Showing posts with label big sister. Show all posts
Showing posts with label big sister. Show all posts

Saturday 5 January 2013

Labour


Consider tougher regulation in obesity fight - Labour

Are legal limits on the fat, salt and sugar content of food needed?

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Labour has urged the government to consider introducing legal limits on sugar, salt and fat-content in food.
The party says the coalition's emphasis on voluntary agreements with industry is not working.
It is starting a consultation on how to tackle obesity.
The Department of Health in England says its Responsibility Deal with food companies shows the voluntary approach can be successful.
At its core this is an argument about how best to reduce levels of fat, sugar and salt in our food - through regulation, or collaboration.
The coalition says working with industry through the Responsibility Dealhas improved food content and labelling.
But Labour argues the government has failed to come up with a convincing plan to tackle rising obesity rates.
Shape the rules
Its consultation paper Children, Food and Obesity says parents are primarily responsible for ensuring their children eat healthily, but it argues that government also has a crucial role.

Which foods should be regulated?

Nutritionist Amanda Ursell highlighted five foods that she says could benefit from regulation:
  • Breakfast cereals: to reduce high sugar content
  • Fruit juice drinks: these are drinks which are not pure fruit juice and can have added sugar - but are confusing to spot among pure fruit juice products
  • Ready meals: regulation would stop some brands adding too much salt
  • Crisps: caps could reduce salt levels
  • Biscuits, cookies and cakes: manufacturers might be encouraged to rethink levels of fat
It says that means "shaping the rules of the system" to help parents who are trying to do the right thing.
The paper cites recent data NHS data indicating that one third of children in England are either overweight or obese by the time they leave primary school. It says this puts them at greater risk than ever before of developing serious problems such as diabetes and cancer.
Shadow health secretary Andy Burnham says the government's response - working with industry through its Responsibility Deal - has been complacent.
"It is clear that the current voluntary approach is not working. We need to open our minds to new approaches in tackling child obesity."
He says it is time for "new thinking" on how to tackle child obesity.
"Labour wants to lead this debate. That is why we are asking the public and experts if new limits for sugar, fats and salts would be the right approach."
The party says measures could include a 30% cap on sugar content in cereals aimed at children - significantly lower than in several well-known brands.
The consultation will also consider tighter restrictions on marketing and improving access to healthy food.
Healthier choices
The Department of Health in England says the Responsibility Deal has succeeded in cutting fat, sugar and salt in foods.
A spokesperson said: "Our successes so far clearly demonstrate that the voluntary approach can work and we now have over 400 partners in the responsibility deal.
"We are working to reduce the amount of salt in food further, cut saturated fat consumption and we are exploring how to promote healthier food choices more widely. We also want more businesses making pledges so we get bigger results ."
The Food and Drink Federation also said collaboration between business and government had been a success.
"Through voluntary commitments, manufacturers have made significant progress in reducing salt, saturated fat and calories in their products. Salt levels have reduced 9% since 2006 and some manufacturers have introduced calorie caps in particular for snacks and soft drinks."
However, former regional director of public health, Professor Gabriel Scally, said the voluntary "collaboration" between food companies and the government was not working.
Speaking to the BBC he said: "I don't anyone in this country actually thinks that the food industry are the right people to decide what we should be eating."
Professor Nick Finer, who co-authored a recent report on obesity by the Royal College of Physicians, said legislative measures had already worked in other European countries.
"In French schools food and drink is controlled and all marketing of foods high in fat, sugar and salt is banned unless they are taxed and marketed with a health warning.
"Studies have shown that following these measures, the number of overweight children in France has dropped from 18.1% in 2000 to 15.5% in 2007."
Nutritionist Amanda Ursell said introducing legal limits on food could be "incredibly useful" if it meant "manufacturers are encouraged to reformulate their products" and market in "a responsible way".
Speaking to BBC News she said: "Children's food up to the age of one is closely regulated - so you know they won't have too much sugar, salt or fat. But at the age of one those regulations disappear.
"It's a slow process and the food industry has done quite well over the years, but this would be an extra incentive to go one stage further."

Tuesday 1 January 2013

Public health minister Anne Milton: "We're too fat and we need to do something about it"

Global governments 'must get tough on obesity'

Body fat being measured using callipers.The international group of researchers, who have published a series of articles in The Lancet, said no country had yet got to grips with the problem.
Obesity-related problems, such as diabetes, were now accounting for between 2% and 6% of health care costs in most countries.
Rising spending
But as one of the articles showed, this is likely to get worse if current trends continue.
Researchers made projections for the US and the UK - two of the developed countries with the worst rates of obesity.
They predicted obesity rates would rise from a quarter in the UK to about 40% by 2030.
Such a scenario would cost the NHS an extra £2bn a year - the equivalent of 2% of health spending.
The rise in costs would be even greater in the US, where obesity rates would rise from one in three to about one in two.
The researchers accepted that the whole of society - from the individual to industry - had a role to play in tackling the problem.
But they said governments needed to take a lead by using legislation and direct intervention to create a better environment.
They said many measures - including taxes on unhealthy food, restrictions on junk food advertising, traffic light labelling and school-based education programmes - would save money as well as benefit health.

OBESITY MEASURES

CategorySaves moneyMinor costHigher cost
SOURCE: THE LANCET
FOOD
  • Tax junk food
  • Limit junk food ads
  • Traffic light labelling
  • Cost benefit category
LIFESTYLE
  • Discourage kids from TV
  • Exercise and healthy eating at school
  • Work with obese children
  • Help families with overweight children
  • School walking trains
TREATMENT
  • Surgery for obese teenagers and adults
  • Weight loss drugs
Others, such as providing obesity surgery and health programmes aimed at families with overweight children, would come with a minor cost although should still be looked at.
Oxford University expert Professor Klim McPherson, who was one of the lead researchers, said: "It is about changing the environment in which people live so they can make healthier choices."

But he said too many countries shied away from taking the right action and urged a forthcoming UN summit on health in September to "show leadership" by putting pressure on governments to act.
In particular, he criticised the government in England, which has been focusing on voluntary agreements with industry rather than legislation.
He said ministers were "enfeebled by their ideology" and too worried about accusations of the nanny state.
"They have this idea that government action in this sphere would not be a good idea," he added.
Professor Boyd Swinburn, who is based in Australia and works for the World Health Organization, agreed governments had been too slow to act on the "obesity crisis".
"There is more willingness to invest in drugs and surgery than dealing with the underlying causes."
He also compared the tactics of the food industry - in terms of getting people addicted to their products and in blocking attempts to discourage consumption - to those of tobacco firms in previous decades.Dr Frank Atherton, president of the Association of Directors of Public Health, also said he was in favour of the interventions being suggested: "Of course we have to work with industry, but there is a feeling that the emphasis of this government has turned too far away from legislation."
However, Terry Jones, of the Food and Drink Federation, said the industry had been taking positive steps.
"The Lancet fails to recognise the lengths to which the UK food and drink industry has gone to help improve the health of the nation, particularly in relation to rising obesity levels," said Mr Jones.
Public health minister Anne Milton said the government believed the best way to achieve results was through a "collective voluntary effort".
She said this was achieving results, citing the pledge by industry to put calorie information on menus.

"We have no current plans to impose a 'fat tax', but we are working with food companies to reduce fat, sugar and salt and ensure healthier options are available.
"We also want to see businesses use more consistent and informative front-of-pack nutrition labelling than has been achieved in the past," she added.
"We recognise the significant threat that obesity poses to society and have taken a proactive part in improving health."


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Of course we have to work with industry, but there is a feeling that the emphasis of this government has turned too far away from legislation”
Dr Frank AthertonAssociation of Directors of Public Health

Friday 7 December 2012

'Never mind the patient, tick the box'


'Never mind the patient, tick the box'

PaperworkRegulation and inspection are often increased after a crisis
Scandals lead to inquiries and to recommendations - leading to a focus on filling in forms and ticking the right boxes.
But in this week's Scrubbing Up Sue Bailey, president of the Royal College of Psychiatrists, says it's time to listen to those receiving the care.
Why do care standards break down? We've all read heartbreaking stories of elderly people with dementia or patients with learning difficulties being neglected, mistreated and abused.
When things go wrong, inquiries are set up, reports are published and lessons learnt.
Think Winterbourne View; Mid-Staffordshire; childcare in Rochdale, or the Carlisle Report.
At heart, the recommendations boil down to improving communication, listening, learning and acting. It means taking notice of what patients and service users have to say.
Blame culture
But when trying to deliver the right kind of care, the health service often addresses regulation, standard setting, inspection and monitoring.
This approach aims to improve scrutiny and accountability, which most people would agree is a "good thing".

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The present blame culture doesn't help anyone.”
But there is a risk that a constant focus on targets, procedures and performance can lead to a tick box approach to healthcare.
This usually ends up placing more controls on healthcare workers, greater monitoring and prescriptive procedures.
Unfortunately, this is often at the expense of professional judgement, leading to dissatisfied and demoralised staff - with the all important relationship between the patient and healthcare worker forgotten.
I'm not saying that people shouldn't be held to account for their actions, but the present blame culture doesn't help anyone.
Healthcare is, or should be, a moral as well as a practical undertaking.
It deals with uncertainty in which mistakes are inevitable - but this isn't a message anyone wants to hear. Positive change won't happen if we continue to exist in a risk-averse bubble.
As Professor Eileen Munro of the London School of Economics put it recently, defensive care practice doesn't avoid risk, it simply displaces it - usually onto those using the services.
Time sensitive
What is needed is something in very short supply in the health service - time.
It takes time to develop expertise and build relationships based on intelligent kindness, not just technical skills.
It takes time to build critical reasoning skills and provide effective supervision.
It takes time to allow staff doing a difficult and stressful job to reflect, offload and be mentored by those with more experience.
In an era of unprecedented NHS reform, how can we find the time?
I believe we need a greater focus on helping the workforce develop the skills, knowledge and personal qualities required to meet care needs, support new staff more and improve opportunities for career progression
Workforce development takes time and money, but it is an investment that could support safer and better care, and mutual respect between patient and carer or doctor.
Old fashioned?
Don't get me wrong; improved processes can help, too.
We need data in healthcare but what we want and need are useful, practical tools that help learning and improve care.

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Policy makers will have to be brave to think and act in the long term”
This learning should involve ongoing feedback from patients, which is acted on by people like me.
What's the bottom line? A health service in which the treatment and care of people - not systems and processes - are at the heart of what we do.
Does that seem terribly old fashioned?
It sounds an awful lot like what I came into medicine for 40-odd years ago, but which I have seen start to drift away.
I will be accused of being simple minded, but a just culture should replace a blame culture.
This will require a major shift in approach towards positive risk taking and being open and honest with ourselves and with our patients that not everything can be "cured".
It's not too late, but policy makers will have to be brave to think and act in the long term. But is anybody listening?

Wednesday 12 September 2012

Trust chief executive Lyn Hill-Tout said she welcomed working with Monitor


Rescue package for troubled Mid Staffordshire NHS Trust

Lyn Hill-Tout

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A rescue package is being drawn up for a hospital trust accused of "appalling standards of care" three years ago.
Independent experts will look at a long-term solution for patients using Mid Staffordshire NHS Foundation Trust, health service watchdog Monitor said.
The watchdog, which oversees finance and management, said clinical care has improved but needs to be made sustainable.
Experts will look at how services can be made viable.
Financial advisors, accountants, administrative and legal service firms will form part of the team recommending how services should be run.
'Deeply dysfunctional'
Monitor said the body had an "open mind" about what solutions would be reached but suggested a solvent restructuring of the trust or possibly putting it in special administration could be options.
A final report will be delivered to Monitor in spring 2013.
The trust looks after Stafford and Cannock Chase Hospitals.
A 2009 Healthcare Commission report revealed a higher than expected number of deaths at Stafford Hospital.

Analysis

After the placing of South London Healthcare into administration in July, this is another significant step for the NHS.
The decision by the health secretary two months ago was a first for the health service and could lead to that trust being broken up and services closed.
Mid Staffordshire is a foundation trust so this option is not open to ministers or regulators - yet.
But come April Monitor will have the powers to take the same step and so by announcing troubleshooters will be brought in Monitor has paved the way for that to happen.
It will not be the first time that outside experts have been asked to assess the governance and finances of an NHS trust.
But it is the first time they will have the remit to recommend administration for a foundation trust.
It is another sign that in the current financial climate tough action will be taken against struggling trusts.
A public inquiry into the role of regulators in the lead up to the critical report is set to report later this year.
The A&E unit is also temporarily shut at night and earlier this month an NHS report criticised the standard of breast cancer care, describing the set-up as "deeply dysfunctional".
A contingency planning team will work with local commissioners and clinicians, Monitor said.
Dr David Bennett, chair and interim chief executive of Monitor, said: "We have been working closely with Mid Staffordshire NHS Foundation Trust to improve its performance.
"It has made significant improvements in the clinical care provided for patients, but we need to make sure these services can be secured in the long-term.
"It is therefore time for us as the sector regulator to step in and look for a solution that ensures services are provided for local patients on a sustainable basis.
"We have an open mind about the form that solution might take, but it should be the best one for patients in the long term."
Lyn Hill-Tout, the trust's chief executive, said she welcomed working with Monitor so "clear decisions" could be made.
She said: "Reviews of the trust over the last few years and the changes to the way healthcare has begun to be provided nationally have led to a growing feeling of uncertainty about the future of the two hospitals."
Dr David Bennett: "We are open minded about what is the right answer"
In July a new medical director took over at the trust replacing Manjit Obhrai, who was brought in three years ago to improve standards.
At the same time, the Care Quality Commission lifted all of its previous concerns regarding the hospital, saying all "essential standards" were being met.
A Department of Health spokeswoman said the hospitals trust was "still facing serious financial challenges".
She added: "This puts at risk its work on improving services for patients.
"It is important that valued local services are sustainable and able to continue providing high quality treatment and advice for patients."

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