If you’re reading this you’re probably thinking what has cross promotional marketing to do with children. Personally when I first heard the term I was thinking what exactly is it?

Simply, cross-promotional marketing is the act of strategically aligning businesses that target the same market but do not directly compete with each other. Whenever two organizations join forces to attract their mutual customers they can more than double the number of prospects they each reach.

For example, in 1996 MacDonalds and Disney signed a ten year deal to cross-promote. Get it? Same market, but not in direct competition and double the reach. A subsequent survey by Eric Schlosser of US schoolchildren found that the only fictional character with greater recognitions than Ronald MacDonald – who had 96% recognition – was Santa Claus. Oh, by the way, MacDonalds operates more playgrounds – designed to attract children and their parents to its restaurants – than any other private entity in the US;

This sort of promotion is also seen with film tie-ins such as Burger King and Toy Story.

Sorry to be a spoilt sport, but given the obesity epidemic - currently 10% of children worldwide are either overweight or obese - it’s time to rethink cross-promotion.

Beware; next time you are out and about, particularly if you have children, you will start to see cross-promotion all around you.

It’s unlikely that anybody living on this island missed the furore surrounding the appearance of British National Party’s chairman, Nick Griffin, on the BBC’s Question Time. I will not comment on Mr Griffin’s misguided views and statements, because they have been covered and analysed to death in the broadsheets, the tabloids, the radio waves and the TV screen
this week. However, I did check out the BNP’s website to look for their health policies, listed under “First Class Health Service for a First World Nation: BNP Health Policy”.

Just like Griffin, the policy statements on the surface may seem vaguely sensible to some people, but you only need look just below the surface to see the true colours: ill-thought-out nonsense. If racism is the fundamental tenet of a political party, it is difficult to hang coherent policies from that hook. Firstly, the BNP would “replace 100,000 NHS bureaucrats with doctors, nurses and dentists” but it does not mention anything about healthcare managers, health economists, and many allied health professionals needed in a modern health service, or how it would conjure up these home-grown 100 000 health workers! Secondly, they would “Train and pay to retain British doctors, nurses and dentists instead of looting the Third World of staff who are desperately needed in their home countries”. Although many doctors and nurses are attracted to work in the UK as economic migrants, they are free to do so as long as there is a demand for health workers in this country. Ethical recruitment from poor countries is a key goal for all UK employers and the brain drain has been increasingly recognised and debated in recent years. However, forcing British doctors to stay in the UK or African doctors to stay in Africa is no more feasible than closing UK’s borders tomorrow. The BNP should acknowledge the extent to which the NHS has relied upon foreign health workers throughout its history and the contributions that ethnic minorities in this and other employment sectors have contributed to the richness of life in Britain today.

The medical literature is rife with examples of the negative health effects of racial disparities from around the world. There is no example yet that racial discrimination will be good for the population as a whole, or for any individual element of the population. Much more reasonable and human ways to address inequalities than the BNP proposals are: better data collection and the use of ethical and human rights frameworks to make sure that every member of our society has access to healthcare.

Perhaps the most chilling policy statement reads “We will see to it that no money is given in foreign aid while our own hospitals are short of beds and the staff to run them”. Mr Griffin and his supporters would do well to read about where government money is currently being spent. It is not just British people that grossly overestimate how much they spend on foreign aid, the Americans do it too. The BNP’s misconception is deeply worrying because the rich nations are already underspending in terms of the UN target of
0.7% of GDP for international development assistance, and there are better ways to save government money.

Remarkably, the BNP is pro-prevention: “….more emphasis must be placed on healthy living with greater understanding of sickness prevention through physical exercise, a healthier environment and improved diets”. This, as far as I can tell, is the only positive in the health service under the BNP.

Gobsmacked, bamboozled, annoyed: my emotions on following news stories about the ongoing US healthcare reform debate this week. Then came the onslaught on the UK’s National Health Service by various Americans and Tory MEP, Daniel Hannan. Hannan described the NHS as “a 60 year mistake" and that he "wouldn't wish it on anyone". The Republican former vice-presidential candidate Sarah Palin has called health rationing by NICE "downright evil" , referring to it as a “death panel”. Stephen Hawking has come to the defence of the NHS and even the PM has been Twittering his support.

Everybody is entitled to an opinion. Hannan’s last blog entry on 14th August had drawn over 450 comments from both supporters and fervent opposers of his standpoint. When a person in authority gives an opinion, it is naturally given more coverage than if a member of the public made a statement. Therefore, politicians have a responsibility to check their facts before opening their mouths and we, the public, whether in the UK or the US, have a responsibility to check the facts. In his blog, “The NHS row: my final word”, Hannan argues the sales pitch for his book, “The Plan: Twelve Months to Renew Britain”, which has “a lengthy chapter on healthcare which sets out how Britain compares with other countries in terms of survival rates, waiting times and so on”. Since when did whether or not a book is a bestseller equate to factual scientific evidence? And would you take financial advice from a doctor? Would you take plumbing advice from a banker? Then why are we listening to a politician/bookseller to tell us what is best for the US or the UK’s health?

As somebody who trained and works in the NHS, I know that it has many flaws and many changes are necessary. However, we have to get our facts right when comparing with other systems. I have previously blogged about how charges and private user fees make health systems less fair and less efficient. I am not going to repeat the evidence that is freely available in the public domain. In a nutshell, the UK spends half of the US on healthcare as a percentage of GDP and per capita, has lower infant mortality and higher survival rates as a population. Most importantly, the US comes bottom out of industrialised nations in terms of health equity and 15% of its population do not have health insurance, whereas every UK citizen, regardless of who they are, what colour they are, where they are, is entitled to NHS care.

Atul Gawande, a surgeon and public health advocate in Boston, wrote a great piece in the New Yorker in June about the financial incentives which have led to a country with spiralling health costs and inadequate health services for its population, and makes a strong case for universal health insurance in the US. This week’s NEJM includes a review of recent US nationwide opinion polls, showing that “most of the public wants a major change in the health care system. But majority support for a specific legislative proposal will depend on Americans’ believing that they and the country will be better off if such a change is enacted”. Obama has higher approval ratings than Bill Clinton, the last man to attempt US health reform on this scale and he likes evidence-based medicine, which shows that the US is failing its citizens at the moment. If he can’t make America focus on the health of its population, nobody can.