Ministers revolt on British rights bill

The prime minister's high-profile plan to introduce a "bill of rights and responsibilities" is in disarray following a cabinet revolt. Ministers have warned Gordon Brown that his proposed charter laying out the rights and duties of citizens is unworkable and could pave the way for a deluge of court cases.

Earlier this year Brown hailed the proposed bill as "of fundamental importance to our liberties and to our constitutional settlement" and said it "opens a new chapter in the British story of liberty". However, the plan, unveiled to the cabinet last week by the prime minister and Jack Straw, the justice secretary, has been labelled "pointless" and "provocative" by ministers, who fear they will be given a hostile reception by a public weary of the "human rights culture".

The bill is at the heart of Brown's attempt to position Labour as the party of strong national identity. He has encouraged home-owners to fly the Union Jack in their gardens and established Veterans Day to pay tribute to the armed forces. He had hoped that by matching new rights with "responsibilities", the government could avoid accusations of giving people more rights with no duties in return. Some ministers fear that any political gain from laying down new responsibilities for citizens would be outweighed by a public backlash over the new rights proposed.

The draft plan presented by Straw suggests a controversial "right to equality" and an array of socio-economic rights, such as a right to sufficient pay on which to live. Straw, who is committed to producing a green paper on the bill before Christmas, told his cabinet colleagues that it was about "establishing fair rules" and "giving people a fair say". He said the charter would bring under one umbrella European human rights and social and economic entitlements linked to the welfare state.

The government's legal advisers have warned of "massive difficulties", questioning how social and economic rights could ever be "justiciable" - enforced by the courts - and whether a new right to equality was necessary given that the government is also producing an equalities bill. Labour has already passed a Human Rights Act.

One senior Whitehall figure involved with the proposed charter said: "How will all this work? Are people going to use it to demand equality of pay with Jonathan Ross?"

At the cabinet meeting last week several ministers questioned the "point" of the scheme and whether there were "any votes in it". A cabinet source said: "The whole thing was panned. Nobody spoke up for it. It was total humiliation for Jack." Several ministers questioned whether it was appropriate to focus on such an abstract issue at a time when many voters are struggling to pay bills and fear they may lose their jobs. Brown closed the meeting by admitting the public hostility to the Human Rights Act and insisting that a solution be found.

Michael Wills, Straw's deputy, will this week try to revive the scheme by holding one-to-one meetings with key cabinet critics. This month he begins a "roadshow" of Britain, holding focus groups to draft a "statement of British values" to be linked to the bill of rights.

A spokesman for Straw admitted that colleagues had "concerns", but emphasised that the justice secretary still "hoped to get cabinet agreement". He insisted the rights would help to bring people together at a time of economic uncertainty.

The Conservatives have labelled the scheme a "dog's breakfast". Nick Herbert, the shadow justice secretary, said: "No one has a clue how vague and unenforceable socio-economic rights will work, not to mention a meaningless statement of values, and on top of this we'll get the EU's charter of fundamental rights."

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Britishness is under threat from Prime Minister Brown, warns Lord Carey

The former Archbishop of Canterbury has accused Gordon Brown of undermining the identity of Britain. Lord Carey of Clifton criticised the Prime Minister for railroading through changes to the country's ancient constitution, damaging institutions such as the Monarchy and the Church of England. In an outspoken lecture, Lord Carey suggested many of Labour's constitutional reforms had lacked `joined up thinking' and had been forced through by Prime Ministerial `fiat'.

He denounced Labour's efforts to reform the House of Lords by ousting hereditary peers as `piecemeal'. And he suggested the Queen and Church leaders had been largely sidelined when Mr Brown scrapped the historic right of Prime Ministers to choose bishops.

Lord Carey also said the Government had damaged the ancient institutions `upon which Britishness is founded'. He said efforts to reform the Privy Council and the office of the Lord Chancellor in the Lords, one of the most ancient offices in the land, had left them emasculated. He said: `Some, if not most, of these acts have been undertaken by Prime Ministerial "fiat" rather than wide ranging debate. This harms the constitutional balance which has taken centuries to develop. It undermines the respect for the institutions on which Britishness is founded.'

Lord Carey cited the example of the way Mr Brown had axed the Prime Minister's role in selecting bishops. In the past, the Church forwarded two names for senior posts, including that of Archbishop of Canterbury, to the Premier, who could choose either or ask for more names. But Mr Brown announced Prime Ministers would no longer have a choice and just one candidate is now forwarded by the Church. Lord Carey said he had been `astonished' by the casual way Mr Brown had waived his historic rights. The comments reflect growing fears in the Church that it is losing the special position it has held in English life since the Reformation.

Immigration Minister Phil Woolas sparked controversy a week ago when he said plans to shake up the Lords could result in the Church being stripped of its privileges within decades.

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Obese teenagers set to get stomach surgery on NHS in rule change

The NHS has got so much money that they can waste it on this nonsense?? How about confining treatment to people who are ill? There are plenty of ill people who are not getting timely treatment. Very few overweight people have exceptional health problems. Treat the illness (if any), not the speculative cause.

Whenever "obesity" is mentioned, diabetes gets dragged in as an excuse for medical concern over what is really only a social problem. The truth is, however, that very few people get diabetes and very few of them are obese. The case for a causal link is not strong at all. See here and here

And the bottom line is that the lifespan effects of weight are quite small, with people of middling weight having the longest lifespans

Severely obese teenagers in Scotland would be put forward for stomach surgery on the NHS under new draft guidelines for doctors. Considering giving adolescents operations - including the fitting of gastric bands - is set to be included in official advice for Scottish clinicians on how to manage weight problems for the first time. The move comes amid concern that Scotland is following America where experts say there has been an "alarming rise" in the number of young people dubbed "super obese".

Already Scottish youths have developed conditions such as type two diabetes, high blood pressure and asthma because of their weight. At least three teenagers in Scotland are said to have been fitted with gastric bands, which create a small pouch at the top of the stomach that fills-up quickly and limits appetite. However, the first official guidelines for Scottish doctors on dealing with obesity in children, which were published in 2003, do not mention bariatric - obesity control - surgery.

Dr David Wilson, consultant in gastroenterology and nutrition at the Royal Hospital for Sick Children in Edinburgh and the co-chair of the expert group writing the new guidelines, said: "There were no (research) publications at all on surgical treatment in teenagers when we did the last guideline. Since that time there have been very few publications, but we know world-wide that there are teenagers having bariatric surgery, particularly in the states where there are people who are super obese' including children."

The latest figures show not only that 31% of 13 to 15-year-olds in Scotland are overweight, but that almost 10% are considered severely obese. Dr Wilson said clinicians were dealing with adolescents who had developed type two diabetes because of their weight and this situation was unheard of seven years ago. He added: "We seem to be lagging behind the States, but following them. It is not just the number of children who are moving from normal weight, to overweight, to obesity, but the number who are moving to massively obese. "It is that group which is worrying. That group not only has health problems in their future, but health problems now and the success rates for lifestyle changes with them may be pretty slim."

The draft guidelines, published by the Scottish Intercollegiate Guidelines Network (Sign), say surgery should only be considered for severely obese teenagers post-puberty who have other serious health problems because of their weight.

Dr Wilson said all other options, including diet, exercise and the use of anti- obesity drugs, should have been tried without success before surgery became an option. He also said the patient should be looked after by a specialist team and have the operation as part of a long-term plan.

Other ways to tackle weight problems in teenagers before they become severely obese are covered by the guidelines. There is an emphasis on doctors involving entire families in lifestyle changes, rather than expecting the patient to adjust on their own.

Dr David Haslam, clinical director of the UK's National Obesity Forum, said: "It is extremely alarming but there are kids who are so fat that surgery is the only option. There are kids whose health is reaching critical levels and are going to lose decades of their life because of obesity."

He said many guidelines and documents about obesity prevention had not been acted upon, among them the original Sign guidelines on obesity published in 1996 which received international recognition at the time.

Dr Dean Marshall, chairman of the British Medical Association's Scottish general practitioners committee, said: "It appears there is not a huge amount of evidence behind bariatric surgery for teenagers and that would be a concern." Consultation on the draft guidelines is currently under way and they are likely to be finalised after revisions next year.

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Women told to limit caffeine during pregnancy

Now that a few glasses of wine are off the hook, they have to have something else that they can bear down on. But once again all they have is epidemiological evidence. Big coffee drinkers have smaller babies but why? A direct causal link is only an assumption. Maybe (for instance) anxious mothers drink more coffee and it is the anxiety that affects the baby, not the coffee. You wonder how these guys got past Statistics 101 -- if they did

Pregnant women will be warned this week to limit their caffeine consumption to two cups of coffee a day or risk giving birth to underweight babies. The government's food standards watchdog will issue guidance to coincide with a study linking caffeine to low birth weight. Scientists have previously linked it to miscarriages. The advice from the Food Standards Agency (FSA) comes a week after scientists found that a weekly glass of wine during pregnancy could help boost a baby's behaviour and vocabulary.

The FSA is lowering the current recommended caffeine limit of 300mg a day to 200mg, the equivalent of two average-sized mugs of instant or two cups of brewed coffee a day. It has also identified other products containing caffeine that count towards the 200mg total. The limit is equivalent to four cups of tea, five cans of cola, three energy drinks or five bars of chocolate. Andrew Wadge, chief scientist at the FSA, said: "This is new advice but these are not new risks. I want to reassure women that if you're pregnant and have been following the previous advice, the risk is likely to be tiny."

Coffee shops have higher levels of caffeine in their drinks than assumed in the FSA guide-lines, which state that an average mug of coffee contains 100mg. A small cafe latte in Starbucks contains 240mg of caffeine, meaning a pregnant woman would exceed the recommended daily caffeine intake in one drink. A new generation of energy drinks, including Spike Shooter, contain up to 300mg of caffeine in a single can. The mass market drink, Red Bull, typically contains 80mg.

The FSA is changing its guide-lines following advice from the independent committee on toxicity, which after assessing the new research and previous studies decided that caffeine could be harmful to the unborn child at lower levels.

Researchers from Leicester and Leeds universities monitored the daily caffeine intake of 2,500 pregnant women using questionnaires. They compared this with the birth weight of the baby, taking into account the weight and ethnic background of the mother. The research, to be published in the British Medical Journal on Wednesday, found that women with a caffeine intake of more than 200mg a day were more likely to give birth to smaller babies.

One committee member said: "The [body of] research shows we get an adverse effect at a slightly lower caffeine intake than we previously thought, in terms of both reduced birth weight and increased instance of spontaneous abortion. "The final decision mainly went on the birth weight with babies born at a weight appropriate for a baby a few weeks younger. If you're small for gestational age, you're more likely to have intellectual impairment and hyperactivity in later life."

Research in the US published this year in the American Journal of Obstetrics & Gynaecology found that drinking more than 200mg of coffee a day doubled the risk of miscarriage.

Pat O'Brien, consultant obstetrician and spokesman for the Royal College of Obstetricians and Gynaecologists, said he recommended women should abstain from caffeine in the first 12 weeks of pregnancy. He said: "This is a very vulnerable time for the baby, and it's when most miscarriages occur."

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Fight dementia with a keen social life

New research suggests that there is hope for people with dementia, the key is to keep up their social life. Amusing that demented people are mostly happy. That rather confirms my take on the happiness literature

For many of us, there's little more bleak than the prospect of Alzheimer's disease - it's that idea of the loss of self that is so frightening. Yet a new study turns on its head the assumption that a good quality of life ends once Alzheimer's and other forms of dementia take hold. Not only does it indicate that those affected can lead fulfilling lives, but that there's something that will make happiness almost guaranteed: keep up the social life.

The study, from University College London published in the Journal of Neurology, Neurosurgery & Psychiatry, is one of the first to ask people with dementia directly about their feelings over time, to try and gauge their quality of life.

Dementia is the accelerated loss of brain cells, usually due to a disease such as Alzheimer's. It affects 750,000 people in the UK. This new study comes at a time when news stories about the need for treatments, and the decline of high-profile figures such as Iris Murdoch have consistently painted a picture of loss. Baroness Warnock, an expert in medical ethics, has controversially proposed euthanasia for dementia sufferers because of the strain they put on their families and public services.

But Cornelius Katona, a leading expert in old-age psychiatry from University College London's medical school, believes we should pay more attention to the factors that can make a difference to the lives of people affected by this potentially terrifying condition. And his research suggests that if we make sure the right activities and environments are available, we can give people with dementia a good quality of life without searching for elusive, expensive drugs.

"If you work clinically with people with dementia, you aren't usually struck by how distressed and miserable they are," Professor Katona says. "People with dementia generally rate their quality of life highly. That was a starting point for our research. We also suspected that the traditional ideas of what it meant to age `successfully' - avoiding ill-health, poverty and other adversity - were flawed. Actually, avoiding adversity isn't necessarily the key to being satisfied with life as you get older."

The new study focused around interviews with 224 people with mild, moderate and severe Alzheimer's, but its results apply to all forms of dementia. The interviewees were assessed to ensure that they could give meaningful answers and asked questions using standard health status, cognitive impairment and quality of life questionnaires. These indicated how happy they were with their life, and also how well they were mentally and physically functioning.

The researchers went back after 18 months, and asked the same questions. The resulting analysis looked at who had declined most physically and mentally, and who had stayed happiest. It came up with some fascinating results. Generally, those affected by dementia - whether it be severe or mild - didn't experience any decline in their sense of wellbeing over the 18 months, even though an objective assessment might have noted one.

And those with the highest sense of wellbeing were also those who scored highest on "social relationships" measures - how many people they regarded as close, how often they saw them, and what the relationships were like. People who had the best relationships were the most happy, and stayed happy longer. The results also showed that the happiest people were those who hadn't any indication of mental health problems such as anxiety and depression at the onset of Alzheimer's. This, says Katona, indicated that they were ageing "successfully" - despite their decline in cognitive function. It means we should be careful not to judge a decline by our own standards, rather than their own. "When you compare how a carer rates the quality of life of someone with dementia with how the person with dementia themselves rates it, then you find the carer always rates it lower. This is all probably related to the carer's own susceptibility to anxiety and depression, because their lives are so stressed."

A study published in the Journal of International Psychogeriatrics last month found that one in four spouses of people with dementia was suffering from clinical depression.

Since conducting the study into Alzheimer's, with UCL's Professor of Mental Health Sciences, Gill Livingstone, Katona has conducted a larger study into what predicts good quality of life as we age generally. Again the factors are your previous state of mental health, and how socially engaged you are. "The real point of this is that there's something you can do," Katona says. "If we're going to prepare for an ageing population, with a higher proportion of people with dementia, we need to tackle anxiety and depression better whatever age it strikes. And we need to facilitate social networks in middle and late life, before people start becoming more dependent."

For those of us worried about ageing, the lesson is to make sure you don't become socially isolated in mid to late life. And address any problems you have with anxiety or depression - talking to your doctor is a good start.

For those caring for people with dementia, the message is more complex: you can't change someone's history of mental health, and dementia is, by its very nature, an isolating condition. When people no longer behave in a socially acceptable manner, getting out and meeting people - or even having visitors - can be problematic. But local groups, such as those run by the Alzheimer's Society, can provide a continuing opportunity for a social life and for people to talk about their illness by phone or in person.

Professor June Andrews, Director of the esteemed Dementia Services Development Centre at the University of Stirling, says the new research is a welcome recognition that dementia is not the sentence to distress and misery that it's made out to be - and that much can be done now to improve the experience of people affected, without wonder drugs. "What people need, if they're to cope, is not a pill but to get out," she says.

James McKillop, aged 68, from Glasgow, agrees. In fact, a diagnosis of dementia in November 1999 changed his life for the better. For years before that, he'd been depressed. Things kept on going wrong in his personal and work life, and he didn't understand why. In 1995, he'd had to give up his Civil Service job because he was forgetting how to do routine procedures - things that he'd done week-in, week-out for the past 25 years.

"In the end, I couldn't cope. I became a hermit, staring at a blank TV screen all day. I'd become more and more frustrated, unable to make head or tail of what was happening, and I gave my wife and family a really miserable time. But receiving a diagnosis of dementia changed everything because I realised I was at fault and they realised I was ill." McKillop believes that he has a better quality of life now than before the diagnosis. "I have met so many wonderful people who have enriched my life. I wish I had developed dementia many years ago."

And so what is the advice for people with dementia, and their families? It's essential to identify the first signs of the disease early, so family members can discuss how to keep social activities and ties going. Another area to consider is starting a life story book (see box left) - a detailed record of a person's past life which they keep with them, so that even when they're in an environment (like a home) where they're not well known, there are prompts to start conversations and possibly a relationship.

And does Katona have any specific suggestions for activities that might stand people in good stead if they develop dementia? Something, even, that the Government might prescribe in the absence of wonder drugs? "It's all about keeping active socially as well as physically. Something like ballroom dancing seems to be especially beneficial, because as well as giving people a good cardiovascular workout, it provides a social network. So, if you're in your fifties or sixties, I'd recommend people should start that."

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It isn't a crime to call the Irish leprechauns



British court clears teenager of racially harassing neighbour:

"Small and mischievous, they're the green-clad little people who are synonymous with the Emerald Isle. The question a court prepared to wrestle with was whether calling your Irish neighbour a '******* leprechaun' amounts to racial abuse. Andeliza Tucker,18, faced a trial costing thousands after the alleged remark led to police action. However common sense prevailed on Thursday when her lawyer, Louise McCloskey - herself of Irish ancestry - successfully argued that the prosecution was 'political correctness gone mad'.

Miss Tucker was arrested after her neighbour, mother of five Eleanor Vince, who is Irish, claimed the leprechaun comment was directed at her during the latest chapter in a long running feud. After being questioned, the teenager was charged with racially aggravated harassment, an offence which carries up to two years' imprisonment...

When the case came before a judge at Liverpool Crown Court, Miss McCloskey argued that her client should never have been prosecuted. Crown lawyer Michael Stephenson then conceded that describing someone as a 17th century mythical being was not a straightforward racial insult.

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British government to 'name and shame' preachers of hate

Let's hope this really is applied impartially. A lot of "anti-Zionist" Leftists could get caught, but I suppose they won't. "Anti-Zionist" is such a thin excuse for antisemitism. Only a small minority of Israelis are Zionists

"Preachers of hate who have been banned from entering the UK face being "named and shamed" by the Government as part of the Prime Minister's promise to take stronger action against those accused of stirring up community tension. Jacqui Smith will tell MPs today that foreigners could be banned from the country forever unless they can persuade the Government they are no longer preaching hate. They will be expected to make a public renunciation saying they no longer preach hate or violent extremism. The move will affect Islamic exremists and others including neo-Nazis and animal rights activists.

A total of 230 people have been excluded from entering the country since August 2005 on suspicion that they are a threat to national security or foster and promote extremism. Among those barred from coming into the UK are 79 individuals, including preachers of hate, barred for "unacceptable" behaviours.

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