Medical Life

What, exactly, is the problem with a pharmaceutical diet pill, costing about £1.50 a day, being made available over the counter for the first time? News of the pill has triggered a sudden rush of blood to the head among protesters complaining that it will undermine those essential human qualities of discipline and willpower.

Consumers International, a global campaigning organisation, said it was "deeply disappointed" at the EU's decision to make the drug, Alli, available to consumers without a prescription. "It means fewer people will address issues of diet or lifestyle which are a much safer and more reliable way to control weight for the majority of people."

That is like saying abstinence is a better way of preventing pregnancy than the contraceptive pill. It is – but a few hundred million women (and their menfolk) who might disagree. All lifestyle drugs – of which the contraceptive pill was arguably the first – attract a similar response from those who think we are on the road to rack and ruin. Yet most have of these drugs enhanced life. Think Viagra....

Each new addition must be judged on its merits. I am no defender of the pharmaceutical industry and there are plenty of examples of "disease mongering", where companies have sought to create ailments – female sexual dysfunction, social anxiety disorder (otherwise known as shyness) – and then market treatments for them. But I cannot share Consumers International's objection to Alli. It is a rather smart drug – not an appetite suppressant but a "fat blocker" – preventing absorption of fat from the gut, thereby cleverly ensuring the patient sticks to a low-fat diet.

Alli has causes wind and diarrhoea in those who eat too much fat. It has been compared to Antabuse, given to alcoholics to make them vomit if they touch a drink. Unlike an appetite suppressant, which might be abused by those desperate to shed pounds, overdosing on Alli would be unlikely. Doctors say it is like having a personal minder who slaps you on the hand as you reach for the cream cakes. Clever, as I said.


By an accident of exquisite timing, on the very day last week that Gordon Brown signed the NHS constitution, its first in 61 years, guaranteeing rights to treatment for patients and an equal right to support for staff, the Law Lords delivered one of the most stinging rebukes to the Department of Health I can remember.

Five of the country's most senior judges unanimously condemned the Department's policy of blacklisting nurses against whom allegations of abuse had been made, effectively barring them from work (and pay), while the allegations were being investigated. A more transparent abuse of power I find difficult to imagine and while the NHS constitution may be admirable, this episode makes me doubt whether it is worth the paper it is written on. Around 5,000 nurses have been affected since the Protection of Vulnerable Adults regulations were introduced in 2004. An early test of the constitution will be whether the Department now pays them the compensation they deserve.