Trousers…

Training Primary Care - NHS - GPs - buy a bigger pair of trousers.

Kylie knows she shouldn’t do it but needs must. She’s almost skint and there’s nothing in the cupboard.

A bag of chips is warm, tasty and the alternative… Jack goes to bed hungry. It’s a solution and a bag of crisps on the way to school, is breakfast.

The Soft Drinks Industry Levy, added to the price of soft drinks, is yet to finds its way to fund the re-opening of Jack’s school’s breakfast club.

Therein the modern day story of public health; poverty, austerity, deprivation. Poor diet and we have some of the most obese kids in Europe and unhealthy foods are three times cheaper.

Nearly half of all pregnant women are overweight.

‘If we reduce childhood obesity, we will help children living in the most deprived areas have better life chances… if trends continue… as many as 1 in 3 children, in the most deprived areas, will be obese by 2030.’

If you read nothing more from Dame Sally Davis’ final report; ‘Time to Solve Childhood Obesity‘, as she steps down as Chief Medical Officer, read that paragraph and read it again.

This is a beautifully presented report with some of the best graphics I’ve seen. Really hard hitting; the average Indian takeaway has 1391 calories, fish and chips 1657 and a pizza, a whopping 1820. Ouch.

If you are partial to a pizza you should know, since 1990, there’s been a 53% increase in their size from 200g to 305g. No wonder yer waistline is expanding!

The CMO is independent of government and a departing Dame Sally has given it to them with both barrels and exposes the heart of the public health conundrum. Can we persuade people something is for their own good, cajole them or should we make them do it.

Thomas McKeown, a controversial public health doctor first spoke of the problem, back in the ’60s. In-terms, he said; governments have done all they can with public health, clean water, childhood immunisation and adult literacy. The rest depends on the extent governments are prepared to interfere in the lives of ordinary people.

McKeown was right. It’s the law that changes our behaviour; seat belts in cars, crash helmets on motor-bikes, health and safety legislation and of course, the ban on smoking in the workplace.

The levy on soft drinks has worked, reducing sugar but has not damaged the industry’s growth.

Governments are getting the message. In Amsterdam strong political commitment is driving multi-sector action with ambitious targets.

Our politicians must show similar steel. And, page 11, the public do support change.

Seventy percent think it is the responsibility of government to tackle childhood obesity and nigh-on three quarters want restrictions on fast-food outlets near schools.

The report is not short of ideas.

Private sponsorship and celebrity role models, investing in the built environment, exercise and healthy weight in pregnancy, breast feeding and the role of the NHS in tackling weight related stigma.

It gets tougher; prioritising childhood health over company profits, rebalance to favour healthy options through regulation, manipulation of VAT… something we would be free to do if we leave the EU.

Change planning policy to refine fast-food classifications and make it easier for a council to say, no.

A clamp down on advertising and tax-deductible expenses.

Tough enough? What about banning eating and drinking on urban public transport. Banning unhealthy foods at sports events… ooh, no more pies at half time.

Free drinking water in public places. Car-free weekends.

There are pages of recommendations. It looks like a team have done a brainstorm and filled a white board with ideas and concluded, ‘you know what, we won’t chuck anything out’… and they are right.

Maybe not all are doable or even practical but do you know what…

… school kids stopping lessons to walk a mile every day. Bonkers? No, I’ve seen it for myself and it works. They and the teachers love it.

You can see it here, on The Academy of Fabulous Stuff.

In England, as many as 650,000 children are showing signs of fatty liver disease. If that’s not a warning, what is.

This is a report for parents, teachers, the NHS, politicians and anyone who’s had to buy a bigger pair of trousers.

Contact Roy – please use this e-address – roy.lilley@nhsmanagers.net

Know something I don’t – email me in confidence.

Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.