Memorandum by The Maranatha Community
(WP 45)
1. INTRODUCTION
1.1 This Document
This document has been prepared in response
to the Consultation by the Health Committee on the Government's
Public Health White Paper "Choosing Health" launched
by The Secretary of State for Health.
The submission has been prepared by the Maranatha
Community together with the Council for Health and Wholeness.
Representatives from both bodies would be happy to give oral evidence
to the Committee.
1.2 The Maranatha Community
The Maranatha Community is a Christian movement
with many thousands of members throughout the country active in
all the main churches. Its membership includes a substantial number
of people involved in the health and caring professions and in
a wide range of voluntary work. Since its formation 23 years ago,
it has been deeply involved in work amongst children and young
people, people with drug and alcohol problems, the disabled and
disadvantaged. It has taken the initiative in a broad range of
projects directly contributing to the health of the nation and
it also has extensive international experience. The Trust is a
registered charity number 327627.
1.3 The Council for Health and Wholeness
The Council is a multi-disciplinary body embracing
doctors drawn from a variety of specialisms, nurses and various
medical auxiliaries, counsellors, chaplains and others. It has
close links with the healing ministry of the Christian church
and is involved in a broad range of research projects.
The Council for Health and Wholeness is based
in the offices of the Maranatha Community.
2. SUMMARY WITH
RECOMMENDATIONS
2.1 The Maranatha Community and the Council
for Health and Wholeness welcome this consultation. We believe
that this is a timely opportunity to re-evaluate the current approach
to public health. We recognise many excellent proposals in the
White Paper, however are concerned at a large number of areas
that have not been addressed which are major determinants of public
health. We are therefore concerned that the beneficial impact
of this White Paper will be much smaller than the Department of
Health would have hoped for.
2.2 We are convinced that the UK faces the
greatest challenge to public health since the inception of the
NHS. If current trends continue, we will not be able to fund the
cost of treating the explosion of chronic diseases.
2.3 The dramatic increase in family breakdown
has led to a trail of casualties, especially among children. There
has been a dramatic increase in family breakdown over the past
40 years: In 1961, 350,000 British people got married for the
first time, 50,000 remarried, and 30,000 divorced. Forty years
later, 180,000 married for the first time, 120,000 remarried,
and 150,000 divorced. The proportion of children raised in single-parent
households is higher in the UK than elsewhere in Europe. Could
it be, that at the root of many of the concerns we have for children,
such as the high rates of drinking, drug taking, teenage pregnancy
and childhood poverty (all the highest or among the highest in
Europe) is the high rate of family breakdown in the UK?
2.4 There is a wealth of evidence linking
family breakdown with many adverse health outcomes for children,
such as higher mortality, emotional problems, poor school performance
and poverty. Children from broken families are also more likely
to become drug addicts, teenage parents and contract sexually
transmitted diseases. They are more likely to engage in criminal
activity and are over-represented in the prison population. Conversely,
marriage confers many health benefits including lower mortality,
less depression and less alcohol abuse and increased life expectancy.
This is similar in men to the increased life expectancy of non-smokers.
Cohabitation does not confer the same protective benefit that
marriage does. While the White Paper obviously is concerned about
the above mentioned problems such as childhood poverty, emotional
problems in children, teenage pregnancy etc. the White Paper fails
to recommend the most basic and in our view most effective strategy
to address these issues, the strengthening of the marriage-based
family.
2.5 With the direct cost of family breakdown
being estimated in the region of £15 billion per yearif
one takes into account the indirect costs, then the total cost
of family breakdown is likely to be in the region of £30
billion and risingthere is an urgent public health need
to strengthen the family and marriage, supporting dysfunctional
families and thoroughly reviewing legislation and policies that
undermine marriage. We are concerned that the White Paper does
not even mention marriage or family breakdowneven though
a majority of the population consider the marriage-based family
as the ideal for children to be brought upbut rather speaks
of parents. The White Paper is concerned about childhood poverty
but fails to recognize that one of the major contributing factor
to childhood poverty is family breakdown, which leads to a significant
reduction in the income available to families. Unfortunately,
strengthening marriage and families dose not appear to be a political
priority nor does it feature in the White Paper. Therefore, a
major determinant for public health is not even addressed in the
White Paper.
2.6 The "safe(r) sex" experiment
has failed. We face a public health crisis regarding sexual health.
Sexually transmitted infections now are out of control. Most STIs
have doubled over the past six years and chlamydia infection rates
among young women have trebled over the past decade. Syphilis
has increased by over 500% over the past six years. Teenage pregnancy
rates are the highest in Western Europe. Some Genitourinary clinics
turn hundreds of patients away a week and are unable to cope with
the huge demand. GU-clinic attendances have doubled over the past
decade.
2.7 Official strategies such as the National
Strategy for Sexual Health and HIV as well as the Teenage Pregnancy
Strategy have singularly failed to address the underlying cause
for the explosion in STIs and will continue to do so. Underlying
this dramatic increase in STIs is a dramatic increase in casual
sex, promiscuity including an increase in concurrent and sequential
sexual relationships, earlier sexual activity and increasingly
risky sexual behaviour. Casual sex may be casual in intent, but
certainly not in outcome.
2.8 The only evidence-based definition of
"safe sex" isapart from abstinencemutual
monogamy with an uninfected partner. This is in essence the meaning
of marriage. However it is a sad truth that sexual abstinence
until marriage is not even mentioned as a possibility in the UK
sexual health strategy. The most important risk factor for contracting
a STI is the number of sexual partners a person has. Condoms are
not as "safe" as they have been promoted to be and many,
especially young people, are stunned to find that they have contracted
an STI, often incurable, despite using condoms. Condoms may be
effective in reducing the risk of contracting HIV ("always
condom use" reduces the risk of HIV transmission by 85%),
however the risk reduction is far less for essentially all non-HIV
STIs, such as chlamydia, gonorrhoea, syphilis, genital warts etc,
where the risk reduction, even with "always condom use"
is more in the region of 50% or less. The "faith in the condom"
is misplaced.
2.9 The widespread adoption of the ABC approach
in Uganda has led to a 70% decrease in HIV over the past decade.
This contrasts with a more than 100% increase of most STIs in
the UK over the same period. Abstinence until marriage needs to
be actively promoted from a public health point of view. Opponents
of this approach frequently state that this equals to "moralising"
or "preaching". However, to promote sexual abstinence
is as much "moralising" or "preaching" as
it is to encourage a smoker to quit smoking. Both are public health
interventions aimed at reducing a lifestyle, sexual promiscuity
or smoking, that have very adverse effects on the health of the
nation. As the White Paper fails to address the real reasons for
the explosion of STIs, we are not convinced that the chosen strategy
will be effective and predict further increase in the number of
STIs diagnosed.
2.10 Illicit drug misuse in the UK is out
of control.The UK has probably the worst drug problem in Europe.
British young people have higher rates of drug misuse, including
cannabis, cocaine, ecstasy and amphetamines than most other young
Europeans. Over 4 million of the population use an illicit drug
and 1 million use class A drugs such as heroin, cocaine, crack
or ecstasy. The economic, social and health costs of Class A drugs
alone is conservatively estimated to be up to £17 billion
per year. The Home office estimates the total cost of the UK drug
problem to be in the region of £20 billion per annum. This
translates to just under £800 per household per year. The
number of drug-related deaths exceeds 3,500 per year.
2.11 Across Europe, countries with a high
level of cannabis misuse, for example the UK, also have high levels
of "hard drug" misuse such as cocaine and ecstasy. Countries
with low levels of cannabis misuse such as Sweden have low levels
of other "hard drug" use. Indeed, Sweden has among the
lowest, possibly the lowest, rates of drug misuse of any European
country.
2.12 Sweden appears to be the only European
country with the goal to create a drug-free society. Drug misuse,
especially cannabis misuse is strongly discouraged. There is a
very strong consensus in society against drugs and parents, teachers,
police and politicians are all strongly supportive of a restrictive
drug policy. The basis of the Swedish drug policy is the recognition
that the only indispensable part of the drug problem is the drug
user and therefore primary prevention of drug misusedemand
reductionis given the highest priority.
2.13 The Swedish approach contrasts greatly
with the UK approach where increasingly drug policy appears to
be based on the very dubious concept of "harm reduction".
"Harm-reduction" essentially portrays drug misuse as
inevitable, based on the wrong assumption that "young people
are going to use drugs anyway so we might as well teach them how
to do it safely".
2.14 It is interesting that a "harm-reduction"
approach is used regarding illegal drugs but not regarding any
other illegal activity. No-one would teach young people how to
speed or to steal safely, the clear message instead is "speeding
is dangerous and illegal". Harm-reduction accommodates and
normalises, rather than prevents, drug misuse. There are examples
of harm-reduction drug education material being used in UK schools
which aim to teach pupils the skills of "safe drug use".
This is a contradiction in itself, since there are no safe ways
of taking drugs. This type of educational material encourages
rather than discourages drug misuse. It should not be used in
schools or in any health education context.
2.15 Significantly, the Swedish Drug policy
was liberal in the 1960s, essentially using a "harm-reduction"
approach. Following this, drug misuse escalated to very high levels
in Sweden and in the 1970s, the goal to create a drug-free society
was adopted with all the above mentioned policies based on demand
reduction and primary prevention. Subsequently, there was a very
significant drop in drug misuse in Sweden. There is no good reason
why this could not happen in the UK. We deplore the downgrading
of cannabis as misguided and are concerned that there is no coherent
political message focussing on drug prevention and demand reduction.
Furthermore, the high rate of family breakdown in the UK contributes
to the drug problem. However, this issue is not addressed by the
White Paper. For these reasons, we are not convinced that the
currently adopted drug strategy will be successful.
2.16 There is an urgent public need to identify
and, wherever possible, to avoid toxic substances. We are at risk
of being poisoned in a variety of different ways, through contaminated
water, contaminated nutrition, through outdoor and indoor pollution,
possibly also low-level radiation and electromagnetic fields.
Perhaps the most worrying issue is our obvious ignorance of the
long-term effects of many of the toxic substances to which we
are exposed. There is legitimate and growing concern that a large
proportion of our entire population are being placed at risk.
2.17 It is impossible to even give an accurate
overview of the effects of toxic substances on human health and
public health. We therefore want to limit our submission to a
few examples of the devastating effect toxicity has on public
health, especially on children.
2.18 Children are exposed to potentially
carcinogenic pesticides from many sources of contamination. Childhood
malignancies linked to pesticides include leukemia, neuroblastoma,
Wilms' tumor, soft-tissue sarcoma, Ewing's sarcoma, non-Hodgkin's
lymphoma, and cancers of the brain, colorectum, and testes. There
has been a significant increase in childhood cancer over past
decades, including non-Hodgkin Lymphoma. Could it be that toxicity
from pesticides and other sources plays a significant role in
this increase?
2.19 It is estimated that every year there
are 8,100 deaths from particulate matter and 3,500 deaths because
of sulphur dioxide in urban areas of Great Britain. The numbers
of deaths by ozone in both urban and rural areas of Great Britain
during summer ranges between 700 and 12,500. Particulate pollution
therefore costs many lives, far more than the number of deaths
from road accidents.
2.20 There has been a dramatic increase
in childhood conditions such as learning difficulties, ADHD and
autism. There are many, sometimes controversial, theories on the
causation of these conditions. However we are concerned that there
appears to be little awarenesseven in professional circlesof
the contribution of neurotoxins such as lead, mercury, cadmium,
dioxins, organophosphates and other toxins to those conditions.
2.21 While there has been some researchnot
all of it independent of industryinto the health effects
of toxic substances such as pesticides entering the food chain
we are concerned that much of the safety data relates to adults.
It is therefore very likely that official "safe" thresholds
are by no means safe for developing bodies, especially the developing
brains, of children. Furthermore, there seems to be only very
little research looking at the adverse health effects of toxic
substances in combination.
2.22 We call for the establishment of a
Royal Commissiontotally independent of the chemical industriesto
assess the full impact of toxic substances on public health, especially
on children. We furthermore are convinced that there should be
a national screening programme for the most common toxins that
adversely affect children such as lead, mercury, cadmium, dioxins,
organophosphates and others. Again, we are concerned that the
issue of toxicity is not given prominence in the White Paper which
we believe to be a major omission.
2.23 Alcohol misuse has a huge toll on the
population. Over 5,500 people die a year due to direct effect
of alcohol, however the total number of deaths where alcohol plays
a part may be in excess of 30,000 a year. The number of alcohol-related
deaths has increased dramatically over the past five years. One
person in 13 is dependent on alcohol in Britain. British adolescents
are among the worst in international comparisons regarding alcohol
consumption, drunkenness and binge drinking. Alcohol misuse costs
the UK in excess of £10 billion a year in health and social
costs. We therefore call for the urgent development of a coherent
Alcohol strategy in the UK.
2.24 It is likely that many of the diseases
that place the main burden on the NHS are due to changes in our
diet and lifestyle. The dominating illnesses in modernised societies
are new, or have become newly prominent, in the past 100-150 years.
Some of these are increasing dramatically. These conditions include
cardiovascular diseases such as ischaemic heart disease, hypertension
and stroke, respiratory diseases such as asthma, metabolic diseases
such as obesity and diabetes, malignancies such as major types
of cancer including cancers of the breast, prostate and colon,
allergies, gastrointestinal conditions such as appendicitis, inflammatory
bowel diseases, irritable bowel syndrome and coeliac disease and
behavioural disorders especially in children such as childhood
hyperactivity and "autism".
2.25 While it is possible that some of the
above conditions are due to a "westernised lifestyle",
part of the "westernised lifestyle" comprises a "western
diet" which in itself consists of increased intake of processed
foods, including increased intake of fats, sugars, salt and an
increased intake of total calories. The WHO finds that worldwide
60% of all deaths are "clearly related to changes in dietary
patterns and increased consumption of processed fatty, salty and
sugar foods". Obviously, other factors also contribute to
a "western lifestyle" such as reduced physical activity
and increased exposure to toxic substances through for example
pollution.
2.26 The medical treatment of many chronic
diseases such as ischaemic heart disease, hypertension, stroke,
diabetes, asthma and cancer uses up most of the resources of the
health service including drug budgets. The cost of diabetes to
the NHS is estimated at £5 billion per year. The economic
cost of being obese or overweight is estimated in the region of
£7 billion a year. The social, economic and health costs
of heart disease is estimated to be another £7 billion per
year. In addition to those costs, the social and economic cost
due to incapacity, disability and death caused by these diseases
can hardly be overestimated. The anticipated increase in these
conditions, especially obesity, diabetes and cancer is likely
to financially crush the NHS. Currently, among the highest prescribing
drug costs in UK General Practice are cholesterol-lowering statins.
However, antihypertensives and inhalers for asthma/COPD also contribute
very significantly to drug costs. Statins are currently prescribed
to about 1.8 million people in the UK, at a cost of £700
million a year. This is expected to rise to more than £2
billion a year by the year 2010.
2.27 The nutritional treatment of many chronic
diseases is relatively cheap compared to drug costs. For example,
one strategy for the secondary prevention of ischaemic heart disease
(IHD) used a Mediterranean-style diet. This intervention led within
three years to a 70% reduction in overall mortality rate, compared
with the far more expensive statin treatment, which, over a five-year
period led to at most 30% reduction in overall mortality. Another
study examined the impact of eating two or three portions of fatty
fish per week on the survival of men with a previous heart attack.
Within two years of the commencement of this simple diet change,
a significant reduction in all-cause mortality was observed. This
mortality reduction was similar to the reduction achieved in trials
using statins for a period of over five years.
2.28 Statin treatment is expensive. It costs
in the range of £4,000-9,000 per year to save one life with
statins in patients who already have established IHD. This contrasts
with Mediterranean diet, which, at a cost of around £300
per life-year saved, is only a fraction as expensive as statin
treatment. Some dietary changes in the secondary prevention of
IHD appear to reduce mortality twice as much as statin treatment.
We are convinced that the currently adopted strategy of combating
IHD with statins while neglecting more beneficial dietary interventions
both for prevention and treatment is a grave misallocation of
scarce public funds.
2.29 There is strong evidence that several
dietary strategies are effective in preventing the development
of IHD. A recent review from Harvard University concluded: "Substantial
evidence indicates that diets using non-hydrogenated unsaturated
fats as the predominant form of dietary fat, whole grains as the
main form of carbohydrates, an abundance of fruits and vegetables,
and adequate omega-3 fatty acids can offer significant protection
against coronary heart disease. Such diets, together with regular
physical activity, avoidance of smoking, and maintenance of a
healthy body weight, may prevent the majority of cardiovascular
disease in Western populations."
2.30 Unfortunately, while commonsense teaches
that nutrition is essential for health and well-being, nutritional
medicine as a medical and public health specialty is, in our view,
a neglected area. There appears to be comparatively little research
done in this field, compared, for example, with the research into
drug treatment of chronic diseases funded by drug companies. There
is however a case for a UK-wide integrated nutritional medicine
strategy, especially for the prevention and treatment of chronic
diseases such as heart disease, stroke, asthma, high blood pressure,
diabetes, obesity, cancer and other chronic conditions. We welcome
the suggestions in the White Paper, however believe that these
suggestions do not go far enough.
2.31 A highly controversial area is the
health impact of processed and refined foods and of food additives
including colourings, preservatives, trans-fats and others. We
therefore call for the establishment of a Royal Commission, independent
of the food industry, to examine the short and long-term public
health effects of processed foods and food additives. We are concerned
that political pressure from the food industry prevents the Government
to independently examine the effect of processed foods. We are
convinced that the health impact of processed foods is very significant.
Unfortunately, this issue is not addressed in the White Paper.
2.32 Exposure to media, including watching
TV, playing video games, listening to radio and reading magazines
has a very powerful formative impact on children and young people,
including their physical, emotional and spiritual health. Time
spent watching TV and playing computer games exceeds the time
spent on physical activity for most children and for many children
exceeds the time spent with parents. Time spent watching television
or playing computer games takes away from important activities
such as social interaction and development, especially time spent
with the family, physical activity, including playing, but also
reading and school work. British children spend on average five
hours per day using mediafar more than in any other European
country.
2.33 Because children have high levels of
media exposure, more so than in previous generations, the media
have greater access and time now to shape young people's attitudes,
values and behaviour than do parents or teachers. The media therefore
replaces parents and teachers as educators, role models, and the
primary sources of information about the world. In this context
we disagree with the statement by OFCOM quoted in the White Paper,
that a ban on childhood food advertising on TV would not be effective.
If TV food advertising had no effect, why would food manufacturers
spend millions on food advertising? We consider advertising of
food products to children on TV essentially unethical and call
upon the Government to follow the lead of other countries such
as Sweden and Norway and ban TV advertising of food products to
children completely. We urge the Government to without delay implement
regulation of advertising of unhealthy products, especially those
with high levels of sugar, salt and fat, just as the advertising
of cigarettes has been regulated.
2.34 There is significant evidence linking
time spent watching TV with the prevalence rates of obesity. Obesity
measurably increases for every hour spent watching TV. Reducing
the time watching TV reduces childhood obesity rates. While the
White Paper makes a link between time spent watching TV and childhood
obesity we consider that more action could be taken to reduce
the time that children watch TV.
2.35 There has been a steady increase in
the amount of sex in the media, especially TV but also glossy
magazines and an increase in the explicitness of these portrayals.
There appears to be a fairly consistent sexual message: most portrayals
of sex depict or imply heterosexual intercourse between unmarried
adults portraying promiscuity as the norm, with little reference
to sexually transmitted infections, pregnancy, or use of contraception.
There is evidence that young people aged 12-17 who watch far more
TV are up to twice as likely to engage in sexual activity as those
who watch far less. References in TV regarding possible adverse
consequences of precocious sexual activity can delay early sexual
activity.
2.36 The sexually explicit messages daily
portrayed by the media have a formative influence on children's
and adolescent's sexual behaviour, possibly more so than the influence
of parents and the educational system. We are therefore particularly
concerned about misleading, inaccurate and unrealistic information
about sex which may be taken as "fact" by young people.
For example, how many people in soap operasin contrast
to "real life"contract an STI or become pregnant
following casual sex? We therefore are concerned that the White
Paper does not call for a significant reduction in the sexual
explicit content on TV. We would not be surprised if a significant
reduction in sexually explicit content on TV coupled with portrayals
and information on potential adverse effects of precocious sexual
activity will have more impact in reducing early sexual activity
in adolescents than "traditional" approaches such as
school sex education.
2.37 Viewing media/TV violence can lead
to increased antisocial or aggressive behaviour, desensitisation
to violence or increased fear of becoming a victim of violence.
Exposure to media violence results in many physical and mental
health problems for children and adolescents, including aggressive
behaviour, desensitisation to violence, fear, depression, nightmares,
and sleep disturbances. Furthermore, prolonged exposure to violent
media portrayals results in increased acceptance of violence as
an appropriate means of solving problems and achieving one's goals.
All this has a direct bearing on society and the NHS.
2.38 Many studies show that young children
under eight years of age are developmentally unable to understand
the intent of advertisements and, in fact, accept advertising
claims as inherently true. The youngest viewers, up to age eight,
cannot distinguish advertising from regular television programming.
2.39 We believe that there needs to be an
urgent Public Health Summit involving representation from the
Government, OFCOM, representation from professional organisations,
the media including TV, magazines and advertising companies. This
should assess the impact of the media on young people's health
including the possibility of legislative control. The areas that
need to be examined include: advertising to children, impact of
violence and sex depicted on TV and the impact of electronic media
on eating patterns as well as their impact on health and physical
activity of young people.
2.40 The spiritual dimension of life is
a fundamental part of the healing process. Modern western medicine
acknowledges the contribution of body, mind and emotions in disease
and healing but fails to recognise, and totally lacks understanding
of, the spiritual dimension of health and sickness. We deplore
the complete absence of an understanding of the spiritual roots
of sickness. We consider these very significant contributors to
ill health, perhaps comparable to the contribution of nutrition
both to ill health and to healing.
2.41 Spirituality refers to the relationship
between man and God. Spirituality is the means, both for the individual
and society, to bring a sense of meaning to "being human".
The spiritual component of the healing process enables patients
to have a sense of identity and self-worth, belonging and purpose,
even in sickness. In comparatively recent times there has been
a quite irrational trend towards the dismissal of the central
role of spirituality both in causing disease and in the healing
process.
2.42 Faith significantly reduces the risk
of depression and suicide, and reduces the risk of alcohol, nicotine
and drug misuse. Adolescents who report that religion is important
to them are much less likely to engage in binge drinking, smoking,
or using cannabis. They are more likely to eat in a healthy fashion
and to exercise regularly. Among adults, spirituality is associated
with increased physical exercise, lower rates of smoking and alcohol
abuse, improved mental health including reduced depression, and
maintaining marital stability. Furthermore, spirituality can positively
help patients dealing with recovery from surgery, or with severe
or chronic medical or emotional illness including cancer. Faith
can play a central role in the lives of those who are terminally
ill and allows them to "die well".
2.43 It is therefore not surprising that
faith is linked with significantly increased life expectancy.
The beneficial effect of spirituality on life expectancy is comparable
to the effect of not smoking or taking regular exercise.
2.44 There is very substantial evidence
that Christian experience and belief has a powerful and some times
dominant influence on the healing process. We are today seeing
the emergence of a large number of Christian healing centres in
which there is a partnership between ordained priests and ministers
and health professionals.
2.45 As a Christian community, the Maranatha
community has extensive experience in all aspects of the Christian
Healing ministry and over many years we have experienced many
healingssometimes quite dramatic healingsthrough
prayers. Perhaps one of the most relevant aspects of spirituality
in terms of the healing process is the message of forgiveness,
especially in the Christian faith, whether we call it reconciliation,
restoration, offering new hope, affirming acceptance etc. Experience
has shown that the giving and receiving of forgiveness, personal,
individual and corporate, is pivotal to many aspects of healing.
2.46 Whereas the Department of Health must
clearly meet the needs of the minority religions, sight should
not be lost of the fact that in the last national census, 72%
of the population of the United Kingdom claimed to have a Christian
faith. It is important that the majority of the population should
not in any way be deprived of the benefits of Christian prayer
within hospitals and clinics, especially as there is very clear
evidence supporting the benefits of spirituality in recovery from
illness. It needs to be recognised that a very substantial proportion
of all patients are in a real emotional and spiritual need and
this should not be disregarded.
2.47 As a Christian community, we would
like to introduce the biblical term "righteousness"
into the discussion on public health. Righteousness means "right
relationships" between man and God. Furthermore, it means
a right relationship to myself (Jesus' command is to love your
neighbour as your selfthere is the command to have a right
relationship with others and with oneself) right relationships
with others and right relationships with nature and the environment.
The right relationship of the individual with God leads to a meaningful
life and to healing through experiencing God's love. The right
relationship with oneself leads to a healthy lifestyle, including
healthy nutrition, a healthy self-image which is neither corrupted
by self-aggrandizement nor self-denigration and no need for drug
or alcohol dependencies. The right relationship with others leads
to peace and healthy communities. The right relationship with
the environment leads to a respect for nature and the environment,
reducing pollution and preserving species. We believe that if
this concept of righteousness were followed, it would lead to
a healing of the individual, of society and of the environment.
2.48 There is a need for greater consideration
to be given within the NHS to the spiritual dimension of healing
and it is suggested that the church's experience of the healing
process should be shared more widely with the National Health
Service. It is, therefore, proposed that there should be a consultation
between the Department of Health and representatives of churches
and experienced specialist Christian bodies. Consideration should
be given to the carrying out joint studies with doctors and those
experienced in the Christian Healing ministry, to explore ways
and means of achieving a deeper understanding of the spiritual
aspects of the healing process in the interest of public health.
Put simply, God cannot be dismissed from the healing process.
2.49 We are convinced that the healing process
must be seen as far more than attending to physical ailments.
It must embrace the broader moral, spiritual, emotional and societal
factors, which govern health and wholeness, both personal and
social.
2.50 In this Submission, we focus on some
of those areas where our nation can choose health rather than
disease. We are concerned that, as a society, we are increasingly
choosing disease rather than health. We are concerned that the
individual choices based on "rights" rather than "responsibilities"
have a deleterious impact on public health and the NHS. We deplore
the widespread assumption that "what I do with my body is
my choice and only affects me". This is inherently selfish
and ignores the fact that individual choices have a profound impact
on society as a whole.
2.51 We conclude that far higher priority
should be given to public policies, clinical practices and educational
procedures which focus on the prevention of disease in comparison
with treatment. We recognise that the White Paper is attempting
to do this. However, we are concerned that many areas that have
a major impact on public health are not being addressed, perhaps
out of concern to appear "politically incorrect" (as
in the area of family breakdown and marriage support), perhaps
because of influences of the food industry (food advertising,
impact of processed foods, food colourings etc.) or influence
of the pharmaceutical industry (in the area of nutritional prevention
of chronic diseases). There is an immediate need for political
and social leaders, both nationally and locally, to face up to
what is, in effect, a public health crisis in the nation. In our
opinion the National Health Service will soon be overwhelmed,
unable to provide adequate treatment and be crushed by the huge
burdens placed upon it by the increases in "lifestyle diseases"
such as diabetes, obesity, sexually transmitted infections, to
name but a few. Furthermore, society as a whole will be unable
to fund the dramatic costs of lifestyle choices such as widespread
drug misuse, unstable relationships and family breakdown with
all the adverse effects on children. Catastrophic trends need
to be admitted and the need for radical change honestly accepted.
We are not convinced that the "White Paper" is going
far enough in analysis and recommendations. For this reason, we
are not convinced that it will have only a fairly limited positive
impact on the health of the nation.
3. MARRIAGE
Its positive contribution to public health
3.1 Discussions about public health usually
fail to mention the positive contribution that marriage has for
public health. For example, the health benefit of being married
for men is similar to the health benefit gained from not smoking.
While we see a very strong campaign to try to get smokers to quit,
we do not see any campaign aimed at supporting marriage.
3.2 Recent legislation has sought to undermine
marriage. Furthermore, the UK tax system is less favourable to
marriage than the tax systems of France and Germany. Significantly,
both France and Germany have a lower rate of family breakdown.
3.3 Much of the guidance for teachers of
sex and relationship education (SRE) in schools emphasises the
importance of a "value-free" approach to relationships.
As part of SRE, different family constellations should be discussed
as being equally valid and acceptable. In a sex education pack
intended for primary schools, beginning with key stage one, the
teacher is encouraged to discuss different family arrangements,
for example children living with married or unmarried parents,
single parents, lesbian, gay and bisexual parents, grandparents
etc. Teachers are instructed that "it is important not to
try to `promote' a particular type of home life as the norm or
superior" (Julian Cohen. Primary School Sex and Relationships
Education Pack, Healthwise 2001; p 22) Thus, children are not
being taught that marriage is the most beneficial family structure,
to be discarded at our peril.
3.4 It is clear that marriage has significant
health benefits according to published evidence. Why, therefore,
are pupils not told this?
3.5 It is clear that marriage reduces mortality.
Married people, as opposed to divorced and separated individuals,
have a lower mortality rate and are healthier. Marriage is associated
with greater happiness, less depression and less alcohol abuse.
It is interesting to note that cohabitation does not appear to
confer the same protective benefit than marriage does.
3.6 As a Christian Community, we are convinced
that marriage is the basic building block of society and contributes
massively to the wellbeing of the nation. If marriage is being
abandoned to other forms of living together such as cohabitation
and same-sex partnerships, our entire society and especially our
children will suffer. Marriage is ordained as a covenant relationship
by God and it therefore has a major positive contribution to physical,
emotional and spiritual health of married couples, their children
and society as a whole. Conversely, the adverse effects of marriage
breakdown are devastating for the individuals concerned, especially
children and society as a whole as we see in the next section
on family breakdown. (See evidence in Annex A.) [Not printed.]
RECOMMENDATIONS
The promotion of marriage should,
as a matter of urgency, be firmly placed on the curriculum of
every school and at the centre of all sex and relationship education
programmes.
There needs to be a thorough and
co-ordinated review of legislation introduced during decades which
have had a direct or indirect deleterious effect on the institution
of marriage. This should include aspects of the taxation system
which should be more favourable to marriage.
4. FAMILY BREAKDOWN
Its negative contribution to public health
4.1 There is a wealth of evidence linking
family breakdown with many adverse health outcomes for children,
such as ill health including higher mortality, emotional problems,
poor school performance and poverty. Children from broken families
are also more likely to have problems with substance misuse and
poor sexual health including teenage pregnancy. Furthermore, they
are more likely to be engaging in criminal activity and are disproportionally
over-represented in the prison population. Finally, family breakdown
is associated with an increased risk of being physically or sexually
abused.[89]
4.2 There has been a dramatic increase in
family breakdown over the past 40 years: In 1961, 350,000 British
people got married for the first time, 50,000 remarried, and 30,000
divorced. Forty years later, 180,000 married for the first time,
120,000 remarried, and 150,000 divorced. (Andrew Oswald, The economics
of Love, May 2003).
4.3 With the direct cost of family breakdown
being estimated in the region of £15 billion per yearif
one takes into account the indirect costs of family breakdown,
then the total cost of family breakdown is likely to be in the
region of £30 billion and risingthere is an urgent
public health need to strengthen the family and marriage, supporting
dysfunctional families and reviewing legislation and policies
that undermine marriage.
4.4 At the root of many of the problems
we see in children and young adultssuch as emotional and
behavioural difficulties, poor school performance, substance misuse,
precocious teenage sexuality including teenage pregnancy and juvenile
delinquencyis the dramatic increase in family breakup and
"relationship turnover" of parents, adversely affecting
their children?
4.5 Unfortunately, we do not detect any
strong political leadership encouraging marriage, despite its
many public health benefits, both to married couples, their children
and society as a whole. We are convinced that reducing family
breakdown will have a more significant and positive impact on
many health problems seen in young peoplesuch as substance
misuse, poor sexual health including teenage pregnancy and othersthan
some of the official strategies currently adopted. These strategies,
including drug and sex education, access to family planning clinics
and others, usually fail to take into account the significant
benefits gained for young people through a stable marriage of
their parents. (See evidence in Annex B.) [Not printed.]
RECOMMENDATIONS
More resources should be devoted
to helping dysfunctional families in order to avoid marriage breakup
with all the adverse effects on public health.
Research needs to be carried out
into the financial and social incentives and disincentives to
marriage-based family life.
5. SEXUALLY TRANSMITTED
INFECTIONS: PREVENTION
RATHER THAN
JUST TREATMENT
5.1 The UK faces an epidemic of sexual ill
health. Sexually transmitted infections (STIs) are out of control,
having doubled over the past six years, with some infections such
as syphilis increasing by more than 500%. Over the past decade,
the rate of chlamydia diagnoses in 16-19 year old girls nearly
trebled. Britain's teenage pregnancy rate, the highest in Western
Europe, has not substantially changed over the past 25 years,
despite several government initiatives.
5.2 The underlying cause for this is the
high increase in promiscuity, risky sexual behaviour and earlier
sexual activity. However, the UK sexual health strategy does not
even address the underlying cause for the epidemic in sexual ill
health. It is surprising to note that the National Strategy for
Sexual Health and HIV fails to mention reduction in promiscuity,
it also fails to mention marriage or sexual abstinence until marriage
even as a remote possibility. Instead, the current approach to
sexual health is based on the promotion of condoms and other contraception,
access to family planning clinics and genitourinary clinics in
a "value-free" and "non-judgmental" environment.
However, record attendances at both GU clinics and family planning
clinics together with an increase in condom use have failed to
make a positive impact on the nation's sexual health. Indeed,
the nation's sexual health continues to deteriorate at an alarming
rate. Is it not time to re-evaluate the current approach to sexual
health? Is it not time to assess the significance of powerful
formative influences shaping sexual behaviour?
5.3 The more than doubling of STIs in the
UK over the past decade contrasts with a more than 70% reduction
of HIV in Uganda over the same period of time. Uganda has adopted
the ABC programme: Abstain from sex, Be faithfulPartner
reduction, "zero grazing", monogamyor if that
fails use Condoms. The reduction in HIV was mainly due to behavioural
changeessentially a reduction in casual sex. The promotion
of condoms in Uganda had only a minor contribution to this fall
in HIV. Other African countries that rely on condom promotion
rather than behavioural changes, did not see significant HIV declines.
5.4 While we are aware of cultural differences,
we urge the Government to learn from the success of Uganda's balanced
"ABC" approach to sexual health and urge this approach
to be adopted throughout the UK. A public health campaign aimed
at modifying behaviour, with a predominant emphasis on reduction
of casual sex, is the only measure that will stop the epidemic
of STIs in the UK. To combat STIs with the currently adopted strategy
will inevitably mean continued failure.
5.5 As a Christian community, we recognise
that the guidance given to us by God, for example emphasising
that marriage is a lifelong covenant relationship and discouraging
sex outside of marriage, is very relevant to promote good physical,
emotional and spiritual health for the individual but also for
society as a whole. We are concerned, that the current approach
to sexual health appears to discount the physical, emotional and
spiritual consequences of promiscuity. (See evidence in Annex
C.) [Not printed.]
RECOMMENDATIONS
There should be a complete overhaul
of current sexual health strategies, questioning the fundamentally
flawed assumptions of policies pursued in the past decades.
There needs to be a review of the
allocation of public funds to the various clinics, sexual health
"educators" and others who appear to be a fundamental
part of the problem rather than its solution.
There needs to be a public health
campaign warning both young people and adults of the risks involved
in contracting especially non-HIV STIs, realistic information
about the level of protection conferred by condoms, and a warning
of the extremely dangerous consequences of abnormal sexual practices
such as anal intercourse, which is both unnatural and disease
prone.
6. DRUG MISUSE
Prevention rather than just damage limitation
6.1 The UK has one of the worst drug problems
in Europe. Figures for the prevalence rates of illicit drugs,
including cannabis, cocaine, ecstasy and amphetamines are among
the highest, if not the highest in Europe. Over four million of
the population use an illicit drug and one million use class A
drugs such as heroin, cocaine, crack or ecstasy. The economic,
social and health costs of Class A drugs alone is conservatively
estimated to be up to £17 billion per year.
6.2 Comparing data on the prevalence of
drug misuse across Europe one trend is quite obvious: countries
with a high level of cannabis misuse, for example the UK, also
have high levels of "hard drug" misuse such as cocaine
and ecstasy. Countries with low levels of cannabis misuse such
as Sweden, have low levels of other "hard drug" use.
Indeed, Sweden has among the lowest, possibly the lowest, rates
of drug misuse of any European country.
6.3 What are the lessons that the UK can
learn from Sweden? Sweden appears to be the only European country
with the goal to create a drug-free society. Drug misuse, especially
cannabis misuse is strongly discouraged. There is a very strong
consensus in society against drugs. Parents, teachers, police
and politicians are all strongly supportive of a restrictive drug
policy. The basis of the Swedish drug policy is the recognition
that the only indispensable part of the drug problem is the drug
user and therefore primary prevention of drug misuse ie demand-reduction,
is given the highest priority. Furthermore, the Swedish drug policy
is formulated around the gateway hypothesis, ie use of cannabis
is associated with the use of harder drugs.
6.4 While we are aware that the gateway
hypothesis is controversial we would like to point out that it
cannot be denied that essentially all heroin and other "hard
drug" users started on cannabis as their first illicit drug.
Furthermore, there have been several powerful studies recently
supporting the "gateway" hypothesis. Cannabis is therefore
considered to be a very serious problem in Sweden and Swedish
drug education is very clear about its many dangers. Interestingly,
the Swedish Criminal justice system is given the right to enforce
drug testing and compulsory drug treatment. Significantly, the
Swedish Drug policy was liberal in the 1960s, essentially using
a "harm-reduction" approach. Following this, drug misuse
escalated to very high levels and in the 1970s, the goal to create
a drug-free society was adopted. Subsequently, there was a very
significant drop in drug misuse in Sweden. There is no good reason
why this could not happen in this country.
6.5 The Swedish approach contrasts greatly
with the UK approach where increasingly, drug policy appears to
be based on the very problematic concept of "harm reduction".
"Harm-reduction" essentially portrays drug misuse as
inevitable, based on the wrong assumption that "young people
are going to use drugs anyway so we might as well teach them how
to do it safely". There are examples of drug education material
used in the UK which aims to teach pupils the skills of "safe
drug use", a contradiction in itself, since there are no
safe ways of taking drugs. It is interesting that a "harm-reduction"
approach is used regarding illegal drugs but not regarding any
other illegal activity. No-one would teach young people how to
speed or to steal safely, the clear message instead is "speeding
is dangerous and illegal". Harm-reduction accommodates and
normalises, rather than prevents, drug misuse. While "harm-reduction"
may have its place once a person is addicted, for example some
heroin addicts may benefit from methadone maintenance, it has
no place as part of drug education in schools, where still the
majority of pupils are not taking drugs regularly. Instead, the
focus of drug education should be the prevention of drug misuse.
6.6 The recent reclassification of cannabis
has caused major confusion.Surveys show that many pupils now think
that cannabis is legal, harmless and even some form of medicine.
However, cannabis is not the innocuous drug it is made out to
be. There has been a very significant increase in the numbers
of young people attending drug treatment centres with cannabis
addiction as their main problem. There is a wealth of evidence
linking cannabis with serious mental health problems including
schizophrenia, psychosis and depression. It is estimated that
in London, about 80% of all new cases of schizophrenia are due
to cannabis misuse, therefore causing major problems to an already
overstretched psychiatric service. Cannabis is addictive and impairs
learning, concentration and educational performance. Cannabis
is also associated with significant lung damage including severe
emphysema and head and neck cancers in young people. Cannabis
on its own but especially in combination with alcohol increases
the risks of road traffic accidents.
We agree with the International Narcotics Control
Board when it stated last year: "Advocates of drug legalisation,
particularly of cannabis, are vocal and have access to considerable
funds that are used to misinform the public."
6.7 We believe that widespread cannabis
abuse has become a major public health hazard and we note with
grave concern that, while there is a focussed public health campaign
against smoking tobacco, there is no such campaign against smoking
cannabis.
6.8 From a Christian standpoint we are concerned
that the issue of drug misuse is frequently focussed only on the
physical and perhaps also the emotional aspects of drug misuse,
ignoring the spiritual dimension. For a drug user, drugs offer
"salvation" from pain or a painful reality or from trauma,
from depression, or from poor self-esteem and boredom. This, obviously,
does not just apply to illicit drugs but also to legal drugs such
as alcohol and tobacco. However this "salvation" is
a myth and creates further serious problems including addiction
and potentially early death. (See evidence in Annex D.) [Not
printed.]
RECOMMENDATIONS
There should be an urgent overhaul
of the current national drugs strategy. There must be a major
shift away from harm reduction to primary prevention and demand
reduction as the basis for all drug policies.
The Government should pay far more
attention to leading medical scientists, clinicians and researchers,
rather than just selected advisors and NGOs in pursuing drug policies.
A fundamental element of future policy
should be the reversal of the recent reclassification of cannabis.
There needs to be a major public
health campaign warning especially young people of the dangers
of cannabis abuse and discouraging cannabis abuse.
Consideration, encouragement and
support should be given to the established track records of many
Christian help groups and drug treatment centres. (There is widespread
concern that some of them are being penalised for no other reason
than their religious affiliation).
Schemes for compulsory treatment
for drug offenders should be expanded and far more rigorously
enforced.
7. TOXICITY AND
ALLERGIES
The hidden risks
7.1 There is an urgent public need to identify
and, wherever possible, to avoid toxins.
7.2 It is widely recognised that we are
living in a dangerous environment in which we are in danger of
being poisoned in a variety of different ways, through contaminated
water, contaminated nutrition, through outdoor and indoor pollution,
possibly also low-level radiation and electromagnetic fields.
Perhaps the most worrying issue is the obvious ignorance of the
long-term effects of many of the substances that we are ingesting.
7.3 While there has been some researchnot
all of it independent from industryinto the health effects
of toxic substances such as pesticides entering the food chain,
we are concerned that much of the safety data relates to adults.
It is therefore very likely that official "safe" thresholds
are by no means safe for the developing bodies, especially the
developing brains, of children.
7.4 Furthermore, we are seriously concerned
that the data examining toxic substances appears to focus on isolated
substances. Not much research has been done examining the additive
toxic effects of substances in a "cocktail". There is
evidence, however that there can be a significantly increased
toxic "cocktail effect" by the combination of several
toxic substances even though all of them are well below their
"safe" limits.
7.5 It is impossible to even give an overview
of the effects of toxins on human health and public health. We
therefore want to limit our submission (including the evidence
in the appendix) to a few substances and examples of toxicity,
focusing on the adverse impacts of pesticides, air pollution and
the role of toxicity in childhood conditions such as learning
difficulties, autism and ADHD.
7.6 Children are exposed to potentially
carcinogenic pesticides from use in homes, schools, other buildings,
lawns and gardens, through food and contaminated drinking water,
from agricultural application drift, and from carry-home exposure
of parents occupationally exposed to pesticides. Parental exposure
during the child's gestation or even preconception may probably
have great significance. Childhood malignancies linked to pesticides
in case reports or case-control studies include leukemia, neuroblastoma,
Wilms' tumor, soft-tissue sarcoma, Ewing's sarcoma, non-Hodgkin's
lymphoma, and cancers of the brain, colorectum, and testes. There
has been a significant increase in childhood cancer over past
decades, including non-Hodgkin's Lymphoma. Could it be that toxicity
from pesticides plays a role in this increase?
7.7 In this context we want to remind the
Department of Health of the devastating effect of excessive alcohol
consumption in the UK and deplore, that there appears to be no
current Alcohol strategy in the UK. We are particularly concerned
about the consequences of the proposed liberalising of licensing
laws. This can only add to the already crippling problem faced
by the emergency services.
7.8 Alcohol misuse has a huge toll on the
population. Over 5,500 people die each year due to direct effect
of alcohol. However the total number of deaths where alcohol plays
a part may be in excess of 30,000 a year. The number of alcohol-related
deaths has increased dramatically over the past five years. One
person in 13 is dependent on alcohol in Britain. British adolescents
are among the worst in international comparison regarding alcohol
consumption, being drunk and binge drinking. Alcohol misuse costs
the UK in excess of £10 billion a year in health and social
costs.
7.9 It is estimated that every year, there
are 8,100 deaths from particulate matter and 3,500 deaths because
of sulphur dioxide in urban areas of Great Britain. The numbers
of deaths by ozone in both urban and rural areas of Great Britain
during summer ranges between 700 and 12,500 depending on which
threshold for ozone is used. Particulate pollution therefore costs
many lives, far more than the number of deaths from road accidents.
7.10 There has been a dramatic increase
in childhood conditions such as learning difficulties, ADHD and
autism. There are manysometimes controversialtheories
on the causation of these conditions. However we are concerned
that there appears to be little awarenesseven in professional
circlesof the contribution of neurotoxins such as lead,
mercury, cadmium, dioxins, organophosphates and other toxins in
those conditions.
7.11 Socially, mental and moral toxicity
may be spread through the media which condition viewers, listeners
and readers to sex, violence and degradation. The desensitizing
and indoctrinating of the public has a knock-on effect on national
health. (See evidence in Annex E.) [Not printed.]
Recommendations
We believe that there needs to be
a Royal Commissionindependent of the chemical and food
industriesto assess the full impact of toxicity and of
processed foods on our lives.
In view of the widespread lack of
awareness regarding the adverse effects of toxins, especially
neurotoxins, on children, we believe that there should be a national
screening programme for the most common toxins that adversely
affect children such as lead, mercury, cadmium, dioxins, organophosphates
and others.
In view of the devastating effect
of alcohol on society we urge the Department of Health to develop
an integrated alcohol strategy for the prevention and treatment
of alcohol addiction, including ensuring the education system
warns children of the dangers.
Resource allocation should be directly
related to epidemiological evidence, and to the operation of "early-warning"
public health systems. This should not be restricted just to infectious
diseases, but should focus on a wider remit.
8. DIET AND
NUTRITION
A neglected area
8.1 Healthy nutrition demands that we have
a balanced diet, but millions of people suffer because of a serious
imbalance of diet. We are constantly encouraged by commercial
interests to consume excessive amounts of fat, salt and sugar.
Children are encouraged to eat junk food and adults to have an
excess alcohol intake. All this is leading to enormous social
and health problems with substantial strain on the health service,
which no government can ignore.
8.2 It is likely that many of the diseases
we see currently in western societies are due to changes in our
diet: The dominating illnesses in modernised societies are new,
or have become newly prominent, in the past 100-150 years. When
traditional societies modernise, they, too, seem to develop these
same "modernisation diseases" within a few decades.
These illnesses include cardiovascular diseases such as ischaemic
heart disease, hypertension and stroke; respiratory diseases such
as asthma, metabolic diseases such as obesity and diabetes, malignancies
such as major types of cancer including cancers of the breast,
prostate and colon, allergies, gastrointestinal conditions such
as appendicitis, inflammatory bowel diseases, irritable bowel
syndrome and coeliac disease and behavioural disorders especially
in children such as childhood hyperactivity and "autism".
8.3 While it is possible that some of the
above conditions are due to a "westernised lifestyle, part
of the "westernised lifestyle" comprises a "western
diet" which in itself consists of increased intake of processed
foods, including increased intake of fats, sugars, salt and an
increased intake of total calories. Obviously, other factors also
contribute to a "western lifestyle" such as reduced
physical activity, increased exposure to toxins through for example
pesticides, air pollution, etc. exposure to electromagnetic fields,
reduced amount of sleep and other influences.
8.4 The medical treatment of many chronic
lifestyle diseases such as ischaemic heart disease, hypertension,
stroke, diabetes, asthma and cancer uses up most of the resources
of the health service including drug budgets. The anticipated
increase in these conditions, especially obesity, diabetes and
cancer is likely to financially crush the NHS. Currently, among
the highest prescribing drug costs in UK General Practice are
cholesterol-lowering statins. However, antihypertensives and inhalers
for asthma/COPD also contribute very significantly to drug costs.
In addition to those costs, the social and economic cost due to
incapacity, disability and death caused by these diseases can
hardly be overestimated.
8.5 The nutritional treatment of many chronic
diseases is relatively cheap compared to drug costs. For example,
one strategy for the secondary prevention of ischaemic heart disease
(IHD) used a Mediterranean-style diet. This intervention led within
three years to a 70% reduction in overall mortality rate, compared
with the far more expensive statin treatment, which, over a five-year
period led to at most a 30% reduction in overall mortality. Statin
treatment is expensive. For secondary prevention, statins costs
in the range of £4,000-9,000 per life-year saved. Primary
prevention is even more expensive. Mediterranean diet is with
a cost of around £300 per life-year saved only a fraction
as expensive. Another study examined the impact of eating two
or three portions of fatty fish per week on the survival of men
with a previous heart attack. Within two years of the commencement
of this simple diet change, a significant reduction in all-cause
mortality was observed. This mortality reduction was similar to
the reduction achieved in trials using statins for a period of
over five years. We are convinced that the currently adopted strategy
of combating IHD with statins and neglecting more beneficial dietary
interventions both for prevention and treatment is a grave misallocation
of scarce public funds.
8.6 There is strong evidence from many studies
that at least three dietary strategies are effective in preventing
IHD: replace saturated and trans-fats with non-hydrogenated unsaturated
fats, increase consumption of omega-3 fatty acids from fish or
fish oils, and consume a diet high in fruits, vegetables, nuts,
and whole grains and low in refined grain products. However the
usual recommendation to simply reducing total fat in the diet
is unlikely to reduce IHD. A recent review from Harvard University
concluded: "Substantial evidence indicates that diets using
non-hydrogenated unsaturated fats as the predominant form of dietary
fat, whole grains as the main form of carbohydrates, an abundance
of fruits and vegetables, and adequate omega-3 fatty acids can
offer significant protection against coronary heart disease. Such
diets, together with regular physical activity, avoidance of smoking,
and maintenance of a healthy body weight, may prevent the majority
of cardiovascular disease in Western populations."
8.7 There are examples of community-based
intervention programmes, such as the Finnish North Karelia Project,
which influence diet and other lifestyles that are crucial in
the prevention of cardiovascular disease. Broad community organisation
and the strong participation of people were the key elements.
Following this, the diet of the population has changed and these
changes have led to a major reduction in average serum cholesterol
and blood pressure levels. Following this, ischaemic heart disease
mortality has declined by 73% in North Karelia. The project was
based on low-cost intervention activities, where people's participation
and community organisations played a key role.
8.8 Unfortunately, while common sense teaches
that nutrition is essential for health and well-being, nutritional
medicine as a medical and public health specialty is, in our view,
a neglected area. It is a fairly new science, is not routinely
taught at medical school and appears to attract less attention
than drug prescribing.
8.9 It appears that far more research is
done into drug treatment of chronic diseases funded by drug companies.
Drug companies are obviously more interested in selling their
drugsideally, from a company point of view, to patients
with often life-long "incurable" illnesses such as IHD,
hypertension, diabetes and asthma, than into the prevention and
possibly even cure through nutrition. How many times have doctors
been approached by drug representatives trying to promote for
example a statin as opposed to someone wanting to promote olive
oil or nutritional supplements?
8.10 One relatively recent development over
the past decades is the increase in consumption of processed foods.
Processed foods include those that have been heated or fried,
refined, artificially coloured, blended, or enriched to provide
different flavours, textures and colour. Almost all processed
foods contain many different chemicals and additives to help stabilise
and preserve the texture, colour, flavour and freshness of the
food. Additives including animal and vegetable fats, trans fats,
salt colour dyes and chemical flavours are added to food to make
them more appealing. In addition, preservatives like nitrates,
sulphates and salt, are added to prolong the shelf-life of processed
foods. This processing of food must be balanced against the fact
that foods naturally degrade over time.
8.11 The significant increase in ready-made
meals which are based on processed foods show the following statistic:
In 2002, the average household spent just 20 minutes preparing
each main mealdown from one hour in 1980. British consumers
now spend £7,000 a minute on ready meals. This is three times
more than any other European country. (The Guardian, 29
May 2004)
8.12 Eating excessive amounts of sodiumusually
in the form of salt in processed foods or added by consumerscan
lead to health problems, especially high blood pressure. Hypertension
increases the risk of stroke, heart disease, and kidney disease.
To reduce this risk of chronic illness, the daily intake of sodium
should be limited to less than 2.5 grams. There are populations
in the world that are able to subsist on much lower sodium intakes
in the range of 0.2 grams per day. Few people currently consume
less than the upper level of 2.5 grams of sodium, largely because
of the amounts of sodium added during food processing. For example
two slices of pizza contain about half of the upper level of sodium.
Consuming this one meal would leave little room for additional
sodium intake at other meals throughout the day.
8.13 There is now no doubt that many food
additives are actually or potentially dangerous, but often little
seems to be done to take this matter seriously, presumably because
of huge commercial pressures. Manufacturers deliberately manipulate
the taste process of foods, increasing the appetite for "more"
of the same food. The government needs to be far more aware of
the significant danger of allowing commercial interests to endanger
public health, particularly with the use of very dangerous chemicals
which enter the food chain.
8.14 Frying foods, especially starchy foods
(potato and cereal products) at high temperature produces acrylamide,
classified as probable carcinogen in animals. Furthermore, acrylamide
is toxic to the nervous system of animals and humans. Swedish
research found that while their raw ingredients contained no detectable
levels of acrylamide, crisps contained levels 500 times more than
the WHO maximum recommended level for drinking water. French fries
contained levels 100 times more.
8.15 Despite the widespread increase of
allergies there appears to be very little knowledge on how to
prevent the development of allergies in the first place. Treatment
of allergies should not be limited to the reducing or eliminating
of allergens but with altering the "wrong" immunological
response of the allergic individual. Far more attention, therefore,
needs to be given in the healing process to methods of building
up the immune system so that it can deal effectively with disorders.
A substantial contribution in this respect can be made by diet
and with mineral and vitamin supplements. Sadly, under obvious
pressure from international pharmaceutical companies, the European
Union have seen fit to pass legislation which will dramatically
hinder the use of these supplements. (See Annex F.) [Not printed.]
Recommendations
There is a case for a UK-wide integrated
nutritional medicine strategy. There is a need for a nutritional
prevention strategy of chronic diseases such as heart disease,
stroke, asthma high blood pressure, diabetes, obesity, cancer
and other chronic conditions.
A highly controversial area is the
health impact of processed and refined foods and of food additives
including colourings, preservatives, trans-fats and others. We
therefore call for the establishment of a Royal Commission independent
of the food industry to examine the public health effects of processed
foods and food additives.
We strongly recommend there should
be a national programme of research and development to guide the
food industry in developing alternative technologies to decrease
the content of food additives but also sodium, sugars and fat
in prepared and processed foods, while maintaining quality, acceptability,
and cost.
9. HEALTH, CHILDREN
AND THE
MEDIA
Power without responsibility?
Lifestyle and the Media
9.1 Exposure to media, including watching
TV, playing video games, listening to radio and reading magazines
has a powerful formative impact on children and young people,
including their physical, emotional and spiritual health. Time
spent watching TV and playing computer games exceeds the time
spent on physical activity for most children and for many children
exceeds the time spent with parents. British children spend on
average five hours per day using mediamore than in any
other European country. In the US a young person graduating from
high school has spent more time in front of a TV than at school.
9.2 Television and the media therefore have
a major influence on the values and behaviours of young people
in addition to the impact on health and educational achievement.
We are convinced that it has not yet been fully realised that
the media has a formative influence on the values and behaviour
of children and adolescents.
9.3 Because children have high levels of
media exposure, more so than in previous generations, the media
have now greater access and time to shape young people's attitudes,
values and behaviour than do parents or teachers. The media therefore
replaces parents and teachers as educators, role models, and the
primary sources of information about the world and how to behave.
9.4 Time spent watching television or playing
computer games takes away from important activities such as social
interaction and development, especially time spent with the family,
physical activity including playing but also reading and school
work.
9.5 Children's behaviour is influenced by
information from television totally inappropriate for their age,
and even incorrect. While there is the "watershed" this
is rendered essentially irrelevant through video recorders that
can be pre-programmed and the fact that nearly two-thirds of all
children under six have a television in their room, and one-third
of those up to the age of three have their own screen in their
room.
9.6 Younger children under the age of 8
often cannot tell the difference between the fantasy presented
on television versus reality. Children are also adversely influenced
by the thousands of advertisements they see each year, many of
which are for alcohol, junk food, fast foods, and toys.
9.7 Advertising often works by making the
viewer feel unhappy with our lives, anxious and dissatisfied,
lacking something. The messages are that you are not OK unless
you buy this, wear that brand, wash your hair with, and look like
that very slim model. It attacks our self-esteem. Girls in early
adolescence are particularly vulnerable to messages about being
OK as they are sensitive about their body image and whether they
measure up to the peer group. Recent research indicates that there
is a marked link between TV watching, and negative body and eating
disorders in adolescents.
9.8 Violence, sexuality, certain stereotypes,
but also drug and alcohol abuse are common themes of television
programmes and some computer games. Young children are impressionable
and may assume that what they see on television or experience
in a computer game is typical, safe, and acceptable. As a result,
television and computer games expose children to damaging behaviour.
9.9 Children who watch a lot of television
are likely to have lower grades in school, read fewer books, exercise
less, be overweight and are more likely to be verbally and physically
violent.
9.10 Public health initiatives therefore
need to address the negative impact of the media on public health.
We should not, however, overlook the fact that the media can sometimes
have a positive impact on behaviour.
9.11 We are particularly concerned about
the negative effect of the media including TV advertising on public
health in the following areas: nutrition and health including
obesity and diabetes, behavioural changes including increased
violence, sexual behaviour and self-image, educational achievement
including literacy.
Food, Healthy Eating and the Media
9.12 There are many adverse effects of watching
TV on children's health. The time spent watching TV is not spent
on physical activities and the foods depicted on TVboth
in programmes and in advertisementsare frequently unhealthy.
Also, while watching TV children are more likely to snack. Watching
TV lowers children's metabolic rate to below what it would be
even if they were sleeping, therefore by watching TV children
"burn off" fewer calories than while sleeping.
9.13 It is interesting to note thatat
the same time where there is an explosion in childhood obesitythere
has been a steady increase in time children spend watching TV,
playing computer games or spending time on the internet. While
the media alone cannot explain the explosion in childhood obesity,
they play a major role in causing the epidemic of childhood obesity.
9.14 There is significant evidence linking
time spent watching TV with obesity. In one of the first studies
examining this link it was found that among 12 to 17-year-olds
the prevalence of obesity increases by 2% for every hour spent
watching TV. Conversely nearly one-third of childhood obesity
could be prevented by reducing TV watching to 0-1 hour per week.
9.15 In addition to obesity caused by reduced
physical activity while watching TV, the advertisements seen while
watching TV are a powerful force to influence children's behaviour.
They influence children to eat certain foods, drink certain drinks
or buy certain toys. Advertisements have a powerful force to influence
values (for example to impart the values of a consumerist society)
and to shape behaviour.
9.16 In the US, it is estimated that children
have viewed an average of 360,000 advertisements on TV before
graduating from high school. In addition to this children are
exposed to advertisements in radio, newspapers, magazines and
billboards.
9.17 Many studies show that young children
under 8 years of age are developmentally unable to understand
the intent of advertisements and, in fact, accept advertising
claims as true. The youngest viewers, up to age 8, cannot distinguish
advertising from regular television programming.
9.18 The media regularly carries advertising
campaigns advocating the taste or the value of various foods,
or promoting the image of the food supplier. What these campaigns
often ignore is the absolute health factor of the food being promoted.
In particular, sugar, salt and fat levels are often way above
the levels that dietary experts say should be the maximum daily
intake. Even foods promoted with campaigns that expound a healthy
aspect of a particular food often ignore worryingly high levels
of other ingredients such as sugar, salt or fat.
Alcohol Consumption and the Media
9.19 The media have consistently depicted
the drinking of alcohol as socially acceptable. Most television
"soap operas" are built around the "local"the
Queen Vic for Eastenders, the Rovers Return for Coronation Street
and the Woolpack for Emmerdale. In these programmes, all transmitted
before the watershed, excessive consumption of alcohol is regularly
depicted.
9.20 Even in "docu-soaps" excessive
alcohol consumption is regularly seen. Programmes about holiday
reps and those programmes built around images from public monitoring
cameras, tend to present images of peers who are drinking heavily,
promoting the excessive intake of alcohol as a norm. Reality TV
shows such as "Big Brother" often use alcohol as a reward
measure. Many adolescents admire the fact that drunken behaviour
has "bought" a member of their peer group their "15
minutes of fame".
Sexual Health and the Media
9.21 There has been a steady increase in
the amount of sex in the media, especially TV but also magazines
and an increase in the explicitness of these portrayals. There
appears to be a fairly consistent sexual message: most portrayals
of sex depict or imply heterosexual intercourse between unmarried
adults portraying promiscuity as the norm, with little reference
to sexually transmitted infections (STIs) and AIDS, pregnancy,
or use of contraception.
9.22 The sexually explicit messages daily
portrayed by the media have a formative influence on children's
and adolescent's sexual behaviour, possibly more so than the influence
of parents and the educational system. We are therefore particularly
concerned about misleading, inaccurate and unrealistic information
about sex which will be taken as "fact" by young people.
For example, how many people in soap operasin contrast
to "real life"contract an STI or become pregnant
following casual sex?
9.23 Heavy exposure to media sex leads to
a wrong perception in that young people wrongly believe that "everyone
is doing it". Exposure to media sex makes young people believe
wrongly that sex is more common at an early age and more frequent
than in reality. As a result, the media, especially TV may normalise
precocious sexual activity and promiscuity.
9.24 The media have consistently depicted
sexual adventure and unstable sexual relationships as socially
acceptable. In television "soap operas" such as Eastenders,
Coronation Street and Emmerdale, all transmitted before the watershed,
marital and sexual infidelity is regularly depicted. The constant
featuring of sexual activity through television, is the cause
of exciting story lines and inevitably leads to sexual curiosity
occurring before sexual competence is reached.
9.25 On television, abstinence among teenagers
is rarely portrayed in a positive fashion. Modesty is mocked and
charity ridiculed. Analyses show that the average American teenager
will view nearly 14,000 sexual references, innuendoes, and jokes
per year, yet only 165 of the references will deal with such topics
as birth control, self-control, abstinence, or STIs. On soap operaswhich
are extremely popular with teenage and pre-teenage girlsthe
sexual content has more than doubled since 1980. Soap opera sex
is 24 times more common between unmarried partners than between
spouses. Music Television (MTV), 75% of concept videos (videos
that tell a story) involve sexual imagery, over half involve violence,
and 80% combine the two, portraying violence against women. While
we are not aware of similar British data, we expect similar findings
on British TV, especially since many American series are shown
here.
9.26 Advertising uses a significant amount
of increasingly explicit sexual imagery. Sex is used to sell many
everyday products. Advertising therefore directly contributes
to the sexualising of society.
9.27 The link to the media of this explosion
in promiscuity and STI's is clear. Newspapers, teenage magazines
and television all actively promote promiscuity and present extramarital
sex as the norm. The music industry has rising sales of records
which are often based on perverted sexual activity and promiscuity.
9.28 Lyrics such as the examples in Appendix
G are being pumped into young people all the time, the industry
is totally unregulated and self-censorship has not worked. The
net effect of such music is to dehumanise the act of sexual union
and to destroy respect for self and others. The contribution of
such lyrics must be questioned in the light of the current increase
in sexually transmitted diseases as well as sexual crime.
Violence and the media
9.29 There has been a significant increase
in the exposure of children to TV and media violence, not only
in TV programmes but also through violent computer games.
9.30 Viewing media/TV violence can lead
to increased antisocial or aggressive behaviour, desensitisation
to violence (becoming more accepting of violence in real life
and less caring about other people's feelings), or increased fear
of becoming a victim of violence.
9.31 Exposure to media violence results
in many physical and mental health problems for children and adolescents,
including aggressive behaviour, desensitisation to violence, fear,
depression, nightmares, and sleep disturbances. This all has a
direct bearing on the NHS.
9.32 Prolonged exposure to violent media
portrayals results in increased acceptance of violence as an appropriate
means of solving problems and achieving one's goals. Television,
films and videos normalise carrying and using weapons and glamorise
them as a source of personal power in a world which is perceived
to be increasingly dangerous and violent.
9.33 Television exposure during adolescence
has also been linked to subsequent aggression in young adulthood.
A 17-year study concluded that teens who watched more than one
hour of TV a day were almost four times as likely as other teens
to commit aggressive acts in adulthood.
9.34 In July 2000, the American Academy
of Paediatrics, American Academy of Child & Adolescent Psychiatry,
American Psychological Association, American Medical Association,
American Academy of Family Physicians, and American Psychiatric
Association issued a joint statement that concluded: "At
this time, well over 1,000 studies point overwhelmingly to a causal
connection between media violence and aggressive behaviour in
some children."
9.35 There is a direct link between violent
video games and violence and aggression. According to some American
researchers it is estimated that playing violent video games contributes
up to one-fifth to the increase in adolescent violence. Decreasing
the time spent watching TV and playing video games significantly
reduces physical and verbal violence in children.
The Regulation of the Media
9.36 With the introduction of the "digital
age" there has been a vast increase in viewer and listener
choice. Whilst this increase in choice is to be welcomed, there
has been considerable relaxation of regulation and an increasing
reliance on self-regulation. We would submit that many of the
issues highlighted in this document are a direct result of the
more lax standards that are now applying to broadcasting. This
has now become a major public health issue.
9.37 Young people are particularly vulnerable
during their formative years. Research by the Independent Television
Commission (ITC now incorporated into Ofcom, as part of the Digital
Action Plan in 2003), indicated the number of second and third
television sets in households, many of which are watched by children
with little or no parental guidance or supervision. In 2002 the
ITC found that 19% of households had one television set, 36% had
two, 27% had three with 12% having four sets.
9.38 The ITC report "What Children
Watch" issued in June 2003 made it clear that children have
access to television, and are often watching it during the majority
of their "home" time. This access is often unfettered,
and may also include use of video recorders with most children
having their own video collection.
9.39 The proliferation of channels together
with the strong development of the independent production sector
has seriously diluted the regulation of individual programmes.
The licences granted to platform operators may impose responsibilities
for the material carried. However the content provider contracts
negotiated with the platform operators will give indemnity to
the platform operators and the content providers most often source
material from organisations even more remote from the regulatory
authorities. Independent producers, often established for a single
series with itinerant staff, have bought in packages from music
suppliers who will not allow editing of material, or programming
sourced from overseas.
9.40 Unfortunately the media has largely
lost the sense of responsibility that it once had.
9.41 The sad truth is that most children
and young people in the United Kingdom now have direct access
to pornography with grave consequences for their future well being.
9.42 As a Christian community we are very
concerned at the spiritual impact of violence, sexual promiscuity,
and pornography on the young now being transmitted through the
media. (See further evidence in Annex G.) [Not printed.]
Recommendations
We believe that there needs to be
an urgent Public Health Summit involving representation from the
Government, especially the Departments of Health, Education and
Skills, Culture, Media and Sports, OFCOM, representation from
professional organisations such as the Royal College of Paediatrics
and Child Health, the media including TV, magazines, advertising
companies and companies producing computer games and others assessing
the impact of the media on young people's health including legislative
control. The areas that need to be examined include those mentioned
in this submission: advertising to children, impact of violence
and sex depicted on TV and the impact of electronic media on eating
patterns as well as general health and physical activity of young
people.
We urge the Government to implement
regulation of advertising in the media of products with unhealthy
levels of sugar, salt and fat, especially to children, just as
the advertising of cigarettes has been regulated. This should
be introduced in spite of likely pressure from commercial interests
associated with sugar and other commodity production.
Further consideration should be given,
as a matter of urgency, to ways of addressing healthy eating and
increasing levels of exercise amongst young people so as to address
current increasing incidence of obesity. Maranatha acknowledges
that the Government is taking some initiatives on these issues.
However obesity is now approaching epidemic levels and emergency
action on this issue should be initiated this year.
We urge Government to work with the
media to ensure that drinking, drug-taking, casual sex and violence
are not glamorised, and that portrayal of drunkenness is minimised.
We urge the Government to examine
popular television and work with broadcasters to introduce a balance
of fidelity into the depiction of relationships in programmes
transmitted both before and after the watershed.
We urge the Government to work with
the music industry and broadcasting and media to urgently devise
a method of introducing responsibility into the industry and in
the promotion of popular music.
We urge the Government to examine
the regulatory framework for content broadcast on all platforms
and to ensure that Ofcom is exercising its prime responsibilities
in light of the issues raised in this submission.
The Maranatha Community has suggested
in this submission and in previous submissions solutions that
should be considered to reduce the incidence of disease related
to promiscuity, alcohol consumption and poor diet. In our opinion,
the media has a very large part to play in developing and delivering
campaigns on these issues. A responsible media can, indeed must,
help to build a new generation where health is improving.
10. SPIRITUALITY
AND HEALTH
A neglected area
10.1 In the Judeao-Christian tradition the
healing process embraces body, mind and spirit. The spiritual
dimension of life is a fundamental part of the healing process.
Modern western medicine acknowledges the contribution of body,
mind and emotions in disease and healing but fails to recognise
and totally lacks understanding of the spiritual dimension of
health and sickness.
10.2 A very high proportion of the hospitals
and centres for healing were originally established and maintained
for generations by the Church and Christian bodies.
10.3 Spirituality refers to the relationship
between man and God. Spirituality is the means, both for the individual
and society, to bring a sense of meaning to "being human".
The spiritual component of the healing process enables patients
to have a sense of identity and self-worth, belonging and purpose,
even in sickness.
10.4 In comparatively recent times there
has been a quite irrational trend towards the dismissal of the
central spiritual role both in causing disease and in the healing
process. The rejection of spirituality is based on a rejection
of a belief in God. However, to claim that there is no God is
no more "objective", "rational" and "scientific"
than to claim that there is a God, even though those who base
their worldview on the assumption that there is no God often claim
to be "rational" and "scientific". Official
documents may refer to the physical, emotional or social dimensions
of health without mentioning the spiritual dimension at all. The
increased secularisation of society has undoubtedly robbed many
of the benefits of spiritual healing. There are now growing signs
of a rediscovery of this.
10.5 In many respects we are a sick society
and this sickness is manifest in almost every part of our national
life. Sickness is seen in our physical, emotional and spiritual
condition. Sickness may be self-inflicted due to poor nutrition,
smoking or other unhealthy lifestyles. It may be environmental
and may be attributed to toxins/pollution in air, water and food.
This sickness may also be rooted in social influences such as
poverty or working conditions. While we see a recognition of many
of the above factors in public health, we deplore the complete
absence of an understanding of the spiritual roots of sickness
which we consider very significant contributors to ill health,
perhaps comparable to the contribution of nutrition both to ill
health and to healing.
10.6 Studies have shown that religious commitment
significantly reduces the risk of depression and suicide, and
reduces the risk of alcohol, nicotine and drug misuse. Spirituality
can positively help patients dealing with recovery from surgery,
or with severe or chronic medical or emotional illness including
cancer. Faith can play a central role in the lives of those who
are terminally ill and allows them to "die well".
10.7 Spirituality and the practice of religion
generally enhance adolescent and adult health behaviours. Adolescents
who attend church regularly and report that religion is important
to them are much less likely to engage in binge drinking, smoking,
or using cannabis. They are more likely to eat in a healthy fashion,
to exercise regularly, get adequate sleep, and wear seat belts.
Among adults, the practice of religion is associated with increased
physical exercise, lower rates of smoking and alcohol abuse, improved
mental health including reduced depression, and maintaining marital
stability.
10.8 It is therefore not surprising that
faith is linked with significantly increased life expectancy.
The beneficial effect of spirituality on life expectancy is comparable
to the effect of not smoking or taking regular exercise.
10.9 There is very substantial evidence
that Christian experience and belief has a powerful and sometimes
dominant influence on the healing process. We are today seeing
the emergence of a large number of Christian healing centres in
which there is a partnership between ordained priests and ministers
and health professionals.
10.10 As a Christian community, the Maranatha
Community has extensive experience in all aspects of the Christian
Healing ministry and over many years we have experienced many
healingssometimes quite dramatic healingsthrough
prayers. These healings have involved many individuals affected
by conditions such as advanced malignancies, serious "incurable"
medical conditions, infertility and serious mental health problems.
10.11 Perhaps one of the most relevant aspects
of spirituality in terms of the healing process is the message
of forgiveness, especially in the Christian faith, whether we
call it reconciliation, restoration, offering new hope, affirming
acceptance etc. Experience has shown that the giving and receiving
of forgiveness, personal, individual and corporate, is pivotal
to many aspects of healing. The Christian faith gives patients
the ability to forgive and to be forgiven. It is vital that the
NHS provides facilities for this process to be accommodated.
10.12 The role of hospital visitors and
chaplains has been firmly established and much appreciated for
generations. There is, however, currently a widespread concern
about the drastic limitations which have been placed upon the
NHS Chaplaincy. Their role has been diminished by virtue of them
not being allowed crucial information about patients on entry
into hospital. It has been claimed that this is due to the Data
Protection Act. There is no evidence whatsoever of any complaints
over access to this information by chaplains and ministers and
many patients have expressed their dismay at what they regard
to be an unacceptable intrusion of bureaucracy.
10.13 Whereas the acceptance of the spiritual
dimension of healing has brought considerable help to countless
people there is, sadly, much evidence that there are dangers in
allowing occult practices to intrude into the Health Service.
Most occult practices are extremely dangerous and have left a
trail of casualties. The NHS should never under any circumstances
countenance occultic techniques such as Reiki, nor the operation
of spiritist mediums within the Health Service. Many are disturbed
at the possibility of National Health Service resources being
diverted to a variety of dubious and potentially damaging "New
Age" practices.
10.14 Whereas the Department of Health must
clearly meet the needs of the minority religions, sight should
not be lost of the fact that in the last national census, 72%
of the population of the United Kingdom claimed to have a Christian
faith. It is important that the majority of the population should
not in any way be deprived of the benefits of Christian prayer
within hospitals and clinics, especially as there is very clear
evidence supporting the benefits of spirituality in recovery from
illness. It needs to be recognised that a very substantial proportion
of all patients are in a real emotional and spiritual need and
this should not be disregarded.
10.15 As a Christian community, we would
like to introduce the biblical term "righteousness"
into the discussion on public health. Righteousness means "right
relationships" between man and God, right relationship to
myself (Jesus' command is to love your neighbour as your selfthere
is the command to have a right relationship with others and with
oneself) right relationships with others and right relationships
with nature and the environment. The right relationship of the
individual with God leads to a meaningful life and to healing
through experiencing God's love. The right relationship with oneself
leads to a healthy lifestyle, including healthy nutrition, a healthy
self-image which is neither corrupted by self-aggrandizement nor
self-denigration and no need for drug or alcohol dependencies.
The right relationship with others leads to peace and healthy
communities. The right relationship with the environment leads
to a respect for nature and the environment, reducing pollution
and preserving species. We believe that if this concept of righteousness
were followed, this would lead to a healing of the individual,
of society and of the environment. (See evidence in Annex H.)
[Not printed.]
Recommendations
There is a need for greater consideration
to be given within the NHS to the spiritual dimension of healing
and it is suggested that the church's experience of the healing
process should be shared more widely with the National Health
Service. It is, therefore, proposed that there should be a consultation
between the Department of Health and representatives of churches
and experienced specialist Christian bodies.
It is proposed that all chaplains
within the NHS are given equal professional status with other
members of the medical team and enabled to have access to basic
information concerning patients.
Consideration should be given to
the carrying out joint studies with doctors and those experienced
in the Christian Healing ministry, to explore ways and means of
achieving a deeper understanding of the spiritual aspects of the
healing process.
11. POLITICAL
FACTORS AND
HEALTH
Who decides?
11.1 In this section, we wish to look at
three areas where we are convinced, that interests of certain
individuals or groups have unduly dominated the decision-making
process to the detriment of public health. These include the downgrading
of cannabis, the current sexual health strategy and the link between
drug companies and industry-sponsored research overstating the
beneficial effects of their products.
11.2 Often, political decisions are taken
upon the advice of "independent" or "expert"
committees such as the Advisory Council on the Misuse of Drugs,
the Sexual Health and HIV Strategy Integrated Steering Group,
the Teenage Pregnancy Unit or the so-called Independent Advisory
Group on Sexual Health and HIV. There are grave concerns that
these bodies make recommendations, which have widespread implications
for public health, based on an unrepresentative membership.
11.3 It is of serious concern that there
may be potential serious conflict of interests. Organisations
that provide services and are represented on government advisory
bodies include among others the Family Planning Association and
Brook Clinics. It is surprising to note that these organisations,
which directly benefit from the allocation of resources for family
planning services, have been appointed to be members of "independent"
advisory committees, thus deciding the direction of policies regarding
sexual health. Not surprisingly, the policies recommended by these
bodies advocate for example the expansion of family planning services.
11.4 The recent reclassification of cannabis
caused confusion. It is likely that it already has led to increased
use of cannabis with all the detrimental effects on public health.
The reclassification was based on incomplete evidence. The recent
evidence linking cannabis to severe mental health problems such
as schizophrenia and other psychoses could not have been taken
into account because this research was published after the Advisory
Council on the Misuse of Drugs (ACMD) submitted its report in
March 2002. The ACMD report recommended the downgrading (reclassification)
of all cannabis preparations from a class B to a class C.
11.5 We are particularly concerned about
the composition of the Advisory Council on the Misuse of Drugs
(ACMD). A significant proportion of the members of the ACMD are
also members of organisations involved in the promotion of "harm-reduction".
The ACMD had no members of leading drug prevention organisations,
no expert on schizophrenia and only few scientists on its panel.
Even though the majority of research directly linking cannabis
with mental illness including schizophrenia was not published
until November 2002, the Home Office maintained that this research
had been taken into account when recommending the reclassification.
In fact, the ACMD as still not give proper consideration to the
most recent scientific evidence.
11.6 The Home Affairs Committee in their
enquiry "The Government's Drugs Policy: is it working?"
invited many individuals and organisations to give evidence. The
committee invited about three times as many witnesses favouring
the downgrading of cannabis, decriminalisation or even legalisation
of cannabis than witnesses who oppose reclassification or who
favour a restrictive drug policy. Not surprisingly, this enquiry
therefore recommended that cannabis be downgraded from Class B
to C and ecstasy be downgraded from Class A to B.
11.7 Groups such as the Sexual Health and
HIV Strategy Integrated Steering Group or the recently formed
Independent Advisory Group on Sexual Health and HIV takes decisions
regarding sexual health policies upon advice and recommendations.
We are seriously concerned about the composition of these bodies.
Of the membership of those groups we recognise leading members
of "pro-choice" organisations such as the Family Planning
Association, Sex Education Forum, National Children's Bureau,
Brook Advisory Service , Marie Stopes, British Pregnancy Advisory
Service, and others. The Chair of the Independent Advisory Group
on Sexual Health and HIV is Baroness Gould who is also President
of the Family Planning Association and Chair of the All Party
Pro Choice Group. Significantly, there are no members of "pro-life"
groups represented on these panels.
11.8 When the Health Committee of the House
of Commons reported its findings in its report into sexual health
in June 2003, there was a significant imbalance regarding the
printed and unprinted memoranda. Essentially all memoranda published
by individuals or organisations that were critical of the current
approach to sexual health or were "pro-life" were not
reprinted. These unprinted memoranda include submissions by the
Maranatha Community, the Council for Health and Wholeness, by
SPUC, CARE and others.
11.9 There is now rapidly growing concern
that key areas of medical research may be neglected in academic
institutions in favour of research into areas which will generate
profits for large pharmaceutical companies. There is particular
concern that professional advice may be given on important public
health matters by those who have interests in commercial organisations
involved the subject of appraisal.
11.10 Richard Smith, the Editor of the British
Medical Journal writes in an editorial (31 May 2003): "The
pharmaceutical industry is immensely powerful. It is one of the
most profitable of industries, truly global, and closely connected
to politicians, particularly in the United States. Compared with
it, medicine is a disorganised mess. Doctors have become dependent
on the industry in a way that undermines their independence and
ability to do their best by patients."
11.11 We are particularly concerned, that
medical practice is based on evidence gained from trials that
are largely funded by drug companies. Due to the high costs of
funding research, there has been a very worrying trend over past
decades with more and more research being sponsored by drug companies
and less research being funded independently. Researchers participating
in research funded by drug companies usually have to sign an agreement
which prohibits them from publishing results or data without the
permission of the drug company. It is therefore not surprising,
that research funded by drug companies is far more likely to find
in favour of the company's drug than independently funded research.
11.12 Whether a medical trial is sponsored
by a drug company or not has a major impact on the outcome. In
an analysis of 370 studies, the drug under investigation was recommended
as treatment of choice in only 16% of trials funded by independent
organisations, but in 51% of trials funded by drug companies.
Trials funded by drug companies were over five times as likely
to recommend the drug treatment as treatment of choice compared
with trials funded by non-profit organizations. Studies of cancer
drugs sponsored by not-for profit organisations were nearly eight
times more likely to report unfavourable conclusions than drug
company sponsored studies of the same drug. Studies sponsored
by manufacturers of a newer class of antidepressants (Selective
Serotonin Reuptake Inhibitors) favoured this drug class over the
older tricyclic antidepressants more than non-industry-sponsored
studies. It is therefore likely that conclusions in trials funded
by drug companies are more positive due to biased interpretation
of trial results.
11.13 With the advent of evidence-based
medicine many reviews of the scientific literature include an
assessment of how robust the published evidence is, for example
based on the type of study used. For example, anecdotal evidence
is considered to be less reliable than evidence from randomised
trials. Whether or not a study has industry sponsoring or not
is likely to affect the outcome of the trial. We are surprised
that there is no widely used scoring system, which classifies
medical research according to the degree of independence from
industry sponsoring.
11.14 We are particularly concerned that
many experts involved in guideline development for medical practice
such as General Practitioners or hospital doctors, are not independent
of the pharmaceutical industries. Not surprisingly, these guidelines
frequently favour a certain approachfor example drug treatmentover
non-drug including nutritional approaches.
11.15 There is furthermore the danger that
large pharmaceutical conglomerates have an unfair interest on
legislation affecting health. An example of this is an EU Directive
which may close down most of Britain's 2000 health shops. It is
part of the huge programme of EU legislation which is being "fast-tracked".
Pharmaceutical companies have been lobbying behind the scenes
for years to introduce the "Herbal Medicines Products"
Directive which seeks to apply to herbal remedies the principle
of continental law that things can only be allowed when they are
specifically authorised. (See evidence in Annex I.) [Not printed.]
Recommendations
It is imperative that government
advisory groups such as the Advisory Council on the Misuse of
Drugs, the sexual health advisory groups and others become truly
independent groups. There should be no appointments to those advisory
groups of any individuals or organizations that are likely to
benefit financially from policy decisions made. All current members
of all advisory bodies need to declare their potential conflict
of interest publicly. Policy decisions should be made on scientific
evidence, not on the basis of political lobbying.
There needs to be an increase in
independently funded medical research.
We call for the establishment of
a scoring system, which classifies medical research according
to the degree of independence from industry sponsoring. All guidelines
especially government guidelinesneed to incorporate
this scoring system in their assessment of new drugs or therapies.
There needs to be an urgent re-evaluation
of national guidelines issued where the authors have had a potential
conflict of interest.
January 2005
89 All studies of child-abuse victims which look at
family type identify the step-family as representing the highest
risk to children. However, the term step-father needs to be defined,
since it used to refer to men who were married to women with children
by other men. It is now used to describe any man in the household,
whether married to the mother or not. An NSPCC study of 1988 which
separated married step-fathers from unmarried cohabiting men found
that married step-fathers were less likely to abuse: "for
nonnatal fathers marriage appears to be associated with a greater
commitment to the father role". (Gordon, M and Creighton,
S (1988), "Natal and nonnatal fathers as sexual abusers in
the United Kingdom: A Comparative Analysis", Journal of Marriage
and the Family 50, pp 99-105.) Back
|