The background

The Health Secretary has been obliged to defend the government’s record on accident and emergency services again after another organisation warned of a looming crisis in our hospitals.

On Wednesday it was the turn of the Foundation Trust Network, which represents more than 200 health trusts.

Chief executive Chris Hopson said: “A&E services have been under huge pressure and although performance is now stabilising, there is a danger the system will fall over in six months time unless we plan effectively for next winter.”

The dire prediction comes after warnings from the Royal College of Nursing, the Care Quality Commission and Monitor about pressure on emergency departments.

In a BBC interview Mr Hunt praised hardworking A&E staff and added: “It’s also important to say that they are being very successful. We are hitting our national A&E targets.”

The Labour MP Ben Bradshaw immediately tweeted that he was “not sure how Hunt can claim he’s hitting A&E target”. Is this a crisis or not?

The analysis

The target everyone is talking about is a pledge that the vast majority of patients who arrive at A&E will be seen within four hours. The benchmark used to be 98 per cent under Labour, but the coalition relaxed it to 95 per cent.

In 2011 performance was running at 97 per cent, but then A&E waiting times began to increase.

By December 2013 departments were failing to hit the 95 per cent target. It has only been achieved in eight of the last 26 weeks.

It just so happens that the figure has crept up above 95 per cent in the latest two weeks recorded by NHS statisticians, which enables Mr Hunt to say, truthfully, that the government is hitting its targets. For now.

Clearly, the target is an arbitrary one and patients around the country won’t be able to tell the difference between 94.8 and 95.6 per cent.

At no point have wards failed, on average, to treat fewer than 90 per cent of patients within four hours, so we’re not talking about a sudden catastrophic drop in the service.

On the other hand, there are other statistics which don’t give us cause for optimism.

The regulator Monitor pointed out in its latest report that 32 of 144 partly-independent foundation trusts breached the four-hour target in the third quarter of last year, compared to seven in the previous quarter and 14 in the same period a year ago.

Monitor concluded: “This was due to higher attendances and reflected seasonal pressures across the NHS…in addition to seasonal demand, trusts cited outbreaks of the winter vomiting bug, discharge delays due to problems accessing community care services, and increased attendances among elderly people as the causes of breaching the targets.”

There’s a nasty mix of short-term and long-term problems here. Vomiting bugs come and go, but rising numbers of elderly people isn’t a problem that’s likely to go away.

What’s causing the pressure?

As Mr Hunt has rightly pointed out, more than a million more patients attended A&E between February 2012 to January 2013 than they did in the previous 12 months, according to the latest figures from the Health and Social Care Information Centre.

The reasons for this are complex and there’s little expert concensus on the most important single factor. A&E admissions have been rising for more than 30 years but the sharpest rises came after 2003/04.

Britain’s population is ageing, but that doesn’t explain everything. A 2010 study by the Nuffield Trust found that over-85s were 10 times more likely to end up in A&E than people in their 20s, 30s and 40s.

But only 40 per cent, at most, of extra admissions could be explained by the ageing population.

The same study said the rise was not down to one particular kind of illness, and it did not appear that people were becoming more likely to report ill-health.

Oddly, the researchers thought one of the biggest reasons for the rise in admissions is that “advances in medical care and management have reduced the length of stay that patients have in hospitals, which in turn has freed up more available beds and allows doctors to admit more patients”.

In other words, we are victims of our own success. Patients get discharged more quickly now, so there are more empty beds, so patients who turn up at A&E are more likely to get a bed even if they don’t really need it.

The Health Secretary has blamed Labour for changing GPs’ contracts with the NHS in 2004, which allowed them to opt out of providing out-of-hours care.

The decision to shift the responsibility for organising round-the-clock care from individual doctors to primary care trusts has made it more difficult for patients to see a doctor in the evenings and at weekends, according to Mr Hunt.

He says people have lost trust in primary care and A&E has taken up the slack.

Some members of the medical profession have heaped scorn on Mr Hunt for promoting this argument.

Dr Laurence Buckman of the British Medical Association called it “impressively superficial analysis based on no evidence” and “such fatuous nonsense I question the wisdom of the people briefing the Secretary of State”.

In fairness to Mr Hunt, he’s not alone in making a link between rising A&E admissions and problems with the service traditionally provided by GPs.

An Oxford University study on the numbers of children being taken to emergency departments by their parents identified a 28 per cent rise in ten years, with a persistent year-on-year rise from 2003. Increasing numbers of children were being taken to A&E with minor problems like coughs and colds.

The authors concluded: “The increasing admission of children for very short term care, particularly for acute infections, certainly suggests a reluctance of primary care to observe and manage sick children with self-limiting infections in the community.”

The verdict

Mr Hunt is actually correct to say that, in the last couple of weeks we know about, the A&E target has been met. But let’s not crack open the champagne just yet.

The figures show a strong seasonal variation, with emergency services more stretched in winter, so if the pressure remains high towards the end of the year we may see similar failures to meet the four-hour waiting time target.

The health secretary has promised short-term action and long-term reform, but the complex nature of the problem suggest a strategy based on rewriting the GP contract alone will fail to solve it.

By Patrick Worrall

- Theresa May, home secretary, Police Federation annual conference, Bournemouth, 15 May 2013

Addressing the massed ranks of officers, Mrs May said:

“To attack and kill a police officer is to attack the fundamental basis of our society. We ask police officers to keep us safe by confronting and stopping violent criminals for us. We ask them to take risks so that we don’t have to.

“That is why I am clear that life should mean life for anyone convicted to killing a police officer.”

So she wants anyone convicted of killing a police officer in future to face life in jail without the possibility of parole.

Can you be sentenced for life at the moment?

At the moment, lifelong sentences – or “whole life tariffs” – are for a handful of crimes, as set out in the Criminal Justice Act of 2003.

These are currently: murdering two or more people where each murder involves premeditation, abduction or sexual or sadistic conduct;  the murder of a child when they have been abducted and for sexual or sadistic motivation, or murder for political, religious, racial or ideological causes, or a subsequent murder by an already-convicted murderer.

The murder of a police officer gets the next most severe punishment – a minimum term of 30 years.

Mrs May will consult with the Sentencing Council for England and Wales – which sets guidance for judges – with the aim of introducing secondary legislation to have her plan in place before the end of the year.

How many people, and who, are we talking?

There are currently 47 prisoners serving whole life tariffs, according to the Home Office.

The department also said that since 2000, there have been 12 police officers killed in the line of duty.

So if all of these people were given whole life sentences, that would be an increase of a quarter in the overall whole life population.

As to who would be given the life sentences – there seems to be a bit of a discrepancy.

The Home Office said that it only includes police officers – by which they mean anyone employed as a constable by the police forces.

Meanwhile, the Ministry of Justice said that the plans would extend to prison officers as well, although the Home Office was unable to confirm that.

Isn’t there an argument that a “whole life sentence” is a deterrent to good behaviour?

For some prisoners given the tariff, it has been used as a blank cheque.

Take the example of Douglas Vinter, given a whole life sentence after killing his wife in February 2008, having already been on licence for murdering a fellow worker.

A few months after he was given the whole life sentence, he wrote a letter, saying that by being sentenced to whole life, he had already been served the most harsh sentence possible, so in practice, the judge had effectively told him that “no matter how serious … the law can’t touch me. I’m above the law”.

He went on to stab Roy Whiting, who killed eight-year-old Sarah Payne, in the eye. “Don’t waste any money on investigations,” Vinter had said. “Just give me another life sentence…They don’t mean anything any more.”

The Howard League for Penal Reform argues that prison staff could be endangered.

Frances Crook, the CEO of the organisation, tweeted: “Giving full life tariffs could endanger prison staff if all glimmer of hope is removed. Prisoners have nothing to lose.”

But essentially, that’s opposition to the principle of life without parole, not to the fact that it’s been extended to killers convicted of murdering police.

Is it legal under human rights legislation?

It’s not illegal, according to the European Court of Human Rights. At least not yet.

The former president of the court, the British judge, Sir Nicholas Bratza, had hinted that whole life sentences could be in breach of article three of the convention on human rights – the right to freedom from torture, inhuman or degrading treatment or punishment.

Vinter, along with Jeremy Bamber, convicted of shooting and killing his adpotive sister and her two young children, and Peter Moore, who stabbed four gay men to death allegedly for his own sexual gratification, argued at the European Court of Human Rights that their imprisonment without the prospect of release was cruel, and amounted to inhuman and degrading treatment.

But in January 2012, Strasbourg judges ruled four to three that Vinter, Bamber, and Moore’s human rights were not being breached. Lawyers in the case appealed against the decision, and the case is currently before the Grand Chamber awaiting a decision.

Lawyers, researchers and campaigners opposed to life sentences without parole refer to them as “death by incarceration”, saying that they leave the recipient facing mental suffering equivalent to a death sentence.

Since the plans came to light this morning, concerns have been raised that judicial powers will go to the justice secretary, when the House of Lords said in 2002 that ministers should not set tariffs, judges should.

According to the Home Office, this shouldn’t be a problem given that existing legislation is to be used. At the moment, legislation provides for a minimum sentence – whether whole life or 30 years – but the judge can take into account mitigating factors, which may change that. That still stands.

Likewise, prisoners will still have the right to appeal.

Which is exactly what the former American marine, David Beiber, did. He was given a whole life sentence after he was convicted of the murder of PC Ian Broadhurst in 2004, and the attempted murder of two other PCs.

Although appeal judges, headed by the Lord Chief Justice, rejected his lawyers’ arguments that the sentence was a breach of article three of the convention on human rights, they said that the “facts of this case…did no justify the imposition of a whole life tariff” and he was re-sentenced to a minimum of 37 years.

Both were jailed for perverting the course of justice after Pryce took Huhne’s speeding points ten years ago.

Huhne said prison had been a “humbling and sobering experience” while his former wife, a Greek-born economist, thanked fellow inmates and prison officers for the support they gave her on the inside.

Fair enough. But many people were left wondering why the pair had been let out after serving just two months of an eight-month sentence.

‘Good behaviour’

It was very widely reported today that Huhne and Pryce had been given time off “for good behaviour”.

But this phrase is a legal myth. There is no such thing as a reduction in sentence for good conduct in British prisons.

The only way your behaviour inside can affect your sentence is if you are judged to have breached prison discipline and an adjudication panel awards you a maxiumum of 42 extra days as a punishment.

Tags for lags

Most prisoners are released after serving half their sentence behind bars.

They are then “on licence” and can be recalled to prison if they fail to stick to conditions like keeping appointments with probation officers, staying away from victims and so on.

But Huhne and Pryce were released under the terms of the Home Detention Curfew scheme, in which some prisoners are eligible for release after just a quarter of the jail term handed down by the judge.

They were eligible because they were given a sentence between three months and four years and they weren’t convicted for violence, sex crimes or any other of the long list of offences deemed unsuitable.

The former power couple would also have had to pass a risk assessment.

Once on the outside, they wear a tag around the ankle or wrist which sends a signal to a receiver stashed somewhere in the home. If the signal shows they have broken the curfew they are liable to get hauled back to prison.

Does tagging work?

It depends what you mean. There is some research which suggests that Home Detention Curfew is a safe and cost-effective alternative to prison.

Ministry of Justice data suggests that tagged prisoners are very slightly less likely to go on to commit more crimes in the two years after leaving jail.

In 2006, the National Audit Office said it cost £1,300 to monitor a prisoner on a tag for 90 days compared to £6,500 for the same period in custody.

Of course, you could argue that prison is less of a punishment or a deterrent if more people get out after serving a quarter of their time.

How prevalent is tagging now?

Home Detention Curfew was launched in 1999 and was quickly embraced by the criminal justice system, with more than 20,000 prisoners a year being let out early by 2002.

The popularity of tagging has fallen in recent years: between 12,000 and 13,000 prisoners a year have released on the scheme since 2010. There were 2,800 prisoners on Home Detention Curfew at the end of 2012.

By Patrick Worrall

The work and pensions secretary, Iain Duncan Smith, announced that the mere threat of the cap being brought in had already nudged some benefits claimants towards finding a job.

Mr Duncan Smith told the Daily Mail:

“Already we’ve seen 8,000 people who would have been affected by the cap move into jobs. This clearly demonstrates that the cap is having the desired impact.”

In fact, the government research quoted by Mr Duncan Smith made it clear that, while 8,000 more people did move into work, there was no way of knowing that this was anything to do with Jobcentre staff issuing warnings about the looming benefits cap.

Mr Duncan Smith’s own researchers said the figures were “not intended to show the additional numbers entering work as a direct result of the contact”.

Over any period of time, some unemployed people will move into work, regardless of whether a benefits cap is about to be implemented. Experts agreed that a fall in unemployment didn’t prove that government policy was working.

In a second piece of analysis, the researchers said fewer households would be affected by the cap than was initially estimated, but put this down to “normal benefit churn” rather than a change in claimants’ behaviour.

The minister had no excuse for making this slip, as FactCheck had already pulled him up on it.

Mr Duncan Smith first made this claim in July last year, saying:

“The benefit cap is already a success and is actively encouraging people back to work.”

We established that there was in fact no statistical evidence for this kind of optimism. A DWP spokesman simply said: “The secretary of state believes that the benefits cap is havving an effect.”

But that didn’t stop Mr Duncan Smith repeating the same claim in the Mail nine months later.

Now Andrew Dilnot, chairman of the UK Statistics Authority, has backed our Fiction verdict.

In a series of open letters, Mr Dilnot said Mr Duncan Smith’s claim “is unsupported by the official statistics published by the Department on 15 April”, and criticised DWP for releasing the figures Mr Duncan Smith drew on in his comments to the Mail.

Mr Dilnot said: “The statistics do not comply fully with the principles of the Code of Practice, particularly in respect of accessibility to the sources of the data, information about the methodology and quality of the statistics, and the suggestion that the statistics were shared with the media in advance of their publication.”

This is not the first time Mr Duncan Smith’s department has received a rap on the knuckles over its use of statistics.

Mr Dilnot says that the department had assured him after an earlier complaint that “senior DWP officials had reiterated to their staff the seriousness of their obligations under the Code of Practice and that departmental procedures would be reviewed”.

He adds: “The Board of the Statistics Authority would welcome further assurance that the working arrangements within the department give sufficient weight to the professional role and public responsibilities of statisticians.”

Coming from a Conservative heavyweight, Margaret Thatcher’s longest-serving chancellor and a man who voted to join the European Union in 1975, it is a stunning intervention.

Lord Lawson’s argument, laid out in a Times article, is mainly economic. He says: “I strongly suspect that there would be a positive advantage to the UK in leaving the single market.”

Nick Clegg quickly responded, saying Lord Lawson was “totally wrong”. Among other things, the deputy prime minister, argued, three million jobs would be in danger if we left the European Union.

Who’s right?

“I think if we were to leave the European Union we would jeopardise up to three million jobs in this country.”
Nick Clegg, 07 May 2013

There are various possible candidates for the source of this claim, none of which really stand up Mr Clegg’s argument.

In 2000 academics at South Bank University published a study that said about 3.5 million jobs were directly or indirectly dependent on exports to EU countries.

As one of the authors, Professor Iain Begg, told us in a previous FactCheck, that doesn’t mean those jobs would be in danger if we left the EU.

We would presumably continue to sell goods to our European neighbours even if we left the club.

In 2000, the National Institute for Economic and Social Research (NIESR) came up with a similar estimate of jobs associated with exports to EU countries as, apparently, did the Department of Business, Innovation and Skills in 2006, although no one seems to be able to find the original research.

NIESR specifically ruled out mass job losses if we pulled out of the EU.

Note that both these studies are more than a decade old now, but the key question remains the same: would Britain be able to negotiate a free trade agreement with the EU after leaving?

Other countries, like Switzerland, have managed to strike trade deals with the EU without joining, but no one has ever tried it after leaving.

Would the snub be painful enough for the remaining members to make life difficult for Britain, even at the expense of their economic interests? Since no one has ever left the EU before, this is an unknown quantity.

On the other hand, Lord Lawson argues that pulling out would force British businesses out of “the warm embrace of the single market” and focus on raising exports to emerging markets, particularly in Asia.

Equally, this is speculation. But there is no proof that jobs which depend on exports to EU countries would automatically be lost in large numbers in the event of a pull-out.

“In my judgement the economic gains (of leaving the EU) would substantially outweigh the costs.”
Lord Lawson, 07 April 2013

Lord Lawson is of course entitled to his opinion, but this is little more than an opinion. There are few hard facts in the former chancellor’s Times article, and as he himself concedes, producing a credible cost/benefit analysis of EU membership is a tricky task.

Lord Lawson writes: “There would indeed be some economic cost, partly transitional and partly as a result of the loss of the modest advantages of being within the single market…the only gain that can be clearly quantified is that we would no longer pay our annual membership fee of some £8 billion.”

He’s right about the membership fee. The UK has always paid in more than it gets out and the Office for Budget Responsibility forecasts are here:

This is only one side of the equation, and many analysts claimed that Britain gets an economic dividend overall from membership.

The 2000 NIESR study mentioned above concludes that UK GDP would be 2.25 per cent lower in the long run if we were outside the EU. This figure is similar to estimates of gains calculated by other countries.

In 2010 BIS said that increased trade in Europe since the early 1980s may have raised income per head by around 6 per cent in this country.

Last year the think-tank Open Europe concluded that “membership of the EU customs union…remains a benefit to UK firms exporting to the EU”.

Other think-tanks like the Institute of Directors and Civitas have disagreed over the years, while Eurosceptic voices like the economist and former Ukip leadership candidate Professor Tim Congdon say the UK is worse off by astronomical amounts.

Like Prof Congdon, Lord Lawson thinks one of the biggest gains of an exit would be freedom from the burden of EU regulations, which he says are hurting the economy in general and the City of London in particular.

Fair enough, although the issue is not as straightforward as it seems at first.

For a start, estimates of the cost of EU regulation to UK businesses range from £8.6bn (BIS) to nearly £20bn (Open Europe).

These are the supposed costs, but they are not net costs. EU regulations are supposed to bring benefits too – improving consumer protection, freeing up markets – all of which are more difficult to calculate.

According to Open Europe’s analysis of government impact assessments, for every £1 of costs imposed by the EU, there is supposedly a £1.02 benefit.

A good pinch of scepticism is probably called for here, but it’s worth remembering that there are two sides to the story of regulation. And we don’t know how many EU laws in force in the UK would have been passed even in the absence of the EU.

Some claims about EU regulation are patently untrue. One story that gets repeated ad nauseam is that former EU Commissioner Gunter Verheugen put the annual bureaucratic cost to EU businesses at €600bn a year in a Financial Times interview in 2006.

But he never used those words and has made it clear that the newspaper misunderstood what he was saying.

The verdict

Evidence for Mr Clegg’s specific point – that millions of jobs would be at risk if we left the EU – is pretty weak.

It’s difficult to imagine British companies having to cease trading with EU countries in the event of a pull-out, although there would undoubtedly be short-term disruption, and the long-term effects are impossible to predict.

As far as Mr Lawson’s claim that the benefits will ultimately outweigh the costs, it’s worth noting that he doesn’t back this up with any detailed analysis.

The official UK government position is that “a formal cost-benefit analysis would be difficult to carry out meaningfully as some of the most important benefits cannot be quantified”.

This must be right. How do you put a price on Britain’s ability to push for EU-wide sanctions against Iran, or work out the economic benefits of increased peace and stability?

The most credible estimates of what happens if we leave the EU tend to show only a very small plus or minus, which suggests people on both sides of the debate tend to exaggerate the significance of membership on the British economy.

By Patrick Worrall

David Cameron was reported to no longer be in favour of forcing all fags to be sold in plain packets.

That gave Labour an opportunity to bring the fag packet calculation into their retort. “Reports that PM is to protect cigarette packaging. Makes sense – he’ll need those fag packets to write out his 2015 public health manifesto,” Andy Burnham, shadow health secretary, tweeted in response.

Yet some Whitehall sources have told FactCheck the plans haven’t been ruled out at all, and that the matter is still out to consultation.

So FactCheck’s decided to get down to some ashen-faced digging into the arguments around fags and their packets.

What does the government want to do?

Last spring, it launched a consultation into whether all cigarette packets should be “standardised”. “We need to do more to stop young people taking up smoking and to help those smokers who want to quit,” then health secretary Andrew Lansley said in a written ministerial statement as he launched the consultation.

He said the government had an “open mind” at that stage, but it was prepared to examine the prohibition of logos, colours, brand images or promotional information on packaging other than brand names and product names in a one-size-fits-all colour and font.

The consultation, he continued, would consider whether the moves would make tobacco less appealing, give health warnings more prominence, and have a “positive effect” on people, particularly children, on smoking-related attitudes.

It was launched in April, and ended in August, though the report hasn’t been published yet.

As to whether it’s going to go ahead or not, we don’t yet know. Last month, it was reported that the Queen’s speech this month would contain legislation for plain packaging.

This month, there was a report saying the speech wouldn’t.

When we asked the Department of Health whether it would be included or not, a spokeswoman said: “We have an open mind and we are still considering responses and evidence and we have yet to reach a formal decision.”

So officially, the government is saying that it’s still on the table. We understand that some in cabinet are for, and some are against.

Where’s the evidence?

This is where the tobacco industry and health and anti-smoking campaigners are at loggerheads, with little sign of resolution, in the near future at least.

In December, Australia became the first country to introduce plain packaging.

There isn’t, as yet, any evidence to suggest whether it’s stopped people smoking or not – it’s only four full months that it’s been in play.

So when Forest, the Freedom Organisation for the Right to Enjoy Smoking Tobacco, which is supported by British American Tobacco, Imperial Tobacco, and Gallaher Limited (of Japan Tobacco Group of Companies), say, “There is no evidence that ‘plain’ packaging will have a positive impact on public health”, they quite rightly say that it’s because it hasn’t really been tried. It’s not that it doesn’t work, we just don’t know yet whether it does or not.

But there have been studies which have tested plain tobacco packaging. A review of 37 of those studies found that both adults and children found plain packets less attractive than branded packs. They found that the more branding elements were removed, the less attractive the packet came.

The studies also found that cigs in plain packets were found to be of poorer quality by both adults and children. They were thought of as being less cool.

In one example, the plain pack exposed “the reality of smoking”, which made them less attractive.

But packaging also affected whether smokers thought of what they were doing as being harmful or not. Overall, the studies found, darker coloured plain packs were seen as more harmful, and lighter coloured plain packs less harmful.

The pro-smoking lobby says, however, that even if children find a packet attractive, it’s not that that drives them to smoke. Forest cites a paper by Action on Smoking and Health (ASH), in which children said that the factors encouraging them to start smoking were: peer pressure, having family members who smoke, and how smoking was portrayed in films and television. That study did, however, say that exposure to marketing was also a factor in why they chose to smoke.

What would plain packaging mean for the government’s tax revenues?

Last year, the government earned just under £10bn from tobacco duty receipts, according to Revenue and Customs.

The amount that it’s been collecting has been going up, year by year, despite the number of smokers tending to decrease, according to the Office for National Statistics. In 1974, 45 per cent of the adult population were smokers, compared with 20 per cent in 2011.

That’s been the case for smoking in all age groups; in 1998, 31 per cent of 16-19-year-olds smoked. That dropped to 18 per cent in 2011.

Those opposed to plain fag packets say that it would make the packets easier to counterfeit. Take this, from an advert by Gallaher: “Standardising packs will make them even easier to fake and cost taxpayers millions more than the £3bn lost in unpaid duty last year.”

The only problem is that if there is no evidence that plain packets will reduce smoking, neither is there any evidence that they will increase counterfeiting.

Gallaher were also pulled up by the Advertising Standards Authority for their £3bn claim, after complaints, including from Cancer Research UK.

According to the HMRC, the illicit cigarette market led to revenue losses of £1.2bn in 2010-11, and of £660m for rolling tobacco.

What about the packaging industry?

It’s been reported that David Cameron was “persuaded it would damage the packaging industry”.

We don’t know whether that’s the case or not, and Number 10 weren’t able to say, but he was certainly asked about it.

When Mr Cameron visited Keighley, in West Yorkshire, in March, he was asked by Mike Ridgway, who had worked in packaging and was said to have been leading a group campaigning against plans for plain packaging, whether there was any truth in reports that it was going to happen.

“Can you confirm whether that decision has been taken yet? And the reason I ask is that we have three very successful businesses here Bradford area, employing many hundreds of people, and they really want to know what the latest is on is on that, concerning their future,” Mr Ridgway said.

Since then, Forest has often cited the pro-packaging industry argument.

When FactCheck contacted Mr Ridgway, the former MD of packaging group Weidenhammer UK, to ask how much money would be lost for the packaging industry were plain packets to be introduced, he said “millions”, but was unable to say any more, saying there were no sources for this claim.

What does the tobacco lobby say?

Well the Gallaher advert gives us a clue as to what their public arguments are – that it would increase counterfeiting, and Forest says there is no evidence – yet – that it works, and asks that we at least wait and see how Australia pans out.

But internal documents released following court action in the US have revealed how important packaging is to manufacturers, at least.

In 1996, Rothamans Benson and Hedges said in one industry document: “In the cigarette category brand image is everything. The brand of cigarettes a person smokes is their identity. Cigarettes tell others who they are as a person.”

Changes in brand designs “can have a significant impact on sales, as demostranted by the graphical redesign of the Lambert & Butler range in the UK in November 2004, which increased sales by £60m”, one report suggested.

“The UK as the successor state is obliged to hold on to all of the debt. We would be liberated from a population share of UK debt of £125bn.”
John Swinney, 23 April 2013

The background

Chancellor George Osborne fired the latest broadside in the row over Scottish independence this morning.

The Treasury has published a new report casting doubt on the Scottish National Party’s (SNP) plans to hold on to the pound if Scots choose to break away from the UK in next year’s referendum.

The paper says a newly-independent Scotland would have to try to negotiate with the rest of the UK to create a euro-style currency zone – but the UK might well say no.

Scotland could continue to use the pound outside a formal agreement – much as Panama uses the US dollar – but that could be disastrous, with Holyrood unable to print money and left with little control over monetary policy.

The ruling SNP responded angrily, with Scottish Finance Secretary John Swinney accusing the chancellor of “playing with fire”.

Mr Swinney said: “What the Treasury paper is designed to do is to make things sound as difficult and as obstructive as possible. I don’t really think it is a particularly helpful contribution to the debate.

“He is arguing in his paper this morning that the UK would be the successor state, that it would hold on to the pound and we somehow couldn’t get access to that.

“If that’s his position, then the UK’s obliged as a successor state to hold on to all of the debt. We would be liberated from a population share of UK debt of £125 billion.”

It’s a simple idea: if you don’t let us keep the pound, we don’t have to pay our share of UK national debt. It might be fair. But is it true?

The analysis

So much of the debate about Scottish independence hinges on unknowns. Splitting from the UK would be an unprecedented step and the legal, political and fiscal consequences are far from black and white.

Nationalists tend to assume that Scotland will get the lion’s share of the UK’s North Sea oil revenues after independence, because most of the oil is in “Scottish” waters.

Unionists tend to assume that Scots would have to shoulder a per capita share of UK debt, perhaps including the liabilities run up by bailing out Scottish banks.

But none of these things is a done deal. Everything is up for negotiation, and according to the chancellor, that includes the issue of currency.

The British government recently published this paper after seeking a legal opinion from two experts on international law, Oxford Professor James Crawford and Professor Alan Boyle of Edinburgh Law School.

The law professors think that if Scotland votes for independence, it will become an entirely new country in international law (a “successor state”), while the rest of the UK will continue to be the UK in the eyes of the world (a “continuator state”).

This is only an opinion, and there are other academics who dissent, like Dr Andrew Blick, a constitutional historian from King’s College, London, and US law professor David Scheffer, who think the UK would be dissolved and there would be two “successor states”.

But the UK government’s position is that the new Scotland would start with a clean slate and would have to renegotiate entry to the EU and countless other international agreements, while a smaller UK would carry on much as before.

So when Mr Swinney says that George Osborne “is arguing…that the UK would be the successor state”, this is completely wrong. The opposite is true: it’s Scotland who will be the successor state, according to Westminster.

Mr Swinney is either making a slip of the tongue here – getting his successors and continuators mixed up – or misrepresenting the UK government’s position.

Either way, his assertion that if Westminster is right “the UK…is obliged to hold on to all of the debt” doesn’t appear to have any basis in reality.

There’s no legal rule that says the UK as a continuator state would be obliged to hold on to all of its public debt: the transfer of liabilities would be up for negotiation along with everything else.

This is the view set out in the Vienna Conventions on Succession of States, which the SNP has often referred to in the past.

The convention that relates to property and debt says: “When part of the territory of a state is transferred by that state to another state, the passing of the state debt of the predecessor state to the successor state is to be settled by agreement between them.

“In the absence of such an agreement, the state debt of the predecessor state shall pass to the successor State in an equitable proportion…”

The only way this would not apply is if Scotland was treated as a former colony rather than a partner state in the United Kingdom. And in any event, the UK is not a signatory to the Vienna conventions.

The verdict

Professor Boyle told us it was “nonsense” to suggest that his legal opinion implied that the rest of the UK would be “obliged to hold on to all of the debt”.

He told FactCheck: “Scotland would have to negotiate its share of the national debt. It is a negotiation and it will have to be a hard-headed one.”

Of course, the government of a newly independent Scotland could try to refuse to take any of the debt on board as a bargaining position, but the chancellor could be equally confrontational about dividing state-owned assets between the two countries.

The one thing we can say for sure about a “yes” vote is that there would have to be intense negotiations between Holyrood and Westminster. There are few certainties about the outcomes.

By Patrick Worrall

“If we look at the length of the school day, the length of the summer holiday and we compare it to the extra tuition and support children are receiving elsewhere, then we already start with a significant handicap.”
Michael Gove, 18 April 2013

The background

Michael Gove was rarely out of the headlines this week after making a string of high-profile announcements and speeches.

The education secretary opened a debate about the length of the school day and summer holidays yesterday, saying: “We’ve noticed in Hong Kong and Singapore and other east Asian nations that expectations of mathematical knowledge or of scientific knowledge at every stage are more demanding than in this country.

“In order to reach those levels of achievement a higher level of effort is expected on behalf of students, parents and teachers. School days are longer, school holidays are shorter. The expectation is that to succeed, hard work is at the heart of everything.”

He added that some schools in England were already “recognising that we need to change the structure of the school term and in particular that it is poorer children that lose out from longer holidays.

Mr Gove is not alone in questioning the established school routine.

His suggestion that we change the shape of the school year echoed the words of US President Barack Obama, who said in 2009: “We can no longer afford an academic calendar designed when America was a nation of farmers who needed their children at home ploughing the land at the end of each day.”

It’s a global talking point, but the evidence that more hours in the classroom equals more academic success is decidedly mixed.

The analysis

According to the OECD, a major source of comparable statistics about life in the developed world, pupils in England already spend more hours in the classroom than children in most other advanced economies.

This table counts up the time spent on compulsory and non-compulsory subjects from seven to 14.

The OECD also produces figures for the amount of time spent on compulsory subjects alone, and produces an international league table of achievement after testing 15-year-olds from 65 countries in the core subjects of maths, reading and science.

At the age of 15, the average pupil in England gets 950 hours of compulsory education a year, according to the latest figures – more than the average for OECD countries (920) and the EU21 states (907).

English pupils scored significantly above average in science in the OECD’s international tests in 2009, but were almost exactly average in reading and maths.

The European countries in which children spend the longest hours in school – Spain, Italy and France - tended to score lower than England.

The top performers in these PISA tests were Shanghai and Hong Kong (treated like separate countries because they are so much more economically advanced than the rest of China), Korea, Finland, Singapore, Canada, New Zealand, Japan and Australia.

The best-performing European countries included the Netherlands, Belgium, Norway, Estonia and Switzerland.

Some of the top performers worked longer hours on compulsory subjects: Korea, Australia, the Netherlands. Others spent less time in the classroom than in England but still did better in the tests: Canada, Finland, Norway.

Finland fascinates educationalists because it is so unusual: world-beating results from relatively few hours in the classroom. But we don’t know if the one causes the other. The country is an outlier in many other respects, with low levels of poverty and inequality, and virtually no private education.

For the east Asian top performers the data is frustratingly incomplete, with information about hours spent at school in Hong Kong, Singapore, Shanghai and Japan missing.

The partial data we have suggests that Japanese pupils spent less time in school than their English pen-pals.

Anecdotal evidence would point to long hours of learning in Singapore and China, but without hard data all we can say at the moment is that there is no simple pattern here that says children who work longer hours do better in school.

This data compares the total hours worked each year. It doesn’t tell us which countries have more hours because of longer days or shorter holidays, or whether it makes a difference to the children.

Academic evidence from individual countries tends to be mixed too. Studies of schools in the American states Hawaii and Michigan found no relationship between total hours and student performance.

But a Harvard economist who looked at New York charter schools (similar to British academies) found that adding time did have a measurable positive impact.

The verdict

Meta-analyses of the data tend to show a small positive correlation between increasing school hours and achievement, particularly for pupils at risk of failing. It’s unclear whether the improvements would be worth the money we would have to spend on extending school hours.

The charity Education Endowment Foundation concludes: “Most of the studies find evidence of improved learning compared to shorter days or school years, but this is usually quite small and gains are not consistent across all studies. Unsurprisingly, the amount of improved learning appears to depend heavily on how the time is used and which aspects of teaching and learning are increased.

“Evidence suggests that it is likely to be cheaper and more efficient to focus on using existing school time more effectively before considering extending school time.”

Interestingly, despite Mr Gove’s assertion that “some of the best schools in the country are moving to a longer school day”, the evidence here is weak too. In a survey of new academies last year, only 9 per cent said they had taken advantage of their academy status to make changes to the length of days or terms.

By Patrick Worrall

The plan to cap total benefits at £500 a week for most couples and single parents and £350 for single people is being trialled in four London boroughs: Croydon, Bromley, Haringey and Enfield.

If the cap is considered a success it will be introduced across the country from July this year.

The government’s line has always been that the change will encourage some households who make excessive welfare claims to either start working or cut their housing benefit bill by moving to cheaper accommodation.

Iain Duncan Smith says the latest research from the Department of Work and Pensions (DWP) suggests this is already happening, with 8,000 people who were facing cuts under the cap moving into work instead in recent months.

But Jonathan Portes, a former DWP chief economist who is now director of the National Institute of Economic and Social Research, said: “There is as yet no evidence one way or the other that there is behavioural change.”

And now the TUC has called on the statistics watchdog to investigate claims that Mr Duncan Smith misrepresented the official figures.

A tangled web. Can FactCheck unravel it?

“Already we’ve seen 8,000 people who would have been affected by the cap move into jobs. This clearly demonstrates that the cap is having the desired impact.”
Iain Duncan Smith,  April 12 2013

There’s nothing wrong with the first sentence, if DWP’s latest figures are to be believed.

Jobcentre Plus staff rang 82,000 people over the last year to warn them that they were likely to see their incomes slashed thanks to the benefits cap.

Of those people in the danger zone, 25,000 “accepted an offer of help” from advisors, and 8,000 people found a job.

The problem with the second half of Mr Duncan Smith’s claim is that we don’t know for sure that the one caused the other.

Some or all of the people who found work in this period might have done so anyway even without the threat of the benefit cap.

That is a point DWP researchers made when they published these figures, saying: “The figures for those claimants moving into work cover all of those who were identified as potentially being affected by the benefit cap who entered work. 

“It is not intended to show the additional numbers entering work as a direct result of the contact.”

So Mr Duncan Smith is wrong about the strength of the evidence. That doesn’t mean he’s wrong to say that the imminent introduction of the cap has spurred some claimants into finding work.

We can’t say one way or the other unless we know what the normal “churn” – the percentage of people who leave benefits – is over the timescale of this analysis.

Another new piece of DWP analysis says only 40,000 households will be hit by the benefits in 2013/14 rather than 56,000, as was previously thought.

The researchers put this fall down to various policy changes and methodological improvements as well as “underlying caseload changes, due to normal benefit caseload churn”.

There’s no mention here of a change in behaviour caused by the benefit cap, just “normal benefit caseload churn”.

It appears that these two pieces of work were done entirely separately and the number-crunchers who updated the impact assessment weren’t asked to look for any evidence of behavioural change.

If these new figures are right, Alison Garnham, chief executive of the Child Poverty Action Group (CPAG), must be wrong when she says:

“About 190,000 children are affected compared to about 80,000 adults.”

These numbers were based on the old figures, as laid out in a previous impact assessment, before the estimate of the total number of households affected was lowered from 56,000 to 40,000.

The ratio of children to adults may well be similar but the numbers for both must be too high.

Ms Garnham also suggested that, rather than being an incentive to find work, the cap will have exactly the opposite effect of the one Mr Duncan Smith is claiming.

She told the BBC:

“The difficulty with cutting people’s benefits is that it tends to have the opposite effect. It tends to make people poorer and therefore in a less good position to move into paid work.”

The logic of this is that if you have less money, you spend more time worrying about scrimping and saving and have less time to apply for jobs.

But we have to point out the CPAG, like Mr Duncan Smith, have yet to produce any hard statistics which proves that their case is true.

If we come across any hard evidence that shows whether cutting people’s benefits makes them more or less likely to find a job, we’ll update.

By Patrick Worrall

The claim

“The progress made has been phenomenal and we are delighted that in line with our recommendations, as of April 2013, there has been a 50 per cent increase in deceased organ donation.”

The background

A seemingly innocuous press release celebrating a rise in the number of dead organ donors has sparked a bitter row about how we cut waiting lists for transplants – and the use of statistics in public debate.

The head of the government’s Organ Donation Taskforce hailed “significant and consistent increases in organ donation over the last five years”, but warned that there was still much progress to be made if we are to make organ donation “a routine and accepted part of UK society”.

But the former Lib Dem MP  and doctor Evan Harris took to Twitter to complain about the use of figures. He told FactCheck the whole story amounted to “an abuse of statistics and the misleading of the public”.

The analysis

In 2008 levels of organ donation were low and had been flatlining for a decade. Only 13 people out of a million were organ donors, compared to 35 in Spain. More than 90 per cent of people said they were in favour of donation, but only 26 per cent of people were registered donors.

And all the while the waiting list of patients desperate for transplants grew.

The Organ Donation Taskforce published this report in January 2008, making 14 recommendations and setting out a target to improve matters.

The wording of the target is vague.

Elisabeth Buggins, the chair of the taskforce, put it like this in her introduction: “A 50 per cent increase in organ donation is possible and achievable in the UK within five years.”

Does an “increase in organ donation” mean a rise in the number of donors or in the number of transplants they make possible? It’s not clear, although other bits of the report suggest the latter.

Elsewhere, the report says: “A 50 per cent increase in donation would enable an additional 1,200 transplants a year”. Phrased like this, and using these numbers, this looks like the target relates to the numbers of organs getting through to patients, not the number of donors.

Why does it matter?

Because if the target was for transplants not donors, we’ve missed it. The number of donors has gone up by 50 per cent since 2007/08, but the number of transplants that came from those dead bodies only went up 30 per cent.

The plan was that if we missed the 50 per cent target in five years, we would revisit the controversial option of changing the law in favour of “presumed consent” – assuming that people do want their organs used after death unless they specifically say otherwise.

This idea was heavily discussed and attracted the support of the then prime minister Gordon Brown, only to be effectively squashed by the Organ Donation Taskforce in a second report in November 2008.

The taskforce commissioned a group of academics to review the evidence from countries that had tried presumed consent. The researchers concluded: “The available evidence suggests that presumed consent is associated with increased organ donation rates, even when other factors are accounted for.

“However, it cannot be inferred from this that the introduction of presumed consent legislation per se will lead to an increase in organ donation rates.”

Despite this, and the fact that in the most recent survey, 64 per cent of the public said they were in favour, the taskforce came down firmly against introducing presumed consent in the UK, saying it was “not confident that the introduction of opt-out legislation would increase organ donor numbers, and there is evidence that donor numbers may go down”.

In its second report, the taskforce said presumed consent should be reviewed in five years’ time (that’s now) “in the light of success achieved in increasing donor numbers”.

Well, the prediction of success has come true, but only if you measure it with the easier target of increasing donor numbers.

By the time of the second paper, the target was explicitly set out as a 50 per cent increase in the number of donors. But was this the original target or were they trying to rewrite history?

Dr Harris told us: “The wording in the first report was not ambiguous. It was about donations/transplants. The wording was sloppily (or sneakily) changed in the second report.

“My knowledge of the field leads me to believe that they well know the difference between donation and donors and knew what they were doing. The first scenario (sloppiness) is utterly unacceptable for the NHS anyway. Lives are at stake.”

Ms Buggins said she accepted the original target was ambiguously worded but insisted the plan was always to measure success by an increase in donors not transplanted organs.

She told FactCheck: “It talks about donations rather than donors or organs. You can say it’s either-or, but all of the debates in the task force were about donors.

“The thinking was never: ‘Let’s massage this because we are so against presumed consent that we are going to do anything possible to avoid reopening the debate.’”

She said the taskforce had kept an open mind about presumed consent but had finally been persuaded it was a bad idea after looking at all the evidence.

A spokesman for NHS Blood and Transplant rejected any notion of misinformation, saying the health service has always been transparent about organ donation, with figures published on a weekly basis.

The verdict

There’s no doubt that the details of the all-important 50 per cent target were left vague and ambiguous when it was first set out.

But this is not hard evidence of subterfuge by health chiefs. And this week’s news is fundamentally good: an increase in donors and transplants; a fall in the number of people on waiting lists; more lives saved.

The bigger question is whether we could do even better if we introduced presumed consent.

Dr Harris thinks the target was deliberately changed to shut down this debate – an accusation strongly denied by those in charge of the campaign to increase organ donation.

One thing all parties agree on is the fact that we still haven’t cracked the organ donation problem. An estimated three people a day are dying while waiting for a transplant.

By Patrick Worrall