Monday, 16 January 2017

Eat and be merry – but at your own peril?

This piece comes from "The Pilot" in 1978, where Edith Gott seems to have been a prolific contributor of rather nice "filler" pieces. Here is a rather interesting one about food in the 1970s which highlights the lack of seasonality which had already crept in, and also the propensity of food additives. 

Eat and be merry – but at your own peril?
By Edith Gott

The ninety days which have elapsed since January 1 will be remembered, not so much as the winter of our discontent (though this has been around too), as the Winter of the Mercurial Orange.

But Press and Pranksters notwithstanding, an unequivocal lesson can be learnt from the fall and rise of the jaffa. How many of us really know what we are eating? How many read the small print on the labels of processed food? Would we know, if asked, what a small amount of butylated hydroxyanisole does to a biscuit?

(Actually it keeps the shortening sweet - but who's to know that?)

With our ever-diminishing farmland and ever-growing population, farmers everywhere must use pesticides, weed killers and chemical fertilizers to keep abreast of the ever-increasing demand for both fresh, and processed, foodstuff.

That some of the suspect ingredients from these chemicals will seep into the root, leaf, ear, and pod of garden plants seems to be inevitable, sooner or later. The prospect of even the ubiquitous wild blackberry being contaminated by insect spray is a favourite target for the scare-monger

Processed food is handled so many times before it reaches the shelves of the supermarkets in its appropriate containers that one marvels at the expediency of preserving  it at all, let alone the possibility of contamination en route.

For example, consider the case of a certain jam-manufacturer in County Cork, "a daecent man, t' be sure, though he comes from across the wather." He imported fruit pulp from Holland; it came in huge drums looking for all the world like drums of printer's ink. On arrival in Ireland it was divided into three parts. One was infused with strawberry flavouring (synthetic), another with raspberry flavouring (ditto), and the third flavoured with something  else (of dubious origin). These mashes were appropriately bottled, with the addition of wooden pips for the raspberry variety, and again sent back across the Irish Sea. It turned up in the supermarkets of Lancashire.


Which brings us to the subject of preservatives and colouring. Both of these, in food, can be questionable, if not downright dangerous. It is a known fact that in this country laws governing the purity of food, and the advertising of same, leave much to be desired. On the label it is not obligatory to mention the amount of preservative used, or the specific colouring agent. Sufficient unto the day are such evasive descriptions as "tested Preventative" and "vegetable Colouring".

Now all preservatives destroy something - it might be an enzyme or it might be the lining of your stomach. As for "vegetable colouring" not all vegetables are nutritious, to wit, the cassava root. Edible it is -after the poisonous juice has been extracted.

Mouth-watering delicacies which once appeared seasonally have all but disappeared - that is, in their pristine state, because they are with us always, in season and out, thanks to the Frozen Food industry. Sweet corn in January, summer fruit for the thawing, river fish at the seaside, and game all twelve months of the year. The freezer provides all things for all appetites..  instant gastronomic gratification.

Yet, are its delights unmitigated?


Frozen foods are only as good as their brand names. The well-known firms are first class, if directions are observed.

Even the frozen-in freshness of such products (notably fish) will last for only so long; hence there is a time limit chart on every packet of commercially frozen food - how many housewives buying hurriedly in the supermarket, and storing it even more hurriedly at home, ever read this fine print?

For those who "freeze their own", handling is even more important. How many people know, and scrupulously observe, the fact that meat should never be re-frozen after it has been the least bit thawed - a fact which even some butchers disregard? Does every housewife know that only prime quality vegetables and fruit should be frozen, that even one damaged pea in the pack can contaminate its fellows? In short, how many of us have "freezer fingers"?

Far from giving away any secrets of the advertising copy writers' profession, it might be relevant to mention how difficult it is to know for certain what is contained in any processed food. Our laws do protect us to the extent that suda-ash cannot masquerade as flour nor poppy seed as pepper.

But is it well known that cinnamon in its purest form (in the Middle Ages the Arabs used spice, not oil, to hold us to raricom) is practically unobtainable, and what passes for the real thing is cassia-hark? To convince potential customers that one product is superior to all others is the raison d’être of the professional advertiser. Even employing modern hyperbole it would be difficult to pass off chalk as cheese, but it is possible to bamboozle the public into buying the soya bean in any number of guises.

For instance, a sausage made of soya beans could be described as a "meaty-flavoured, protein-packed all-in-one meal. laced with aromatic spices to tease-the-taste -buds and enhance its true food value".

Moral: never judge a sausage by its overcoat.

Soft words butter no parsnips, and for too long the soft-pedalled ethics of our food advertising have been suspect. In the case of the mercurial orange, it can be said that justice has been done, the orange is re-instated and the jaffa is an honest fruit.

Sunday, 15 January 2017

Simon Whom He Surnamed Peter - Part 33

For the next weeks, my Sunday postings will be a transcript of the book "Simon Whom He Surnamed Peter" by the Jersey historian, the Reverend G.R. Bailleine (1873 – 1966).

Most of Balleine's books are either currently in print - as for example his History of Jersey - or online in the form of PDF versions. This book is not, so this is something different. As well as being a Jersey historian, Balleine was also a priest in the Church of England, and Ministre Deservant at St Brelade's Church for a time.

by G.R. Balleine


Peter ends his Epistle by sending a greeting from Babylon, `She that is in Babylon salutes you.'

Whether `she' was a lady or a Church, he was evidently writing from a place he calls `Babylon'. A few scholars from Schmiedel (Encyclopaedia Biblica) to Calvin think that he means the city on the Euphrates. Wild statements have been made on both sides. The Dictionnaire de l'archeologie chretienne asserts that Babylon was then nothing but ruins.

The other side point to Philo's account of his embassy to Caius in 40, which speaks of the large population of Jews in Babylon. The facts are that Babylon was still an important city, and had once contained a large Jewish quarter. But Josephus tells how in 35 anti-Semitic riots had forced the Jews to emigrate en masse, first to Seleucia, then further away to Ktesiphon. So, when Peter wrote, there probably was not a Jew in Babylon.

The statement in Philo is not made by Philo himself. He is quoting a letter from Agrippa, written in 37, giving a long rhetorical list of places inhabited by Jews. As Agrippa had been living for years in Rome, he probably had not heard of the exodus two years before from Babylon, which was in the Kingdom of Parthia. Moreover, in spite of this text, no tradition associates Peter with Babylon. Thomas was thought to have been the Apostle of that region. The Church that grew up there later formed part of the Syriac-speaking Church, which never claimed Peter as a Founder. Indeed one of its earliest books, The Doctrine of Addai, speaks of `the Epistles of Paul, which Simon Kepha sent you from Rome'.

No one takes seriously Bishop Pearson's suggestion that Peter was in a military camp near Cairo, which was called Babylon, because it had been founded by refugees from that city. For more than a century the Jewish Sibylline Oracles had been calling Rome `Babylon', because Babylon in the Old Testament typified wealth and wickedness and oppression; and a little later the Apocalypse denounces Rome as `Babylon, mother of harlots and of all that is abominable on earth'.

All early interpreters agree that by `Babylon' Peter means Rome. Clement of Alexandria said, `Peter used the cryptic word "Babylon" to indicate Rome.' And the vast majority of modern scholars say the same.



In his Epistle Peter sends a greeting from `Marcus, my son', whom both Papias and Irenaeus describe as `Peter's interpreter'.

He was undoubtedly the author of Mark's Gospel. In Acts we meet a John Mark, whose mother's house in Jerusalem was a meeting-place of the Church, who deserted Paul on his First Missionary Tour, but of whom Paul wrote in his last letter, `Bring Mark; he is useful to me.' It is generally assumed that these two Marks are the same. But this is by no means certain.

The name Marcus was exceedingly common. Many Romans well known in history had Marcus as their first name: Cicero, Cato, Brutus, Crassus. Everyone remembers Mark Antony and Marcus Aurelius. `The inscriptions,' writes Professor Swete, `offer abundant examples from every part of the Empire and every rank of society.' In 65, when Peter was in Rome, Marcus Vestinus succeeded Marcus Licinius as Consul; Marcus Arrecinus commanded the Bodyguard; three Marcuses were involved in the Senators' Plot; Marcus Otho, the future Emperor, was governing Lusitania; Seneca's father, brother and son were all named Marcus.

In the ranks of the Church there were probably at least a dozen Marcuses. So Marcus of Rome and Mark of Jerusalem may be two different people.

There are reasons for thinking they were. If Marcus was Peter's interpreter, into what language did he interpret? Peter, who had known Greek from childhood, and had been working for years in Greek-speaking lands, would need no interpreter when talking to the Greek-speaking crowd who formed half the population of Rome. But native Romans spoke Latin. Seneca and Tacitus wrote in Latin. The poorer people spoke Latin. To reach the real Romans Peter would need an interpreter. A Jerusalem Jew, like John Mark, would be unlikely to know much Latin, whereas many Roman-born Jews would be bilingual.

The author of the Gospel shows familiarity with Latin by using many Latin words, written in Greek characters, e.g. speculator, flagellare, quadrans, etc. The Gospel too contains hints that its author was not John Mark. No educated Palestinian could have been so hazy about the geography of his little land. He makes the swine `run down a steep place into the sea', according to R.V. and R.S.V. at Gerasa, according to A.V. at Gadara. Yet Gerasa is six miles from the lake, and Gadara thirty! He makes Jesus travel from Tyre `through Sidon to the Sea of Galilee through the midst of the borders of Decapolis', an impossible route, for Decapolis was on the opposite side of the lake. But a Roman Jew, who had only paid an occasional visit for a Feast, might well know little of the country outside Jerusalem.

Nor would a Jerusalem Jew be likely to call Antipas a `King', able like an Oriental Despot to give a dancing-girl half his kingdom, when he was only a Tetrarch, a Roman official, whom the Emperor could remove at any time.

Again Marcus almost certainly got the date of the crucifixion wrong (See Note F). John Mark, who was in Jerusalem at the time, could not have made that mistake. But a Roman Jew might easily confuse the Day of Preparation with the Feast.

Not till Jerome (end of fourth century) does any early Father identify the Evangelist with John Mark, and he seems a little doubtful. Speaking of Paul's helper he says, `Mark, whom I think to be the author of the Gospel'.



Marcus wrote nearly forty years after the crucifixion. Stories handed down by word of mouth for years often become embroidered, expanded, and exaggerated. This, however, may not be true of those told by Marcus. Papias, giving John the Elder as his authority, says that Marcus based his Gospel on stories which Peter told in his sermons.

Peter thought of himself as a witness. His task was to tell truthfully what had happened. Acts makes him say, `We are witnesses of these things'; `This Jesus did God raise up, whereof we are witnesses.' In his witnessing he must have found certain stories specially useful. These he would repeat again and again, till they fell into a fixed form of words. Marcus must have heard them, and translated them, so often that he almost knew them by heart.

Moreover in those days education consisted largely in learning by heart. The Latin motto Repetitio mater studiorum (Repetition the mother of studies) was firmly believed in the East. In every synagogue the Old Testament stories were learnt by heart, and so handed down unaltered from generation to generation. In the Christian synagogue the method would be the same. Peter's stories would be learnt by heart. Marcus probably had helped to teach them. So, when he wrote his Gospel, he was often able to quote Peter's actual words. `Peter,' says Papias, `framed the lessons he taught to suit the needs of his hearers,' and `Marcus wrote carefully the whole of the things, as he produced them from his memory.' If so, behind his Gospel stands Peter, an eye-witness.

Saturday, 14 January 2017

Natural Magic

The rather wild weather of the past few days prompted this poem. I wonder if anyone notices the hymn that it uses as a pattern. It also references George Macdonald's book "At the Back of the North Wind". I saw the rather wild looking painting in the General Hospital when visiting this week.

Natural Magic

Darkness comes, the day is ended
The darkness falls, and we are blessed
And in the night, the moon ascended
And shines in glory while we rest

The watchful owl at night unsleeping
While earth rolls onward into light,
For prey, his sharp eyes watch is keeping
And rests not now till end of night.

While gales rage so fierce and violent
The dawn leads on another day,
The ocean’s waves are never silent
And even trees are blown away

The sun that bids us rest is waking
A red dawn breaks over western sky
The tempest rises, storm force making
And dark the rain clouds seen on high

The North Wind blows, she shall never
Like earth’s proud empires, pass away:
At the back of the North Wind, forever
The still point of the storm holds sway

Friday, 13 January 2017

First Air Cargo of Cattle from Jersey

BBC News reported on 9th January 2017 that:

“Jersey cows are being used as a key part of a project to improve milk production in Rwanda.
Thousands of straws of Jersey bull semen are being sent to the African country to help breed more productive animals. Jersey crossed cows produce up to eight times more milk than the native Ankole longhorns, and also require less feed”

But in days gone by, it was the cattle, rather than their semen, which made the trips abroad. I came across this interesting story about a first for Jersey cattle, while digging through old stuff at the Jersey library.

In March 1949, there was the first ever air cargo of cattle from Jersey. Eight heifer calves about two months old were loaded into an Air Transport (Charter) Channel Islands Limited Dakota. They would be flying all the way to Nairobi, without unloading on the way.

This unusual cargo was seen on its way by the Lieutenant Governor, Lieutenant-General Sir Arthur Edward Grasett, Lady Grasett, and Miss Mary Grasett and the Bailiff, Sir Alexander Coutanche as well as representatives of Messrs  H.W. Maillard (who had made the arrangements). It also attracted quite a crowd of States officials, interested breeders and other spectators.

They were loaded into special pens on the plane, with sawdust bedding, and the plane went to Eastleigh, Southampton for customs clearances, and then flew to Blackbushe Aerodrome where 14 more calves and 6 dogs joined them on their travels.

From Blackbushe, they flew to Malta, and via El Adem, across the Sahara desert to Wadi Hifa, Khartoum, and Juba in Southern Sudan to Nakuru on the equator in Kenya. Some of the animals would be unloaded there, and the rest would be taken on to Nairobi.

Special feeding arrangements were in place, and on the way back to Jersey, the Dakota took a cargo of bullocks from Khartoum to Castle Benito in North Africa.

Three of the calves went to Mr F.A. Harris and five to Commander Watts-William, both of Kenya.

The names of the calves were as follows:

Dreaming Fairy of the Poplars
Farineuse’s Viola
Evergreen Snowdrop
Jester’s Dream
Dixie’s Lady
Princess Louise
Le Cotil Missie 6th

I love those names. You don't think of cows having names, but farmers obviously do.

It is interesting to note that the World Cattle Bureau says:

The Jersey Cattle Society of Kenya was founded in 1936 to "encourage & improve the breeding of Jersey Cattle in Kenya". Despite the ups & downs, still flourishes & remains committed to promoting the Jersey as the ideal dairy animal for Kenya, & in particular the small-scale farmer

And the latest report from the Society says:

"The Jersey Cattle Society of Kenya was founded in 1936 and has been serving small-holder dairy farmers ever since. The Society's current Chairman is Julius Mutea, who keeps a small herd of Jerseys on his zero grazing unit near Ngong. We are proud that many judges in previous years have said that Kenyan Jerseys would compete favourably in shows anywhere in the world."

"The Jersey judge at the 2009 Brookside Livestock Breeders Show and Sale said "With Jersey cattle winning all the Interbreed classes and competitions against all the other dairy breeds, this convinces me that the Jersey should indeed be the breed of choice for all small, medium and large scale farmers in Kenya. The Jersey breed is the only dairy breed around the world that is increasing in numbers, so surely the rest of the world cannot be wrong!" Jersey cows produce milk which is higher in both fat and protein content than other breeds."

Milk with a high protein percentage is sought after globally for its superior cheese yields, and hence the increasing popularity of Jerseys worldwide. In Africa where protein can be unaffordable for many, Jersey milk is an ideal highprotein food source.

It is good to see the Jersey both in Rwanda and Kenya both serving a social function in improving the diet of poorer Africans. As Carolyn Labey, Chair of JOA, said of the recent export: "This is sustainable development at its best, and people in Jersey should be enormously proud of the fact that we are making a permanent improvement to the quality of an entire nation's dairy herd, and in so doing assisting many people out of poverty with better nutrition and on to better lives."

JEP, 1949

Thursday, 12 January 2017

The States Innovation Fund: A Disaster Waiting to Happen

The States Innovation Fund: A Disaster Waiting to Happen

Now that the Auditor-General’s report is out, a lot of blame will undoubtedly accrue to Mike King, who has just resigned as Chief Officer for EDD. That may well divert attention from other failings by others, or statements made which should not have been made by others in defence of the fund.

The Case of Philip Ozouf

The report states:

06 Nov 2014 New appointment as Minister for Economic Development with responsibility for the Fund. Assistant Chief Minister (Senator Ozouf) assigned responsibility for Innovation

12 Jan 2015 B Board advised that Assistant Chief Minister with responsibility for innovation would have delegated responsibility from Minister for Economic Development to approve loans from the Fund

01 Jun 2015 Approval of loan applications delegated to Assistant Chief Minister with responsibility for innovation.

So Senator Ozouf appears to have been effectively signing off loan applications as approved, which no doubt explains why he has recently tweeted “Expect proper analysis on performance of officials”, suggesting blame will be shifted firmly off his shoulders, and probably onto those of the hapless Mike King, who has resigned, and no doubt signed a gagging order as part of his resignation deal.

ITV ran this news story in June 2016:

Jersey's Assistant Chief Minister says the buck stops with him when deciding to pay out loans to innovative new businesses. Yet Senator Philip Ozouf admitted that the Innovation Fund Board does not have the mandate to monitor the progress of such companies once the loans have been given. He said that checks and balances could be improved.

He received a grilling from backbenchers in the States today following ITV's investigation into the Innovation Fund, which pointed to one company disappearing from the island after getting a £400,000 loan. Public Accounts Committee chairman Deputy Andrew Lewis asked the Minister:"What follow up checks are made on successful applications of the Innovation Fund to ensure they are meeting their business objectives?"

After States' Question Time, Deputy Lewis told ITV he is not satisfied with the Minister's response.

He has not given me enough assurance that sufficient checks are made, he implied that they are in the process of improving this, which further suggests that follow up checks in the past have been inadequate.

It is clear that nothing was done to improve matters, also that Philip Ozouf knew about defects in the mandate of the board but had done nothing between responsibilities being delegated to him in June 2015.

As the JEP also reported:

THE board which granted a £400,000 States loan to a company which may have disappeared ‘acted properly’, the assistant Chief Minister has said.

Senator Ozouf said: ‘What I can say is that I am totally satisfied, and have been throughout the procedures. The ongoing review process of what’s happening with the company has continued and that continues to this day. Let’s be clear, there are going to be some businesses that are not going to succeed.’

No doubt the good Senator will find ways of explaining why defects were not remedied since he was aware of them, and also thought the board was acting properly. He might also care to explain why he approved loan applications despite the defects highlighted in the report.

As the Senator said in 2016:

“As members will recall, the Fund passed formally to the Chief Minister’s office on January 1st of this year. Prior to this, I had delegated responsibility for the Fund as an Assistant Minister in Economic Development.”

“The Chief Minister has delegated responsibility for innovation to me and I am therefore responsible and accountable to this Assembly for the Fund, including all Ministerial decisions, past, future and present, that are associated with it.”

Will he take responsibility for the failings shown in this report? Will the buck stop there?

The Case of Alan Maclean

I remember that having blogged on this

I wrote:

Having voted to establish an Innovation fund, and having appointed Tim Herbert as Chairman, the Minister for Economic Development has now seen fit to give some idea of costs involved.

The States are asked "to refer to their Act dated 1st May 2013 in which they approved the establishment of the Jersey Innovation Fund and agreed the Revised Operational Terms of Reference April 2013, and agree to vary the Revised Operational Terms of Reference so that Board members may be remunerated for their work."

Having approved the Board, the States are hardly likely to rescind the original vote, but it does seem a very slip-shod way of going about matters. Why could this have not been anticipated before?

It now turns out that the proposition in the States was to retrospectively fix a problem highlighted by the Auditor General:

“The Operational Terms of Reference attached to the Proposition adopted by the States clearly state that ‘Board members will not be remunerated’. Despite this provision, the post of Chairman was advertised on a remunerated basis prior to the adoption of a Proposition to pay the private sector members of the Board. It has been suggested to me that the term ‘Board members’ in the Operational Terms of Reference should be interpreted to exclude the Chairman.”

“I do not accept this interpretation: elsewhere the Operational Terms of Reference include the Chairman within ‘members’. Moreover, when the Proposition to remunerate private sector members of the Board was subsequently laid, it covered remuneration to the Chairman and there was no suggestion that this was in any way authorised by the adoption of the previous Proposition;”

So Senator Maclean was not wholly honest with the house in explaining why the terms of reference needed to be changed to include remuneration. Perhaps he can explain why he decided that the States members should not know the real reasons?

It will not do to say his Chief Officer had made a mistake, because that means he was covering up for his Chief Officer’s inadequacies by deceiving the States as to the real reason for the change in the terms of reference.

The Case of Tim Herbert

The appointment of the Chairman notes this:

The Economic Development Minister, Senator Alan Maclean, has appointed Mr Tim Herbert as chairman of the board that will oversee the Jersey Innovation Fund.

Mr Herbert is a qualified Jersey advocate and has spent most of his career in the Island and linked to Mourant Ozannes, of which he was a partner for 25 years. For the majority of his career he focused on mutual funds, corporate law and merger and acquisitions. He is now a consultant to the firm.

Mr Herbert is a non-executive director of a number of funds, the Jersey Legal Information Board and the Channel Islands Stock LBG. He also has experience of audit committees and risk committees.

So here you have a professional in charge of the committee, in a position to make recommendations for improving the risk averse culture – after all he has “experience of audit committees and risk committees.”

In 2014 it was mentioned that:

Tim Herbert, the board’s chairman, said “The whole purpose of JIF is to encourage innovation and improve Jersey’s international competitiveness, and our financial support will give Total Billing Solutions a solid platform from which to achieve both. This is the second company that JIF has supported, and is the most significant financial support that we have given so far.”

What on earth did he do, or rather fail to do? I would very much like to interview him and get the background details on how he found the board operated.

The Rest of the Board

The States website notes that:

Aaron Chatterley, Dave Allen, Peter Shirreffs and Tim Ringsdore have been appointed NEDs to the board of the Jersey Innovation Fund, joining Tim Herbert who was appointed as non-executive chairman in September.

In 2014, Alan Maclean noted that: “the board, which has considerable experience, is meeting on a regular basis to maintain progress”

In 2016, Philip Ozouf stated:

“The Board is made up of some of Jersey’s most successful and experienced entrepreneurs, supplemented by banking and legal professionals, and they have been diligent in discharging their duties.”

So how does the report focus on this diligence? And “meeting on a regular basis”

“Members of the Board on more than one occasion asserted that they did not have the time or expertise to undertake the key task of monitoring loans advanced from the Fund despite the duty in the Operational Terms of Reference for the Board to report to the Minister on the progress of loans made”

“On a number of occasions, the minutes show that private sector members recognised and declared direct financial interests in borrowers that were the subject of discussion by the Board but nevertheless participated in deliberations. Such an interest should, in accordance with normal standards adopted in the public sector (which are based on the Nolan principles), have meant that they did not take part in such deliberations. In my view officers should have provided a clear written framework for the management of such interests when the Board commenced its work.”

"Attendance by some key officer members at the Board in the first year of operation of the Board was poor, despite the high risk associated with the Board’s activities."

Did not have the time or expertise? According to Philip Ozouf, and their glowing CVs, these were the cream – some of the “most successful and experienced entrepreneurs”!

The board also failed to improve matters regarding its own operation:

“To the extent that weaknesses in the Operational Terms of Reference were recognised, the Accounting Officer should have developed proposals to vary the Operational Terms of Reference to make them fit for purpose and the Board should have continued to press for such proposals to be developed.”

In Conclusion

The blame which BBC Radio Jersey appeared to attributing to Mike King for some of the problems with the fund was probably well founded, but he was not alone, nor should be alone, in taking responsibility for the incompetence and failure of the Board.

Wednesday, 11 January 2017

The Sam Mezec Portfolio of Expressions

By way of something light-hearted, do you notice how newspapers always manage to find an appropriate expression for the story.

I thought I'd look at several well-known politicians in this occasional series and look at the wide range of expressions displayed to the general public. Some look moody, fierce, happy, joyful, and indeed the whole gamut of emotions are often present. I started with Chief Minister Ian Gorst, which can be seen here:

And now to show political balance, here's Reform Deputy Sam Mezec:

The Schoolboy Look. Is that an old school tie?

Election Broadcast

Accidental Placement of Poster!

The answer, like the hair, is blowing in the wind.

A very dapper and suave looking Mr Mezec

Game of Thrones!

Hair very neat for TV interview. Harry Potter glasses.

Reform Rocks! 

Through the Porthole. A rather surreal photo!

Startled Rabbit - did someone mention "hair cut"?

A very stylish appearance.

The Deputy speaking  in the States. 

Tuesday, 10 January 2017

Paracetamol restrictions: is more education better than rigid rules?

I went to Waitrose yesterday, to buy 2 packets of Lemsip, but was refused because both contained paracetamol.

I spoke to the staff, but gave up trying to fight against what was presented as "store policy" which no one will deviate from and went to a chemist, who warned me about not taking too many paracetamol, and against taking Lemsip with any other paracetamol based medication, but was happy to sell me 2 packets of 10 so I could keep one at home, one at work.

If you have 4 people with colds, and take one at 6ish, one at 10ish, and everyone does, that's one packet of 8 gone. And this time of year, families tend to all come down with colds. Waitrose have a very narrow minded risk averse policy. I'll return to this later.

One of the reasons there are restrictions are suicide risks. NHS Direct says that

“A person may be at high risk of attempting suicide if they:”
  • threaten to hurt or kill themselves
  • talk or write about death, dying or suicide
  • actively look for ways to kill themselves, such as stockpiling tablets
But that is stockpiling tablets, not Lemsip, and tablets are easier for the suicidal to take quickly.

For instance, in 2006, there was this story in the Daily Mail:

“Student, 17, sold lethal paracetamol dose by Tesco”

“A girl of 17 overdosed on paracetamol after being sold twice the recommended amount in a single transaction. Prudence Scouse died after swallowing four packets of tablets she bought in a Tesco store following a row with her boyfriend. The sale breached Government guidelines which warn against selling more than two packets of 16 tablets at a time.”

But it is notable that

“She bought four packets of 500mg paracetamol pills - 64 pills in total - at a Tesco petrol station near her home after an argument with her boyfriend which left her believing that he wanted to split up.”

That’s 32,000 mg in total (500 x 64), and the packet of Lemsip says each sachet contains only 1000 mg of paracetamol.

24g of Paracetamol is generally accepted to be a fatal dose. The lowest amount of Paracetamol to cause death was found by one study to be 10g.

So one might just overdose on 10 sachets of Lemsip, which is the packet size in the Co-Op and Boots and Lloyds, but it is more likely you would need 24 sachets, over 2 boxes of 10. I have been unable to find any reported cases of anyone committing suicide by an overdose of Lemsip.

What is far, far more likely is mixing medication which contains paracetamol, or not allowing sufficient time between doses.

In 2011, the Daily Mail reported:

“Fitness instructor, 25, dies of paracetamol overdose after self-medicating with Lemsip, cough medicine and pills for her cold”

And in 2015, the Mail again:

"Lesley had had pelvic girdle pain with her previous pregnancy, but this time it was much worse. ‘Some days I could barely get up or even hobble to the bathroom,’ says the 29-year-old mother from Helensburgh in Argyll and Bute. Her GP prescribed co-codamol, a strong painkiller.  Lesley, who was living in Plymouth at the time, took the medication at the recommended intervals of four times a day.  And in between doses, she also took paracetamol — up to the standard four doses a day — to keep the pain at bay. ‘I knew from previous pregnancies that it was safe for me to take paracetamol. And the doctor hadn’t told me to avoid any other drugs.’ But what Lesley didn’t know was that co-codamol contains paracetamol, and that by combining it with the otherwise innocent over-the-counter paracetamol, she was slowly, but surely, giving herself a life-threatening overdose."

Lesley survived, but others have not been so fortunate. In January 2016, the Mirror reported that:

“A mother of three died of an accidental paracetamol overdose after unwittingly consuming Lemsip on top of other pain medication, an inquest has heard.”

“Michelle Walker, 52, from Bolton, Greater Manchester, had been self-medicating with paracetamol tablets in a bid to combat pain caused by osteoporosis. But in the days before her death last October, she started drinking Lemsip - which also contains paracetamol - after developing a series of flu-like symptoms.”

In 2015, there was this story in the Mail:

“A teenage hair salon worker died after she accidentally overdosed on paracetamol tablets having complained that she was ill with a stomach ache, and inquest heard today. Georgia Littlewood, 17, from Huddersfield, West Yorkshire, died of liver failure after apparently taking as many as three times the recommended dose of painkillers. “

Also in 2015, “A woman died after swallowing 20 paracetamol tablets in 20 hours to treat chronic earache. Rebecca Jeffs, 31, was admitted to hospital after taking more than twice the recommended dosage of the painkiller.”

What is clear is that despite warnings at Pharmacies, not enough is being made clear about the dangers of an overdose, either by taking more of a tablet with paracetamol or by taking several painkillers without noting that they all contain paracetamol with therefore a higher risk of overdoes,.

The BMJ reported a study in 2016:

“How well are national guidelines relating to the general sales of aspirin and paracetamol, adhered to by retail stores: a mystery shopper study”

“Stages 1 and 2 of the study deployed eight and four medical students, respectively, to undertake a mystery shopper style investigation. Stage 1: eight medical students attempted to buy ≥96 tablets/capsules aspirin or paracetamol in one transaction in 62 shops. Stage 2: four medical students attempted to purchase 32 paracetamol 500 mg along with a ‘flu remedy preparation also containing paracetamol, in 54 shops.”

“Stage 1 data revealed that 58% and 57% retailers sold more than the MHRA guidelines recommended for paracetamol and aspirin, respectively. We observed that 23% and 28% retailers were willing to sell ≥96 tablets of paracetamol or aspirin with no questions asked. Stage 2 results showed that 57% retailers sold 32×500 mg paracetamol in conjunction with a paracetamol-containing ‘flu preparation; while 98% shops sold 16×paracetamol 500 mg along with a paracetamol-containing ‘flu remedy, with no questions asked of the shopper or advice given.”

Up to 90 000 presentations with paracetamol overdoses are witnessed in healthcare settings per year in the UK with around 200 associated deaths that occur annually.

Many accidental overdoses result from a person with poor pain management, taking more than the recommended limit from lack of education or inadvertently exceeding the recommended dose, by taking two or more different paracetamol-containing preparations (e.g., pure paracetamol and Lemsip max)

To reduce the incidence of paracetamol overdose, legislation was passed in the UK in 1998 to limit the number of tablets that could be bought in one purchase: 16 tablets at present (up to 32 tablets in pharmacies).

However even with these changes it is still possible to obtain large quantities of paracetamol. It is unsurprising that patients may be unaware of the maximum dose of paracetamol and the associated dangers of accidental over-consumption.

One example is given below:

"A 20-year-old female student presented to the A&E department at 11pm over the Christmas period, complaining of toothache even though she had an appointment with her general dental practitioner (GDP) the following day. She admitted that in her efforts to ease her toothache, she had taken 16 paracetamol, 16 ibuprofen and two co-codamol (combined paracetamol and codeine phosphate doses) during the preceding 24 hours. There was no reported intent of self harm."

So rather than restricting them, with just a message that it is “store policy”, which is what Waitrose told me, more needs to be done to get over the dangers of accidental overdose from products containing paracetamol. As the BMJ report noted:

"Answers given when mystery shoppers were refused to be allowed to purchase all three packets of medication in one transaction were: ‘It's due to guidelines’ (two stores), ‘It's store policy’ (three stores), ‘It's illegal’ (one store), ‘Someone was sacked for it recently’ (one store), ‘I'm worried you may overdose’ (one store) and ‘I don't know why—I just can't’ (15 stores). "

The chemists I have been to always tell you that whenever you buy paracetamol – it is a simple “script” which could just as easily be used in general shops, or alternatively a big warning sign. The same article in the BMJ was also critical that medications were placed close to cosmetics in Supermarkets, and were critical of

"their placement next to commonly purchased consumables such as beauty products. The psychology that these medications are consumables rather than potentially harmful drugs is worrying. By shops shifting medications away from these signs and everyday products, customers may recognise that these medications are not for everyday use and should be used with caution."

After all, a sachet of Lemsip contains 1000 mg paracetamol so if somebody decides to take a couple of paracetamol with it then you're up to 2g already. Then maybe an extra Lemsip 'cos they feel really bad and the last one started to clear their snotty nose....

The study concludes that:

“The combination of poor consumer education concerning potential dangers of excessive use of pain relief medication, an ageing population, pressures from an ever busier National Health Service (NHS) system that encourages self-care, and this potential non-adherence to national best practice guidelines will continue to underpin a high number of avoidable paracetamol-induced deaths.”

Returning to my own case at Waitrose, I can understand a refusal if Lemsip purchase was combined with another paracetamol medication, as there would be a strong indication with that purchase that the two would be consumed together, as can be seen above, often with fatal effects.

But two packets of Lemsip are not going to be drunk concurrently. What is needed is a better understanding of why some purchases are more risky than others, rather than an approach which seems to be blind rule following. Deliberate suicide, rather than accidental overdose, occurs with swallowing pills, not drinking Lemsip. A degree of commonsense should prevail.