{"id":975,"date":"2010-11-30T18:14:13","date_gmt":"2010-11-30T18:14:13","guid":{"rendered":"https:\/\/www.zoeharcombe.com\/?p=975"},"modified":"2016-07-01T19:52:15","modified_gmt":"2016-07-01T18:52:15","slug":"the-white-paper-on-public-health-andrew-lansley","status":"publish","type":"post","link":"https:\/\/www.zoeharcombe.com\/2010\/11\/the-white-paper-on-public-health-andrew-lansley\/","title":{"rendered":"The White Paper on Public Health (Andrew Lansley)"},"content":{"rendered":"
The long awaited White Paper <\/a>on public health has been published (30\/11\/2010). Let’s start positively:<\/strong><\/p>\n There are some things that I like about the White Paper 2) The Professor Sir Michael Marmot work on health inequalities. I had the privilege of hearing the Cochrane lecture, delivered by Professor Sir Michael Marmot, at the Wales NHS conference on 11 November 2010. The comparative health and longevity and healthy years of life are indefensibly different for people from different income groups and this cannot be allowed to continue. However, I remain to be convinced if handing responsibility for this to local government will make any difference. It hasn’t for education or economic development, so what will be different to make this work?<\/p>\n Things I disagree with:<\/strong><\/p>\n 1) In the Foreword, Lansley says: “It is simply not possible to promote healthier lifestyles through Whitehall dictat and nannying about the way people should live.” – We introduced a clunk click every trip seatbelt campaign. Robert Gifford, of the Parliamentary Advisory Council for Transport Safety charity, said seatbelts had saved 35,000 lives<\/a> in the UK during the last 25 years. The UK government could and should introduce a sugar tax, as has been introduced in Denmark and Finland. Finland have also taken steps to get Pepsi out of schools by 2012 – still not soon enough in my view, but way ahead of the UK. The government could make an enormous difference to our health (obesity and diabetes especially) by banning food companies from advertising to children (as Sweden has done since 1991); banning sugary drinks and confectionery in school; banning cartoon characters in sugary cereal marketing and attempts by the cereal makers to get children (and adults) to eat more of their processed food; banning similar marketing by the fast food industry who want humans eating more burgers, more fries, more milkshakes, more white flour pizza, more chicken in ‘secret’ ingredients and so on.<\/p>\n This is the biggest outrage of the white paper – it is possible<\/em>. Lansley doesn’t want to go this route because he is more concerned about the food and drink industry than the nation’s health. I challenge him to prove me wrong on this and take decisive action against the food and drink companies.<\/p>\n 2) Lansley is doing the exact opposite to taking decisive action against the food and drink industry. He is meeting with them at Unilever house<\/a>, with Unilever in the chair. His Foreword goes on to say: “All of this will be supported by work with industry and other partners to promote healthy living”.<\/p>\n As Professor Philip James, Chair of the International Obesity Taskforce, said on BBC Newsnight last week – this is utter madness. Food and drink companies have one purpose – to grow. They need to deliver increasing returns to shareholders and their ‘well being’ depends on them selling more of their food and drink. The biscuit companies need humans to eat more biscuits; the cake companies need humans to eat more cakes; the cereal companies need humans to eat more cereal; the confectionery companies need humans to eat more confectionery; the fizzy drink companies need humans to drink more fizzy drinks – human beings end up being nothing more than consumers in the food and drink companies’ pursuit of growth.<\/p>\n The food and drink companies love the current dreadful public ‘health’ dietary advice. They love everything being about calories and energy in and out. They will happily keep the focus on exercise – we need to exercise more; we’re fat because we’re sedentary kind of thing. Heaven forbid that the public stops eating processed food because they realise it makes them fat.<\/p>\n As I detail in my latest book “The Obesity Epidemic: What caused it? How can we stop it?<\/a>” , many food and drink companies actually have the government “eatbadly plate” (I think it is supposed to be called “Eatwell Plate<\/a>“) on their web sites. They love the box of cornflakes on there (branded Kellogg’s in earlier versions of the plate); they love the cola on there (yes really); the Battenberg cake, sweets, biscuits, white bread, sugary baked beans, fruit in syrup, fruit juice – and many more – all the processed food that they love to sell us and they want us to consume more and more of.<\/p>\n Our waistlines grow in sync with the growth in sales of processed food and drink. How on earth can we think that food and drink companies will lead a campaign to reduce waistlines and, inevitably, their sales in parallel. The cure to the obesity epidemic lies in returning to eating food – real food – the food we ate before two thirds of us were overweight. It does not lie in eating the processed food that we have eaten during the time in which obesity has increased nearly 10 fold – the stuff that Lansley’s partners make. It really is utter madness.<\/p>\n 3) I disagree with point 7 in The Executive Summary: enhanced nutrition is heralded as a “formidable public health achievement”. Our nutrition could <\/em>be the best it has ever been, but it is far from this. I analysed the UK Family Food Survey (2008) with the following conclusions:<\/p>\n a) Vitamins: If you take the higher of the Recommended Dietary Allowances (RDA’s) for the USA and Europe, UK intake falls short for Vitamins A, C, D, E and Folic Acid. Interestingly the fat soluble vitamins (those delivered in foods with a fat content) are A, D, E and K. K was not recorded, but the deficiencies in A, D and E make it likely that our low-fat obsession is making us deficient in all the fat soluble vitamins. This should be of deep concern to our governments. Instead, when they present the latest annual food survey we are again told to eat less fat \u2013 and to become even more deficient in these vital nutrients. The vitamin E deficiency is both interesting and worrying \u2013 vitamin E is the body\u2019s natural antioxidant and is known to repair damage in the blood vessels. I wonder if that has anything to do with heart disease?<\/p>\n b) Minerals: The average UK citizen is lacking in every mineral recorded by the National Food Survery, compared to the higher of the RDA\u2019s for the USA and Europe. The UK is missing even the low European target in all but calcium. (No wonder so many people are now taking osteoporosis tablets with 500mg assumed to be adequate for calcium). Since so many of the minerals are not even recorded, we may be able to assume from the deficiencies in those that are recorded, that the overall picture is bleak.<\/p>\n
\n As someone working exclusively in the field of obesity, I had expected the paper to address the single biggest avoidable health crisis in the UK – obesity. The word obesity appears a dozen times in the 98 page document, but only to describe it as a problem, or to assign statistics to the scale of the problem – I could see no recommendations at first sight, other than a note under 3.53 that “employers have the opportunity to improve health outcomes.” I am sure employers will welcome this responsibility during the worst recession many have faced in their lifetime.<\/p>\n
\n 1) Creation of a Public Health England – we have a Public Health Wales and with the right independence and leadership and remit this can be a positive force. However, there needs to be clarity of role. Each country has a Chief Medical Officer whose role includes public health, indeed majors on public health. As with all public bodies, roles and responsibilities need to be clearly determined with CAN DO (as I coined the phrase when I worked as an HR Director) Clear Accountability; No Duplication or Overlap.<\/p>\n
\n I completely disagree.<\/p>\n
\n – We introduced a smoking ban and an estimated 40,000 lives<\/a> have been saved.<\/p>\n