The British art of compromise

Joe Gormley, the old miners’ leader, once said: “When you negotiate wi’ employer, we start over here (gestures left), and employer starts over there (gestures right) and then we walk towards each other. The trick is to walk slower than them beggars!”

The implicit assumption of Gormley’s view of negotiation is that reasonable people in conflict will always find an accommodation; a middle ground; be able to split the difference. This appears to be wishful thinking when it comes to the conflict between the food and drinks industries and so-called “public health”. Recent developments in relation to the childhood obesity strategy and the sugar tax, and an apparent softening of the rhetoric in relation to the new low-risk drinking guidelines illustrate this perfectly.

Sugar and spice

In the past week it appears the government’s childhood obesity strategy has been watered down – to the evident outrage of campaigners for whom any compromise is tantamount to a sell-out. The sugar levy remains but as a tax on fizzy drinks producers, rather than retailers. It would have been hard for the government to renege on this because it’s a revenue-raiser announced in the budget, and they’ve pledged to spend the money on school sports. But most of the other measures demanded by “public health” campaigners – regulation to force mass reformulation of products to reduce sugar, salt and fat content; reductions of so-called junk food advertising directed at children; and to limit supermarket promotions on “unhealthy foods” have all been left out of the government’s strategy.

Instead, the government has set out a voluntary approach – for example, asking producers to reduce sugar content by 20% over five years – with the implicit threat of regulation if they don’t. This is similar to Andrew Lansley’s “industry responsibility deal”, in which drinks producers promised and succeeded in removing a billion units of alcohol from the market. In fact they removed 1.2 billion units – and ahead of time. But health zealots hate private sector solutions to public health problems and have constantly tried to say this initiative didn’t work. Nothing but regulations and bans ever work for them.

Predictably, Jamie Oliver, who campaigned for a wide range of coercive regulatory measures to combat the “obesity epidemic”, was said to be “in shock” at this government sell-out to “Big Food”. Equally predictably, Dr Sarah Wollaston, Conservative MP for Totnes and parliamentary nanny in chief, was appalled by this watering-down process. Perhaps she needs to understand that, unlike her, prime minister Theresa May might just turn out to be a conservative. Certainly May seems to have an instinctive dislike of nanny state measures and is disinclined to view the food and drinks producers as capitalist bad-guys intent on the mass promotion of industrial disease.

For “public health”, Big Food is intent on hooking people on “unhealthy foods” by adding “addictive ingredients” such as sugar and salt. It’s all a conspiracy you see. So, no kind of compromise is ever going to appease them.

No safe level of drinking

An apparent softening of the official line on the new, “low-risk” drinking guidelines published by the chief medical officers of health in March this year has also been reported in the press. While the unisex drinking guideline of 14 units a week remains, along with the “there is no safe level of (alcohol) drinking” mantra, the government is keen to damp down the rhetoric. Health secretary Jeremy Hunt will “give context about not preventing people from enjoying a drink” and say that while there is no totally safe limit of alcohol consumption, the risk is no higher than other everyday activities such as driving a car. Rhetorically this is a long way from CMO Dame Sally Davies’ claim that she thinks of the increased risk of cancer every time she reaches for a glass of wine.

The government seems to have accepted that the science underpinning the new guidelines is correct and the message just needs to be spun differently. But the science isn’t correct and the government should instigate an independent review and a call for evidence. Such a move would probably lead to Dame Sally Davies’ resignation, and the government clearly doesn’t want to be at the centre of another row where they are depicted as being on the side of “Big Alcohol”. The drinks industry nevertheless points out that the government champions British exports of products such as Scotch whisky abroad, while condemning alcohol as a health risk at home.

We are a long way from Joe Gormley’s vision of warring parties walking towards each other. Instead, in relation to the obesity strategy and the softening of the rhetoric around the drinking guidelines, we have that most British of solutions: a government compromise that pleases no one.

THE SILLY SEASON HAS COME EARLY THIS YEAR!

The Silly Season: it happens every year and usually coincides, for some reason, with the party political conference season. This year it has come a little early. 

First, a little levity: the Palace of Westminster in which our MPs sit is a wonderful Gothic building; but it’s crumbling and needs more than just running repairs. Some may see this as a metaphor for our entire political system. When you look at the political events since the Brexit vote, and the state of turmoil in the political parties, it’s enough to drive MPs to drink!

And therein lies a tale. MPs are due to move out of their offices to enable much-needed reconstruction to the Palace of Westminster that will commence in 2020 and last for six years. However, the Department of Health offices they will move into are in a building called Richmond House which is held under an Islamic bond scheme that forbids the sale of alcohol. So, where will our heroic representatives of the people go for a little taxpayer-subsidised libation when the House of Commons ceases to be the best gentlemen’s club in London? Well, there is a nice little pub between the two buildings called the Red Lion, and it has been reported that nationalising it in order to reserve it for MP’s use was on the agenda. Fortunately the owners have refused to sell.

There is more than a little irony to all this. There has been a growing tendency to denigrate alcohol and to favour a temperance approach among some parliamentarians; well MPs, be careful what you wish for, a little Islamic teetotalism might be just what you need – remember what Chief Medical Officer Dame Sally Davies said “there is no safe level of alcohol consumption” - so prepare to set a good example.

Meanwhile there is a House of Lords all party committee looking into the workings of the Licensing Act 2003. How is the Act doing? Do we need more licensing objectives? How about one on ‘health and wellbeing’ or one that requires licensees to ‘promote equality’? They can’t leave it alone can they? I do suspect that this committee is really about banging the health drum and calling for a health licensing objective, but I could be wrong. 

But the House of Lords seems particularly exercised by alcohol at the moment. Lord Tariq Ahmad, our unelected new Aviation Minister, is concerned about incidents involving drunken people at airports or on board flights; to the extent that he is looking at restricting the hours of opening of airport pubs and bars. Helpfully he has said “I don’t want to end merriment altogether”. So, just a bit then? And on what basis does he consider this to be a problem? There are approximately 241 million people going in or out of UK airports every year. A FOI request by the Press Association revealed that there had been just 442 drunken incidents at UK airports in 2015 – just 0.0001% of the total throughput – time for a moral panic then!

Our politicians’ attitude to alcohol at both national and local level has historically been driven by paternalism. Some people feel quite nostalgic about this. So, July saw a spate of articles about the ‘Carlisle Experiment’. In July 1916, while the Battle of the Somme was raging, a new pub opened in Carlisle called the Gretna Tavern; it was our first nationalised pub. The Defence of the Realm Act was then used extensively to create a Central Control Board (Liquor Traffic) and to nationalise five breweries in Carlisle as well as 235 pubs in the Carlisle, Gretna and Annan area. In 1917 pubs in the Enfield Lock area of London and Invergordon in Scotland were taken over. In all some 363 pubs were nationalised over 300 square miles either side of the English-Scots border around Solway Firth, where a giant munitions factory was being built; the idea was to keep the munitions workers sober and turning up on time for work.

The Central Control Board then took an axe to licences, with 40% of all alcohol licences in the area being declared ‘redundant’, including all grocers’ off-licences. Some authors today see this as a noble experiment to ‘civilise’ the pub; they suggest this was a successful example of nationalisation because the Central Control Board made a profit out of these pubs for every year it ran them. Well, I guess if you can buy a packet of already profitable pubs using taxpayers’ money, and then use your legal powers to close down most of the competition to them, that might give you a flying start!

Since the Labour Party appears to be undergoing a terrible attack of socialism at the moment, I wonder whether Diane Abbott might have a little word with Jeremy and see if he would like to nationalise some pubs along with the railways. Peoples’ quantitative easing; the peoples’ railways; the peoples’ pubs. You never know. It all depends on how long this year’s Silly Season lasts.

NETFLIX CAUSES CANCER

‘Netflix causes cancer’ is the title of an article written by Hank Campbell, who is the President of the American Council on Science and Health. It’s a satirical title of course, and the article that followed was designed to show how epidemiology can prove that almost anything can either cause cancer, or protect against it, which is why epidemiology is an excellent vehicle for creating moral panics about alcohol, amongst other things. My article today relates back to my last blog for Propel Opinion in which I referred to an opinion piece in the journal Addiction, in which the author wrote about alcohol as a cause of cancer at seven different sites in the human body. There was nothing new in this article, but the media picked up on it and declared it was a new study. The headline read: “Finally proof that alcohol causes cancer”, when in fact it was just an article, an opinion piece.

Hank Campbell, in his article, had this to say: “You may have seen renewed recent media claims that alcohol is linked to cancer, based on a new commentary in Addiction. While overuse of alcohol can certainly cause something like fatty liver disease and then cirrhosis, so can too many cheeseburgers. Lots of things can be harmful when misused, that is why the American Council on Science and Health talks about dose-response when environmentalists only want to talk about hazard.”

And then this: “It has been commonly established in longitudinal studies that alcohol in moderation has some positive effects, like with cardiovascular disease risk, but then some meta-analyses say it causes cancer. Which is it? If you are in the media, it doesn’t matter; you write about both as the Big Story. Many of us are reductionists; we want to eliminate bad luck and true randomness as much as possible, so we try to find cause and effect for everything. Which is why we love to read articles claiming X is a Miracle Product or later that X will Cause Cancer – and we do, over and over, like last week with alcohol causing cancer. Again.”

And then he goes on to give a template for how activist academics can misuse science to get publicity for their pet cause by following a well-tried template. Here’s how it works, the way to show Netflix causes cancer in 10 easy steps:

1. Get a random sample of 1,000 people and ask them to recall their viewing habits
2. Find out how many watch Netflix
3. Find out which disease they share in common
4. Do some data-dredging and use the seductive certainty of significance to suggest that your p-value is relevant
5. Pay to publish it in an open access journal, or find a niche relevant journal desperate for impact factor
6. Pay AAAS Eurekalert to carry the press release
7. Answer emails from harried science journalists writing three articles that day. Send snappy quotes about implications for longevity. Slate, Vox, etc. then write blog posts about the newspaper articles and then Inquisitr, Mashable, etc. rewrite those blog posts
8. Someone writes a New York Times bestselling book based on it
9. Academics needing R01 grants rush to produce papers validating the claims in the book
10. Academics like Marion Nestle write about all of the new papers and declare anyone disagreeing is a shill for Big Streaming.

There you have it. Your first epidemiology paper. And this will get read, because a lot of people have Netflix.

My point in quoting this article is to illustrate how activist academics exploit fear of cancer in relation to alcohol precisely in order to generate headlines and to justify the “there is no safe level of alcohol consumption” narrative. Below is a graphic which illustrates the distribution of studies that show how what we eat either causes or protects against cancer:

I’ll never believe an epidemiologist again!

Paul Chase