Sunday, 21 December 2014

Foodbanks, French fries, Fat Fines and Happy Christmas 2014

Last Friday I worked from home. As a consequence I was able to get out early to do my shopping. Usually I shop at my local Tesco’s (there are other food retailers) and on this occasion it was no different. In the store there was a sign saying how successful this year’s food collection (in partnership with the Trussel Trust and FareShare) had been. Twice a year customers are encouraged to donate an extra item of food when they go shopping, which is then distributed to foodbanks. Tesco pledge to add an extra 30% to the donations and this year the food collection helped provide 4.7 million meals to people this winter.

As to why, in the UK, in 2014, we need to have foodbanks is the subject for a future blog. I was struck however, in reading of the food collections and a story seen on the same day about the rationing of french fries in Tokyo’s McDonald fast food outlets. Despite airlifting over 1000 tonnes of potatoes there is a shortage of potatoes and McDonald's are having to serve only small portions of chips to their customers. There is a considerable evidence base that links fast food intake to obesity. But whilst the lack of availability of fast foods might be a good news story in the UK, where the rates of obesity are around 61% of the population, the same isn't true for Japan where only 3.5% of the population are classed as being obese.  

Japan has a unique approach to dealing with obesity. And selling completely black-burgers, this year's 'food craze' isn't it. Unlike Dubai, who pays people to lose weight, or New Zealand where overweight immigrants cannot gain an entry visa, Japanese citizens must adhere to a government-mandated waistline measurement or face the consequences. Waistline measurements have been set for men and women aged 40 – 74. For men, 33.5 inches, women, 35.4 inches. These limits are part of a wider approach to reduce the health costs resulting from problems such as diabetes and vascular disease, particularly in Japan's growing ageing population.

People whose waistlines are bigger than the prescribed limits are required to attend counselling and support sessions. Companies and public sector organisations face fines if the targets set are breached – these targets include not only current employees, but their families, and even retired employees. Employees have annual check-ups. The fines imposed can run into millions of pounds a year for large companies. Somehow I can't see Public Health England adopting this approach to improving the health and wellbeing of the general population.

But I was impressed with the approach set out in the Care Act 2014, which possibly represents the greatest reform to how we conceptualise integrated health and social care since the Beverage Report. According to the Social Care Institute for Excellence the Care Act represents a real opportunity to adopt an assets-based approach to planning, commissioning and developing social care. Asset-based or strengths based approaches recognise and value the relationships, skills, shared facilities and networks we use as individuals and in our communities. 

Such approaches help ensure that people who might require services are not just problems that need fixing by the State. It’s a person-centred approach that recognises that individuals should be given a voice which can enable them to have a greater say in the way local health and care services might better help support them. Possibly, it could also be an approach that is more effective at improving the health and wellbeing of individuals and the communities they live in than reducing the number of chips served or imposing fines for bigger waistlines. 

Expanding waistlines might be on some people’s minds this week – we are, after all, in the run up days to Christmas 2014 – in this house we have at least three Christmas Days with three Christmas Dinners, a consequence, and a good one, of having a large extended family - I love it! Today it is time for Christmas Dinner II. I hope you have a great Christmas celebration too and here's wishing you, your families and your friends a relaxing and peaceful time.