Bungling British bureaucracy kills mother who fell ill after hours

Penny Campbell became ill and died over the course of a bank holiday weekend despite the attention of eight doctors. Her grieving partner believes that she would still be alive if the NHS out-of-hours system worked properly. Angus MacKinnon said that Ms Campbell, 41, had been a victim of the Government's approach to healthcare reform. She died from blood poisoning at the Royal London Hospital, East London, after she became infected during an operation for haemorrhoids. Her condition would have been easy to treat if caught in time, but she fell ill over the Easter weekend in 2005, while her GP was on holiday.

Eight doctors from Camidoc, a private company contracted to provide out-of-hours cover, misdiagnosed her condition because they did not have access to notes made by her GP or by each other. An inquest ruled in October that they had contributed to her death.

Mr MacKinnon, who intends to sue Camidoc, said: "I'm fairly confident that if Penny had been seen by a doctor from her own surgery, then you would not have had a situation where you can be seen by eight doctors, none of whom could diagnose correctly."

He has been told by a government source that the policy for providing out-of-hours cover was not discussed in Cabinet. "The reform was introduced without any kind of pilot scheme, which is absurd." He said that the coroner wrote to Patricia Hewitt, the Health Secretary, after the inquest to warn her that the case raised national issues. "Five months later I am still waiting for a letter from her. I think that is shocking."

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Reform of GP out-of-hours service an expensive shambles, says report

Government preparations for a new out-of-hours GP service were "shambolic", a report from the Public Accounts Committee has found. Doctors were allowed to opt out of providing a 24-hour service in return for a salary sacrifice of only 6,000 pounds each - half what the service costs to provide. The Department of Health was not directly involved in the negotiations and never clearly defined what it wanted.

Poor monitoring means that some primary care trusts do not know whether the services they provide are any good. In cases where quality has been measured, performance is poor.

The department overlooked the fact that ending Saturday surgeries would be inconvenient for many patients, the committee said. It also allocated 70 million pounds less to trusts than the new service cost to provide, forcing them to incur deficits or to cut budgets for other services.

Edward Leigh, Conservative MP for Gainsborough and chairman of the committee, said: "The Department of Health thoroughly mishandled the introduction of the new system of out-of-hours care. The department chose to act as an observer, and no more, in the negotiations with GPs' representatives. This hands-off approach was good news for the doctors but no one else. They were given a strong incentive to opt out - a lot less work for a small loss of income - and a disproportionate amount of taxpayers' money is now having to be spent to provide the replacement service." About nine million patients require out-of-hours care in England each year. This is provided by in-house primary care trust teams, GP cooperatives and private companies.

Mr Leigh added: "The new service is getting better, but the needs of patients are not best served by the ending of Saturday morning surgeries. They are not best served where access to advice and treatment is often extremely difficult and slow; and they are not best served where no one knows whether the service is meant for urgent cases only or for any requests for help at all. "To cap it all, the cost of the new service is around 70 million a year more than was expected. That's the last thing the primary care trusts need at this time of increasing financial pressure." The total allocated by the Department of Health to trusts for out-of-hours services in 2005-06 was 322 million, according to the report from the Public Accounts Committee. However, figures from the National Audit Office showed that actual spending in 2005-06 was likely to be 392 million.

Those who provide out-of-hours care have been set targets relating to how long it takes to answer a call and to assess whether a patient is an emergency case. But the percentage of trusts meeting the targets was extremely low, the report said.

Stephen O'Brien, the Conservative health spokesman, said: "The Government has failed on out-of-hours provision. Everyone up and down the country is suffering because of it. Patricia Hewitt's pitiful attempt to claw back money from GPs is to try and shut the gate after the horse has bolted. "Not only has the extra cost added to the billion-pound cash crisis in our NHS, but it has pushed more people into busy A&E units, putting greater pressure on our hospitals."

Norman Lamb, of the Liberal Democrats, said: "Yet again, the Government has grossly mishandled an NHS contract, putting further pressure on cash-strapped trusts and leaving patients confused about where care is being provided. The effect of this mess is that A&E services will be swamped by patients who don't know where else to turn."

The Department of Health claimed that "most patients" were benefiting from improvements in out-of-hours services thanks to the new arrangements, and denied that the ending of Saturday surgeries had anything to do with the new contract. A spokesman said: "Patients right across the country should now be assured timely and responsive care, including the guarantee of a face-to-face consultation with a GP if needed. "It was clear from the rising number of complaints that the previous system was not meeting patients' needs and was affecting the ability to recruit and retain GPs."

Hamish Meldrum, chairman of the British Medical Assocation's GPs Committee, said: "We would confirm the committee's findings that the quality of many out-of-hours services leaves a lot to be desired. We have commented about this both nationally and locally. "However, we would reject the implication that GPs were the only ones to do well out of this deal and that the Government was not really involved. The Department of Health was fully aware at all stages of the negotiations about the opt-out price."

-Before 2004 GPs were responsible for their patients 24 hours a day. For out-of-hours care (6.30pm to 8am weekdays and all weekend) they either did it themselves, shared the load with other doctors or employed locums

-The new contract allowed them to opt out of 24-hour care by sacrificing 6,000 a year. Ninety per cent of GPs accepted

-Primary care trusts had to organise out-of-hours care by employing GPs, private companies or even GPs who had opted out of providing it themselves

-As a whole, the new contract gave GPs a big rise in pay, raising the average to nearly œ100,000. A points system that rewards GPs for a quality service easily exceeds what they lost in giving up out-of-hours care

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Britain: Islamic extremists 'infiltrate Oxbridge'

Leading universities including Oxford and Cambridge have been targeted by Islamic extremists who remain widely active on campuses, a prominent academic is warning. Up to 48 British universities have been infiltrated by fundamentalists and the threat posed by radical groups must be "urgently addressed", according to Prof Anthony Glees. The claim calls into question the Government's attempted crackdown on Islamic extremism in universities and casts doubt on claims by Bill Rammell, the Higher Education Minister, that the problem is not widespread.

Prof Glees will warn the Association of University Chief Security Officers (Aucso) next month that the disbanded extremist group, al-Muhajiroun, claims to have infiltrated "the main campuses such as Cambridge, Oxford, the London School of Economics and Imperial College". His speech on "radicalism in universities" also states that at its peak before the July 7 bombings in 2005, al-Muhajiroun had a presence at "more than 48 universities and faculties", and that Omar Bakri Mohammed, the group's founder, claims it is "still operational" in several campuses.

Prof Glees, the director of Brunel University's Centre for Intelligence and Security Studies, said: "We must accept this problem is widespread and underestimated. Unless clear and decisive action against campus extremism is taken, the security situation in the UK can only deteriorate." Following a report from Prof Glees showing that 31 universities and colleges had hard-line Islamic groups within their campuses, the Department for Education and Skills last year issued guidelines on dealing with any extremism.

Student Islamic societies have faced growing scrutiny after it emerged that one of 12 men charged in connection with the alleged plot to blow up transatlantic airliners was president of the Islamic Society at London Metropolitan University. Last year, Aucso launched a "counter-terrorism" group to tackle the spread of Islamic fundamentalism on campuses.

Prof Glees called on the Government to provide extra investment in campus security and urged university officials to interview undergraduates to ensure that they were bona fide students.

A spokesman for Oxford University said: "We always take any extremism seriously and work closely with the police on any form of extremism that might affect our students or staff." A Cambridge University spokesman said he was not aware of any current extremist activity but that the university "remained vigilant". The Government's controversial guidance asked university staff to "monitor" student Islamic societies and report any "Asian-looking" students they suspected of extremism to the security services. Student groups attacked the move as "bearing on the side of McCarthyism". Other critics suggest that the guidelines are widely ignored. Chris Pope, an associate fellow of the Royal United Services Institute for Defence and Security Studies, said: "My understanding is that this problem is ongoing and expanding in some campuses."

A spokesman for Universities UK, the umbrella group for British vice-chancellors, said: "In the rare event of such problems, universities work very closely with the police and other authorities."

In a recent report from a London-based Arabic newspaper, Anjem Choudary, the former head of al-Muhajiroun in Britain, who joined the group as a student at the University of Surrey, confirmed that while the movement officially disbanded in 2005, "the students of Omar Bakri continue to preach on campuses".

Last year, Dhiren Barot, said to be al-Qaeda leader Osama bin Laden's "UK general", was jailed for 40 years for planning terrorist attacks. Barot, 34, faked his identity in order to study at Brunel University. The London School of Ecomonics and Imperial College were unable to comment. Mr Rammell said: "Our assessment has not changed. Violent extremism in the name of Islam is a real, credible and sustained threat to the UK and there is evidence of a serious, but not widespread risk of violent extremism in the name of Islam on our university campuses."

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British university is accused of censoring lecture on Islamic anti-Semititism

The University of Leeds was accused of infringing free speech last night when it cancelled a lecture on "Islamic anti-Semitism" by a German academic. Matthias Koentzel arrived at the university yesterday morning to begin a three-day programme of lectures and seminars, but was told that it had been called off on "security grounds".

Dr Koentzel, a political scientist who has lectured around the world on the antiSemitic ideology of Islamist groups, told The Times there were concerns that he would be attacked. He said that he was "outraged" that his meetings had been cancelled and had yet to receive an explanation. The university, which acted after complaints from Muslim students, denied that it was interfering with the academic freedom of Dr Koentzel, and said that proper arrangements for stewarding the meeting had not been made. The lecture, entitled "Hitler's Legacy: Islamic antiSemitism in the Middle East", was organised by the university's German department and publicised three weeks ago. A large attendance had been expected.

Dr Koentzel, a former adviser to the German Green Party, said: "I have been told that it has had to be cancelled for security reasons. It seems there were concerns that there could be violence against my person. "I have lectured in lots of countries on this subject. I gave the same talk at Yale University recently, and this is the first time I have been invited to lecture in the UK. Nothing like this has ever happened before - this is censorship. "It is a controversial area but I am accustomed to debate. I value the integrity of academic debate and I feel that it really is in danger here. This is a very important subject and if you cannot address it on university property, then what is a university for?"

Dr Koentzel, a research associate at the Vidal Sassoon International Centre for the Study of Antisemitism at the Hebrew University of Jerusalem, said that he had been shown two e-mails that had been received, which objected to his lecture. One, apparently written by a student, said: "As a Muslim and an Arab this has come to me as a great shock. The only intention that you have for doing this is to increase hatred as I clearly regard it as an open racist attack."

Ahmed Sawalem, president of the university's student Islamic Society, confirmed that he had contacted the office of Professor Michael Arthur, the Vice-Chancellor, to register an official complaint. "The title of the talk is provocative and I have searched the internet to read his writings and they are not very pleasant," Mr Sawalem said. "We are not opposed to freedom of expression. We just sent a complaint, we did not ask for the talk to be cancelled."

The university authorities contacted the German department on Tuesday and asked for a change in the title. The department agreed to relabel the talk as "The Nazi Legacy: the export of antiSemitism to the Middle East". Yesterday morning, the head of the German department, Professor Stuart Taberner, was called to a meeting with the Vice-Chancellor's staff and the head of security. After the meeting, Dr Koentzel's lecture and workshops were cancelled.

Annette Seidel Arpaci, an academic in the German department, said: "This is an academic talk by a scholar, it is not a political rally. The sudden cancellation is a sell-out of academic freedom, especially freedom of speech, at the University of Leeds." A spokes-woman for the university said that it valued freedom of speech and added that the cancellation of the meeting had been a bureaucratic issue. "The decision to cancel the meeting has nothing to do with academic freedom, freedom of speech, antiSemitism or Islam-ophobia, and those claiming that is the case are making mischief," she said.

What he wrote

" AntiSemitism based on the notion of a Jewish world conspiracy is not rooted in Islamic tradition but, rather, in European ideological models. The decisive transfer of this ideology to the Muslim world took place between 1937 and 1945 under the impact of Nazi propaganda . . . "Although Islamism is an independent, antiSemitic, antimodern mass movement, its main early promoters, the Muslim Brotherhood in Egypt and the Mufti and the Qassamites in Palestine, were supported financially and ideologically by agencies of the German National Socialist Government."

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After Hate Speech, the war against ‘Mate Speech’

As the language police turn their attention to banter between buddies and football-ground chants, no area of life is safe from the censors.

Over the past 10 to 15 years, governments in the West have instituted laws against ‘Hate Speech’. To varying degrees they have criminalised the use of racist, misogynistic, homophobic, xenophobic, anti-Semitic or anti-religious words by groups or individuals on the basis that they might incite hatred and possibly even violence against vulnerable minorities.

Now, if recent cases in Britain are anything to go by, the language police are turning their attentions to what we might call ‘Mate Speech’. They’re cracking down on banter between buddies, throwaway chants at football matches, and words uttered in informal, behind-the-scenes settings, on the basis that someone somewhere, if they ever caught drift of these words, might possibly be offended by them.

Welcome to the humourless society, where no off-the-cuff remark, gag or utterance is beyond the sanction of the sanctimonious word-watchers.

Last week, Conservative MP and former army colonel Patrick Mercer was sacked from the Front Bench by party leader David Cameron for saying the words ‘black bastard’ in an interview with The Times. Mercer said: ‘If someone is slow on the assault course [in army training], you’d get people shouting: “Come on you fat bastard, come on you ginger bastard, come on you black bastard.”’ Cameron said Mercer’s words were ‘completely unacceptable’ and within three hours of their being published in The Times he had kicked Mercer out of the shadow cabinet.

Also last week, eight schoolboys aged 15 and 16 were arrested in Hertfordshire, England after a couple of them chanted ‘Yid Army’ at a leaving do for Jewish teacher David Appleman. ‘Yid Army’ is a knowing term used by fans of Tottenham Hotspur Football Club to describe themselves, in recognition of the fact that much of Spurs’ traditional support came from the Jewish community in north London. Apparently Mr Appleman was ‘smiling and shaking hands with the boys’ when the incident occurred, but when he later saw a video of it on YouTube he made a complaint to the police.

Meanwhile, the police force investigating allegations of racist behaviour in the Celebrity Big Brother house in January have announced that they’re dropping the case. Who can forget the CBB incident (however much we might have tried), when an argument over Oxo cubes between reality TV has-been Jade Goody and Bollywood star Shilpa Shetty – which reached its heady conclusion when Goody said the phrase ‘Shilpa Poppadom’ – caused an international stink? The Crown Prosecution Service said that while what occurred in the house ‘was clearly offensive, it was not criminal’.

Phew. It’s not a crime – yet – to say someone’s name and then put the word ‘Poppadom’ after it.

Perhaps the most striking thing about these ‘Mate Speech’ incidents is the separation of words from intent. No one really thinks Patrick Mercer is a racist. Even those denouncing him for using ‘insensitive words’ point out that he isn’t racist and has probably done some good work in the army. The schoolboys chanting ‘Yid Army’ were using a football-ground chant that is not remotely anti-Semitic in intent; indeed it is chanted by Jewish fans of Tottenham Hotspur. And the police investigating the CBB affair have failed to uncover any evidence that the words used in the house – which ranged from ‘liar!’ and ‘fake!’ to a suggestion that Shilpa Shetty should ‘spend a day in the slums’ – had racist underpinnings.

The lack of any racist intent is clear from the fact that there are no ‘victims’ in these cases. Mercer did not say ‘black bastard’ to one of his black constituents or to a black journalist; he merely described, in a quiet and polite interview with The Times, what sometimes gets said on army training courses. Likewise, despite their best efforts, the police looking into CBB did not find anyone who thought they were a victim of racism. In interviews with the housemates, ‘everyone stated that they had not witnessed or perceived they were the victim of any racist behaviour’.

It would seem that schoolteacher David Appleman did not think of himself as a victim of an anti-Semitic slur at the time that the schoolkids were chanting ‘Yid Army’, but later changed his mind when he saw a video on YouTube. And now there are demands for Spurs fans to rethink their ‘Yid Army’ tag, despite the fact that no one in Spurs circles thinks of it as an insult that harms them: they’re the ones who chant it!

The fact that you can have an outcry, even a police investigation, over words that are not racist in intent, and which have not harmed anyone, takes censorship to a terrifying new level. These days, it doesn’t matter what your words mean, or who you say them to. It doesn’t even matter if they are true; for example, whether you think it is right or wrong that this kind of thing happens, Patrick Mercer is no doubt correct to state that during army training the phrase ‘come on you black bastard’ is used to spur on black soldiers doing obstacle courses. Rather it is assumed that there are certain words and phrases you simply cannot say these days – anywhere, anytime, to any person, or for any reason whatsoever.

So Jade Goody may not have been racist when she said ‘Shilpa Poppadom’, but you just cannot use cultural references to have a pop at people you don’t like these days. Patrick Mercer was not being racist when he pointed out that those responsible for training soldiers sometimes say ‘come on you black bastard’, but you cannot say those two words – ‘black bastard’ – anymore. The ‘yiddos’ of the Yid Army have ‘taken back’ the word yid and turned it into a badge of footballing pride – but don’t they know that you shouldn’t say the word yid in any context or at any time?

Some are understandably perplexed by this censorship of individuals who have not attacked or slurred anyone else (and who are sometimes referring to themselves!). In The Sunday Times, Rod Liddle confesses to being ‘poleaxed by the strange logic’ behind the Mercer incident, where a shadow cabinet minister is given the boot for saying something that was intended to be neither racist nor offensive, but rather was an attempt to ‘explain, with candour, what he’d observed during his time serving this country as a soldier’. Where does this perplexing censorship come from?

The idea that words can be offensive, even racist, even if they are not intended as such – and even if they are not aimed at anyone else or if the person they are aimed at does not consider them to be racist or harmful – was institutionalised by the Macpherson Report of 1999. Based on an inquiry into the investigation of the racist murder of black teenager Stephen Lawrence in London, the Macpherson Report established a new definition of a racist crime and racist slur. It said that an incident should officially be deemed racial if anybody – not just the victim, but ‘anybody else’ – considers it to be racial. Such a sweepingly relativistic view of offensive speech and criminal action has become institutionalised in policing, politics and public debate in Britain.

And it has given rise to a stultifyingly censorious climate.

Speech is no longer a matter for the speaker and the listener; rather it has been laid open to third parties, to the perceptions, sensitivities and judgements of ‘anybody else’.

So what was once par for the course on army training courses – where soldiers may have been called ‘ginger bastard’ or ‘black bastard’ in order to toughen them up – is now seen as ‘completely unacceptable’ because others outside of the army culture judge it to be racist. Where Shilpa Shetty did not consider Jade Goody’s mouthy insults to be racist, they were still widely discussed as such – by numerous journalists, quango officials and politicians – because people outside of the CBB house perceived them as racist. And while ‘yid’ is used as a term of endearment by Spurs fans – tough, because there are people outside of Spurs who reckon it is anti-Semitic and thus should never be uttered.

In post-Macpherson Britain, ‘offence’ is no longer something specific between two parties, where one person might intend offence and another person might take it. Rather, offence has become a moral judgement that can be made by anyone against your words and their meaning. Words are no longer judged in context, or in terms of the impact they made on the person they were aimed at; rather they are judged by an ever-broadening category of offensiveness that can be wielded by anybody who heard your words, whether in person or, in the case of Patrick Mercer, through a newspaper story, or in the case of CBB over the TV airwaves. 

This policing of our words by the catch-all category of ‘anybody else’s offence’ alienates us from what we think, say and believe. Our words are no longer our own; anyone who hears them can attach a meaning and intention to them, beyond what we ourselves meant and intended. This massively dents our right to speak freely with one another, and it undermines our own responsibility for what we say. Apparently it is no longer for us to decide with our friends or colleagues or fellow football fans what kind of words and phrases to use, and how and when to use them; rather it is the judgements of others that really count. And, of course, it will always be the most over-sensitive souls, those who make a profession of seeking out and exposing ‘offensive words’, who will butt into our everyday exchanges and declare that they are offensive.

I always hated the campaigns against Hate Speech. They were underpinned by an insulting view of the public, who were thought to be easily cajoled into becoming hate-fuelled racists or anti-Semites. And they were more concerned with brushing prejudice under the carpet – silencing its practitioners – rather than having the argument out and really doing something to challenge inequality. The new campaign against ‘Mate Speech’ that the post-Macpherson politics of offence has given rise to is far, far worse. It has turned ‘offence’ from something real and direct into a free-floating moral code that can be used to judge anybody’s words at any time. And it intrudes into the most intimate aspects of our lives.

When any words said by anyone in any context can be perceived by anybody else who hears them, or who hears of them, as offensive, then really no area of life is free from censorship: not the football stadium, the workplace cafeteria, the rough and tumble of a training course, the school playground. And when our words can end up being judged as racist and harmful even when we meant them innocently, the end result can only be self-doubt and self-policing: we become uncertain about what to say and when to say it. We internalise the new censoriousness; our words stick in our throat.

This is deeply troubling. We need areas of life that are free from the judgements of officialdom. It is in these areas where we experiment with words and ideas and forge friendships with like-minded individuals. Football fans bond through stadium chants; soldiers become a coherent squadron by developing their own codes of conduct and lingo, however bizarre they might seem to the rest of us; schoolchildren take risks with words in the playground, away from the formal, stuffy classroom. Closing down these informal arenas - by opening them up to the sensibilities of ‘anybody else’ - is not only illiberal; it does harm to our ability to make and sustain real and humane relationships.

It is time we took back responsibility for working out amongst ourselves what we should think and say, and responsibility for the consequences of our utterances. Our thoughts and words should not be the business of ‘anybody else’, that sly codeword for the new thought and speech police who believe they know what’s best.

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Riot police called in to quell riot at British immigration centre

"Seven staff and two inmates were taken to hospital after suffering smoke inhalation after a riot broke out at an immigration detention centre today. Riot police carrying shields were seen entering the centre at Kidlington, Oxfordshire, to help specialist Tornado units - highly trained prison officers trained to deal with riots. A Home Office spokeswoman said: "Police, fire and ambulance teams are on the scene and a number of Tornado units from the Prison Service have been deployed to the centre.

A Thames Valley Police spokesman said all three emergency services were called to the centre, to the north of Oxford, at 6.50am. He said 30 firefighters were at the scene to deal with a fire, although the main issue was smoke damage. "No serious injuries have been reported and the fire has now been put out," he said. "Police on the scene and the fire service are investigating the cause but it's likely to be suspicious."

The centre, which is run by private company GEO UK Ltd, opened in 1993 and holds 200 adult male detainees, including failed asylum seekers and immigration offenders awaiting deportation.

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Now living together makes you fat!

It's all men's fault, of course

Men and women might belong to the same species but they can have very different eating habits. Women are generally fruit eaters who are able to eat their fruit whole. Men, on the other hand, tend to eat less fruit unless someone (usually a woman) cuts it into pieces for them. They're also likely to eat fewer vegetables, are more likely to be meat eaters, while women are more likely to eat chicken and fish or be vegetarian. So what happens when they move in together - whose eating habits rule and can it be a recipe for becoming overweight?

While some research suggests the first year of living together is a time of increased risk of weight gain for both sexes, a review of research into the eating habits of cohabiting and married couples in the UK, USA and Australia found that in general, women came off worse. Although men often picked up healthier food habits when they moved in with a woman, women ended up eating more foods high in fat and sugar, and put on weight, according to the report by the Human Nutrition Research Centre at the University of Newcastle in the UK.

"It's hard to eat as many vegetables as I'd like because my partner will only eat potatoes, corn, salad leaves, carrot and avocado - unless you count baked beans. He's into English stodge and I like a Mediterranean diet," complains a friend who moved in with her partner last year. "I tend to tailor my choices to what he eats because I don't want to cook two different meals at night - but I'm trying to find more ways to adapt our meals so I get more vegetables."

So far she's not gained any extra kilos, but ask would-be weight losers when they gained weight, and many will tell you it's when they got married. That's the observation of Marie Elliott, who leads four Weight Watchers' meetings a week in Camden in Sydney. "I lost weight for my wedding, but I started gaining it once I was married. Maybe it's because you get a bit more relaxed. If you're cooking for someone else and you want to impress them you might make dessert more often, and whereas you might not drink while you're alone, when you're living with a partner there's always someone to share a drink with. Women who start cooking for a man might also start serving larger portions," she says.

But once the weight is on, men and women need different approaches to getting it off, according to dietitian Karen Miller-Kovach, Chief Scientific Officer with Weight Watchers in the US. "Both men and women are emotional eaters, but women overeat when they're sad, while men tend to overeat when they're happy - when they're out with the boys or they're celebrating an anniversary," says Miller-Kovach, who is the author of She Loses, He Loses: The Truth About Men, Women and Weight Loss (to be published in the US in April).

And while it's common for women to believe they're fat when they're not, it's common for men to think they're not overweight when they are - some men have to be obese before they think they're overweight, she adds. "But the things that inspire men and women to lose weight or to eat healthier are different. While women are more likely to change their eating [habits] to prevent a health problem, men often wait until they get a problem."

If you're a woman who wants to encourage her partner to eat better or lose weight, Miller-Kovach's advice is to give him a problem that can be fixed by having a healthier diet or losing weight. "Men are problem solvers - if you can present him with a problem, like the fact that he now needs clothes in a larger size, or needs to lower his cholesterol or blood pressure, a guy will fix it," she says.

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