Memorandum by Diabetes UK (WP 42)
Diabetes UK is delighted to contribute to this
inquiry into the Government's Public Health White Paper. Diabetes
UK is the charity for people with diabetes. One of Europe's largest
patient organisations, it aims to improve the lives of people
with diabetes and work towards a future without the condition.
1.8 million people in the UK have diabetes. A further 1 million
have the condition but don't yet know it. Diabetes is a leading
cause of blindness, heart disease and amputations.
Obesity, poor diet and leading a sedentary lifestyle
are major contributing factors to the development of Type 2 diabetes.
This type of diabetes usually appears in people over the age of
40, though in South Asian and African-Caribbean people often appears
after the age of 25. However, over recent years Type 2 diabetes
has been diagnosed in British children, precipitating research,
such as the "Early Bird" study, into why this worrying
development is occurring and the true nature and extent of the
problem.
Diabetes UK is committed to promoting good public
health through physical activity, eating a healthy balanced diet
and public awareness of the risks of developing diabetes—poor
weight management being a significant risk factor. We awaited
the publication of the Government's Public Health White Paper
with anticipation and hoped that it would provide us with a major
step forward in tackling this increasing problem.
1. WILL THE
PROPOSALS ENABLE
THE GOVERNMENT
TO ACHIEVE
ITS PUBLIC
HEALTH GOALS?
As the delivery strategy for the white paper
has not yet been published, it is difficult to fully assess whether
the proposals will help the Government achieve its public health
goals. However, our initial thoughts on the White Paper were positive,
being the first of its kind and trailed as a framework for real
action. Much of the media attention focussed on the issues of
banning smoking in public places and banning advertising of junk
food to children. However, these issues, while important, are
only part of a much wider picture. The white paper starts to look
at this wider picture but at this stage may raise more questions
than answers.
2. ARE THE
PROPOSALS APPROPRIATE,
WILL THEY
BE EFFECTIVE
AND DO
THEY REPRESENT
VALUE FOR
MONEY?
Increasing the amount of physical activity people
take has been outlined as a priority within the white paper. We
welcome the fact that action is being taken on this issue. Increasing
physical activity will reduce obesity, lowering the number of
people developing diabetes and improving the health of those who
already have the condition. The vast majority of England's 1.5
million people with Type 2 diabetes are overweight at the time
of diagnosis. Support and facilities are required to help people
become more active. The white paper has started to address this
with initiatives such as NHS health trainers in the community
and more physical activity in schools. These proposals are certainly
an appropriate response but their efficacy and value for money
will only be clear once there is more detail on these and the
other fitness initiatives outlined.
Reducing obesity through improving diet and
nutrition is another essential target within the white paper.
Eating a healthy, balanced diet is important for everyone and
is a key part of managing diabetes. Balancing medication and physical
activity with the food eaten is an everyday task for people with
diabetes. Along with physical activity, providing people with
easy to read nutritional information about the food they are buying
can make a real difference. Diabetes UK will be watching closely
to see how food manufacturers respond to the Government on issues
such as labelling and promoting unhealthy food. We are concerned
the Government did not take this opportunity for immediate regulatory
action as the voluntary code may be ineffective and valuable time
could be wasted. Any failure to make real progress is unacceptable.
Again, it is impossible to assess efficacy and value for money
of the proposals before we have the detail on exactly how the
initiatives will be implemented.
We welcome action to reduce the numbers of people
who smoke. People with diabetes are already at an increased risk
of heart attacks, strokes, erectile dysfunction and other circulatory
problems. Smoking doubles that risk again. Action is required
to both help people give up smoking and to protect them from the
harmful effects of passive smoke. The white paper's proposals
to restrict smoking in public places and to provide more information
and support to quit will go a long way to reducing the threats
for people with diabetes. However, only making the ban applicable
in certain circumstances is questionable and will leave unjustifiable
gaps.
3. WHETHER THE
NECESSARY PUBLIC
HEALTH INFRASTRUCTURE
AND MECHANISMS
EXIST TO
ENSURE THAT
PROPOSALS WILL
BE IMPLEMENTED
AND GOALS
ACHIEVED
Much still needs to be done to ensure the infrastructure
is in place to implement the proposals within the white paper.
For example improved and accessible sports facilities need to
be put in place in many areas, funding is needed for new posts
like NHS trainers and full time school nurses and the building
blocks to support community health programmes need to be established.
The delivery strategy needs to outline exactly how the Government
intends to put in place the infrastructure to support their proposals.
The challenge is now for the Government to deliver
real improvements. The first step is to inform people about healthy
choices and why they are important, mechanisms then need to be
in place to ensure people are supported as they make lifestyle
improvements. Diabetes UK looks forward to seeing the detail of
the white paper implementation in the delivery strategy, the "Food
and Health Action Plan" and the "Physical Activity Plan".
January 2005
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