The Budget delivered on 21 March presented a number of surprises for us all and not least the imposition of VAT on a number of hot foods. It was Greggs’ pasties that took the lime light. My personal favourite (cheese and onion) will now be £1.09 instead of 90p but will that stop me having one as an occasional treat? Would it stop me if I bought one every day? Was it meant to stop me? After so much coverage in the press, I am sure you are all aware that this budget change was closing a loophole in legislation going back as far 1984; wouldn’t it have been so much better if it were part of a considered public health strategy to improve health through a variety of means including legislation and price fixing? ‘Not the Nanny State again!’ I hear you cry, however, a tax on high-fat foods sits right along minimal pricing on alcohol, increased prices on cigarettes and restrictions on smoking in public, as far as I am concerned. We need some national action to help nudge people into healthier lifestyles and we know legislation can help. Much was made in the media about this being a tax on the working man – that would be the working man who already suffers from considerable health inequalities than his more affluent neighbours? As nurses, we see the impact of obesity, alcohol and smoking every day. According to the Academy of Medical Royal Colleges, the UK now has the highest rate of obesity in Europe (2012). The impact on society is too great to note here but the extent of that impact on the NHS is, as you know, severe. This impact ranges from equipment requirements to research trials. A current trial to give obese pregnant women metformin to reduce the supply of insulin to the foetus and hopefully reduce the size of the baby at birth was noted in the media in early April. Alcohol consumption has doubled between 2000 and 2008. Deaths from alcohol-related causes have also doubled, though over a slightly longer time period. Alcohol misuse is estimated to cost the NHS £2.7 billion a year (National Audit Office, 2008) in England. The move towards legislation introducing minimum pricing is quickening across the UK, with Scotland taking the lead and likely to introduce it within the year. This move is strongly backed by evidence showing that increasing the price of alcohol decreases consumption and saves lives. Smoking has decreased dramatically over the last 40 years but approximately 10 million people still smoke in the UK and a quarter of cancer deaths are smoking related (Cancer Research UK, 2012). The Melanie Hornett Nurse Director NHS Lothian Health Board decline in smoking has been helped by legislation, including price control, with a further step due this month when large shops will need to keep tobacco products out of sight. However, the impact of smoking dominates our oncology units, medical wards and long-term conditions care in the community. All this makes me think about our role in public health as nurses and midwives. Many colleagues have specific roles to improve our public health but the rest of us also have opportunities, and not just related to obesity, smoking and alcohol. Sexual health, mental health, infectious diseases and drugs are just as important – and I am sure you can think of many others. The Nursing and Midwifery Council Code (NMC) obliges us to
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