of omega-3 in organic milk were on average 68 per cent higher than in non-organic alternatives.34

But as well as giving us more of what we do need, organic food can help to give us less of what we don’t. In 2000, the UN Food and Agriculture Organization (FAO) found that organically produced food had ‘lower levels of pesticide and veterinary drug residues’ than non-organic did.35 Although organic farmers are allowed to use antibiotics when absolutely necessary to treat disease, the routine use of the drugs in animal feed – common on intensive livestock farms – is forbidden. This means a shift to organic livestock farming could help tackle problems such as the emergence of antibiotic-resistant bacteria.

9. Seed-saving

Seeds are not simply a source of food; they are living testimony to more than 10,000 years of agricultural domestication. Tragically, however, they are a resource that has suffered unprecedented neglect. The UN FAO estimates that 75 per cent of the genetic diversity of agricultural crops has been lost over the past 100 years.36

Traditionally, farming communities have saved seeds year-on-year, both in order to save costs and to trade with their neighbours. As a result, seed varieties evolved in response to local climatic and seasonal conditions, leading to a wide variety of fruiting times, seed size, appearance and flavour. More importantly, this meant a constant updating process for the seed’s genetic resistance to changing climatic conditions, new pests and diseases.

By contrast, modern intensive agriculture depends on relatively few crops – only about 150 species are cultivated on any significant scale worldwide. This is the inheritance of the Green Revolution, which in the late 1950s perfected varieties Filial 1, or F1 seed technology, which produced hybrid seeds with specifically desirable genetic qualities.37 These new high-yield seeds were widely adopted, but because the genetic makeup of hybrid F1 seeds becomes diluted following the first harvest, the manufacturers ensured that farmers return for more seed year on year.

With its emphasis on diversity, organic farming is somewhat cushioned from exploitation on this scale, but even Syngenta, the world’s third-largest biotech company, now offers organic seed lines. Although seedsaving is not a prerequisite for organic production, the holistic nature of organics lends itself well to conserving seed.

In support of this, the Heritage Seed Library, in Warwickshire, is a collection of more than 800 open-pollinated organic varieties, which have been carefully preserved by gardeners across the country. Although their seeds are not yet commercially available, the Library is at the forefront of addressing the alarming erosion of our agricultural diversity.

Seed-saving and the development of local varieties must become a key component of organic farming, giving crops the potential to evolve in response to what could be rapidly changing climatic conditions. This will help agriculture keeps pace with climate change in the field, rather than in the laboratory.

10. Job creation

There is no doubt British farming is currently in crisis. With an average of 37 farmers leaving the land every day, there are now more prisoners behind bars in the UK than there are farmers in the fields.38

Although it has been slow, the decline in the rural labour force is a predictable consequence of the industrialisation of agriculture. A mere one per cent of the UK workforce is now employed in land-related enterprises, compared with 35 per cent at the turn of the last century.39

The implications of this decline are serious. A skilled agricultural workforce will be essential in order to maintain food security in the coming transition towards a new model of post-fossil fuel farming. Many of these skills have already been eroded through mechanisation and a move towards more specialised and intensive production systems.

Organic farming is an exception to these trends. By its nature, organic production relies on labour-intensive management practices. Smaller, more diverse farming systems require a level of husbandry that is simply uneconomical at any other scale. Organic crops and livestock also demand specialist knowledge and regular monitoring in the absence of agrochemical controls.

According to a 2006 report by the University of Essex, organic farming in the UK provides 32 per cent more jobs per farm than comparable non-organic farms. Interestingly, the report also concluded that the higher employment observed could not be replicated in non-organic farming through initiatives such as local marketing. Instead, the majority (81 per cent) of total employment on organic farms was created by the organic production system itself. The report estimates that 93,000 new jobs would be created if all farming in the UK were to convert to organic.

Organic farming also accounts for more younger employees than any other sector in the industry. The average age of conventional UK farmers is now 56, yet organic farms increasingly attract a younger more enthusiastic workforce, people who view organics as the future of food production. It is for this next generation of farmers that Organic Futures, a campaign group set up by the Soil Association in 2007, is striving to provide a platform.

Ed Hamer is a freelance journalist

Mark Anslow is the Ecologist’s senior reporter

References

1 Andre Leu, ‘Organic Agriculture Can Feed the World’ in Organic Farming, Winter 2007, citing Jules Pretty, 2001

2 Pretty, 2006. http://www.rimisp.org/getdoc.php?docid=6440

3 Pretty, 1999, ‘The Living Land’.

4 Cited in Woodward, 2003. http://www.efrc.com/?i=articles.php&art_id=42&highlight=organic

5 Fairlie, 2007, ‘Can Britain Feed Itself?’, The Land, Winter 2007-8.

6 EEA data for EU-15, 2003, for nitric acid production cited by Soil Association

7 Drinkwater LE et al. ‘Fundamental differences between conventional and organic tomato agroecosystems in California’, Ecological Applications 1995, 5(4), 1098-1112.

8 http://www.newfarm.org/depts/NFfield_trials/1003/carbonsequest.shtml

9 US EPA, 1998, ‘Ruminant Livestock and the Global Environment’

10 Using a multiplier factor of 24.5

11 Russia annual CO2 emissions: 1,524,993,000 tonnes; UK annual CO2 emissions: 587,261,000 tonnes.

12 Weis, T. (2007) The global food economy: the battle for the future of farming, Zed Books, London.

13 UNESCO (2006) United Nations Educational Scientific and Cultural Organisation, World Water Development Report 2006: http://www.unesco.org/water/wwap/wwdr/index.shtml

14 Alteiri, M. (1987) Agroecology: The Scientific Basis of Alternative Agriculture, Westview Press, Boulder.

15 FAO (1997) The State of the World’s Plant Genetic Resources for Food and Agriculture, Food Agriculture Organisation of the United Nations, Rome.

16 Lampkin, N. (1990) Organic Farming, Farming Press Books, Ipswich.

17 Lim Li Ching (2005) Organic Outperforms Conventional in Climate Extremes, web accesses: http://www.i-sis.org.uk/OrganicOutperforms.php

18 FOE (2006) http://www.foe.co.uk/resource/press_releases/green_new_year_resolutions_…

19 Defra (2005) The Validity of Food Miles as an Indicator of Sustainable Development: Final report, Department of Environment Food and Rural Affairs.

20 Soil Association (2006) Organic Market Report 2006, Executive Summary, Soil Association, Bristol.

21 Whitehead, R. (1999) UK Pesticide Guide, British Crop Protection Council, CABI Publishing, Cambridge.

22 World Health Organisation (1990) The Public Health Impact of Pesticides Used in Agriculture, WHO, Geneva

23 Pesticide Action Network UK (2007) Pesticides on a Plate, A consumer guide to pesticide issues in the food chain, PAN UK, London

24 Sustain (2003) Myth and Reality, Organic vs. non-organic: the facts, Sustain, London.

25 Francis, C. A. & Clegg, M. D. (1990) Crop Rotations in Sustainable Production Systems, Sustainable Agriculture Systems 107-122

26 International Federation of Organic Agriculture Movements (1998) Basic Standards for Organic Production and Processing, IFOAM, Germany

27 Soil Association (2006) How does organic farming benefit wildlife? Soil Association 2006.

28 Spencer, J. & Kirby, K. (1992) An inventory of ancient woodland for England and Wales, Biological Conservation 62, 77-93.

29 IFOAM (2003) Organic Agriculture and Biodiversity information sheet, International Federation of Organic Agriculture and Management.

30 Hole, A. G., Perkins, A. J., Wilson, J. D., Alexander, I. H., Grice, P. V., Evans, A. D. (2005) Does Organic Farming Benefit Biodiversity? Biological Conservation, 122, 113-130.

31 Worthington V. Nutritional quality of organic versus conventional fruits, vegetables, and grains. Journal of Complimentary Medicine 2001; 7 No. 2: 161–173

32 Soil Association, 2008: http://tinyurl.com/3aye3g

33 Gundual Azeez, Policy Manager, Soil Association, Personal Communication 01/2008.

34 Soil Association, 2007: http://tinyurl.com/3e3fby

35 Food and Agriculture Organisation, Food Safety & Quality as Affected by Organic Farming, Report of the 22nd regional conference for Europe, Portugal, 24-28 July 2000.

36 FAO (1997) The State of the World’s Plant Genetic Resources for Food and Agriculture, Food Agriculture Organisation of the United Nations, Rome.

37 Shiva, V. & Gitanjali, B. (2002) Sustainable Agriculture and Food Security, The Impact of globalisation, Sage Publications, London.

38 Soil Association (2006) Organic Works Report: An investigation into employment on organic farms conducted by University of Essex 2005.

39 ISEC (2002) Bringing the Food Economy Home: Local Alternatives to Global Agribusiness, Zed Books, London.

NHS Whistleblower speaks out

tim — Tue, 27 May 2008 12:35:59 +0000

Senior mental health nurse Karen Reissmann was sacked last year after being found guilty of gross misconduct by Manchester Mental Health and Social Care Trust for speaking out against NHS cuts. Tom Haines-Doran catches up with her to ask about the latest in the campaign to have her reinstated.

Where are you at with the campaign to get you reinstated?

The campaign started when I was first suspended [June 2007] for bringing the Trust into disrepute. We had 700 people on strike for 14 days of action, followed by further action in November. My appeal was turned down and is now going to an employment tribunal. MPs will be asked to sign Early Day Motion 443 which calls for my reinstatement and there may be further days of strike action. We’re trying to persuade Alan Johnson to sign the motion. It’s ironic that I am being supported by Stephen O’Brien the Shadow Minister for Health, and not his opposite in the Labour government.

Is the return to work something that can keep the campaign alive?

The campaign is not going to fizzle out. I have received an incredible amount support from my colleagues and many others. People are worried about the Health Service; there is a fear of speaking out and a number of health workers are saying they’re glad that I did. One of the questions I was asked by the management was ‘what loyalty do you have to our organisation?’ I said I have plenty of loyalty to the patients, but what they wanted to know was what corporate loyalty I had to the individual trust. The aim of my suspension was to break our union, but now we have seven more Unison stewards than at the start. The fight to stop staff cuts in our service, the campaign that led to my suspension in the first place, has been won – the managers have conceded they will keep the original staffing levels.

During the campaign you brought in many activists from the Trade Union movement and the left. How was this achieved?

One of the first things we recognised was that we needed to mobilise political pressure from the outside. There was a deliberate strategy of including trade unionists and service user groups and networks. We have fought to get users heard. They overcame the stigma of mental illness and have been articulate in their defence of the service. We made an effort to write to every Unison branch to pass information on and particularly helpful were the CWU and RMT unions who made donations to the campaign and invited us to speak at their meetings.

Regarding the NHS in general what would you say are the key issues?

One of the key problems is the tendering process. It identifies areas of work, for example, hip replacement operations and parcels them off. The idea is to create a competitive market within the Health Service. South Manchester Psychiatric Unit is run by a Private Finance Initiative that uses a private contractor to clean the ward and it costs the NHS four times what it did when the work was in-house. Also more of the work is target-driven.

As an NHS employee how would you say working conditions have changed during your career?

When I started 25 years ago we provided a service to patients. Now targets are the be all and end all and we can no longer prioritise in terms of need. On the other hand 25 years ago nurses’ wages were worse because they were less unionised. But with this slight improvement in wages has come a greater workload. The pace is unrelenting. For example occupancy rates are much higher. Now there are 20 beds for 24 or 25 patients with occupancy rates at 120 per cent to 130 per cent. This leads to stress amongst the staff and patients.

Would you recommend a job in the Health Service to people?

I love the work and the people I work with are fantastic. If you do a job that is helpful to others it is generally more satisfying. But more time is spent filling out forms and battling bureaucracy. I would say ‘do it’ but you’ll have to fight your corner.

Michael Moore’s documentary Sicko gave an overview of what a privatised health system looks like in the US, is that something that could happen here?

Nothing is automatic about the NHS. People who fought in the Second World War weren’t prepared to go back to the provisions available in the 1930s. Unlike the Tories, this government dresses up privatisation in complicated proposals. They don’t say they will privatise it but they are in effect creating a market – they’re saying that 15 per cent of the Health Service should be outside the NHS. Not only has the NHS management chosen private operators to run aspects of the service but now private companies are set up to do this on their behalf.

The Insanity of Biofuels

tim — Mon, 12 May 2008 23:47:21 +0000

There is something obscenely ironic that whilst the poor starve and struggle over soaring food prices, the rich convert food into fuel so they can carry on driving in their large gas-guzzling vehicles.

The rich world is rushing to invest in biofuels as one of the solutions to climate change. Fuels made from corn, sugar, or maize are seen as producing less carbon dioxide than conventional fuels from oil. As Western nations belatedly struggle to come to grips with the daunting challenge of radical reductions in climate changing gases, biofuels offer a theoretical solution.

What biofuels conveniently mean for America and Europe is that they can carry on driving and flying, thinking they have a clean conscience over climate change. Such is their appeal that last year the US Congress mandated a fivefold increase in their use. Europe, too, is committed to raising the share of biofuels in transport from current levels of around 2% to at least 10% by 2020.

The only problem for those who support biofuels is that despite this rush, never a week goes past without further evidence of their harmful effects. These range from rainforest destruction to being partly to blame for rising food costs.

In March, the Nobel Peace Prize winner and chair of the UN Intergovernmental Panel on Climate Change, Rajendra Pachauri was the latest in a long line of people who warned of the problems of biofuels.

Speaking at the European Parliament, he said “We should be very, very careful about coming up with biofuel solutions that have major impact on production of food grains and may have an implication for overall food security.”

Pachauri warned that the rush to convert corn to ethanol in the US was having an adverse knock-on effect on the agricultural sector. A fifth of the US’s corn crop is now used to brew ethanol for motor fuel. As farmers rush to plant corn, the acreage of other crops, particularly soybeans, has been cut. The rocketing demand for corn has also meant the price has gone up. Ironically other critics argue that the process of converting corn into ethanol actually releases more carbon dioxide per gallon than simply burning conventional fuels.

Then last month, Pachauri’s warning was followed by both the Bolivian President Evo Morales and President of Peru, Alan Garcia, who said using land for biofuels was putting food out of reach for the poor. They were responding to Brazil’s President Luiz Inacio Lula da Silva who had tried to dismiss claims that biofuels are responsible for the recent rise in global food prices.

Also last month, the UN’s special rapporteur on the right to food, Jean Ziegler, did not mince his words when blaming biofuels for making the poor starve. “This is silent mass murder,” he said. Last year he said biofuels were “a crime against humanity.”

As the politicians squabble over whether biofuels are to blame for rising food prices, the poor continue to starve and the price of food becomes ever more expensive. Global food prices have increased by 83 percent in the last three years, according to the World Bank. As basic food staples become too expensive to buy for millions, anger has spread rapidly. At least six people were killed in riots over food prices that contributed to the dismissal of Haiti’s prime minister last month. Millions are struggling to survive on the island after food prices have increased 45 percent since the end of 2006.

In Africa, there have been riots in Ivory Coast, and Senegal and Egypt where the military is assisting baking bread. In Mozambique some six people were killed and in Cameroon an estimated 100 killed in protests linked to the food prices. In Burkina Faso, where there were also riots in February over food, the unions have now called for a general strike. In South Africa, there have been protest marches.

Meanwhile in Asia, fifty people were injured after factory workers protested against the food rises near Dhaka. Indonesia has also seen protests, whereas Vietnam has seen panic buying. Pakistan has reintroduced some rationing, while India has banned the export of most rice. The ruling coalition in Malaysia was very nearly ousted by voters who cited food as one of their major concerns. Last week, the Philippine government said it was introducing “rice access cards” for help the poor buy grain.

In Latin America, there have been riots in Mexico, whilst farmers went on strike for three weeks in Argentina. In Peru, farmers blocked key road links. In Europe, Russia, which has seen a six per cent increase in food prices since the beginning of the year, has been forced to freeze the price of milk, bread, eggs and cooking oil.

Coupled with rising oil prices, rising food prices are creating global tension. “This is a perfect storm,” President Elías Antonio Saca of El Salvador told the World Economic Forum on Latin America in Cancún, Mexico last month. “How long can we withstand the situation? We have to feed our people, and commodities are becoming scarce. This scandalous storm might become a hurricane that could upset not only our economies but also the stability of our countries.”

Other voices agree the situation is getting critical. Earlier this month, Ban Ki-Moon, the UN Secretary General warned that the global food crisis could have grave implications for international security, economic growth and social progress. “If not handled properly, this crisis could result in a cascade of others and become a multidimensional problem affecting economic growth, social progress and even political security around the world,” Ban told a conference in Ghana.

Last week, Ban Ki-Moon went further, saying that the UN was setting up a special task-force to address the food shortages, which was designed to avert “social unrest on an unprecedented scale”. Ban said “The first and immediate priority, that we all agree, is that we must feed the hungry”.

A second priority should be to ban biofuels that could be used for food crops. The inescapable fact is that biofuels are partly to blame for the rising food costs. The International Food Policy Research Institute in Washington argues that biofuel production accounts for a quarter to a third of the recent increase in global commodity prices. The UN Food and Agriculture Organization of the United Nations comes up with a slightly smaller figure of biofuels being responsible for between 10 to 15 percent rise in food.

So concerned was it over biofuels impacts that last month, the European Environment advisory panel urged the EU to suspend its 10 per cent goal by 2020. The panel, made up of some of Europe’s most prestigious climate scientists, called the 10 percent target “overambitious” whose “unintended effects are difficult to predict and difficult to control.” Laszlo Somlyody, the panel’s chairman and a professor at the Budapest University of Technology and Economics said: “The idea was that we felt we needed to slow down, to analyze the issue carefully and then come back at the problem.”

Rather than slow down, countries in the EU are speeding up. In Britain, new legislation passed last month means that all gasoline must contain at least 2.5 per cent biofuel. The same day that the legislation was passed, one of Britian’s most respected conservation charities, the Royal Society for the Protection of Birds, condemned the law as “over-hasty” and “utter folly”.

The situation is now getting even more ironic. As many simply cannot afford to eat, the rich world is now squabbling over the huge subsidies it gives its biofuel producers to produce more biofuels. Last week, European biodiesel producers triggered the prospect of a new transatlantic trade war by urging the EU to impose penalties on “unfair” biofuel subsidies from the US.

The subsidy allows US exporters to undercut European rivals by up to a quarter. The subsidy system is also being exploited by ruthless commodity traders, who are actually adding to climate change.

Known as “splash and dash” within the industry, the legal trick makes a mockery of the purpose of biofuels, which are meant to reduce emissions of carbon dioxide. The biofuel is being needlessly shipped from Europe to the US and then back again. The traders buy biodiesel on the European market and then ship it to the US. There it is “splashed” with gasoline which means that conventional gasoline is added to the biodiesel so that traders can qualify for the export subsidy. Then the cargo is “dashed” or shipped back to Europe and resold at a subsidized price which then undercuts European producers.

Peter Power, a spokesman for EU Trade Commissioner Peter Mandelson, said “We will not under any circumstances tolerate unfair trade.” The EU and US are now threatening to take their argument to the World Trade Organisation.

It is also beyond irony that as they say they will not tolerate trade that is unfair to their own industries, they seem content to tolerate the fact that millions of people are slowly dying of hunger….

Unhealthy Influence

eddie — Sat, 10 May 2008 13:41:56 +0000

As MPs on Thursday question former Health Minister, Lord Warner, over his lobbying activities, the Alliance for Lobbying Transparency (ALT)[i] calls for the system for monitoring the revolving door between Westminster, Whitehall and business to be radically tightened.

Lord Warner, who currently holds paid jobs with 7 private sector companies, many in the health field, has been called to give evidence to the current inquiry into lobbying alongside former Sports Minister Richard Caborn MP, who is a paid consultant to nuclear services company Amec[ii], and Stephen Haddrill, Director General of lobbying body the Association of British Insurers (Thursday 8 May 2008).[iii]

Lord (Norman) Warner was until December 2006 Health Minister with responsibility for NHS delivery, which included overseeing the troubled NHS IT programme. A member of the House of Lords, his current, paid private sector jobs include:

· Non-executive Chairman of UK HealthGateway, a company which aims to facilitate private contractors’ access to NHS contracts

· Adviser to Xansa, a technology firm, and Byotrol, an antimicrobial company, which both sell services or products to the NHS

· Adviser to DLA Piper, which advised Ministers on the £12billion NHS IT project

· Part-time adviser to professional services company, Deloitte

· Adviser to private equity investment group, Apax Partners.

Lord Warner is just one of a number of former Department of Health officials to have recently gained employment in the private sector. These include:

· Former Health Secretary Patricia Hewitt landed two paid jobs with Boots and a company that owns 25 private hospitals earlier this year.

· Former Health Minister Alan Milburn MP is a paid member of the Lloyds pharmacy’s Healthcare advisory panel, and Pepsico’s nutritional advisory board.

· Former Public Health Minister Melanie Johnson became an advisor to the lobbying organisation, the Association of the British Pharmaceutical Industry in 2006.

While all Ministers have to consult the Advisory Committee on Business Appointments prior to taking a job in the private sector, the system has come in for much criticism for reasons including the limited time banning them from lobbying Government, and the lack of checks on whether former ministers and senior civil servants are following the advice of the committee regarding restrictions on lobbying.

Prof David Miller of SpinWatch, a member of the Alliance for Lobbying Transparency said: “There is a now a real need for the public to know in whose interests officials are working – the public’s or those of the businesses who hire them. Across all sectors, the revolving door is clearly out of control and a longer ‘cooling off’ period urgently needs to be introduced. If we are to protect services like the NHS, we need tougher rules to ensure that companies are not given privileged access to Government and that any lobbying by them is out in the open.”

For further information please contact Tamasin Cave on 07973 424 015; tamasin@SpinWatch.org. Alliance for Lobbying Transparency website: www.lobbyingtransparency.org

involNotes to editors

[i] ALT is an alliance of civil society groups who are concerned about the growing influence of lobbying on decision-making in the UK. It is campaigning for the regulation of lobbyists, and improved ethics regulation for politicians and public officials to raise standards and restore public trust in decision-making. www.lobbyingtransparency.org

ALT’s key demands are:

· A mandatory public register of lobbyists, with full financial disclosure

· Enforceable ethics rules for all lobbyists

· Enhanced rules on ethics for politicians and public officials on the so-called ‘revolving-door’ syndrome between lobbyists and public bodies; and to halt privileged access to decision makers.

Current members of the Alliance for Lobbying Transparency are: Action Aid; Campaign Against Arms Trade; Campaign for Press and Broadcasting Freedom; Corporate Watch; Enough’s Enough; Friends of the Earth; Greenpeace; National Union of Journalists; Pesticides Action Network; Platform; SPEAK Network; SpinWatch; Unlock Democracy; War on Want; and World Development Movement.

[ii] According to the Register of Member’s Interests, Richard Caborn MP is paid up to £75,000 for his role as a consultant to Amec.

[iii] The current Parliamentary inquiry into lobbying is being conducted by the Public Administration Select Committee. For details, visit: http://www.parliament.uk/parliamentary_committees/public_administration_…

The Great Consolidation

Ellie Keen — Tue, 29 Apr 2008 20:49:50 +0000

Everything is getting bigger and further away. Hospitals, post offices, schools and prisons are being “rationalised” and “consolidated”. The government says that this process improves efficiency. Instead, it outsources inefficiency: we must travel further to use public services. This is bad for the environment, bad for community life, bad for universal provision. But we haven’t seen anything yet. We are about to be confronted with the biggest shutdown of all: the government has started the process of closing England’s network of doctors’ surgeries.

If you know nothing of this, don’t blame yourself. The announcement was buried in an interim report published last October by a health minister(1). The report was 52 pages long, and the policy was explained in a single paragraph on pages 25 and 26. Rather than being brought before parliament, it was released four days before MPs returned from their recess. Since then there has been no further public announcement. But in December the Department of Health sent a letter to all the strategic health authorities in England, demanding that the policy be implemented immediately(2). The greatest transformation in the history of the NHS is taking place without public debate, public consent or formal consultation.

The government’s policy is to consolidate doctors’ surgeries into a series of giant health centres or polyclinics. Thousands of small practices will be closed and patients will be processed in buildings containing up to 50 GPs. The new clinics will also house some services currently provided by hospitals, which allows the government to claim that it is bringing healthcare “closer to home”. The net effect will be a massive reduction in convenience.

The policy was launched by Ara Darzi, a colorectal surgeon who has been raised to the peerage and made under-secretary of state for health. He wrote his interim report in three months, during which he claims to have spoken to thousands of people. But it contains no record of who they are, how they were selected or what their answers were: he reveals only that “their views have helped shape this interim report.”(3) His final report will not be published until June, but the Department of Health has instructed England’s primary care trusts (PCTs) to advertise for bidders for the new polyclinics by May 2008(4): the first notices have already been posted in the Health Service Journal.

During a parliamentary debate launched by the Conservatives last week, Alan Johnson, the secretary of state for health, claimed three times that this policy is not being imposed on primary care trusts. “There is no national policy,” he said, “for replacing traditional GP surgeries with health centres or, indeed, polyclinics”; “we are not specifying polyclinics as any part of the exercise”; “[the Tories say] we are imposing a system of polyclinics throughout the country. We are not.”(5) Three times, in other words, he misled the House. The letter sent by the Department of Health in December ordered that “each PCT will be expected to complete procurements during 2008/09″(6). In a parliamentary answer in Febrary, the health minister Ben Bradshaw confirmed that “every PCT in the country will be procuring a new … health centre during 2008-09.”(7) A press release published by the Labour Party on April 15th confirmed that the new health centres would be built “in every town and city.”(8) I hope MPs demand that Alan Johnson apologise to parliament.

Lord Darzi insists that polyclinics will offer “a more personalised service”(9). This is nonsense: in the huge new centres we are less likely to be able to see the same GP and more likely to get lost in the system. A recent paper in the British Medical Journal reveals that “patients in small practices rate their care more highly in terms of both access and continuity” and that small practices “achieved slightly higher levels of clinical quality than larger practices”(10). The new centres will be built not where they are most convenient for patients but – as Darzi revealed to the Commons health committee – where the NHS happens to own land(11). If you live in a village or a distant suburb and depend on public transport – as many elderly and sick people do – visiting the doctor could take all day. Ara Darzi is the new Dr Beeching, shutting down the branch lines of our primary health service.

So why is this happening? In seeking surreptitiously to privatise healthcare, the government has a problem. Primary care is already in private hands: GPs run their own practices. But they are the wrong hands: the corporations demanding guaranteed streams of income from the taxpayer can’t play. Polyclinics are perfectly designed to let them in, while preventing doctors from competing.

It’s not just that GPs can’t raise the capital; because the contracts are much bigger than ordinary practices’ and involve many different services, the tendering process is expensive and fiendishly complex. The big service companies can produce the same bid for any number of clinics: they need spend their money only once. The Department of Health says that primary care trusts should use a type of contract called Alternative Provider Medical Services(12), which is designed to allow corporations to bid. This is not a public-private partnership: it is the outright privatisation of primary healthcare.

Do I need to explain the implications? The US health system, which the British government seems determined to emulate, is both more expensive and less efficient than ours; those who can’t afford to pay are either excluded or treated like battery pigs(13). The independent sector treatment centres (ISTCs) – private clinics performing routine operations for the NHS – that the government introduced in England in 2003 have been a costly disaster. Private companies receive their money whether or not they carry out the work they are contracted to do. The government refuses to release comparative figures, but the little evidence we have suggests that their costs are much higher than the public sector’s(14). The risks have been transferred back to the taxpayer and in some cases the standards of treatment are appalling. In 2006 Angus Wallace, professor of orthopaedic and accident surgery at Nottingham University, told the Guardian, “We expect failures of hip replacements at approximately 1% a year and knees at about 1.5% a year. But we have got some of the ISTCs that are looking at 20% failure rates.”(15) Because they put profits first, companies that run these centres have generated a stack of litigation claims and a huge NHS bill for repairing the damage they have caused(16). Far from reversing its policy in the light of this evidence, the government is setting up a competition panel, to ensure that the health service never discriminates in favour of the public sector when awarding contracts(17).

Did any of us ask for this? Are there crowds on the streets demanding the privatisation of the NHS? Even the Tories, for God’s sake, have come out against it: David Cameron’s speech last week placed them to the left of Labour(18). Why, after the 60-odd consecutive quarters of growth that Gordon Brown keeps boasting about, can he not maintain a public service founded in the midst of poverty and rationing? What mysterious hold on policy do the corporations possess, that they can persuade this government to wreck Labour’s finest achievement and damage its chances of re-election?

www.monbiot.com

References:

1. Ara Darzi, October 2007. Our NHS, Our Future. NHS Next Stage Review: Interim report. National Health Service. http://www.ournhs.nhs.uk/

2. Ben Dyson, Commissioning and System Management Directorate, Department of Health, 21st December 2007. Letter to SHA Directors of Commissioning.

3. Ara Darzi, ibid, p3.

4. Ben Dyson, ibid, para 14.

5. http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080423/debt…

6. Ben Dyson, ibid, para 5.

7. http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080229/text…

8. The Labour Party, 15th April 2008. NHS on your side. http://www.labour.org.uk/nhs_on_your_side,2008-04-15

9. Ara Darzi, ibid, p30.

10. Martin Roland, 22nd March 2008. Assessing the options available to Lord Darzi. British Medical Journal, vol 336, pp625-626. doi:10.1136/bmj.39510.702234.80

11. Professor Lord Darzi of Denham KBE, 25th October 2007. Minutes of Evidence taken before the House of Commons Health Committee. Answer to Q94. http://www.publications.parliament.uk/pa/cm200607/cmselect/cmhealth/uc11…

12. Ben Dyson, ibid, Annex A.

13. During the Commons debate last week, Richard Taylor MP cited two recent papers about the failures of the US medical system, published in the BMJ and the New England Journal of Medicine. http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080423/debt…

14. Allyson M Pollock and Sylvia Godden, 23rd February 2008. Independent sector treatment centres: evidence so far. British Medical Journal, vol 336, pp421-424. doi:10.1136/bmj.39470.505556.80

15. Quoted by Sarah Boseley, 1oth March 2006. NHS forced to fix bungled private sector hip replacement operations. The Guardian.

16. See also Stewart Player and Colin Leys, April 2008. Under the knife. Red Pepper magazine.

17. Nicholas Timmins, 16th March 2008. NHS providers to win right of appeal. Financial Times.

18. David Cameron, 21st April 2008. Speech on Primary Care.
http://www.conservatives.com/tile.do?def=news.story.page&obj_id=143765&s…

Deaths in Detention

Ellie Keen — Fri, 18 Apr 2008 21:14:15 +0000

‘When I calmed down I asked them why they hit me in the nose and jumped on me. They said it was because I wouldn’t go in my room so I said what gives them the right to hit a 14 year old child in the nose and they said it was restraint.’

These poignant words were written by Adam Rickwood who was found hanging in his room at Hassockfield Secure Training Centre in August 2004 – at 14 he was the youngest child to die in custody. Hours before his death, he had been subject to restraint by four male officers including the use of a technique designed to inflict pain known as ‘nose distraction’ and which caused his nose to bleed for an hour. His death followed that of Gareth Myatt a mixed race 15 year old boy who was killed at Rainsbrook STC on 19 April 2004 during the application of physical restraint methods which continued despite Gareth complaining he could not breathe, that he was going to defecate, did defecate, and then vomited. He died from asphyxia and was the first child to die following the use of restraint.

What became clear from the inquests in 2007 was the complete failure of the Youth Justice Board to properly manage the circumstances in which physical restraint was used and the safety and appropriateness of the techniques used. INQUEST has worked closely with the families and their legal team to brief parliamentarians, other child rights and penal reform organisations and the Children’s Commissioner on the human rights abuses these cases exposed resulting in widespread public, parliamentary, and media concern about the treatment of children in custody.

After the conclusion of the inquest into Gareth Myatt’s death the Coroner, His Honour Judge Pollard made a report to Rt Hon Jack Straw MP, Secretary of State for Justice and Lord Chancellor, under Rule 43 (of the Coroners’ Rules). Following extensive consultation with the family’s lawyers, the report specified 34 preventative actions which range widely over the treatment of children, the use of restraint, monitoring, good practice, access for emergency vehicles, and inspection saying that it would be ‘wholly unforgivable and a double tragedy’ if there was any delay in learning from and acting upon the lessons of Gareth’s death. This followed the scathing narrative verdict reached by the inquest jury which implicated failures by the Home Office/Ministry of Justice and Youth Justice Board in the death.

The government’s abiding lack of will to engage with the serious and wide-ranging failures to emerge from the tragic deaths is reflected by unjustified and undemocratic amending of the Secure Training Centre Rules. This broadened the circumstances in which children can be forcibly restrained without parliamentary debate or consultation.

Instead, in July 2007, the government announced a joint review of the use of restraint in STCs, Young Offender Institutions and Local Authority Secure Children’s Homes. This review is an inadequate response to the broader systemic issues these deaths raise about how we deal with children in trouble with the law. A proper legacy for these families and their children would be an independent, holistic enquiry in public of the juvenile justice system with the effective participation of families, children, and those working within the youth justice system. Such an enquiry could effect meaningful change by moving us towards a more humane and safer society – and by preventing future child deaths. We fervently believe that there can be fewer goals which are more important.

INQUEST has been calling for such an enquiry since the death of 16 year old Joseph Scholes in HMYOI Stoke Heath in 2002. He was a vulnerable boy with a history of self-harming behaviour who, despite the expressed concerns of professionals with whom he was engaged and clear warnings by himself, took his own life, by hanging, in his prison cell just nine days into his sentence.

At the time of writing, we learned of the death of a 15 year old boy found hanging in HMYOI Lancaster Farms. Why, despite the deaths of 30 children in detention since 1990, have successive governments resisted a public enquiry? The deaths raise issues that go beyond the prison walls and to the heart of society’s collective responsibility for tolerating a system that responds to challenging children and young people with punishment and the infliction of pain to control behaviour.

What often goes unmentioned is the high price paid by bereaved families in remaining involved in the lengthy, complicated investigation and inquest process. The families have shown incredible courage, diligence, and persistence to ensure that the disturbing issues surrounding the deaths of Gareth and Adam came to light. Without their participation in the process, it is doubtful that these hidden practices within STCs would have been exposed to any proper scrutiny.

While these two deaths are deeply shocking because they involve children, INQUEST deals on a daily basis with some of the most horrendous consequences of detention in prison, in police custody or in psychiatric detention.

Last year, INQUEST published Unlocking the Truth: Families’ Experiences of Investigation of Deaths in Custody that documents some of the unseen consequences of deaths in detention – the impact of a death and its investigation on the family of the deceased and the lack of adequate mechanisms to ensure similar deaths are prevented.

INQUEST has consistently worked alongside families to build up relationships of trust, respect, and compassion so that the families feel empowered and engaged, and feel they can cope with the intrusive and complex legal process in which they are involuntarily engaged. The strategy of persisting in trying to broaden scope of enquiry at inquests, supported by detailed knowledge of other cases and an experienced network of lawyers, has ensured that the details of many deaths in custody are made public.

Establishing the truth about deaths in custody sheds light on the way we treat some of the most vulnerable men, women, and children in society. It is important that we recognise, scrutinise, criticise, and argue for reform of the way the state deals with deaths in custody, as these processes are an indicator of the condition of its democracy.

Last year, of the 45 inquests that have concluded on INQUEST’s cases, many after delays of years since the death, four have involved deaths in psychiatric detention, six police custody, and 35 deaths in prison. Many of these inquests have been unreported, not even deemed worthy of a couple of lines in the local media. But they reveal, again, shocking failures in the treatment of vulnerable detainees. Inquests into deaths in police custody have highlighted ongoing concerns about the poor treatment of people with mental health problems, drug and alcohol problems, and poor medical care.

Running through INQUEST’s work are concerns about the lack of accountability and failure to learn lessons to prevent similar deaths by taking follow up action on inquest and investigation outcomes across custodial institutions. We worked with others to successfully achieve amendments to the Corporate Manslaughter and Homicide Act 2007 to ensure it would apply to deaths in detention. The government attempted to present the current mechanisms of investigation and accountability as sufficiently robust. Parliament disagreed, and this was further underlined when the Forum on Deaths in Custody published its Annual Report in September 2007 in which the number of deaths in all forms of custody in the preceding year were officially collated and published centrally for the first time. These figures need more scrutiny and analysis than the Forum can provide, in particular the 328 deaths in psychiatric detention.

It does not have the capacity to research deaths in custody, to collate and analyse jury findings and coroner’s reports or to monitor the implementation of recommendations arising from inquests or investigation reports. It cannot call to account and recommend action against those institutions and individuals who fail to take action. In May 2007, the government conceded that the Forum’s powers and resources were insufficient and made a commitment to reviewing and strengthening the current arrangements, something which is ongoing.

INQUEST has proposed a properly resourced independent overarching Standing Commission on Custodial Deaths with statutory powers to address the complexity and breadth of issues that arise. It is clear that the current mechanisms are insufficient as death after death occurs revealing horrific conditions and lack of basic humanity in the care of detainees. In November 2007, the inquest into the death of 25 year old Martin Green, who died in HMP Blakenhurst in July 2002, concluded with the jury returning a highly critical narrative verdict. Found dead in his cell in the health care centre while undergoing detoxification, Martin, who was 188 cm (6 ft 2 in) tall, weighed just 43 kg (6 st 10 lbs). The jury made numerous criticisms in their verdict, and concluded that his poor medical state coupled with poor assessment, planning, and communication contributed significantly to his death.

The shocking fact of this case, the lack of media interest in the inquest, and the delay of nearly five years in concluding the investigation make a mockery of the government’s arguments earlier last year that current investigation mechanisms are sufficient, further illustrated by the last-minute ditching of the promised coroners reform bill. The circumstances of this death raise very serious questions about the quality of medical care afforded prisoners in the custody and care of the state. Martin Green was owed a particular duty of care, and that duty was not met. As a result, he died an inhuman and degrading death.

The number of custodial deaths remains far too high, and many cases reveal a horrendous catalogue of failings in the treatment and care of vulnerable people in custody or otherwise dependent on others for their care. They raise questions about excessive and inappropriate use of custody for some of the most vulnerable people in society; they also highlight failures to fulfil the state’s duty to protect life. Inquests repeatedly identify the failure to implement existing guidelines on the care of ‘at risk’ detainees.

It is clear from INQUEST’s monitoring and analysis of deaths in custody that understanding why these deaths occur requires an examination of their broader social and political context. No discussion of self-inflicted deaths in prison can ignore the regimes and conditions operating in prisons, criminal justice policies that imprison the mentally ill and vulnerable or the institutional culture of violence and racism that exists there.

Deborah Coles and Helen Shaw are co-directors of INQUEST.
http://www.inquest.org.uk

Simon Jones' Story Repeated

Ellie Keen — Mon, 14 Apr 2008 22:31:02 +0000

A decade since the death of Simon, we look back on the campaign to bring Euromin to justice. Simon was well known in the Brighton community – as well as a writer for SchNEWS – and it was this community who combined with his family to mobilise and form the Simon Jones Memorial Campaign…

In 1998 Simon Jones was sent to one of the most dangerous jobs in the country, one he had no training for. Simon had been killed by a profiteering gangster, James Martell, whose company, Euromin, ran the dock where he died. Complicit to the crime were the employment agency Personnel Selection which sent him to his death without any checks or references.

On 1st September 1998, which would have been Simon’s 25th birthday, the Simon Jones Memorial Campaign went into action. Thirty protesters shut down the dock where Simon was killed, climbing two 80-foot towers with banners reading “Simon Jones RIP” and “Casualisation Kills”.

That evening, a packed meeting in a Brighton pub decided it couldn’t stop there. “A lot of the people at the meeting had casual jobs,” said Emma, Simon’s girlfriend at the time of his death. “People were furious that employment agencies could get away with taking half your wages without even making sure the job they sent you to was safe.” Two days later Personnel Selection was occupied and a “Murderers” banner hung from its window.

In March 1999 the MP George Galloway gave a speech in parliament calling for the prosecution of Euromin over Simon’s death. Afterwards campaign supporters occupied the Department of Trade and Industry’s offices – those supposed to regulate employment agencies.

The campaign kept up the pressure by targeting the Health and Safety Executive a few weeks later. But this time security guards were waiting for an attempted occupation – and looked on while thirty members of the campaign turned round, walked onto Southwark Bridge and blockaded it for three hours.

The result of the campaign was a complete climb down by the state. The Crown Prosecution Service had refused to prosecute anyone over Simon’s death all along. In March 2000 two High Court Judges ordered the CPS to reconsider this decision – the first successful judicial review of a decision not to prosecute for manslaughter over a workplace death in British legal history. The judges described the CPS as behaving “irrationally”, “failing to address the relevant law” and adopting an approach that “beggared belief”. They told the CPS to review its decision “with dispatch”.

Nine months later, after a spirited picket of the CPS where a campaign supporter was arrested and locked up for demanding someone who had killed his mate got arrested and locked up, the CPS finally agreed to prosecute.

The trial of Simon’s killers took place in November 2001 and resulted in conviction on health and safety charges but aquittal on the charge of manslaughter. Following the verdict the campaign issued a statement saying:

“We are painfully aware that in 21st century Britain the fight for the most basic of workers’ rights – the right not to be killed or injured at work – is still being fought. Without direct action James Martell and Euromin would never have faced prosecution in the High Court for Simon’s death. As long as this government and its agencies refuse to take action against companies that profit from casualisation at the expense of their workers’ lives we will continue, where necessary, to break the law so that justice will prevail.”

Simon Jones Memorial Campaign www.simonjones.org.uk

Under the Knife

Ellie Keen — Sun, 06 Apr 2008 19:02:01 +0000

Tom Nairn recently described parliament as ‘a dry-rot infested ruin where one shame succeeds another’. Decay appears to be spreading rapidly. The speed with which former health secretary Patricia Hewitt, and the former health minister Lord Warner, have transferred their services to private healthcare companies appears less and less shocking. It’s not simply the snouts-at-the-trough aspect that is of concern. What their actions show is that the advance of private healthcare at the expense of formerly public provision is sufficiently entrenched to make them confident of a lucrative future.

It should make what is happening clearer to the public too. Since 2000, the year of the NHS Plan, a central feature of government policy for the NHS has been the concealment of its real trajectory. At the acute healthcare conferences organised annually by private healthcare analysts Laing and Buisson, for example, ministers and top civil servants have for several years given detailed policy briefings to companies on new private sector healthcare opportunities, while Hewitt was constantly assuring journalists that NHS privatisation was ‘out of the question’.

Creeping privatisation

Nowhere has concealment of the government’s real aims been more rigorously applied than in the independent sector treatment centre (ISTC) programme. Ostensibly designed primarily to harness additional capacity from the private sector to reduce waiting times for elective (non-emergency) operations such as knee replacements and cataract removals, privately owned ISTCs – 23 of them, spread across England, plus one in Scotland – have in reality served as a bridgehead for market penetration of the NHS, the first time that NHS surgical care has been systematically handed over to for-profit providers.

So far this has meant ensuring adequate and financially risk-free levels of clinical activity, encouraging companies to set up in business to compete with NHS hospitals and treatment centres. It also involves significant and ongoing transfers of NHS staff. But because the NHS remains one of the most popular institutions in the country, replacing public with private services involves enormous political risk. How many MPs – including Conservatives, at least in marginal seats – would be prepared to declare that NHS treatment should increasingly be handed over to private companies, like the railways? Managing and mitigating that risk involves a wide array of mechanisms.

A key example is an exercise in spin called ‘integration’. In reality the only way the private ISTCs can carry out the number of elective procedures they have contracted to provide is to have NHS staff transferred to them. Originally, because they were supposed to bring in ‘additional capacity’, they were not allowed to employ anyone who had worked for the NHS in the previous six months. This rule was repeatedly diluted, either through secondment of NHS staff, or by applying it to an ever-shrinking number of specialties.

By September 2007 ISTCs could use NHS consultants for almost all surgical procedures. A key method in enabling this change has been calls by various bodies, notably the BMA consultant committee leadership, and the Healthcare Commission, to integrate ISTC facilities with those of NHS hospitals in the interests of patients.

While the overall threat of NHS privatisation is denounced, measures to ensure that NHS staff are transferred to the new private employers are supported. For example, the BMA’s Dr Paul Miller told a 2005 BMA conference that ‘as things stand, I would not accept an MRI scan or elective surgery from these ISTCs’ – yet the leadership firmly resisted a motion opposing the centres, arguing that ISTCs could bring about ‘a sustainable expansion of capacity’ and that NHS consultants should be allowed to work in them. A year later, commenting on the health committee’s report, Miller stated: ‘For the last three years, the BMA has been shouting from the rooftops about its concerns regarding ISTCs. I am particularly pleased to see the committee agrees that the Department of Health needs to go further in enabling NHS doctors to work and train in ISTCs, as I believe this will benefit standards and integration of patient care.’

Revolving doors

Political risk has also been managed through the development of a ‘policy community’ of insiders committed to marketisation. The rapid interchange of personnel between government and the private sector – policy makers, management consultants, and healthcare company executives – has been particularly glaring in health policy circles.

The example of Tony Blair’s senior health policy adviser, Simon Stevens, who left to become president for Europe of the giant US company UnitedHealth, is well known. Another example is the former special adviser to both the prime minister and the health secretary, Darren Murphy, who became director of corporate lobbyists APCO UK. APCO’s clients rapidly came to include all the companies involved in the ISTC programme. By February 2006 these companies had formed an ‘NHS Partners Network’, under the aegis of APCO, and had a meeting with Tony Blair where they were warmly welcomed into ‘the NHS family’.

Tom Mann, formerly head of the Department of Health’s ‘national implementation team’ which imposed the first ISTC contracts on sometimes highly reluctant primary care trusts, subsequently became chief executive of Capio, which won a large number of these contracts. Patricia Hewitt’s defection to the healthcare venture capital group Cinven, which now owns Bupa’s former hospitals, and Lord Warner’s to the health insurer AXA PPP, are only the latest in a long line. And within the NHS itself a new ‘national leadership network’ has been formed, consisting of some 150 ‘clinicians and managers from partner organisations’ (i.e. including the private sector) to provide ‘collective leadership for the next phase of transformation, advise ministers on developing policies … and promote shared values and behaviours’. What these values and behaviours are is kept secret. Access to the network’s webpage is restricted to its members, and publications, resources and contacts are all password-protected.

Concealing data

These restrictions are a good example of another key means of limiting political risk – information control. Such control was particularly sensitive in relation to the quality of operations done in the private centres. The first official quality assessment of ISTCs, carried out in October 2005 by the National Centre for Health Outcome Development (NCHOD), found that poor data returns rendered ‘any attempts at commenting on trends and comparison between schemes and with any external benchmark futile’.

The one direct indicator of clinical outcomes at ISTCs had been completely ignored. This did not stop Lord Warner declaring that the NCHOD’s report provided ‘heartening’ evidence of a ‘robust and comprehensive quality assurance and reporting system’. A further study was undertaken by the Healthcare Commission, but in July 2007 it had to report that the necessary information was still lacking. Yet the data concerns NHS patients, whose health and lives are at risk.

Concealment would appear to have been essential, as many first-hand reports by NHS specialists on clinical quality in ISTCs have been highly critical. For example, the professor of orthopaedic surgery at Nottingham University, Angus Wallace, told the Guardian in March 2006 that: ‘We expect failure rates of hip replacements at approximately 1 per cent a year. But we have got some of the ISTCs that are looking at 20 per cent failure rates.’ A study by Dr Gordon Bannister, a leading orthopaedic surgeon in Avon, found that 9 per cent of hip and knee replacements carried out at a nearby ISTC had to be reoperated on, compared with 0.6 per cent in the local NHS hospital – in spite of ISTCs being able to select simpler cases. Notably the surgical repair work fell on the local NHS hospitals.

Such results are hardly surprising. Most of the surgeons originally involved in the first wave of ISTCs were brought in from overseas. They were often unfamiliar with NHS surgical techniques, sometimes had language problems, and were under pressure to achieve high levels of productivity. Release of information about their results therefore had to be kept to a minimum. Once sufficient numbers of NHS consultants have transferred to ISTCs the availability of outcome data will no doubt improve.

All these measures to limit political risk show that ministers and their advisers are acutely aware that the risk is real. The counterpart of this is that if the public clearly understood what is being planned, there is an excellent chance that this path to privatisation would have to be abandoned.

Stewart Player’s and Colin Leys’ new book, Confuse and Conceal: the NHS and Independent Sector Treatment Centres, is published by Merlin Press at £10.99

More Like Arbitrary Execution

Ellie Keen — Thu, 20 Mar 2008 21:40:37 +0000

During the period 1972-6, the gap in life expectancy between social classes I and V was 5.4 years for men and 4.8 years for women. By the time New Labour succeeded the Tories in government, these gaps had risen to 9.4 years and 6.3 years respectively. See tables 1 and 3 in:
‘Life expectancy by social class’, UK Government Statistics.

One of New Labour’s purported aims in office was to reduce these inequalities. Health Secretary Frank Dobson stated that “Inequality in health is the worst inequality of all.

There is no more serious inequality than knowing that you’ll die sooner because you’re badly off”; while Tony Blair himself wrote: “Our society remains scarred by inequalities. Whole communities remain cut off from the greater wealth and opportunities that others take for granted. This, in turn, fuels avoidable health inequalities. The statistics are shocking enough. Families in these communities die at a younger age and are likely to spend far more of their lives with ill-health. Behind these figures are thousands of individual stories of pain, wasted talent and potential. The costs to individuals, communities and the nation are huge. Social justice demands action”.

The interim research indicates that Labour have utterly failed in this aim. Examining Labour’s record, the British Medical Journal reported in 2005 that “inequalities in life expectancy have continued to widen” and that “When individual local authority districts are compared, the difference between the one with the lowest life expectancy (Glasgow City) and the one with the highest (East Dorset) has risen to 11 years. Since Victorian times, such inequalities have never been as high” ( ‘Health inequalities and New Labour: how the promises compare with real progress’,British Medical Journal,2005).

This week saw the publication of the third and final edition of ‘Tackling Health Inequalities’, the Department of Health’s own verdict on Labour’s efforts: ( ‘Tackling health inequalities: 2007 Status Report on the Programme for Action’,Department for Health).

It found that “The latest data for 2004–06 show that the relative gap in life expectancy between England as a whole and the fifth of areas with the worst health and deprivation indicators was wider than at the baseline (1995–97) for both males and females… For males, the relative gap is 2% wider than at the baseline (the same as 2003–05) and for females it is 11% wider than at the baseline (compared with 8 % wider in 2003–05)”.

The report also found that among babies born to families in “routine and manual” occupations, the infant mortality rate “was 17% higher than for the total population in 2004–06, compared with 18% higher in 2003–05 and 19% higher in 2002–04. It was 13% higher in the baseline period of 1997–99”. So far from eliminating health inequalities, Labour has in fact succeeded in increasing them.

Inequality, not poverty

Why is this? After all, there has been record investment in the NHS under Labour’s watch. However, as the World Health Organisation’s figures show, the US spends more on health care per capita per annum than any other country in the world ($6096 at 2004 prices), yet life expectancy is only six months greater than Cuba ($229) and five years lower than Japan ($2823), so large-scale expenditure is not in itself enough, particularly if the distribution of that spending is highly skewed.

Much of Labour’s so-called ‘investment’ has in fact simply been a transfer of public funds into private hands, via PFI and other various privatisation initiatives. However, this alone does not explain Labour’s failures.

Current research in the field of epidemiology, centred around Richard Wilkinson and Sir Michael Marmot (a New Labour adviser and author of the preface for the Tackling Health Inequalities report) is increasingly finding that it is inequality, rather than poverty, which is the key determinant of health outcomes once a certain minimum level of income has been passed (Wilkinson postulated around $5000 at 1992 prices: ( ‘Income distribution and life expectancy’,British Medical Journal,1992).

As Marmot puts it: “Autonomy –how much control you have over your life- and the opportunities you have for full social engagement and participation are crucial for health, well- being and longevity. It is inequality in these that plays a big part in producing the social gradient in health… the lower in the hierarchy you are, the less likely it is that you will have full control over your life and opportunities for full social participation. Autonomy and social participation are so important for health that their lack leads to deterioration in health”.

As the Tories redistributed wealth in favour of the rich, so health inequalities increased. Health inequalities are increasing under Labour because this process of redistribution has not reversed, and is, if anything, increasing.

(Gini coefficient, the standard statistical measure of inequality in Britain, 1979 to 2005/6. Source: http://www.ifs.org.uk/bns/bn73.pdf, p19.)

The consequences of this are not trivial. According to the winter 2007 Office of National Statistics figures, Kensington and Chelsea has the highest life expectancy of any local authority in Britain by a distance (83.1 years for men, 87.2 years for women).

By way of comparison, in the lowest ranked London borough, Islington (399th out of 432), life expectancy is 8.2 years lower for men and 7.2 years lower for women; for Birmingham those figures are 7.9 years and 6.7 years respectively; for Newcastle 7.9 years and 6.9 years; for Liverpool 9.3 years and 8.9 years; for Manchester 10.1 years and 8.6 years; and for the lowest ranked local authority, Glasgow City, 12.6 years and 10.2 years (‘Life expectancy at birth & age 65 by local area in the UK, 2004-06’).

Away with excess enemy, but no less value to property

On an even more localised level, within the London borough of Camden, life expectancy in the wards of Kentish Town, and St Pancras & Somers Town is 7.9 years lower than in Belsize ward; within Kensington and Chelsea, life expectancy in St Charles –north of the Westway- is 11.4 years lower than in Courtfield between the Fulham and Cromwell Roads ( Office for National Statistics).

Michael Marmot states in the 2005 textbook Social Determinants of Health that within Glasgow life expectancy in the poorest districts is twelve years lower than in the wealthiest.

It is Richard Wilkinson who best articulates the scale and significance of these phenomena: “We are used to feeling indignation at the human rights abuses in countries where people are imprisoned without trial, or simply disappear, but health inequalities exact a much greater toll. What would we think of a ruthless government that arbitrarily imprisoned all less well-off people for a number of years equal to the average shortening of life suffered by the less privileged in our own societies?

“Given that higher death rates are more like arbitrary execution than imprisonment, perhaps we should liken the injustice of health inequalities to that of a government that executed a significant proportion of its population each year without cause”.