The idea that the world needs to double its food production by 2050 in order to feed a growing population is wrong,

Food figures need a pinch of salt

VIEWPOINT Isobel Tomlinson

The idea that the world needs to double its food production by 2050 in order to feed a growing population is wrong, says Isobel Tomlinson from the Soil Association. In this week's Green Room, she says the misuse of data could be used to allow even greater intensification of the global agricultural industry.

It is important that scientific research is now done to show how a better future is possible Food needs 'fundamental rethink'

In the last couple of years, scientists, politicians and agricultural industry representatives around the globe have been using two statistics: the need to increase global food production by 50% by 2030, and for food production to double by 2050 to meet future demand.

These figures have come to play a significant role in framing current international policy debates about the future direction of global agriculture.

These apparently scientific statistics have been dominating the policy and media discourse about food and farming, leading almost everyone to assume we need vast increases in agricultural production to feed a population of nine billion people by the middle of this century.

While ensuring an equitable and sufficient future food supply is of critical importance, many commentators are using this to justify the need for more intensive agricultural practices and, in particular, the need for further expansion of GM crops.

Cooking the books

When the Soil Association, in its report Telling Porkies, looked into the reported sources for these figures, none of the sources actually stated that global food production needs to increase by 50% by 2030, or to double by 2050.

The food web is complex and tough to break down into simple soundbites

What the reports on which the claims are based do say is that certain sectors, in certain parts of the world, may have to increase food production by significant amounts.

For example, for cereals, there is a projected increase of one billion tonnes annually beyond the two billion tonnes produced in 2005.

For meat, in developing countries only (except China), the reports say that some of the growth potential (for increased per capita meat consumption) will materialise as effective demand, and their per capita consumption could double by 2050.

So this is a projected doubling of meat consumption in some developing countries - not a doubling of global food production.

Indeed, recent calculations show that the key source for the "doubling" claim - a 2006 report from the UN Food and Agriculture Organization (FAO) - implies that global food production for 2006-2050 would need to increase by around 70%, not 100%; a difference that is equivalent to the entire food production of the continent of America.

But while a re-evaluation of the veracity of the claim that food production needs to double by 2050 is to be welcomed, simply switching to the figure of 70% does not solve the problem.

Food for thought

The statistic of a 70% increase is still predicted on the same "business as usual" model as the "doubling" figure and that is problematic for several reasons:

Some region will have to produce considerably more food Food push urged to avoid hunger

First of all, the projections reflect a continuing pattern of structural change in the diets of people in developing countries with a rapid increase in livestock products (meat, milk, eggs) as a source of food calories.

However, the continuation of dietary transition in developing countries, as assumed by the modelling work, is likely to cause worsening health problems as such diets are a leading cause of non-communicable diseases including cardiovascular disease, some cancers and Type 2 diabetes.

Secondly, the data used to measure food security focuses attention on the level of agricultural production without considering access to food, distribution, and affordability which are all important in ensuring that people do not go hungry.

Thirdly, the projections assume that the developing world continues to import growing quantities of staple food stuffs when, in fact, increasing local production of staple foods is vital in ensuring food security.

Finally, according to these scientists, meeting these projected food demand targets will not solve food insecurity anyway. Indeed it is predicted that there will still be 290 million under-nourished people worldwide in 2050.

The assumptions and projections in this modelling reflect the authors' vision of the "most likely future" but not necessarily the most desirable one.

At the Soil Association, we now want to have an honest debate about how we can feed the world in 2050 in a way that doesn't lead to the further increases in obesity and diet related diseases, ensures that the global environment is protected, and that puts an end to hunger and starvation.

The misuse of the doubling statistic, based as it supposedly is on just one particular forecast of future demand for food, has prevented alternative visions of food and farming in 2050, which do not rely on the further intensification of farming and use of GM technologies, from being taken seriously in food security policy circles.

It is important that scientific research is now done to show how a better future is possible.

One recent scientific study has examined how we can feed and fuel the world sustainably, fairly and humanely. It explored the feasibility of feeding nine billion people in 2050 under different diet scenarios and agricultural systems.

The study showed that for a Western high-meat-diet to be "probably feasible" would require a combination of massive land use change, intensive livestock production and intensive use of arable land.

This would have negative impacts for animal welfare and lead to further destruction of natural habitats like rainforests.

However, the study also provides evidence "that organic agriculture can probably feed the world population of 9.2 billion in 2050, if relatively modest diets are adopted, where a low level of inequality in food distribution is required to avoid malnutrition".

Isobel Tomlinson is the policy and campaigns officer for the Soil Association, the UK's leading organic organisation

The Green Room is a series of opinion articles on environmental topics running weekly on the BBC News website

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Do you agree with Isobel Tomlinson? Is it wrong to suggest that the world needs to double its food production by 2050? Will it lead to the intensification of the globe's agricultural industry? Or do we just have to accept that there is never going to be universal food security, and develop ways to help as many people has possible with the resources we have?

We have to plan infinite things to satisfy one unplanned thing i.e. Growth of human population. Either, there are 'without power' powerful leaders, who can not speak on the most basic issue or there are 'genuine' powerful leaders who are wasting their power in neutralizing the frivolous issues raised by their opposition and media. Most of the places, we are handling the results of the problem. Why do not we hit at the source? Why do not we raise the most basic issue? Why not this issue is getting importance in my own country? Not a single political leader is realizing the abnormal growth of human population.
Sanjay Singh Thakur, Indore,India

If more were done to encourage people to have fewer babies, then, whatever the statistics, less food would be needed to feed the global population.
Venetia Caine, Poitiers, France

The FAO was very quick to adjust their projection to a 70 per cent increase after the initial quote got out and most commentators adjusted accordingly long ago, so it's a bit disingenuous to extend the critique of an estimate that has already been refined and will continue to be. To quibble about how big an increase will be required diminishes the matter at stake, but of course that's the objective of the article. To sum it up: FAO has made a credible forecast; we'll never know for certain until it's all over and we certainly can't wait till then to do something about it. It's our food supply after all. Whether we need to increase production by 50 or 70 or 100 percent is not the point. What's really important is that the population of Europe and the world will continue to increase and food supplies will have to be boosted in the face of critical challenges (climate change, availability of water, environmental protection, biodiversity, distribution, affordability etc). The big question is whether we are going to increase the agricultural land base (and cut down more forests to grow food) or become more productive in a sustainable way on existing farmland. Deforestation is agriculture's single biggest contribution to greenhouse gas emissions and the destruction of biodiversity. It's a fact that organic methods require more land to grow the same amount of food (up to three times) and the crops are by far more susceptible to the pests and disease that have plagued food production throughout human history when the whole of agriculture was "organic". Organic is fine in some circumstances and not in others, but it's not the answer to the food supply challenge, which is very likely the biggest we face. It would be very helpful if every stakeholder in the agricultural and food policy community accepted this cold, hard fact as soon as possible. It's not a matter of the right or wrong ideology of farming. It's about resisting the age-old human solution to hunger which is to expand farmland. It's about efficiency and productivity, quality and affordability, and the full and rational application of science and technology to sustaining the our food supply sustainably. Phil Newton, ECPA (European Crop Protection Association)
Phil Newton, Brussels

One would hope that long before 2050 or even 2030, we in the so-called Developed World will have realised that we are eating far too much. I was born in 1969, and everyone I grew up with was slim during the 1970s and 80s. Now 1 in 3 are overweight or obese. And guess what, our calorie intake is much higher. The answer is to drop back down to a more reasonable level of personal consumption - which will also overcome many of the diseases of excess such as heart disease and tumours. Then make projections on what is likely. The fact is that, much as advertisers would like us to, we don't need to all eat a burger and chips and chocolate diet.
Andrew Smith, Milton Keynes, UK

You can't believe anything when it comes to food. We're all on a healthy eating kick now. Due to the large number of centenarians in the Mediterranean countries, we've been coerced and bullied into changing our diet. Now we find that most of these 104 year olds have been dead for decades while their families continued to claim their pensions.
Alan, UK

Food equality is the key issue. Global production of food in vegetable form is twice what is needed to feed the world's population - 4,200 calories per person per day. But it's not so unequally distributed, and much is wasted. E.g. about 40% of global food production is fed to animals not people, and the meat produced contains less than a third of the calories of the animal feed. So I think we urgently need an open debate on alternatives to "business as usual". We don't need high-tech, but we do need high-ethic.
Phil Entwistle, Beverley

Nobody should take any prediction that far into the future seriously. On the other hand, the Soil Association wants to move the world backwards in agriculture, not forwards. They and the rest of the anti-technology anti-GM comfortable middle class (i.e. rich) are part of the problem, not part of the solution.
W Boucher, Cambridge, UK

It's certainly a question of how food is produced, rather than just focusing on how much is produced. As mentioned recently on BBC News - looking at bees shows a clear indication of increasing broad scale mono-culture is unhealthy, and ultimately unsustainable. Here in Australia, there are many examples of farmers applying ecological perspectives in land management, utilising natural services and producing greater yields more "naturally".I also agree that much of the western diet and food management creates both needless health problems and excessive waste. Isobel is correct in saying that we need to "have an honest debate about how we can feed the world in 2050 in a way that doesn't lead to the further increases in obesity and diet related diseases, ensures that the global environment is protected, and that puts an end to hunger and starvation." There is great potential for improvement which should lead to greater efficiency (and ultimately reduction in cost of food, plus health related issues). However, the problem is as much social - where it's cheaper to grow (often with transport being cheap, this leads to what seems odd choices), what is culturally desired etc. Eventually you'll find that you're no longer looking at food production, but how we choose to live. Asking questions here will lead to even greater resistance. But again - real debate and discussion, based on solid evidence, is the only way forward. I also feel it premature to rule out GM as playing any role - not that I'm advocating GM over all else, but I do feel that it must play an important role in some way.
Tim Lubcke, Adelaide

I think the most important thing is to tell some countries and people stopping produce more human beings, slowing down the depletion our limited resources, recycling everthing as much as we can. Don't chase the luxury life, have a comfortable and happy life.
Caren Wang, China

I have mixed feelings,it is very essential to explore how globalization, broadly conceived to include international human rights norms, humanitarianism, and alternative trade, might influence peaceful and food secure outlooks and outcomes. It should review studies on the relationships between (1) conflict and food insecurity, (2) conflict and globalization, and (3) globalization and food insecurity. Next, it would be analyzed country level, historical contexts where export crops, such as coffee and cotton, have been implicated in triggering and perpetuating conflict. It suggest that it is not export cropping per Se, but production and trade structures and food and financial policy contexts that determine peaceful or belligerent outcomes. Export cropping appears to contribute to conflict when fluctuating prices destabilize household and national incomes and when revenues fund hostilities.
Engr Salam, LGED, Bangladesh

Stephen Hawking's argument in his new book that science can explain the Universe's origin without invoking God,

Daily View: Stephen Hawking's Universe theory

Clare Spencer | 10:01 UK time, Friday, 3 September 2010

Commentators discuss physicist Stephen Hawking's argument in his new book that science can explain the Universe's origin without invoking God, instead arguing that the existence of gravity means the Universe can create itself from nothing.

Chief Rabbi Lord Sacks says in the Times [subscription required] that Stephen Hawking's idea is both unoriginal and that he doesn't understand that religion and science answer different questions:

"What would we do for entertainment without scientists telling us, with breathless excitement, that 'God did not create the Universe', as if they were the first to discover this astonishing proposition? Stephen Hawking is the latest, but certainly not the first. When Napoleon asked Laplace, two hundred years ago, where was God in his scientific system, the mathematician replied, Je n'ai pas besoin de cette hypothèse. 'I do not need God to explain the Universe.' We never did. That is what scientists do not understand.

"There is a difference between science and religion. Science is about explanation. Religion is about interpretation. Science takes things apart to see how they work. Religion puts things together to see what they mean. They are different intellectual enterprises."

In the New Scientist Roger Highfield dismisses the newness of the theory:

"Media furore over Stephen Hawking's new book, The Grand Design, has made it the biggest science news story of the day. But it's not like Hawking has suddenly given up a religious belief - let alone proved that God doesn't exist...

"As Hawking's long-suffering assistant dealt with a deluge of enquiries from journalists from around the world, she told me how the furore says more about the silly season than any change of mind. It also says much about how God is used to sell science to the public."

The Guardian imagines the relationship between Stephen Hawking and God:

"One accepts that if God were to choose one day to explain the universe to Hawking, the professor would be one of the few people on the planet with any serious chance of understanding the conversation. But spontaneous creation is, for most folk, just a contradiction in terms. God may or may not find all this amusing. The thing is - how to put this gently to Professor Hawking? - that God does not necessarily follow the ins and outs of our many arguments about His existence."

In the Catholic Herald Quentin de la Bedoyere argues that there is still a gap in Stephen Hawking's explanation of the creation of the Universe:

"Most particularly it would not touch the question of how something existing comes out from nothing. That is a question which science cannot answer, and will never answer, because nothingness is not within its domain. Hawking apparently does not address this question - which is the true and ultimate Theory of Everything."

In the Daily Mail John Lennox describes himself as a scientist and a Christian who teaches maths as Oxford university. He argues that Stephen Hawking is wrong to think they can't live alongside each other:

"Much of the rationale behind Hawking's argument lies in the idea that there is a deep-seated conflict between science and religion. But this is not a discord I recognise. "For me, as a Christian believer, the beauty of the scientific laws only reinforces my faith in an intelligent, divine creative force at work. The more I understand science, the more I believe in God because of my wonder at the breadth, sophistication and integrity of his creation.

"The very reason science flourished so vigorously in the 16th and 17th centuries was precisely because of the belief that the laws of nature which were then being discovered and defined reflected the influence of a divine law-giver."

In the Telegraph Graham Farmello is sceptical about the reasons behind scientists getting involved in the question of God:

"The science-religion relationship, in so far as there is one, continues to be a crowd-pleaser. It seems to be a fundamental law of PR that the God-science debate is a sure-fire source of publicity. Always welcome when one has a book to sell."

3 September 2010 Last updated at 00:03

Link between bone drugs and oesophageal cancer

The drugs work by strengthening the bones

Long-term use of bone-strengthening drugs - used to treat fractures - may boost the risk of oesophageal cancer, Oxford University research suggests.

The study of 3,000 people found taking bisphosphonates for five years upped the risk from one in 1,000 to two in 1,000 for 60 to 79-year-olds.

The researchers said the risk was small, but reliable information on risks and benefits was needed.

But experts said for many, the case for taking the drugs "would be strong".

The findings, published in the British Medical Journal, were based on an analysis of anonymised GP records.

They contrast with previous research which found no increased risk for the bone-strengthening drugs.

'Talk to doctor'

Continue reading the main story

“Start Quote

Anyone who is taking these drugs and is worried about their risk of cancer should talk to their doctor”

End Quote Dr Laura Bell Cancer Research UK

It is not known why the risk may be increased, although the drugs are known to irritate the oesophagus.

Thousands of stomach and colorectum cancers were also studied, but no increased risk was found.

Lead researcher Dr Jane Green said even if the findings were confirmed by other studies "few people" taking bisphosphonates would ever develop the cancer.

"Our findings are part of a wider picture. Bisphosphonates are being increasingly prescribed to prevent fracture and what is lacking is reliable information on the benefits and risks of their use in the long term."

About 600,000 people in the UK are currently taking the drugs - including a tenth of all women over the age of 70.

Dr Laura Bell, from Cancer Research UK, agreed the findings should be treated with caution, pointing out the risks were "still small".

"Anyone who is taking these drugs and is worried about their risk of cancer should talk to their doctor."

The National Osteoporosis Society said: "It is a case of balancing the reduced risk of fractures against the side effects of treatment.

"When you consider the fact that there are 230,000 osteoporotic fractures every year in the UK and 1,150 hip-fracture-related deaths every month, the case for treatment is strong."

If I'd proposed solving the pension problem by compulsory euthanasia for every fifth pensioner I'd have got less trouble for it

1 September 2010 Last updated at 09:01

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Blair's memoirs: Key quotes

Tony Blair's memoirs have been published. We will be updating this page showing some of the key quotations from the book. ELECTION NIGHT 1997

This was not a win. It was a landslide. After about two hours for a time I actually became worried. The moving line at the bottom of the TV screen was showing over a hundred Labour seats. The Tories had just six. I began to think I had done something unconstitutional.

IN POWER

On 2 May 1997, I walked into Downing Street as PM for the first time. I had never held office, not even as the most junior of junior ministers. It was my first and only job in government.

DEATH OF DIANA, PRINCESS OF WALES

Through it all, we were trying to work out how it should be managed. I know this sounds callous. I was genuinely in grief. I liked her and I felt desperately sorry for her two boys, but I also knew that this was going to be a major national, in fact global event like no other. How Britain emerged was important for the country internally and externally. I was prime minister; I had to work out how it would work out. I had to articulate what would be a tidal wave of grief and loss, in a way that was dignified but also expressed the emotion and love - not too strong a word - people felt for her.

PRIME MINISTER'S QUESTIONS

If I did seem to be enjoying it, then it was a supreme instance of acting. I hated it.

9/11 ATTACKS

At that moment, I felt eerily calm despite being naturally horrified at the devastation, and aware this was not an ordinary event but a world-changing one. It was not America alone who was the target, but all of us who shared the same values. We had to stand together.

GEORGE W BUSH

I had come to like and admire George. I was asked recently which of the political leaders I had met had the most integrity. I listed George near the top. Some people were aghast... thinking I was joking. He had genuine integrity and as much political courage as any leader I ever met. He was, in a bizarre sense... a true idealist.

IRAQ - BEREAVED FAMILIES

Do they really suppose I don't care, don't feel, don't regret with every fibre of my being the loss of those who died? To be indifferent to that would be inhuman, emotionally warped.

DEATH OF DR DAVID KELLY

I will never know precisely what made Dr David Kelly take his own life. Who can ever know the reason behind these things? It was so sad, unnecessary and terrible.

ON WIFE CHERIE

She was a rock to me, strong when I was weak, determined when I was tempted to falter, and fierce in her defence of the family.

ON DRINKING

By the standards of days gone by I was not even remotely a toper, and I couldn't do lunchtime drinking except on Christmas Day, but if you took the thing everyone always lies about - units per week - I was definitely at the outer limit. Stiff whisky or G&T before dinner, couple of glasses of wine or even half a bottle with it. So not excessively excessive. I had a limit. But I was aware that it had become a prop.

ROWS WITH GORDON BROWN

I'm afraid I stopped taking his calls. Poor Jon [an adviser] would come in and say: "The chancellor really wants to speak to you." I would say: "I am really busy, Jon." And he would say: "He is really demanding it." Then I would say: 'I'll call him soon." And Jon would say: "Do you really mean that, prime minister?" And I would say: "No, Jon."

ON GORDON BROWN'S FOLLOWERS

The curse of Gordon was to make these people co-conspirators, not free-range thinkers. He and Ed Balls and others were like I had been back in the 1980s, until slowly the scales fell from my eyes and I realised it was more like a cult than a kirk.

THE FINANCIAL CRISIS

I profoundly disagree with important parts of the statist, so-called Keynesian response to the economic crisis; I believe we should be projecting strength and determination abroad, not weakness or uncertainty.

DAVID CAMERON

David Cameron was clever and people-friendly but he had not gone through the arduous but ultimately highly educative apprenticeship I had gone through in the 1980s and early 90s.

ED BALLS

I've had some harsh things to say about Ed Balls - I thought he behaved badly at points, and was wrong on policy - but I also thought he was really able, and a talent that any political party should be grateful to have.

FOX HUNTING BAN

If I'd proposed solving the pension problem by compulsory euthanasia for every fifth pensioner I'd have got less trouble for it.

IAN PAISLEY AND NORTHERN IRELAND PEACE DEAL

Once, near the end, he asked me whether I thought God wanted him to make the deal that would seal the peace process. I wanted to say yes, but I hesitated; though I was sure God would want peace, God is not a negotiator.

Nine Primary Care Trusts have agreed a contract with NHS SBS - a partnership of the Department of Health and IT firm Steria - with some work going to

NHS records move in East Midlands sees some 90 jobs cut

NHS bosses have insisted information such as cancer screening correspondence will not go abroad

NHS patient record services in the East Midlands are being outsourced, with the loss of about 90 jobs.

Health officials said the move will save up to £9m over six years and will not impact on patient care.

But unions said staff had been "sold out" and having some tasks sent to India risked vital information.

The move will see payment processing, cervical and breast cancer screening correspondence, medical records and patient registration done by the new firm.

Clinical data

NHS staff have been told the current workforce of about 150 will be reduced to 65, based at offices in Leicester and Derby .

Officials insisted sensitive information would not be sent abroad.

Andrew Booth, of NHS Derby City, said: "There are some services which are being provided from India but the majority of services will be located in this country.

"No clinical data will be in India, it is all based in servers here.

"From an information governance side, for accessing data there, which I know has been a concern, actually the Indian operation has been independently validated as being as good as, if not better, than in this country."

Privatisation fear

But Scott Kingswood, from Unison, said: "There could be hiccups in transfer of information, data protection.

"But the crux of it, despite all that, is that the job still exists, the people who are currently doing those jobs are being told those jobs are no longer theirs and having it taken away from them.

"In my book that is privatisation of the NHS and staff who have spent many years working for the NHS are feeling let down and sold out."

The reorganisation is due to be completed by the summer of 2011.

The nine Primary Care Trusts involved are NHS Bassetlaw, NHS Derby City, NHS Derbyshire County, NHS Leicester City, NHS Leicestershire County and Rutland, NHS Lincolnshire, NHS Northamptonshire, NHS Nottingham City and NHS Nottinghamshire County.

the 6km-long (3.75-mile) long dam will threaten the survival of indigenous groups,

26 August 2010 Last updated at 20:49

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Brazil government gives go-ahead for huge Amazon dam

The proposal to build a dam on the Xingu river has long been a source of controversy

Brazil's government has given the formal go-ahead for the building on a tributary of the Amazon of the world's third biggest hydroelectric dam.

After several failed legal challenges, President Luiz Inacio Lula da Silva signed the contract for the Belo Monte dam with the Norte Energia consortium.

Critics say the project will damage the local ecosystem and make homeless 50,000 mainly indigenous people.

But the government says it is crucial for development and will create jobs.

Bidding for the project had to be halted three times before a final court appeal by the government allowed Norte Energia, led by the state-owned Companhia Hidro Eletrica do Sao Francisco, to be awarded the contract.

Continue reading the main story

“Start Quote

We will persuade them that we took seriously into account the environmental and social issues”

End Quote Luiz Inacio Lula da Silva Brazilian president

'Death warrant'

At the contract signing ceremony in Brasilia on Thursday, President Lula said he himself had criticised the dam before he learnt more about it.

"You cannot imagine how many times I spoke against Belo Monte without even knowing what it was about, and it is precisely during my government that Belo Monte is being unveiled," he said.

"I think this is a victory for Brazil's energy sector.

"We will persuade them that we took seriously into account the environmental and social issues," he added.

The proposal to build a hydro-electric dam on the Xingu river, a tributary of the Amazon in the northern state of Para, has long been a source of controversy.

The initial project was abandoned in the 1990s amid widespread protests both in Brazil and around the world.

Environmental groups say and the lives of up to 50,000 people could be affected as 500 sq km (190 sq miles) of land would be flooded.

Officials have dismissed the criticism and promised the winning consortium will pay $800m to protect the environment.

"The government has signed a death warrant for the Xingu river and condemned thousands of residents to expulsion," local Indian leaders said on Thursday.

The 11,000 MW dam would be third largest in the world, after the Three Gorges in China and Itaipu, which is jointly run by Brazil and Paraguay.

It is expected to cost between $11bn and $17bn, and provide electricity to 23 million homes.

With Brazil's economy continuing to show signs of growth, ministers say hydro-electric plants are a vital way to ensure power supplies over the next decade - and at least 70 dams are said to be planned for the Amazon region.

Critics say the Belo Monte plant will be hugely inefficient, generating less than 10% of its capacity during the three to four months of the year when water levels are low.

Broccoli 'boosts' healthy gut

Broccoli is high in vitamins and minerals

Extracts of broccoli and banana may help in fighting stomach problems, research suggests.

Laboratory studies show fibres from the vegetables may boost the body's natural defences against stomach infections.
Trials are under way to see if they could be used as a medical food for patients with Crohn's disease.
Crohn's disease is an inflammatory bowel disease that causes symptoms such as diarrhoea and abdominal pain.
It affects about 1 in 1,000 people, and is thought to be caused by a mixture of environmental and genetic factors.
The condition is common in developed countries, where diets are often low in fibre and high in processed food.

• 
  

Scientists at the University of Liverpool looked at how roughage from vegetables influenced the passage of harmful bacteria through cells inside the gut.

They found that fibres from the plantain, a type of large banana, and broccoli, were particularly beneficial. But a common stabiliser added to processed foods during the manufacturing process had the opposite effect.
Dr Barry Campbell, from the University of Liverpool, said: "This research shows that different dietary components can have powerful effects on the movement of bacteria through the bowel.
"We have known for some time the general health benefits of eating plantain and broccoli, which are both high in vitamins and minerals, but until now we have not understood how they can boost the body's natural defences against infection common in Crohn's patients.
"Our work suggests that it might be important for patients with this condition to eat healthily and limit their intake of processed foods."
M-cells
The research, published in the journal Gut, and carried out in collaboration with experts in Sweden and Scotland, investigated special cells, called M-cells, which line the gut and ward off invading bacteria.
Work was carried out in laboratory-grown cells and tissue samples from patients undergoing surgery for stomach problems.
Clinical trials are now underway in 76 Crohn's patients to find out whether a medical food containing plantain fibres could help keep the disease at bay.
"It may be that it makes sense for sufferers of Crohn's to take supplements of these fibres to help prevent relapse," said Professor Jon Rhodes of the University of Liverpool.
Commenting on the study, a spokesperson for Crohn's and Colitis, which represents patients with inflammatory bowel disorders, welcomed further insight into how the gut combats bacteria like E.Coli.
"Knowledge of the M-cell role offers a more detailed explanation as to why a healthy diet can improve the health and well being for people with Crohn's disease and healthy individuals alike," she said

Religion may influence doctors' end-of-life care

Guidelines stress doctors should discuss treatment with their patients

Doctors with religious beliefs are less likely to take decisions which could hasten the death of those who are terminally ill, a study suggests.

The survey of nearly 4,000 doctors found those with a strong faith were also less likely to discuss end-of-life treatment options with their patient.
The London University research urges greater acknowledgement of how beliefs influence care.
Doctors and campaigners described the findings as "concerning".
Dr Clive Seale of Barts and the London School of Medicine analysed 3,733 responses from doctors practising in a wide variety of fields, with a particular focus on those who worked in palliative care and with the elderly.
The General Medical Council, which regulates the profession, says that while doctors should start from the assumption that life should be prolonged, this should not be at any cost.
While it is illegal to give drugs with the deliberate intention of ending someone's life, doctors may administer morphine or other medication to relieve pain or distress which may have the effect of shortening life - so-called deep sedation.
The GMC also advises that discussions surrounding end-of-life care, including issues such as tube-feeding, hydration and resuscitation, which can all cause avoidable distress, be started with those who are terminally ill well in advance of their dying days.
Patient communication
Those who described themselves as very or extremely non-religious were about 40% more likely to sedate than religious doctors, the study in the Journal of Medical Ethics reported.

Whilst entitled to their beliefs, doctors should not let them come in the way of providing patient-centred care at the end of life”

End Quote Dr Ann McPherson Dignity in Dying

Being very or extremely religious was also associated with significantly fewer discussions of decisions with patients around treatment at the end of life.

More than 12% of the doctors surveyed described themselves as very or extremely religious, compared with just over 6% of the UK general population - as documented in the last national survey of attitudes.
However one in five described themselves as very or extremely non-religious, slightly higher than the general population.
The UK medical population differs in ethnic profile from the population as a whole, with a higher proportion of doctors from South Asian backgrounds.
The survey showed that specialists in the care of the elderly were more likely to be Hindu or Muslim than other doctors, while palliative care doctors were slightly more likely to be white and Christian.
The British Medical Association said: "Decisions about end-of-life care need to be taken on the basis of an assessment of the individual patient's circumstances - incorporating discussions with the patient and close family members where possible and appropriate.
"The religious beliefs of doctors should not be allowed to influence objective, patient-centred decision-making. End-of-life decisions must always be made in the best interests of patients."
Deeply troubling
Professor Mayur Lakhani, chair of the National Council for Palliative Care, said he was concerned by the findings of the paper.
"Core training in palliative care should be mandatory for all doctors to ensure consistency of decision-making, based on best practice and current evidence.
"Decisions must be taken in partnership with people approaching the end of life and those close to them.
Dr Ann McPherson of the charity Dignity in Dying added that while there was growing awareness of the need to put patients' wishes first, the research indicated there was "still some way to go".
"The fact that some doctors are not discussing possible options at the end of life with their patients on account of their religious beliefs is deeply troubling.
"Whilst entitled to their beliefs, doctors should not let them come in the way of providing patient-centred care at the end of life."
David Praill, chief executive of Help the Hospices said the findings highlighted "the maze of complex moral and legal dilemmas that doctors can face when caring for patients at the end of life".
"Doctors need support to ensure that they have the information, skills and confidence necessary to make the best end of life care decisions with their patients."

Venezuelan village key in search for Huntington's cure

The village of Barranquitas in Venezuela has the highest concentration of Huntington's disease, a devastating brain condition, in the world. The BBC's Will Grant accompanies a US scientist there as she continues her life's work to find a cure.

Dr Nancy Wexler has been coming to Barranquitas for many years

Angela staggers across Barranquitas under the blistering sun to reach the children's lunch hall, her matchstick-thin legs struggling to support her frail frame.

Although it is a small village, it is hard work crossing it when your limbs won't do what you tell them to.

But Angela is determined to make the effort because an old friend has just arrived.

Continue reading the main story

HUNTINGTON'S DISEASE

• Hereditary neurological disorder
• Causes progressive degeneration of cells in brain
• Slowly impairs ability to walk, talk, think, or reason
• Symptoms usually appear between age 30 and 50
• Person has 50% change of inheriting the gene if a parent has HD
• No cure to date

• BBC: Huntington's disease

That friend, American scientist Nancy Wexler, has been travelling to Barranquitas for more than 30 years.

She is sure it holds the key to an answer she has been looking for her entire adult life: a cure for Huntington's disease (HD).

For Dr Wexler this is more than an academic pursuit or a career goal, it's a family obsession.

"My mother died of Huntington's and she was a scientist. My father was a scientist too, and so we said 'let's find a cure','" said Dr Wexler.

"And we still say that. You can't get up in the morning without having hope and confidence that the cure is just around the corner."

As the daughter of an HD sufferer, she has a one-in-two chance of carrying the fatal genetic flaw herself.

Huntington's is an incurable and fatal hereditary disease which causes the sufferer to lose control of their muscles.

Click to play

Click to play

Nancy Wexler explains what motivated her to seek a cure

It develops into serious problems with swallowing and many patients die from choking or malnutrition. Beyond the physical symptoms, deep depression can often take hold.

It affects 1 in 10,000 people, but in Barranquitas, a remote location where over the years there has been much inter-marrying between few families, the rate is more like 1 in 10.

Some 1,000 villagers already have fully-blown Huntington's; many more carry the gene.

Such a high concentration of Huntington's patients made it the backbone of Dr Wexler's research.

Her research in Venezuela was crucial for the breakthrough in 1993 when the abnormality that causes HD was identified: a single defective gene on chromosome 4.

Ciro Soto is one of the villagers whose DNA and family history helped that discovery.

Dr Wexler met Mr Soto when he was just eight years old. Now almost 40, his body twitches uncontrollably from the disease.

"Ciro was a wonderful drummer, very athletic, a beautiful fisherman," said Dr Wexler.

"Both of Ciro's parents had Huntington's," she explained. "There were 14 siblings and 10... have Huntington's. Some of them have unfortunately already died of the disease."

Tough life

Despite the breakthrough, the team had not been back to Venezuela since 2002 given the strained ties between the Bush administration and President Hugo Chavez.

There is still no formal protocol with the Venezuelan government for removing the DNA samples Dr Wexler needs.

But in a positive development, the Venezuelan Health Ministry sent a representative to Barranquitas to meet her.

"I think Dr Wexler's persistence has been admirable," said Dr Federico Savinon.

Casa Hogar is a care home looking after some 50 people

While acknowledging there been some "difficulties in working together", Dr Savinon said that "the ministry and the health minister herself, Col Eugenia Sader, are completely disposed to reopening a space for joint work with Dr Wexler".

However, Dr Wexler and the people of Barranquitas have heard such promises before.

Successive health ministers have voiced support for the research, but the New York-based team are yet to see any serious progress on the signing of the protocol for the research.

Life in Barranquitas is tough. The government has provided new housing for some families, including Ciro's.

But most Huntington's sufferers still live in deep poverty while simultaneously trying to deal with the fatal illness.

In 1999, Dr Wexler co-founded a care home for HD patients outside the state capital, Maracaibo.

Built on the site of the "roughest bar in town", the Casa Hogar is a haven for more than 50 people whose families can no longer cope.

Everyone who works there has relatives with Huntington's sufferers. Many of them don't know if one day they may develop the disease too.

Dr Wexler's long association with Barranquitas gives her hope

The Casa Hogar is facing a chronic lack of funding, possibly even closure. Still, Dr Wexler remains confident that one day it won't be needed.

"We never know when some miraculous discovery is going to be made," she said.

"There are science breakthroughs on the horizon and happening now so I am very hopeful about the cure in the near future."

When Angela made it to the lunch-hall, she was greeted with a huge hug by Dr Wexler.

Despite the setbacks, Dr Wexler is optimistic that Angela's grandson, who is also at risk of the disease, will have more of a chance at a cure than she did

NHS spends more than £300m on consultancy services

21 August 2010 Last updated at 00:04

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By Clare Murphy Health reporter, BBC News

IT, project management and human resources were included in the consultancy bill

NHS trusts in England spent more than £300m on external consultancy services last year, figures show.

The money was used to pay for advice on a range of issues, from legal contracts to human resources and media work.

The NHS Confederation, which represents trusts, says taxpayers' money should not be wasted but that outside help was often needed to deliver reform.

The figure represents less than half of 1% of the NHS budget but the health secretary described it as "staggering".

Overall, primary care trusts (PCTs) and strategic health authorities (SHAs) spent £313.9m on consultancy services in the financial year 2009/2010.

Pounds and pence

London areas spent nearly three times more per head on consultancy services than any other part of the country.

Camden PCT spent more than £12m, in excess of £50 per head of the local population, although they stressed much of this was down to a large spend on a body providing support to help achieve value for money and efficiency in commissioning services.

In contrast, Bournemouth and Poole PCT spent just 20p per head.

The government's health White Paper, released last month, includes measures to abolish SHAs and PCTs and replace them with GP-led consortiums.

Continue reading the main story

“Start Quote

There are currently more managers within the NHS than at any point in its history, so why are SHAs and PCTs buying in additional expertise?”

End Quote Royal College of Nursing

Health Secretary Andrew Lansley said he was "staggered by the scale of the expenditure", adding that he had asked PCTs and SHAs to reduce their management costs by 46% over the next four years.

"This will root out unnecessary bureaucracy and any expensive duplication of functions," he said. "Every penny saved will be re-invested in improving patient care, meeting demand and driving up quality."

Nigel Edwards, acting chief executive of the NHS Confederation, said: "Any spending of taxpayers' money has to be justified, and the NHS has been asked by successive governments to perform tasks for which internal expertise was not present or needed to be developed. Dismissing all this spending as wasteful is unfounded."

He added that the proposed overhaul would likely increase the need for consultants' services.

"External advice will be necessary if NHS organisations are to deliver change and, with the financial challenges and size of the current reform programme, it is probable NHS organisations, especially new GP consortia, will require external help to deliver what the government wants," he said.

But the Royal College of Nursing described the figures as "shocking and nothing short of a scandal".

"It is extremely difficult to see how spending more than £313m on consultancy services in one year can be justified. There are currently more managers within the NHS than at any point in its history, so why are SHAs and PCTs buying in additional expertise?" said its chief executive Dr Peter Carter.

"At a time when nurses and other staff are seeing front line services cut and being asked to accept a pay freeze, these organisations need to clearly demonstrate they are getting good value for money from the taxpayer's health pounds."

Shadow health secretary Andy Burnham said: "We were already acting to bring consultancy spend down by one-third but Mr Lansley's reforms will give consultancy firms a field day.

"What he seems not to understand is the NHS needs good managers. By wiping away the expertise currently in primary care trusts, he is opening the door to consultancy firms who know that hundreds of new, untested GP groups won't have the experience to go it alone."

This is the first time the figures have been collected in this way. Estimates published by the Conservatives in 2006 suggested trusts had spent £172m on external advice that year

20 August 2010 Last updated at 00:46

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Green leafy veg 'may cut diabetes risk'

By Emma Wilkinson Health reporter, BBC News

Green leafy veg, rather than a healthy diet in general, were linked to benefits

A diet rich in green leafy vegetables may reduce the risk of developing diabetes, UK research says.

In an analysis of six studies into fruit and vegetable intake, only food including spinach and cabbage was found to have a significant positive effect.

A portion and a half a day was found to cut type 2 diabetes risk by 14%, the British Medical Journal (BMJ) reports.

But experts urged people to continue to aim for five portions of fruit and vegetables a day.

Continue reading the main story

“Start Quote

This study suggests that green leafy vegetables seem to be particularly important in terms of preventing diabetes”

End Quote Professor Melanie Davies University of Leicester

The researchers from Leicester University reviewed data from the studies of 220,000 adults in total.

They found that eating more fruit and vegetables in general was not strongly linked with a smaller chance of developing type 2 diabetes but "there was a general trend in that direction".

Yet when it came to green leafy vegetables, which the researchers said also includes broccoli and cauliflower, the risk reduction was significant.

The team calculated that a daily dose of 106g reduced the risk of diabetes by 14% - a UK "portion" is classed as 80g.

It is not clear why green leafy vegetables may have a protective effect but one reason may be they are high in antioxidants, such as vitamin C and another theory is that they contain high levels of magnesium.

Study leader Professor Melanie Davies, professor of diabetic medicine at the University of Leicester, said the message to eat five portions of fruit and vegetables a day remains an important one.

But she added: "People like very specific health messages.

"We know that intake of fruit and vegetables is important, but this study suggests that green leafy vegetables seem to be particularly important in terms of preventing diabetes."

The team are now planning a study in people at high risk of developing the condition to see if increasing their intake of vegetables like spinach and kale can help to reduce their chances of being diagnosed with diabetes.

Fruit and veg

In 2008/09, the National Diet Nutrition Survey showed that, although fruit and vegetable intake has risen over the past decade, only a third of men and women eat the recommended five-a-day.

In an accompanying editorial in the BMJ, Professor Jim Mann from the University of Otago in New Zealand, stressed that the message of increasing overall fruit and vegetable intake must not be lost "in a plethora of magic bullets," even though green leafy vegetables clearly can be included as one of the daily portions.

Dr Iain Frame, director of research at Diabetes UK said: "We already know that the health benefits of eating vegetables are far-reaching but this is the first time that there has been a suggested link specifically between green leafy vegetables and a reduced risk of developing type 2 diabetes."

But he warned the evidence was limited and it was too early to isolate green leafy vegetables and present them alone as a method to cut the chances of developing the condition.

"We would be concerned if focusing on certain foods detracted from the advice to eat five portions of fruits and vegetables a day, which has benefits in terms of reducing heart disease, stroke, some cancers and obesity as well as type 2 diabetes."

Diabetes UK is currently funding research into whether fermentable carbohydrates found in foods such as asparagus, garlic, chicory and Jerusalem artichokes could help weight loss and prevent Type 2 diabetes.

Dark chocolate can be good for the heart,

16 August 2010 Last updated at 21:08

Dark chocolate can be good for the heart, study says

Higher cocoa content in the chocolate is associated with greater heart benefits

Older women who eat dark chocolate once or twice a week could be lowering their risk of heart failure, says a US study.

It found those eating chocolate once or twice a week cut the risk of developing heart failure by a third, but those eating it every day did not benefit.

The Boston study, in a journal of the American Heart Association, looked at nearly 32,000 Swedish women aged between 48 and 83 over nine years.

Dieticians say eating chocolate too often can be damaging and unhealthy.

The study notes that one or two 19 to 30 gram servings of dark chocolate a week led to a 32% reduction in heart failure risk.

This fell to 26% when one to three servings a month were eaten.

But those who ate chocolate every day did not appear to reduce their risk of heart failure at all.

Continue reading the main story

“Start Quote

Whilst antioxidants in chocolate may be helpful to your heart, they can also be found in fruit and veg - foods which don't come with the saturated fat and high calories”

End Quote Victoria Taylor British Heart Foundation

The researchers conclude the protective effect of eating chocolate reduces as more or less is eaten than the optimum one to two servings a week.

'Flavanoids'

Too much chocolate is unhealthy because it contains high levels of sugar and fat which can make people put on weight, the researchers say.

But chocolate also contains high concentration of compounds called flavonoids which can lower blood pressure and protect against heart disease, previous studies have found.

The researchers behind this study say this is the first time long-term effects related specifically to heart failure have been shown.

Dr Murray Mittleman is study leader and director of the Cardiovascular Epidemiology Research Unit at the Beth Israel Deaconess Medical Centre in Boston.

He said: "You can't ignore that chocolate is a relatively calorie-dense food and large amounts of habitual consumption is going to raise your risks for weight gain.

"But if you're going to have a treat, dark chocolate is probably a good choice, as long as it's in moderation," Dr Mittleman said.

Cocoa content

Differences in chocolate quality will affect the study's implications, the authors say. Higher cocoa content is associated with greater heart benefits.

Although the chocolate consumed by the Swedish women in the study was milk chocolate, it contained a high concentration of cocoa solids - about 30%.

This is equivalent to dark chocolate by UK standards.

Dark chocolate can contain as much as 75% cocoa while standard milk chocolate may have 25% or less cocoa.

Victoria Taylor, senior dietitian at the British Heart Foundation, said the study showed the importance of finding the right balance in our diets.

"Before you rip open those sweet treats, remember that whilst antioxidants in chocolate may be helpful to your heart, they can also be found in fruit and veg - foods which don't come with the saturated fat and high calories that chocolate does," she said.

Dr David Kelly inquest

Michael Howard urges Dr David Kelly inquest

Lord Hutton's inquiry found that Dr Kelly had committed suicide

Ex-Conservative leader Michael Howard has urged a full inquest into the death of government scientist Dr David Kelly.

He told the Mail on Sunday "serious questions" had been raised by experts who said the official cause of death was "extremely unlikely".
Dr Kelly died in 2003 after he was exposed as the source of a BBC story on the grounds for going to war in Iraq.
An inquiry found the 59-year-old had died from blood loss after slashing his wrist with a blunt gardening knife.
Severed artery
Michael Howard, who is now a Tory peer, led his party at the time the scientist's body was found in woods near his Oxfordshire home.
He told the newspaper: "In view of the growing number of relevant questions that have arisen and cast doubt on the conclusions reached by Lord Hutton, I believe it would now be appropriate for a full inquest to be held.

"Recent evidence by the first police officer on the scene, together with new statements by doctors, raise serious questions which should be considered.

"This has been on my mind for quite a while and recent events have crystallised my view."
Last week, a group of prominent experts cast doubt on the official cause of death.
They wrote a letter to The Times arguing that a severed ulnar artery, the wound found to Dr Kelly's wrist, was unlikely to be life-threatening unless an individual had a blood clotting deficiency.
The letter's signatories included a former coroner, Michael Powers, a former deputy coroner, Margaret Bloom, and Julian Bion, a professor of intensive care medicine.
When former prime minister Tony Blair appointed Lord Hutton to head the public inquiry into the scientists's death, the then lord chancellor, Lord Falconer, unusually ruled it should also act as an inquest.

'No Sun link' to climate change By Richard Black Environment correspondent, BBC News website

'No Sun link' to climate change

By Richard Black Environment correspondent, BBC News website

Cloud cover affects temperature - but what determines cloud cover?

Scientists have produced further compelling evidence showing that modern-day climate change is not caused by changes in the Sun's activity.

The research contradicts a favoured theory of climate "sceptics", that changes in cosmic rays coming to Earth determine cloudiness and temperature.

The idea is that variations in solar activity affect cosmic ray intensity.

But UK scientists found there has been no significant link between cosmic rays and cloudiness in the last 20 years.

Presenting their findings in the Institute of Physics journal, Environmental Research Letters, the University of Lancaster team explain that they used three different ways to search for a correlation, and found virtually none.

The IPCC has got it right, so we had better carry on trying to cut carbon emissions Terry Sloan

This is the latest piece of evidence which at the very least puts the cosmic ray theory, developed by Danish scientist Henrik Svensmark at the Danish National Space Center (DNSC), under very heavy pressure.

Dr Svensmark's idea formed a centrepiece of the controversial documentary The Great Global Warming Swindle.

Wrong path

"We started on this game because of Svensmark's work," said Terry Sloan from Lancaster University.

Terry Sloan has simply failed to understand how cosmic rays work on clouds Henrik Svensmark

"If he is right, then we are going down the wrong path of taking all these expensive measures to cut carbon emissions; if he is right, we could carry on with carbon emissions as normal."

Cosmic rays are deflected away from Earth by our planet's magnetic field, and by the solar wind - streams of electrically charged particles coming from the Sun.

The Svensmark hypothesis is that when the solar wind is weak, more cosmic rays penetrate to Earth.

That creates more charged particles in the atmosphere, which in turn induces more clouds to form, cooling the climate.

The planet warms up when the Sun's output is strong.

Professor Sloan's team investigated the link by looking for periods in time and for places on the Earth which had documented weak or strong cosmic ray arrivals, and seeing if that affected the cloudiness observed in those locations or at those times.

FEELING THE HEAT Three theories on how the Sun could be causing climate change In graphics

"For example; sometimes the Sun 'burps' - it throws out a huge burst of charged particles," he explained to BBC News.

"So we looked to see whether cloud cover increased after one of these bursts of rays from the Sun; we saw nothing."

Over the course of one of the Sun's natural 11-year cycles, there was a weak correlation between cosmic ray intensity and cloud cover - but cosmic ray variability could at the very most explain only a quarter of the changes in cloudiness.

And for the following cycle, no correlation was found.

Limited effect

Dr Svensmark himself was unimpressed by the findings.

"Terry Sloan has simply failed to understand how cosmic rays work on clouds," he told BBC News.

"He predicts much bigger effects than we would do, as between the equator and the poles, and after solar eruptions; then, because he doesn't see those big effects, he says our story is wrong, when in fact we have plenty of evidence to support it."

But another researcher who has worked on the issue, Giles Harrison from Reading University, said the work was important "as it provides an upper limit on the cosmic ray-cloud effect in global satellite cloud data".

Climate change: No Sun link A cosmic climate connection?

Dr Harrison's own research, looking at the UK only, has also suggested that cosmic rays make only a very weak contribution to cloud formation.

The Svensmark hypothesis has also been attacked in recent months by Mike Lockwood from the UK's Rutherford-Appleton Laboratory.

He showed that over the last 20 years, solar activity has been slowly declining, which should have led to a drop in global temperatures if the theory was correct.

The Intergovernmental Panel on Climate Change (IPCC), in its vast assessment of climate science last year, concluded that since temperatures began rising rapidly in the 1970s, the contribution of humankind's greenhouse gas emissions has outweighed that of solar variability by a factor of about 13 to one.

According to Terry Sloan, the message coming from his research is simple.

"We tried to corroborate Svensmark's hypothesis, but we could not; as far as we can see, he has no reason to challenge the IPCC - the IPCC has got it right.

"So we had better carry on trying to cut carbon emissions."

mixed-sex hospital wards

16 August 2010 Last updated at 07:24

Pledge to end mixed-sex hospital wards by end of 2010

Patients' groups have questioned how the goal can be achieved during a period of cut backs

The coalition government is preparing to announce an end to most mixed-sex hospital wards in England by the end of the year, it has been reported.

Despite Labour committing to the policy when it won power in 1997, it failed to completely abolish them.

Health Secretary Andrew Lansley said bringing about the change was a priority, but patients' groups have questioned how it could be achieved.

The move would apply to all wards except for intensive care and A&E.

It would mean patients sharing sleeping, bathroom and toilet facilities only with people of the same sex. This could be through single rooms or whole wards occupied by men or women only, or mixed wards in which men and women are separated in bays or rooms.

Mr Lansley said: "I have made clear repeatedly my deep frustration at the fact that mixed-sex accommodation has not been eliminated from the NHS.

Continue reading the main story

Related stories

• Call for improved hospital stays
• Mixed-sex wards to be penalised

"Eliminating mixed-sex accommodation is in patients' best interests, and I made clear the priority I attach to it in the revised Operating Framework published in June. I will have more to say on this shortly."

The Daily Telegraph said Mr Lansley had asked Chief Nursing Officer Dame Christine Beasley to visit all hospital trusts that still have mixed-sex wards to see what they were doing to ensure that male and female patients did not have to share facilities.

Cost of conversion

Catherine Murphy, of the Patients Association, told the newspaper: "Given that each incoming secretary of state, and there have been a lot, and every new prime minister has made this same pledge since 1997, we will wait to see if this time it really is more than just rhetoric.

Continue reading the main story

Analysis

Norman Smith Chief political correspondent, BBC Radio 4

---

Although mixed sex wards are still distressing for many patients - they are no longer the great political issue they once were - when Tony Blair first promised to get rid of them in 1997.

Its estimated now that only around one in ten hospital wards are still mixed sex.

Labour eventually concluded it would be impossible to abolish all of them - because of the disproportionate costs involved in converting some of the older Victorian hospitals.

And like Mr Lansley, Labour too threatened to fine NHS trusts which failed to get rid of them.

If anything it may be even harder for Mr Lansley to achieve because of the costs pressures now on the NHS. For although the NHS budget is set to increase in real terms, hospital managers are still having to make sweeping savings to meet rising health care costs.

Many NHS managers may well conclude they simply don't have the money to carry out expensive building work.

"At a time when we know that there are huge savings that have to be made in the health service, it is hard to see how hospitals are going to find the money for this."

The BBC's political correspondent Norman Smith said only about one in 10 wards in England were still mixed-sex, and the majority of those were in old, redbrick, Victorian hospitals which would be very expensive to convert.

He said the previous government decided that the money needed to do so would be better spent elsewhere in the NHS.

Now, however, the suggestion appeared to be that any hospitals which failed to remove mixed-sex wards by a certain deadline could be fined, our correspondent added.

Two years ago, Lord Darzi, who was made a health minister by Gordon Brown, said providing single-sex wards across the NHS was an "aspiration that cannot be met".