Funding the NHS


In the news this week (see here) I learnt that the NHS in Cheshire and Merseyside are spending £300,000 on fees to Pricewaterhouse Coopers (PwC) to cut frontline services.  There have been many similar stories up and down the country.

I’m well aware that, thanks to wonder drugs like statins etc, we’re all living longer.  As a result costs for healthcare are increasing. However I’m getting concerned about how much money is being spent in the wrong areas.

Take the Stafford Hospital scandal for instance. I’m a big believer in a NATIONAL Health Service and wonder how much money has been wasted setting up NHS foundation trusts?  Stafford Nurses at Stafford were struck off for falsifying information to avoid breaches of targets.  Why would any nurse want to do this?  I suspect pressure was put on them by managers and their accountants.  Some services were transferred elsewhere, which may have saved that hospital costs – but may  not help the NHS as a whole, if the costs simply go to another centre.

There seems to be an increasing emphasis in paying highly paid people to run our hospitals as businesses, rather than trained healthcare professionals looking at preventing ill health.

I’m very proud of our NHS, and accept that I may have to pay more for it in the future. I’m fed up with politicians (and others) meddling with it.  If I’m seriously ill I want a consultant with medical qualifications looking after me, not a consultant who’s an expert on Balance Sheets and Net Worth.

Today I heard here that a nurse took her own life after becoming stressed from work.  I hope that even the accountants will realise that that is a cost that is too high.

Why I don’t like foodbanks

Foodbank sign inviting donationsI’ve always felt uneasy about foodbanks. Don’t get me wrong, they’re run by kind and caring people – who care pasionately about some very vulnerable people. However, I watched an academic debate about foodbanks, and realised that I was right to have concerns.

I think it should be a basic human right to be able to have some choice about what you eat. I’m not talking about whether to have beluga caviar or foie gras (and I wouldn’t want to eat either). I’m talking about the right to choose my own basic food items. I can’t imagine how I’d feel if my diet consisted of items chosen by others.

The Trussell Trust, a Christian charity, is the main  organiser of foodbanks in this country. They are also the main source of information/statistics (which the debate I watched felt was a cause for concern). Their site shows nearly a million people were being helped last year:People helped by foodbanks

and I fear this figure is rising.

The Trussel Trust ask for donations of the following items:

  • Milk (UHT or powdered)
  • Sugar (500g)
  • Fruit juice (carton)
  • Soup
  • Pasta sauces
  • Sponge pudding (tinned)
  • Tomatoes (tinned)
  • Cereals
  • Rice pudding (tinned)
  • Tea Bags/instant coffee
  • Instant mash potato
  • Rice/pasta
  • Tinned meat/fish
  • Tinned fruit
  • Jam
  • Biscuits or snack bar

So where’s the fresh and healthy ingredients like fruit and vegetables? I realise why they’re not asking for these items – it’s not very practical for the operation they’re running.

So if you’re destitute, our society now thinks you should live on sugary processed goods (to help your health deteriorate)?

I have a particular problem with fruit juice:

Food Bank request for fruit juice
– because it includes the word “fruit” many people think it’s a healthy choice. As someone who has diabetes I know it makes my blood sugars soar (and crash) almost as fast as pure sugar. That leaves me feeling first tired and then irritable, and once your blood sugars become unstable it’s a job getting them right again.

The politicians like foodbanks, as they can pretend the problem is being dealt with – at no cost to them.

The supermarkets also love supermarkets, as it’s an opportunity to increase their sales and pretend they have a conscience! You see messages like “Buy an extra tin and leave it on the way out”. Wouldn’t it be better, from a logistics point of view, to ask for cash and buy exactly what was needed (in bulk from a cheaper supplier)?

In Each One of Us is Precious, Eddy Knasel talks about inequalities in pay, and how the rich are getting richer and the poor are getting poorer. That article led me to read The Spirit Level: Why More Equal Societies Almost Always Do Better by Richard Wilkinson and Kate Pickett.  It is hard to think of a more powerful way of telling people at the bottom that they are almost worthless than to pay them one-third of one percent of what the CEO in the same company gets…

So when politicians come knocking on my door, I’ll be asking them what they intend to do about food poverty – so that foodbanks, like slavery, can hopefully become part of our history.

A nation of drug takers?

Prescription drugsIn 1776 Adam Smith (in The Wealth of Nations) described us as “a nation of shopkeepers”. With our high streets in decline, this is no longer true. If Adam Smith was alive today, perhaps he would call us a nation of drug takers?

Nearly half of us now take prescription drugs, with a cost of over 15 billion pounds! I can feel my GP’s blood pressure rising as he reads this. So before any more angiotensin-converting enzyme (ACE) inhibitors are prescribed for hypertension, let me make some things clear. As an insulin dependant person with diabetes, the medical profession have saved my life. Without insulin, I would have been dead many years ago, and the plethora of other drugs I take help prevent me get complications like strokes and heart attacks. These days, with the help of Google (other search engines are available) everyone is a “medical expert” and I don’t have any medical qualifications. However there are some obvious facts, which many are chosing to ignore, about what could be done to reduce drug costs and make us healthier.

A nation of fatties?

What worries me is that our GPs now barely have time to treat symptoms, let alone find and treat the underlying causes. It’s not hard to find what’s wrong with the nation’s health. The Health Survey for England, published yesterday, show us that we’re getting fatter:

Weight of adults

It’s now almost become politically incorrect to suggest to someone that they should loose weight. Nearly half the population don’t do sufficient physical activity, and we’re eating more junk food . More than 27% of women consume more than 3 units and 37% of men conume more than 4 units of alcohol. The poorer you are, the more likely you are to be affected. There’s a very clear link (particularly with women) between waist circumference and social deprivation:

Waist circumference & social deprivation


Sadly it’s these people who are often the least mobile, and often have had a poorer education. So there’s no point in telling them about health vegetarian meals, made with ingredients from Waitrose, when their nearest shop is Home Bargains or Poundland.

Building up trouble for the future?

It’s even more worrying when you look at the data concerning childrens’ health. Eat up your greens? The number of children geting their five a day has fallen in the last 6 years and is now only 16%:

Children five a day

Over half our kids get less than three portios of fruit and veg a day, and 7% don’t get any! Last year 15% of girls and 16% of girls were classified as obese! In 2012 0nly 18% of our children did the recommended physical exercise (compared with 24% in 2008);

Who’s to blame?

I believe this problem has come about as a result of lack of education. Our politicians need educating, and also need to stop listening to some of the very effective lobbying from the food industry.They need to be aware that having more people educating us on exercise and diet could save prescription costs.

The parents of today’s children also need educating. Many of them rely on ready meals, and don’t now how to cook good simple meals with fresh ingredients which are cheap and nutritious.

The last person I want to blame is our GPs.

What can you do?

If you’ve got kids, take them on a hike! The endorphins you get as you climb a hill beat anything their local dealer can supply, and theyll lose weight and be less likely to be depressed. You’ll also feel better.

Read books like Joanna Blythman’s Bad Food Britain: How A Nation Ruined Its Appetite to find out how we got into this mess, and then read (by the same author) What to Eat: Food that’s good for your health, pocket and plate, to find out what you can do. about it.

Visit (and preferably walk to) your local shops and find (if you’ve still got them) your local butcher and greengrocer. The butcher can tell you how to cook the cheaper (and tastier) cuts and your greengrocer will show you cheap seasonal foods (which will be riper and better tasting than the supermarkets).

Cook with your family – it’s far more fun than watching celebrity chefs on MasterBore. If you make a mistake have a laugh and learn from it. As a small child I loved visiting an aunty who’s cooking sometimes went wrong. When the sponge she’d baked turned out to be a bit runny in the middle she used a tin can to sut out the middle and then called it a polo cake!

Co-operate with your neighbours. If you can’t afford a sack of potatoes, share one. You’ll both save money and you don’t have to worry if they won’t keep as you’ll get through a smaller quantity twice as quickly.

Change food from being a chore to a source of fun – and feel better at the same time.

Healthy hospital food?

White toast


Last week I was admitted into hospital. I can’t fault the wonderful staff, all were professional and friendly at the same time. However I can’t believe some of the unhealthy foods we’re still being offered in hospitals.

I’ve had insulin dependant diabetes since 1980, so am very careful what I eat. The ideal diet for someone with that condition, is a good diet for most of us to follow. I aim to eat a balanced diet, that is low in fat, sugar and salt and contain a high level of fresh fruit and vegetables. In particular I aim to eat carbohydrate foods which have a low GI (Glycemic Index).

My first meal was breakfast. A lady asked me if I would like some toast. I asked if I could have some granary or wholemeal bread. Only white bread was available (pictured above). I wasn’t expecting hand crafted rolls from an artisan baker. But I do think that in hospital I should have at least been offered (and preferably encouraged) a more healthy alternative to this mas-produced white bread. A local bakery does a sliced oatmeal bread, which would have been better, and is not expensive.

I then found I could have had cereals, including Rice Krispies! I suppose I should have been pleased that we weren’t offered Ricicles (although that decision was probably made by the accountant and not the nutritionist).

I was offered sugar in all my drinks, despite having insulin dependent diabetic written above my bed.

I tried to choose my lunch carefully. I certainly didn’t choose this:

Healthcare orange juice

but one arrived anyway! Most of the people in my ward had diabetes and I noticed were drinking this. The only time I ever drink orange juice like this is when I’ve got hypoglycemia (low blood sugar). I find it’s almost as good as Lucozade (which is high in glucose syrup) for getting my blood sugars up.

The problem highly processed foods, like white bread and orange juice is that they make your blood sugars shoot up and then drop as quickly. This applies to everyone, not just people with diabetes.  That’s why people on unhealthy diets can get irritable when they get hungry (as their blood sugar drops). Most people in ward had a poor understanding of good nutrition, and (despite havingdiabetes) didn’t appear to have spoken to a nutritionist.

I realise the NHS has a very difficult job to do, and there are financial pressures.  Sadly our food industry often makes healthy eating dearer (white bread is usually the cheapest – which I don’t understand as the flour needs less processing).

In 1980, when I first had diabetes, I was surprised to be offered white bread, ice-cream and jelly (not low sugar) in hospital! I was hoping that things would have improved more than they have.

A hospital visit is a great opportunity to make people rethink their diet, make healthier choices and hopefully cut down the chances that they are readmitted. That would actually save the NHS money.

Manufacturing trouble?


Friends, who work in the food industry, think they do a superb job making food that’s both easy to serve and affordable. A book I read in the 70’s told me that the mission statement of Marks and Spencer was to subvert the class structure of Britain by making items available to the working classes that previously only the upper classes could afford! I can remember the excitement of having a Chicken Kiev for the first time! The example of Chicken Kiev is interesting. Most of us tend to think it’s a traditional dish, probably from the Ukraine. However I think it’s origins are French – and it was originally made with veal.

Posh restaurants changed it to chicken, because it was more expensive! Now you can buy two Chicken Kievs and get change from £1! How did this come about?

We can thank factory farmers for bringing down the price of chicken. I think most people would be appalled if they walked through a modern intensive poultry farm.

Florida chicken house

The few that allow cameras in are probably the better ones, in terms of animal welfare. Due to their intensive rearing, a typical supermarket chicken today contains more than twice the fat, and about a third less protein than 40 years ago.

How can the supermarkets sell food so cheaply?  A look at the ingredients gives us a clue. In the one I looked at there was less than 50% chicken! The ingredients listed were:

“Chopped and Shaped Chicken Breast Mix with added Water and Soya Protein (67%) [Chicken (48%), Water, WHEAT FIBRE (contains Gluten), Tapioca Starch, SOYA PROTEIN ISOLATE, Stabilisers (Triphosphates), Salt, White Pepper] , Garlic Butter (10%) [Unsalted Butter (from MILK), Garlic Powder, Sugar, Parsley, Citric Acid, Flavouring] , Rapeseed Oil , Fortified Wheat Flour and Wheat Flour Blend [Fortified Wheat Flour [WHEAT FLOUR (contains Gluten), Calcium Carbonate, Iron, Niacin (B3), Thiamin (B1)], WHEAT FLOUR (contains Gluten)] , Salt , Dextrose , WHEAT SEMOLINA (contains Gluten) , Maize Starch , WHEAT GLUTEN , WHEAT STARCH (contains Gluten)”.

The problem, as I see it, stems back to the industrial resolution, when workers left the land and moved into cities. Factories sprung up, producing cheap processed food.

There’s a long history of the food industry buying cheap ingredients, and then adding flavouring, sugar and salt to make it more appealing. I can recommend reading Swindled: From Poison Sweets to Counterfeit Coffee – The Dark History of the Food Cheats by Bee Wilson.  I’ve used chickens as an example, but I could have used many others.  It’s frightening when you read the real reasons why prawn are now so cheap, and you’ll probably want to cut them out of your diet when you read more (see here for an example). Another good read is Felicity Lawrence’s Not On the Label: What Really Goes into the Food on Your Plate. It’s shocking that, after the horse meat scandal, I’m struggling to find evidence of prosecutions etc.

As supply chains have lengthened, we’ve become more distanced from food producers. A small producer probably wouldn’t bother to substitute a cheaper ingredient to save a penny – but if you’re producing 100,000+ then saving a penny can add thousands to the bottom line.

One of the main problems is lack of education.  The eminent Professor John Webster told me in the 70’s the British public profess to have an interest in animal welfare, until they walk through the supermarket door and buy the cheapest food there is! Thirty years on and his message hasn’t changed (see here for example).

When I buy a chicken, I’m surprised how many meals I get out of it.  I buy a good one, and bulk it out with pulses and vegetables.  Nothing goes to waste, I always make a stock out of the carcass.

A recent report, by The Centre for Diet and Activity Research (CEDAR), looks at the growing price gap between more and less healthy foods.  According to the report, healthy foods in 2012 were three times more expensive per calorie than less healthy foods:

Price gap between more and less healthy foods

It’s no wonder obesity is increasing. When I look in shops like B & M and Home Bargains I see lots of cheap, but heavily processed foods. We’re lucky, where I live, to still have a greengrocer.  Many places no longer have one…

I welcome programmes like Jamie’s 15 minute meals, which show you that you can make tasty, reasonably priced meals in no time at all without resorting to packets and ready meals. I also commend Joanna Blythman’s What to Eat: Food that’s good for your health, pocket and plate – follow her guidelines and you can eat better and help save the planet.

Incredible Edible Wilmslow

Just over a year ago I visited Incredible Edible Todmorden.  Like most people who visit this fantastic project I came away impressed and inspired.  The idea is now spreading (Todmorden gets visitors from afar away as Australia and Chile) and similar initiatives are beginning to bloom in France (see here).

I thought I’d visit Wilmslow to see how it’s going there.  I wanted to be green, so went by train:

and found herbs, edible flowers, and even strawberry plants growing on the station platform.

Outside the station I gather Community Payback had helped to create beds:

there’s wild flower meadows and apples, damsons and blackcurrants.

A sign:

explains about the shared town centre growing space and encourages you to help weed water and plant spare edible plants.

I then used their map to visit some of the other plots in the town.  My first stop was the King William pub:

to admire the edible flowers at the front, and the edible courtyard around the back.

Then it was on to Waitrose, where I found herbs growing outside their store:

Helen, from Incredible Edible Wilmslow, had suggested I visit when it was the Artisan Market, and I was glad I did.  Here I met Transition Town Wilmslow

where a very helpful lady told me what they’re doing to help tackle climate change, fossil fuel depletion and economic contraction.

The man at Growing Places:

besides selling stylish garden tools, was also actively involved in the project.

I didn’t get as far as Shenton Farm Shop in Handforth (where they have a herb bar), but they also had a stall in the market:

There was a composting area:

and a few planters helped make this area look better:

Off South Drive, four large raised beds are packed with herbs and vegetables:

Even outside Sainsbury’s they were doing something different:

The Incredible guide told me to find trolley attendant Mark, for more cookery ideas than Jamie Oliver!

Even businesses with no land had managed to grow hanging baskets with edible flowers:

and two opticians and a dentist are also involved:

You can see all the places I visited here.

I didn’t manage to get to the community orchard site as I spent longer than I’d intended in the Artisan Market.

They’re just making a start at Wilmslow Health Centre, which I think is great. A better diet had obvious benefits for our health, and I suspect the psychological benefit of communal growing are even greater.  Everyone I spoke to about the project was so positive about it. They’ve achieved a lot in a very short period and I left Wilmslow feeling a happier person.

Happy Easter

When I first started writing this blog, I struggled to find rare breed eggs – like these beautiful ones from Ladymeads organic farm in Sussex.  Happily it’s a lot easier now, but this made me wonder what proportion of the population would be eating such items this Easter?

My research left me feeling rather depressed.  I spent my Easter holidays walking in Swaledale, visiting Farmers’ markets and buying food from small independent retailers, as featured in this blog.   I suspect my activity is relatively unusual.  I see that markets are still in decline, with less than 0.5% of food purchases being made in all markets (not just Farmers’ markets).

DEFRA have just released their family food survey for 2010 here.  This report provides statistics on purchases, expenditure and the nutrient content of food purchases in the United Kingdom.  We’re spending less on items like milk and cream, fish, fruit and bread, and spending more on soft drinks and alcoholic drinks.

5 A DAY purchases peaked in 2006 and have fallen back to approximately 4.0 portions purchased per person per day in 2010.  More worryingly poorer households reduced their purchases by 20 per cent between 2007 and 2010, down to the equivalent of 2.7 portions per person per day:

Trends in 5 a day purchases

The report shows that lower income families also consume lower levels of fibre and higher levels of NMES (non-milk extrinsic sugars).

I’ve just watched Doctor Robert Lustig’s video Sugar: The Bitter Truth.  It’s nearly an hour and a half long  – but well worth watching if you want an insight into what’s going wrong with what we eat.

Better education is clearly needed.  I don’t think we can rely on the politicians or big businesses to properly promote healthy eating.