Malnutrition and public health - it's not austerity that's the problem

****

Some "Doctors" have written a letter to the British Medical Journal expressing concerns about malnutrition:

In a letter to the British Medical Journal, David Taylor-Robinson from the University of Liverpool and six other academics warn: "This has all the signs of a public health emergency that could go unrecognised until it is too late to take preventive action."

They say they are particularly worried about the number of children with malnutrition because it can cause cardiovascular and other chronic diseases in adulthood.

And the newspapers and broadcasters lap it up without asking some simple questions - ones like "how many cases of child malnutrition are there?"

To help them, here are the figures from an answer to a Parliamentary question  - in 2008/9 there were 201 cases of children admitted to hospital where  the primary or secondary diagnosis was malnutrition. In 2012/13 this figure had soared to 205 admissions.

There is absolutely no evidence at all - other than anecdotes from teachers - to support the contention that child malnutrition is rising. The thing that should concern us is malnutrition among the elderly because this has risen significantly. The question is why?

Here's one stab at assessment that followed a report in The Independent earlier this month:

People with certain long-term health conditions can't always retain all the nutrients they need - particularly the elderly, who might also struggle to make the trip to the supermarket. With this in mind, the higher incidence of malnutrition might also reflect broader demographic trends, including the fact that the UK's population is ageing. The most recent Nutrition Screening Survey showed that those aged 65 plus were more likely to be malnourished than those who were younger. In addition, it may also be that hospitals are now more likely to screen a patient for symptoms of malnourishment. 

The reasons for increased malnourishment may be entirely unrelated to the current economic climate. Since the elderly are largely protected from the impact of welfare reform and make up the overwhelming majority of malnutrition cases, we should perhaps look elsewhere for the causes of the problem. There may be consequences from 'austerity' - reductions in social care visits, for example - that impact on the elderly eating properly but equally the rise may be a simple reflection of people living longer.

All this may not suit the political agenda of the people writing to the BMJ but we should perhaps pay more attention to the real challenges rather than write ill-researched and polemical letters that serve only to misdirect (and get a nice headline).

....

Public health? Focus on the real problem please....

****

The Association of Directors of Public Health (let's call them Nannying Fussbucket Central) has issued a grumpy statement explaining why they threw all their toys out of the pram and are screaming their toddler heads off. It includes this comment:

"Both standardised packaging and minimum unit pricing (MUP) are evidence -based interventions..."

The sole evidence (or should I say computer model) supporting MUP is rapidly unravelling (and alcohol consumption especially amongst the young continues to fall) and there is no evidence at all supporting the theory that shiny packs make children more likely to take up smoking other than the reasonable observation that we'll pick a colour over a plain pack when given that choice.

More to the point - the public health point that is - while the nannying fussbuckets are doing this:

These measures will primarily protect the future health of children...

The real public health problem is out there - and the public health people don't know why it's happening:

Around 600 more people – mainly elderly – have died every week so far this year compared with the average for the last five years, official figures show.

Since early 2012 there have been 23,400 more deaths than would have been expected in England and Wales.

This could be related to a series of bad winters, it could be the reductions in adult social care provision and it could be because public health's obsession with drinking in recent years has meant we've simply switched attention from the real health problems in society.

So perhaps, instead of throwing tantrums about government policy choices, these great public health brains might care to focus on the real problem?

....

The Conservative Party's problem...

****

...capured here:

Most of all, broadly speaking, I think you’d struggle to find many people under the age of 40 who are appalled or outraged or betrayed by this, far less many who really feel insulted or punished. This may reflect my own selection biases of course but, really, I look at today’s Tory papers and wonder where and when these people are living and to whom they think the modern Tory party should be trying to appeal. Because, on the evidence of today’s papers, it sure ain’t middle-class (and metropolitan!) women.

It's not David Cameron's problem or even the parliamentary party's problem, it's a problem of our image, focus and preference. The Party's image and outlook - again this isn't a consequence of policy, ideology or strategy but one of positioning - is designed to sustain it's core. And that core, the 'Conservative Base' if you wish, is over 55, living in the South East and wealthy pockets elsewhere.

Don't get me wrong, there are a lot of these people. They form the core constituency and customer base for the Daily Telegraph and Daily Mail, they don't approve of newfanged things like gay marriage and women going out to work, and they make up nearly all of the Conservative Party's 150,000 members (as an aside, when I joined the party in 1976 it had around 2 million members).

The Party has lost the support of two generations of educated young people - the bunch who finished university and started work in the 1990s and the cohort who did likewise in the 2000s. This goes a long way to explaining why the Party got less than 40% of AB voters - its traditional core support - in the 2010 General Election.

Alex Massie is right. It would be a poor do if this was just the response to giving working mums a tax break on childcare. But it isn't - the same goes for almost any policy that might look even the slightest bit socially liberal. Whether it's gay rights or racial discrimination, the knee-jerk of the conservative press - echoed by the 'party faithful' next time they meet their MP - is to say no and gibber about political correctness or traditional values.

Until this changes, the Conservative Party will decline. For sure, vacuuming up the grumpy old man vote might work as a short term strategy but in the long term all it does it annoy the hell out of 30 and 40 something voters. Voters who really don't have a choice but for mum to work - and who will welcome a little tax break on childcare.

....

Killing off old people to deal with climate change - the real green agenda

****

The long campaign by the greens and their fellow travellers to raise the cost of heating our homes has resulted in record numbers of old people dying unnecessarily in cold houses.

“We have seen the death rate in the past month alone quadruple since December last year and if the cold weather continues we could be looking at horrendous figures

“At the rate we are going, and if this extreme cold continues we could be looking at 30,000 or more.

“Many elderly health conditions are worsened by cold weather and there is a definite risk of the highest national winter mortality figures since 2008-09.”

Despite this our government is trapped in a hideous and pointless programme of closing down efficient means of energy production and replacing them with more expensive methods. Apparently this will save the planet. I guess the Greens - eugenicists to a man - are only too happy to see a few human casualties in their fanatical pursuit of reducing "carbon".

Don't be fooled by the chaff thrown around by these fanatics - the stuff about evil gas companies or wicked electricity producers from France. These people want higher fuel prices because it's the only way they can get the subsidies for wind, tide, solar and all the other twee green generation methods.

The greens have hobbled nuclear by pretending it's dangerous when it isn't, they've pushed the coal mining business to the brink of closure and they want to prevent the safe, low-cost gas that would come from frakking. And they've shoved up the price of fuel by subsidising inefficient generation.

The result of this is that old people can't afford to heat their homes. And too many of them die because of this policy. Those 30,000 deaths - the greens did that.

.....

Labour's plan - tax the poor to pay for the care of the wealthy.

****

Fresh from championing recipients of housing benefit earning over fifty grand, Labour is now planning to be the hero of the relatively wealthy. Apparently, the proposals on social care - where how much we might have to cough up is capped at £75,000 and people with £125,000 or less in assets will receive state help - still mean that people will have to sell their home.

I'm fine with this. What possesses people like Andy Burnham to believe that the taxes paid by people on minimum wage should go to pay to care for someone sitting in a house worth hundreds of thousands? Does he really think it justifiable - I mean morally - for a struggling family to pay taxes so someone else can inherit mum's house? Is it really OK that government borrowong climbs through the roof - taxing future generations of children - so someone can leave their "life savings" fructifying in some investment fund?

If there's one thing that makes me cross it's the assumption that these assets, these savings are simply there so people can inherit the cash. Surely those assets and savings are precisely there to look after mum or dad in their lifetime - to provide comfort, to secure care and to provide a little pleasure.

So rather than talking rubbish about family homes and nonsense about life savings, sit down with your parents and talk about how to use that money to make the last years of their lives less or a worry, more of a comfort. And stop counting the money in their bank and expecting the poor to pay higher taxes so you can inherit that cash.

...

The thinking man's nannying fussbucket

****

Ah! Joan Bakewell! Dubbed the 'thinking man's crumpet' by Frank Muir many moons ago and a feature of every self-regarding, slightly left wing, artsy-farty programme ever since, the woman has become (for reasons that escape me) some sort of champion for the elderly.

Now, in line with the latest piece of prohibitionist propaganda, Ms Bakewell has transformed from crumpet to fussbucket overnight. Apparently, she has been told that every second old widow woman is now a complete lush, out of her brains on wine or G & T.

Barbara is in her seventies and since being widowed has lived alone. She and her husband were enjoying a happy retirement in France’s expat community. But his illness and death plunged her into gloom. Come 4pm, she starts on the wine and downs a bottle a day.

So Barbara needs a social life, perhaps someone like Joan to take her to the theatre or perhaps just shopping. Maybe just a road trip to the seaside or into the hills. Or an occasional visit to a nice cafe. But that's not what Joan is offering. She's offering a stern lecture about drinking and support for making Barbara's bottle of wine (or actually not unless M. Hollande plans to completely destroy his electoral chances by making wine more expensive) more pricey.

The saddest thing is that Joan Bakewell - who is approaching the grand old age of 80 in fine health - has got the drinking thing about nailed:

Which brings us back to those units. I won’t recite them now because they’re confusing and contradictory: what exactly is “half a standard glass of wine”? All I can say is that my drinking diary registered me as well over the limit. Yet I share the same way of life as many, never drink at lunchtime, rarely touch spirits. And I enjoy the conviviality of old age.

Joan's 'drinking diary' may exceed the limits recommended by the prohibitionists but she's doing fine and has no need - or reason - to change her drinking habits. Certainly not on the back of a pack of lies from the Church of Public Health about old people drinking.

Sadly Joan, once so liberal in outlook, has become just another nannying fussbucket. Indeed, the thinking man's nannying fussbucket!

...

No we don't, we need to give them a glass of water...

****

Baroness Greengross, who used to run Age Concern, says:

The government should introduce a nationwide policy to ensure elderly patients in hospitals do not get dehydrated, a former head of Age Concern has said.

I am led to believe that there are people called "nurses" in hospitals whose job is to look after patients who are there for treatment, operations or convalescence. Might I suggest that, if those nurses are doing their job properly they will give elderly patients a drink - a glass of water, maybe a cup of tea?

However the response from Baroness Thornton, Labour's health spokesman is priceless:

Baroness Thornton accused the government of “washing its hands of a hydration policy” and called for ministers to provide “leadership”.

You couldn't make this stuff up, could you? What next, a national strategy for making beds?

....