Friday, June 15, 2007

What's behind the rise of `Tescophobia'? (The British equivalent of Wal-Mart hatred)

Today's Tesco-bashers are a degenerate alliance of blue-blooded conservatives and cynical left-wingers. Their assaults should be resisted

The number of complaints against Tesco seems to grow even faster than the supermarket giant itself. Slamming the opening of new stores, the amount of goods and services they sell and the vast profits the company makes has become a preoccupation of liberal broadsheets, such as the Independent and the Guardian, as well as cranky tabloids like the Daily Mail and the London Evening Standard. There are also numerous websites devoted to `exposing' Tesco's practices. In February 2007 Channel 4 devoted an hour's worth of primetime television to a feeble `investigation' of how Tesco operates (1).

In his new book Tescopoly, Andrew Simms of the New Economics Foundation (a self-proclaimed `think-and-do-tank') attempts to provide a detailed survey of Tesco's high street omnipresence and why it should be stopped. Although Simms specifically targets Tesco, the supermarket chain is merely a canvas through which he reveals all kinds of vile prejudices against modern-day society and, in particular, the modern-day working class. Tescopoly is another unwelcome addition to the growing pile of shrill, phoney anti-capitalist books that use vaguely left-wing credentials to disguise contempt for the masses.

It should be said that Simms is at least more honest about his political ideas and motivations than, say, George Monbiot. He reveals that his `father ran a small business and voted Conservative' and, sure enough, Tescopoly is a rallying cry for the beleaguered petit bourgeoisie and all its conservative preoccupations (2). Unfortunately for Simms, however, he ends up being hamstrung by his flawed methodological approach. While he attempts a social scientific analysis of Tesco's apparent destructiveness, via a smattering of facts and figures, on the whole Tescopoly is an entirely subjective complaint against the `evils' of economic growth and social change.

What is perhaps more significant is that the remains of the radical left now take people like Simms at face value (3). Quite why championing small businesses against big business is progressive is never convincingly explained, by either Simms or his left-wing fans. In fact, Simms' garbled alternative to efficient big business is probably the most reactionary blueprint for a new society this side of an al-Qaeda website. Yet while the rantings of Osama bin Laden et al are generally assumed to be nonsense, the arguments and prejudices put forward in Tescopoly are as mainstream and widespread as Tesco itself.

The purpose of this essay is firstly to dissect Simms' arguments against supermarkets and his proposed alternatives, and secondly to assess why such conservative prejudices have suddenly found favour with leftist radicals.

One of the most familiar complaints against Tesco is that its unstoppable expansion of stores is destroying the fabric of local communities. What Simms means is that Tesco is forcing the closure of small shops and businesses. These claims are central to Simms' overall argument and he repeats them ad nauseam. Ideally, Simms would like a monopoly of small traders via some kind of state protection. However, simply to champion the material self-interest of the petit bourgeoisie would probably be seen as a bit, well, unethical. So Simms promotes the economic, social and moral worth of your `friendly' local trader, and he ties himself in knots in the process.

Firstly, he argues that supermarkets are not as economically viable as local businesses. As an example, he says that big supermarkets do not employ as many people as small traders and small businesses do. He also argues that the wealth generated doesn't `irrigate around a community'. He points out that, according to recent figures, Tesco `employed 250,000 people while small grocery shops. employed double the number of people' (4). That may be so, but Simms ignores the jobs created by Sainsbury's, Asda and Morrison's (supermarkets which he often lumps alongside Tesco in other chapters of the book). Totalled together, the number of jobs created by these supermarkets would be double the small retail sector.

What these figures also reveal, and what Simms ignores, is that the small and large retail sectors can exist side by side. Simms may point out that `specialist stores like butchers and bakers shut at the rate of 50 per week', but he would like the same rate of closure to befall the big four supermarkets. Would the small retail sector be able to absorb the million-plus jobs lost if supermarkets were forced to close down? It's highly unlikely.

Simms' claim of a direct `cause and effect' relationship between big supermarkets opening and small shops going to the wall is also unconvincing. Specialist shops have always been prone to economic failure because the market for the goods on offer is often weak. To be frank, budding entrepreneurs don't always have the best business acumen. Those financial geniuses who insist on opening a shop selling such non-essentials as scuba diving equipment or authentic Victorian fireplaces in a residential area have only themselves to blame when the bailiffs are called in.

Yet Simms is so in awe of small traders that he can't contemplate that local shops might close down simply because they're rubbish. Indeed, the ubiquity of Tesco, Starbucks, Subway and McDonald's on the high street only emerged because Britain's caf,s and small shops have mostly been drab, scruffy and uninviting. Britain might supposedly be a `nation of shopkeepers' but, unlike the Spanish or French, this country hasn't been particularly good at producing small traders.

Ironically enough, one area in which small traders have been successful recently - specialist food - has largely been thanks to the arrival of supermarkets. Although Simms attempts to prove otherwise, the average grocery bill for UK households has dramatically declined thanks to price-busting supermarkets. This frees up more cash for luxury food items, such as specialist cheeses, and pheasant and duck from specialist butchers. On Essex Road in the Islington district of London, long queues often form outside of the local fishmongers and butchers at the weekend, and both of these small shops are within walking distance of a Tesco store. Likewise, the specialist food market in Borough, south London, is always far busier than any Tesco or Sainsbury's. Many Britons now tend to divide their shopping between supermarkets for basics and local shops for specific ingredients. The fact that small stores and specialist shops continue to thrive suggests that they can benefit from the arrival of supermarkets.

Although Simms reckons that Tesco `stifles' retail diversity, in reality he would like the state to deny choice to shoppers and force them to shop at small stores and markets. He forgets that housewives once spent many hours each week on such drudgery, often having to go out and buy some essentials on a daily basis. Yet Simms wants us to do that kind of thing because he reckons there would be greater community spirit and social cohesion. This notion is the most ridiculous and facile part of Tescopoly; at times Simms positively fantasises about village life.

Much more here


The school curriculum has been corrupted by political interference, according to a new report from independent think-tank Civitas. The traditional subject areas have been hi-jacked to promote fashionable causes such as gender awareness, the environment and anti-racism, while teachers are expected to help to achieve the government's social goals instead of imparting a body of academic knowledge to their students.

The contributors to The Corruption of the Curriculum show that no major subject area has escaped the blight of political interference. Michele Ledda shows how issues of race and gender ('external criteria that have more to do with biology than literature') trump the love of language in the works of literature that students are given to study.

The anthology of poetry produced by the Assessment and Qualifications Alliance (AQA) divides poetry into two groups: poetry from different cultures (16 poems) and a further 48 poems from British poets, of which 32 are post-1950: 'The whole tradition of English poetry from its origins to 1914 is represented by 16 poems while modern poetry has three times as many... A British pupil can go through the school system and get the top marks in English and English Literature without knowing that Spenser, Milton or Pope ever existed, but having studied Carol Ann Duffy twice, both at GCSE and A-level. With all due respect to Carol Ann Duffy, she is on the syllabus, not because she is a greater poet than Milton, but because she is more "relevant", dealing as she does with very contemporary issues such as disaffected learners.' (p.18)

Educational apartheid: David Perks reveals, in his chapter 'What Is Science Education For?', that, whilst professing to want to encourage more pupils to study science, the DfES has introduced a new science curriculum that will probably have the opposite effect. The new approach, introduced last September, conflates the three disciplines of chemistry, physics and biology into 'scientific literacy', which has more to do with media studies than hard science. Students are asked to discuss issues such as global warming and GM crops, based on media coverage, and to consider whether or not scientists can be trusted: 'We don't need to flatter young people by asking them what they think about these issues. We do need to help them learn as much as they can about science, so that they can understand what science tells them about the natural world and their place in it... Asking teenagers to make up their minds about anything is pretty daunting. But if you try to ask them to decide if we need to replace the UK's nuclear power stations, you are far more likely to get the question: "Sir, what is nuclear power?"' (p.121)


Dumb Britain to attack its highly skilled immigrants

But if you are a useless Muslim "refugee", that is fine of course

Close on the heels of the Commission for Racial Equality rapping the British authorities for discriminatory changes effected in the Highly Skilled Migrants Programme that affected mostly Indians, the shadow Immigration Minister Damian Green on Wednesday asked the government to keep the changes under suspension. In a letter addressed to Liam Byrne, Immigration Minister, Green suggested that all changes in the HSMP affecting those already in the UK, retrospectively, be suspended.

This comes after the Commission for Racial Equality claimed the changes to the HSMP breached race laws.

Green, who has been supporting the cause of the HSMP holders since November 2006 changes, said in his letter to the Immigration Minister, "I am interested to see that the CRE believes that the changes to the HSMP introduced last year may have breached the law. "As you know, I spoke and voted against these changes because of our objection to the retrospective element within them. We believe it is unfair that skilled and useful workers who have made a commitment to this country should have the rules of the game changed after they have arrived here," he said, adding the changes as "unfair".

"Since the CRE has raised a new point about the failures in consultation before these changes were introduced, I would ask that all measures affecting those who were already in the UK when the changes came into force should be suspended while the legality of the changes is tested. Due to the great interest in this matter, I am making this letter public."


Health screening as dangerous quackery

In A Day at the Races, the Marx Brothers’ 1937 classic, a generously unholstered matron, played by Margaret Dumont, threatens to leave the Standish Sanatorium because it cannot find anything wrong with her. “I’m going to someone who understands me, I’m going to Dr Hackenbush! . . . Why, I didn’t know there was a thing the matter with me until I met him!” she says. Hackenbush, played by Groucho, takes her money and feeds her pills intended for horses.

Some doctors suspect that today’s craze for screening is not so very different. Feeling healthy? Come and have a CT scan and we’ll soon find you’re not. It’s hard to escape the relentless plugging of health scans from pop-up ads on the internet to women’s magazines and even Men’s Health. We haven’t gone as far as the US, where CT scans are advertised on gantries over freeways, but the message is the same: a day spent being screened could save your life.

Rejecting this seductive patter may seem contrary, even Luddite. But screening can be dangerous. Companies offering scans imply that being screened will detect hidden medical problems so early that they can be nipped in the bud. The process is compared to giving the car a service or an MOT. Anybody failing to listen is selling themselves and their loved ones short. The presumption is that by acting now we can buy our way out of future ill-health and that it’s worth spending a lot of money to do it. When an American physician asked a group of 55-year-olds if they regarded cancer screening as an obligation, most said they did. Asked to choose between a whole-body scan and $1,000 in cash, 73 per cent went for the scan.

Exact UK figures are scarce, partly because the scanning companies are relatively new. But Prescan, who opened in London just eight months ago, say they have carried out an average of 25 full body scans a week at an average cost of 1,200 pounds — a total of 960,000.

But screening has a downside. At worst, it may increase your risk of disease. Equally, it could set you off on a conveyer-belt of ever more intrusive and unpleasant tests that will leave you poorer but no healthier. This month, the Committee on the Medical Aspects of Radiation in the Environment will discuss a draft report on the radiation doses from unregulated screening. The Department of Health asked it to investigate after warnings from bodies including the British Medical Association that scans could do more harm than good.

CT scans represent only about 6 per cent of the X-rays done in Britain, but are responsible for 40 per cent of the radiation exposure. A typical dose from a CT scanner is around 10 millisieverts per scan, 500 times as much as in a typical chest X-ray. That may be a price worth paying if the scan is being used to monitor treatment of a serious disease, but to expose healthy people to such high doses is hard to justify. The estimate is that a dose this high increases the lifetime risk of cancer by about one in 2,000. Are the benefits of CT scanning of healthy people greater than this? The scanning clinics’ response is that in 2 to 3 per cent of those scanned, some life-threatening abnormality is found. Sometimes they can be treated successfully. For these individuals, the benefit certainly exceeds the risks.

But for the generality, we simply don’t know. For every dangerous aneurysm discovered and dealt with, there are a plethora of what radiologists call “incidentalomas” — odd abnormalities that probably don’t matter but often need further investigations to make sure. In one US study of 1,200 body scans, nearly a third of patients were advised to have further tests, most of them unnecessary because there wasn’t anything wrong.

CT scans produce amazingly detailed images, and no two individuals are identical. As one American radiologist put it: “With this level of information, I have yet to see a normal patient.” Scanning clinics, well aware of these criticisms, have focused on magnetic resonance imaging (MRI) rather than CT scans. Prescan, for example, based in London, says: “CT scans have a very high incidence of false positives. In other words, when the scan does find something (which can be as high as 90 per cent of the time) it has to be investigated with further costly and often invasive procedures. “The finding is usually a benign tumour, cyst or scar tissue but the person has incurred the cost and the discomfort of further tests — plus the stress of waiting for results.” Peter Mace, the assistant medical director of BUPA, said that the private health insurance company does not offer whole-body scanning using either CT or MRI because the benefits have not been clearly demonstrated and the radiation dose — in the case of CT — is significant. “What we do do are closely focused scans on the heart, looking for evidence of calcium,” he said.

The rationale for this is that as hardening of the arteries develops, the amount of calcium detectable by CT scanning rises, and there are studies that correlate calcium scores with the risk of heart attacks. The issue is whether knowing this calcium score adds to the predictive value of the other risk factors for heart disease, such as cholesterol levels, blood pressure and smoking status. Last year the American Heart Association concluded that it did, but only in people at medium risk. In those of low or high risk, it adds no extra predictive value. “I think that there is a reasonable amount of evidence, and it is growing, that coronary calcium is important,” Dr Mace says. “What we haven’t got is evidence that knowing the coronary calcium score will make people live longer. But inferentially, using common sense, I believe that is true.”

Most people tend to see screening as an entirely benign procedure. But it is not. Muir Gray, for many years programme director of the UK National Screening Committee, puts it strongly. “All screening progammes do harm,” he said. “Some do good as well, and some do more harm than good.” For NHS screening programmes, strict rules apply. The disease being screened for must have an early stage, for which an effective treatment exists. There must be an effective test, shown to work in properly conducted trials, that does not throw up too many false results, either positive or negative. And the benefits in lives saved must exceed the risks.

Even when these criteria are met it is hard to be sure that a screening programme is justified, as the arguments over the effectiveness of breast mammography make clear. The claim is that breast cancer screening saves 300 lives a year in Britain, but critics contest it. Their reasons include a dearth of convincing blind trials, and that scans may pick up early tumours that never develop, causing unnecessary treatment.

Cervical screening is less contentious, and the NHS is now slowly implementing a bowel cancer screening programme. There is good evidence that the use of ultrasound to screen for aortic aneurysms — swellings of the blood vessels in the abdomen that can burst without warning — would be costeffective.

Private screening clinics do not need to satisfy such demanding criteria. They rely on the worried well — or, as one wag put it, the worried wealthy — to pay large sums of money for tests that have not been shown to be cost-effective or really to save lives. There is anecdotal evidence of patients for whom such a test does pick up something that matters — an aneurysm or a tumour. If it can be treated successfully, that is a positive outcome. If not, it may mean that someone has longer to live in the knowledge of an incurable disease.

The medical literature is short of any convincing evidence that MRI scans, used on healthy people, save lives — one reason why BUPA does not offer them, Dr Mace says. But companies such as Prescan, Preventicum and ScanandScreen do. A whole-body MRI scan at Prescan costs 1,090 pounds, or 1,390 if you add a CT scan of the heart. Prescan failed to respond to my requests for evidence that such scans do more than lighten a patient’s wallet. What we do know is that such scans do typically pick up medically significant findings in 1 to 2 per cent of healthy people tested.

In a proportion of these positive findings, something can be done. For example, the discovery of an aneurysm in the brain might justify life-saving surgery to repair it. But even then the situation is more complicated than it seems, as a team from the University of Edinburgh makes clear in the latest issue of the Journal of Medical Screening. For healthy people with no family history, the lifetime risk of a bleed from an aneurysm in the brain is 0.6 per cent. But aneurysms are found in about 2 per cent of people scanned.

That means that for every three found, less than one would ever have been a problem. But once an aneurysm is found, treatment is likely. If 1,000 adults were screened, 20 of them would be found with an aneurysm, only six of which would ever have bled. If all of these 20 were treated surgically, two would be dead, disabled or brain-damaged by one year after the operation, and in eight cases out of the 20 the operation would have been only partly successful, leaving a risk of a future bleed.

That makes the discovery of an aneurysm a far less positive thing than the scanning companies pretend. It would, in fact, face the patient with an agonising choice and a fair chance of being killed or disabled to treat a condition that might never have caused him or her any harm.

The Edinburgh team, led by Dr Rustam Al-Shahi Salman, are in little doubt. The balance of risks and benefits mean that brain MRI scans “cannot be recommended outside the context of a research study”. They go on: “Undoubtedly, further research is needed to establish whether whole-body screening is effective, although it would require a very large randomised trial. “Regulatory bodies in the UK should follow the example of others such as Health Canada and the Royal Australian and New Zealand College of Radiologists by stating their view on whether whole-body screening is appropriate.” MRI scans do have appropriate uses in screening. They are, for example, better at detecting breast cancer in young women than conventional mammography, and the National Institute for Health and Clinical Excellence recommends their use in women between 20 and 49 known to be at high risk of the disease because they carry a predisposing gene.

At the very least, the companies that offer whole-body scans should make it clear that the procedure is unproven and that there is no robust evidence to show health benefits from undergoing it. “Why not treat a loved one or a valued employee to the ultimate spring gift?” asks Preventicum on its website. Frankly, it’s a gift I would have no hesitation in turning down. I’d just as soon have a horse pill.


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