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| Sir Donald Acheson Chief medical officer who oversaw the UK response to the Aids and BSE crisesSir Donald Acheson, who has died aged 83, was chief medical officer (CMO)between 1983 and 1991 and is widely acknowledged as the key policymaker of the UK's successful drive against Aids. He will also be remembered for raising the profile of public health and his 1998 Acheson report on health inequalities.The shock of the emergence of a deadly new epidemic, Aids, is only equalled by the shock, in retrospect, of Acheson's ability to persuade Margaret Thatcher's Conservative government to adopt a liberal approach to tackling the sexually driven disease. It involved concentrating on massive health education programmes, in parallel with detailed plans to accurately track and combat the spread of the disease. He persuaded ministers to abandon a proposal for the compulsory testing of Aids and avoid making it a compulsory notifiable disease – on the grounds that it would deter patients from seeking help, as earlier exercises with sexual epidemic campaigns had experienced.The focus was on harm reduction not prohibition. Safe sex rather than no sex. He even obtained Conservative consent to what was, in effect, a scheme which condoned illegal drug use – needle exchanges for drug addicts, which had demonstrated their success in dramatically reducing the spread of the disease in Amsterdam and Berlin.How did he do it? Acheson, born in Belfast and educated at Merchiston Castle school, Edinburgh, and Brasenose College, Oxford, arrived at the Health Department after spending more than 20 years studying diseases in hospitals or medical research units in London, Oxford and Southampton. Better still, in terms of the impending Aids crisis, he was an epidemiologist: an investigator of the causes and control of epidemics. He brought with him an important epidemiological principle: all actions should be based on scientific evidence and, where evidence is lacking, a precautionary principle should be applied.There were a mere 28 known Aids cases in the UK when he started work as CMO. There was no Aids policy and no known cure. One initial challenge facing the new CMO was the need to integrate two separate medical worlds: biomedicine and public health (screening, education, epidemiology). He also successfully bridged two other groups: the medical world and the gay community, where the disease initially was most prevalent. He set up an informal group of senior medics and public health officials, to which he also invited people from the Terrence Higgins Trust, an HIV charity with its roots in the gay community. From there he moved on to establishing an expert advisory group, which he chaired.As one medical historian has noted: "His passionate conviction that this epidemic must be quashed before it could take hold was one of his main strengths in persuading the government and his colleagues to take the disease seriously." She added that Acheson "ate and slept Aids from 1985 onwards".The large, well-funded and sustained education campaign began in 1986 with press and television adverts along with "Aids – don't die of ignorance" leaflets circulated to 23m homes. Ministerial press briefings followed. By February 1987, an Aids week involved 19 hours of public service broadcasting across all four existing TV channels.The campaign achieved unstoppable momentum. Acheson went on to broker international guidelines within the World Health Organisation, ensuring the dominant ideology remained the British liberal consensus. By the time of his retirement in 1991, Aids in the UK had moved from initial shock through several intermediate phases towards being a manageable chronic condition. Many of the hundreds of hospital beds that had been earmarked were found not necessary.His eight years as CMO ended less happily. First, on the day before he retired, at a press conference on his final annual report, he replied to a journalist who had asked about breast cancer that self-examination was not an effective method of detecting the disease. This was a complete contradiction of government policy and generated a media fuss. Within two weeks of the event, new government guidelines were issued reinforcing the benefits of proper self-examination.More seriously, one ill-advised sentence on BSE 16 months before his retirement ended up with him being censured, long after he had left office, by the committee of inquiry set up to examine the handling of the epidemic. It was a vivid illustration of the perils that CMOs face in their tightrope walk determining risk management.What triggered the furore was the disclosure in May 1990 of a suspected case of BSE in a cat. If there could be a transmission of the disease between animal species, then why not to humans too? Acheson was pressed by the department to make a prompt response. He issued a press statement that the risk posed to human health by BSE was still remote, but he also made a videotape that could be used by television news programmes during which he asserted there was "no risk associated with eating British beef". It was a much longer explanation, but it was this nugget that was extracted by television news editors. Nearly 10 years later, he told the Phillips committee of inquiry, which criticised him for giving the public "false reassurance", that "the use of such a phrase must have resulted from a slip of the tongue".There was a third unhappy part to his final years as CMO: serious attempts to cull his medical staff. Historically within the Department of Health there were two parallel hierarchies: administrative staff who reported to the permanent secretary and medical staff to the CMO. This began in 1919 and by the early 1970s the CMO had a staff of 190. In a world of team medicine, this was questionable, but Acheson argued he could not have achieved his successful Aids campaign without them. He declared: "You cannot be independent if what you have access to is controlled by administrative staff who may have a different agenda."But Whitehall efficiency reviews in the Thatcher years were unrelenting and merciless. Acheson survived, but only by spending 20% of his time fighting cuts and merger. His successor, Kenneth Calman, declared himself sunk when the 140 staff under him became merged. New Labour repaired some of the damage by the introduction of tsars for several important categories of patients.Of all his achievements – the founding of the new medical school at Southampton University, his research reports on the health hazards of asbestos and the desperate state of inner-city primary healthcare – Acheson would probably have been most proud of raising the profile of public health. Both his father, a Northern Ireland doctor, and his older brother Roy, a Cambridge professor, were public health doctors.His last public service, for which he gained widespread respect, was his report on health inequalities in 1998. Recruited by New Labour after the 1997 election, he was given one year to review the current state of inequalities and set out priorities for future policies. True to his reputation, he was on time and in a most thorough manner. He documented the degree to which health inequalities had brutally widened during the Thatcher/Major years and set out 39 recommendations. Many have been implemented – money for poor families, a restriction on smoking in public places, more money for inner-city schools, better sex education – but some of the most crucial, such as reducing the incomes gap, remain to be done.Acheson was knighted in 1986. He is survived by his wife Angela and their daughter, and a son and four daughters from his first marriage, to Barbara (another daughter from this marriage predeceased him).• Ernest Donald Acheson, medical officer, born 17 September 1926; died 10 January 2010HealthHealth policyAids and HIVBSEMalcolm Deanguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds guardian.co.uk |
Cadbury deal turns Bournville to Mournville 'Is it going to taste different? When you go to America the Cadbury's chocolate there doesn't taste as good,' said one residentIt felt a little bit like a death in the family in Bournville today. Just about everyone in this leafy model village on the edge of Birmingham has worked at the famous factory or has a relative who has done so.Even those few who had nothing at all to do with Cadbury had something to say. They wanted to talk about their favourite brand, their best memory of the company's many treats.At Beryl's Florists, Julie Vaughan, said the whole village was in shock. "Cadbury is what Bournville is all about. We're really worried about what is going to happen," she told the Guardian.Vaughan's husband, Carl, has worked at Bournville for 32 years driving forklift trucks. His father and grandfather also used to work there. "It's a family sort of place. People tend to stay there for years," she said.The link between Bournville and the UK's most famous chocolatier goes back to 1879 when a "factory in the garden" was built by George Cadbury, the son of company founder and Quaker philanthropist John.His idea was to create a profitable company but one that cared for and nurtured its employees. By 1900 the estate included 330 acres of land with 313 cottages housing workers from Cadbury and elsewhere.Today at Bournville Infant School, built in 1910 by George and Elizabeth Cadbury, headteacher Pam Dexter was explaining how at one time almost all of the pupils were sons and daughters of Cadbury workers. That is slightly less so now but the factory is still a central part of the community. Dexter said she was "concerned" about the developments but said she hoped that the new owners would uphold the values that the Cadbury family had always lived and worked by. She didn't sound too convinced.Pride and angerStop anyone outside Bournville's neat row of red-brick shops and they have a memory. Jo, 22, recalled how her uncle had worked for 20 years at the factory. "It was the sort of place people loved to work at. They stayed for years. And wherever you went in the world, people knew about Cadbury. It made you proud."Jo said her favourite bar remained CDM (Cadbury Dairy Milk to outsiders). Her friend, Sam, said her grandfather used to work there. He loved the company's generous sports facilities and often came home with reject chocolates or biscuits."That's another thing," said Stan Jones, not a worker but a chocolate fan. "Is it going to taste different? When you go to America the Cadbury's chocolate there doesn't taste as good. I'm worried that they are going to ruin the taste even if they keep the company going as it is."Local councillor Nigel Dawkins sounded furious that another of Britain's "jewels" was being lost. "Completely mad" was his bottom line. This is a corner of the West Midlands that has already been badly hit by job losses over the last few years, not least the tortuous problems that have beset the Longbridge car plant a few miles up the road.Cadbury workers were reluctant to talk but one described the mood in the factory as "very flat", adding: "We know it's been on the cards but you always hope it's not going to happen. Suddenly today we all feel a bit more insecure than we did yesterday."It was a time for memories, as if it was a wake after a death. Someone wanted to talk about those languid, sexy Flake adverts; someone else recalled the iconic martian Smash adverts – the instant mashed potato was another Cadbury product. Another person fondly remembered childhood bed-times when she was comforted by Bournvita. "Can you still get that? And what about Old Jamaica chocolate?" Suddenly the questions seemed to matter.CadburyFood & drink industrySteven Morrisguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds guardian.co.uk |
Balancing security and rights | John Wadham Full-body scanners may be a valuable addition to airport security, but profiling is likely to prove unjustified and ineffectiveThe right to life is the ultimate human right. One of the government's most important jobs is to protect it, and it needs to ensure that the measures it takes enable all of us to travel in safety and confidence. However, the threat of terror is not a trump card which allows governments to disregard all other human rights. Nor is it carte blanche to exercise the power of the state at the expense of civil liberties. In the past, we have sometimes seen governments get carried away – most notably, perhaps, with proposals to extend the period for detention without charge to 42 days. The argument that terror is a genuine and serious threat does not absolve the state from carefully designing and justifying its proposed solutions. Today, we are concerned to ensure that the latest proposals relating to body scanners and profiling in airports are properly constructed, justified and proportionate.The home secretary has said that full-body scanners will soon be used to screen passengers before they board flights. The scanner operators will see passengers as if they are naked. That this affects an individual's right to privacy is beyond doubt. Many of us may feel uneasy at the prospect. We might also be particularly concerned about, for example, the scanning of our children or older relatives. The question is: is this infringement of privacy justified and proportionate?The commission is keen to see more detail about how the proposed system would work in practice. What kind of training and security clearance will the scanner operators be required to have? Would the operator be of the same sex as the person being scanned? Would images be stored? If so, where and for how long? The answers to these questions will be crucial to judging whether the use of full-body scanners will work. When it comes to ascertaining whether it is justified, one major question comes to the fore: will it work to make us safer? We have asked government to provide the evidence.The home secretary has also raised the issue of "targeted" profiling – that is, subjecting certain people to more scrutiny, including searches, because they happen to have a particular set of personal characteristics. Our concern is that the practice of profiling is likely to lead to selection of people on the grounds of race, ethnicity or religion. The commission believes that this is divisive, discriminatory, unlawful, and in breach of international human rights standards. Once again, we have asked the government for the evidence which shows that profiling is an effective means of dealing with the threat of terrorism. Scanning on the basis of intelligence or suspicious behaviour is both more likely to be justified and lawful as well as the best way of making us safer.The government has acknowledged that its review will raise questions about equality and human rights, and has said that it will consider the issues very carefully. General statements of good intention are very welcome, but the next vital step will be to produce detail and evidence. The Equality and Human Rights Commission is keen to help government get this right.Air transportUK security and terrorismTerrorism policyTransport policyTransportPrivacyCivil libertiesJohn Wadhamguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds guardian.co.uk |
Arrest over three city burglaries A 30-year-old man is arrested by police after three burglaries took place in east Belfast in less than three hours. news.bbc.co.uk |
Moore 'suffered mock executions' • Captured consultant tells of gunshot behind head• First year held in Iraq described as very harshIn his first television interview since being released, Peter Moore, the British hostage kidnapped in Iraq, revealed today that he endured mock executions during his 31 months in captivity.Moore, 36, a computer consultant from Lincoln, was seized with four bodyguards from a government building in Baghdad in 2007. He was released last month and arrived home on New Year's Day.Describing the first year of his captivity as "very harsh", he told Channel 4 News: "We were in chains, shackled, blindfolded, handcuffed, periodically beaten, water poured over us."Recounting a mock execution, he said: "One time the guards came in, handcuffed me behind my back, blindfolded me, walked me out, put a pistol to my head and pulled the trigger, and fired another one off behind my back."I thought I was dead. Then I realised, actually, I can still hear laughing, I'm still handcuffed and that wasn't the case."He said he got through the ordeal by imagining he was "walking the dog or riding his motorcycle". "I also used to count dots on the wall and work out mathematical formulas," he said.Moore paid tribute to the other four men seized, saying he was "very grateful" for their help and the medical treatment they gave him after his abduction. "Certainly without their help and advice, I definitely wouldn't be stood here today."Jason Creswell, Jason Swindlehurst and Alec Maclachlan were shot dead and their bodies returned to Britain last year. Alan McMenemy, the fourth bodyguard, is also believed dead.Moore called for McMenemy's body to be returned. During the interview, he was shown visiting the vigil maintained for the men at Lincoln Cathedral. He lit a candle for each fellow hostages.Moore said that, in 2008, he was separated from the other men and, in 2009, his conditions were "pretty good" as he was let out of chains and given a PlayStation,satellite TV, laptop computer and en-suite bathroom. A Guardian investigation reported that the hostages were taken to Iran within a day of their kidnapping in an operation led and masterminded by the Quds Force, a part of Iran's revolutionary guard.But Moore said he believed he was held in Baghdad and Basra and moved from house to house every three months. Iraqi intelligence sources told the Guardian the British captives were never made aware that they had crossed the border.The Foreign Office has continued to insist there was no evidence that Moore was held in Iran, despite claims by Iraqi intelligence that they told their British counterparts and the Foreign Office that the hostages were taken across the border. General David Petraeus, head of US central command, has said Moore was "certainly" held in Iran for at least some of his time in captivity, although he told Reuters it was "difficult to say" what role the revolutionary guards played.A source close to the kidnappers told the Guardian that part of the deal for the men's release was that "no country could be accused of kidnapping them". Iran has denied involvement.In a video released in 2008, Moore said: "All I want is to leave this place. I tell Gordon Brown the matter is simple: release their prisoners so we can go."Moore was installing asset tracing software at Iraq's finance ministry when he was seized. He said his captors made him appear in more than a dozen "proof of life videos" but only one was made public.His release was on the same day as the transfer of Qais al-Khazali, the head of an Iranian-backed Shia group which claimed responsibility for the kidnapping.A representative of Asaib Ahl al-Haq or the League of the Righteous, al-Khazali's group, and an Iraqi member of the negotiating team that helped secure Moore's release, said he had not been released until the group had confirmation that its leader had been transferred.The Foreign Office has denied suggestions of a deal, insisting Britain does not broker agreements with kidnappers.But some of the families of the hostages have been highly critical of the British government's conduct.Dennis McMenemy, the father of Alan – whose body has still not been returned – accused the Foreign Office of "deceit, lies and cover-up" over the kidnappers' links to Iran, while Moore's natural mother, Avril Sweeney, said the government had "never told the truth".British hostages in IraqIraqHaroon Siddiqueguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds guardian.co.uk |