‘Eat more healthily, exercise more and smoke less’ is the message from the government in its White Paper on public health, Choosing health: making healthier choices easier.

It aims to give people the choices to change their lifestyles by tackling the public health issues of smoking, obesity, sexual health, alcohol and mental health.

In introducing the proposals, Prime Minister Tony Blair said:

‘We are clear that government cannot — and should not — pretend it can “make” the population healthy. But it can — and should — support people in making better choices for their health and the health of their families. It is for people to make the healthy choice if they wish to. Choosing health sets out what this government will do to help them.’

New measures in the White Paper include:

• increasing the number of smoke-free workplaces
• curbing the promotion of unhealthy foods to children
• clearly labelling the nutritional content of food
• introducing personal NHS-accredited health trainers
• providing faster access to sexual health clinics
• tackling social and geographical inequalities in health

New funding of £1bn will be used to convert the plans of Choosing health into a reality. It is reckoned that once in place, these policies could save the health service £30bn over the next few years.

The measures in full…

The consultation that led to this White Paper was launched in March 2003 and provided a large response from the public — over 150,000 people made their views known to the Department of Health.

‘People make their own choices about health’ Health Secretary John Reid said, ‘but they have made plain in our consultation that they want the information, advice and support in making their own choices so, we need to ensure that people have the information they require to make properly informed choices; and that they are presented with genuine opportunities and the practical support to make healthy choices.’

Media attention has focused on the plans to ban smoking, with pro-smoking groups claiming the proposals go too far and opponents (including doctors) claiming they don’t go far enough.

‘This goes beyond what the public has said it wants’, said Tim Lord, chief executive of the Tobacco Manufacturers' Association. ‘We are disappointed at this missed opportunity to strike the right balance between sensible regulation and voluntary measures that accommodate non-smokers and smokers alike.’

Cancer Research’s chief executive, Professor Alex Markham remarked:

‘It seems bizarre that the government has accepted the wisdom of a ban but is then happy to deny the benefits of it to people who work in private clubs and pubs where food is not served.’

Last week, Scotland pledged to ban smoking in all enclosed public places by 2006.

The Healthcare Industries Task Force (HITF) has announced its work programme for the medical devices industry. The plan includes:

• modernising device evaluation service (DES) by placing them under the control of the NHS Procurement and Supply Agency (PASA)
• creating a centre to promote innovation in the NHS
• piloting healthcare technology co-operative to act as academic centres of excellence (ie, pioneering specialist treatments and techniques)
• building R&D capacity for medical devices through UK Clinical Research Collaboration (UKCRC)
• improving training and education of NHS staff on the use of medical devices
• maximising the UK’s influence in regulatory matters on the world stage
• creating a focused export strategy
• communicating better with patients on the role of healthcare products
• establishing a data collection system to analyse the industry

The task force was created in 2003 to bring together the medical devices industry and the government.

More children in the UK are being prescribed antidepressants, stimulants and other mind-altering drugs than ever before.

• In 2000 there were 400,000 prescriptions
• In 2002 there were 700,000 prescriptions (a 68 per cent increase)

The nine countries* with the most sales of psychotropic (mood-affecting) drugs to under-17s were studied, with the rise in prescription rates highest in the UK. Many prescriptions are used to treat attention defecit hyperactive disorder.

London University’s centre for paediatric pharmacy research conducted the study. The results can be found in the Archives of Disease in Childhood.

* Argentina, Brazil, Canada, France, Germany, Mexico, Spain and the United States

NHS waiting lists fell during September 2004 by 4,500 to 856,600. This is the lowest figure since September 1987 and the first time waiting lists have fallen nine months in a row.

The number of people waiting over six months for admission has fallen by 100,000 in the last year.

‘By 2008’, health minister John Hutton said, ‘no one will have to wait longer than 18 weeks from GP referral to hospital treatment, and most people will experience much shorter waits, with even quicker access in priority areas such as cancer.’

A further 85 Welsh nurses and pharmacists will start training as supplementary prescribers in January 2005.

They will join the 160 already at work prescribing from special formularies.

Health Minister Jane Hutt said:

'Today’s doctors spend a considerable amount of time treating patients with chronic conditions such as asthma, diabetes, mental health problems and cardiovascular disease, to name just a few. Supplementary prescribing, which allows nurses and pharmacists to prescribe to patients, will help to ease this pressure.

'The Wanless review said that to deliver the best standard of health service we would need to reshape services and encourage new innovative professional roles. Supplementary prescribing is one way in which this is happening.

'Helping health services to be more flexible and responsive will also enable them to respond positively to Health Challenge Wales, the national focus for action to improve health in Wales.'

An overhaul of the Medicines and Healthcare Products Regulatory Agency (MHRA) will distance it from the pharmaceutical industry and make it more transparent.

The measures, which were announced on Thursday by health minister Lord Warner include:

• The MHRA will set up a new Commission on Safety and Efficacy of Medicines to bring together the existing Medicines Commission and the Committee on Safety of Medicines.
• The commission will be structured to include two lay representatives on the committee and patient representatives on every expert advisory group. This is to give patients more involvement in medicines monitoring. Lord Warner comments: 'As patients become more knowledgeable about the healthcare they receive we must also give them the power to advise on the safety and efficacy of their medicine.'
• Tighter rules on board members' interests to ensure advice is kept impartial. Members will also have to declare interests held by their immediate family.
• The MHRA has asked pharma companies to publish their clinical trial data.

The Association of the British Pharmaceutical Industry (ABPI) agrees there is a need for greater transparency and trust in the present system.

It commented that experts on the MHRA already do have to declare their interests and withdraw from discussions where conflict could arise.

It urged the government to guard against rules that prevented the regulator from taking advice from some of the leading experts in medicines.

The association also confirmed that it is encouraging pharma companies to publish their clinical trial results. It has had a website since May 2003 on which member companies can record the clinical trials they have undertaken on UK patients.

'Nevertheless,' comments the ABPI, 'this does require co-ordination on a global basis as international companies carry out clinical trials in many countries. Such coordination takes time, but there is now broad consensus that the voluntary registration process needs to be expanded.'

GlaxoSmithKline launched its own clinical trials register in June this year.

Drawn-out suspensions are costing the NHS £40m each year and leaving staff suffering from depression, skill erosion and lasting career damage.

After finding 30 cases where exclusion lasted more than two years the Commons' public accounts committee made the criticism in a report titled The management of suspensions of clinical staff in NHS hospitals and ambulance trusts. Other findings included:

• The average length of suspension for doctors is 47 weeks
• The average for other clinical staff is 19 weeks
• Exonerated staff may require extensive retraining on their return to work
• A significantly higher proportion of ethnic minority consultants were excluded

The report said that trusts rushed to exclude clinicians with insufficient initial investigations and also failed to make employment checks when recruiting.

It also criticised trusts for stopping investigations if a member of staff resigned — one fifth of trusts did this, meaning that future employers would not be alerted.