Tuesday, January 24, 2012

British insanity: Local councils will be handed £5bn to combat obesity

And it won't make a scrap of difference. It never does. Even when people do lose weight, they eventually put it back on -- and more

Local government is to take back responsibility for public health for the first time since the 1970s and will be given more than £5billion a year to stem obesity, binge drinking and smoking.

Powerful new public health directors based in councils will be asked to transform the NHS so it focuses much more on preventing illness rather than dealing with its consequences.

Announcing the plans today, Health Secretary Andrew Lansley will argue that a decade of failure has seen obesity rates spiral – with more than a quarter of adults now dangerously overweight – sexually transmitted infections double and gaps in life expectancy between rich and poor areas persist.

Mr Lansley, who aims to create a new ‘public health service’, will say that under Labour, public health was seen as ‘something to be sidelined’.

He will announce that next year £5.2billion will be spent on public health as responsibility is returned to local authorities for the first time since 1974. In a speech to health professionals, he will also pledge that the Government will increase health spending in real terms each year after that.

From April 2013, for the first time the funding will be ringfenced, meaning public health cash can no longer be raided to bail out other parts of the system.

Public health is currently the responsibility of primary care trusts. But as these will be scrapped with the introduction of GP consortiums in 2013, it has been decided that it should revert back to local government – which is responsible for wider determinants of health, such as housing, transport and leisure.

Local government will devise its own schemes for promoting public health, though ministers favour ‘nudging’ people to make healthy choices by presenting them as social norms rather than Labour’s ‘nanny state’ approach.

One example was the use of signs in shops saying ‘most people who shop here buy at least two pieces of fruit’, a tactic which proved effective in trials.

Under the new system, local authorities will be judged against a wide range of measures including tooth decay in children and reducing the number of falls in older people, and wider factors such as school attendance, domestic abuse, homelessness and air pollution. There will also be a major push to promote breastfeeding.

Mr Lansley will say: ‘The job of the Government – and my responsibility – is to help people live healthier lives.

‘The framework is about giving local authorities the ability to focus on the most effective ways to improve the public’s health and reduce health inequalities, long-term, from cradle to grave. Moving away from an old-style, top-down, target-driven regime, and towards outcomes that we all want to see.

‘Some are straightforward and obvious. Others are more complex, maybe things you wouldn’t immediately think of. ‘But they all help us live longer, healthier lives, and improve the health of the poorest, fastest.

He will also point out that ‘2000 to 2010 was a decade in which public health was seen as relatively unimportant, something to be sidelined’.

He will say: ‘Obesity rates from 2000 to 2010 rose from 21.2 per cent to 26.1 per cent so now over a quarter of adults are obese; sexually-transmitted infections, after the steep declines in the Eighties to Nineties, doubled in the subsequent decade; and health inequalities persist, with gaps in life expectancy of over a decade between people born in the richest areas and people born in the poorest.’

Mr Lansley will cite last year’s National Audit Office report which was unable to conclude that the £20billion Labour spent on reducing health inequalities was good value for money.

Councils who succeed will be rewarded with a ‘health premium bonus’ to spend on public health in the following year.

‘I want local government to be bold,’ Mr Lansley will say. ‘Really push to make things better. The health premium will encourage that, rewarding local authorities that make a real, demonstrable difference.’


'Breast is best advice is too posh': Charity stops promoting it in ante-natal classes

A leading childbirth charity will stop telling mothers to breastfeed over fears its image is ‘too posh’.

The National Childbirth Trust will no longer promote the practice to all women in its ante-natal classes. Instead it will encourage those who have already decided to take it up to do it properly.

The change follows concerns that its ‘breastapo’ tactics are alienating some women reluctant to breastfeed, particularly among the working class. The charity wants women from more diverse backgrounds to attend its classes.

The NHS recommends that babies are breastfed exclusively for six months. Breastfeeding rates range from 90 per cent for more affluent women, to just over 70 per cent for those in the poorest social classes and only 63 per cent for teenage mothers.

It provided ante-natal classes for about 90,000 couples last year, 16 per cent of them free through the NHS. But it has been criticised for alienating women who decide not to breastfeed or those who chose to have a caesarean.

Last year TV presenter Kirstie Allsopp claimed that she and thousands of mothers were being made to feel a ‘failure’ for having c-sections.

Spokesman Anne Fox said: ‘We need to get the message out that the NCT is for everyone, not just for “posh” parents as some people assume. ‘We want to have a more diverse reach. We have always worked on word of mouth, but now we want the person who says “You should go to NCT” to be a pregnant 15-year-old in central Manchester. ‘Our practitioners and volunteers are training to support all parents; those from ethnic minority groups, families that are newly arrived and those who parent on their own.’

The NCT, formed in 1956, has 100,000 members, making it the biggest parenting charity in the country.


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