Sue Kedgley: Nanny State faces Big Daddy of a crisis

Poor diet accounts for about 30 per cent of deaths in New Zealand. Photo / Getty Images

Government refusal to support public health programmes fuelling diabetes epidemic, writes Sue Kedgley.

One of the National Party's favourite taunts against the former Labour Government was that it was a "Nanny State" government. National MPs seldom missed an opportunity to paint Helen Clark as a "health Nazi" or ridicule Labour's healthy eating policies as examples of "Helen Clark getting into your pantry".

According to National, public health strategies to improve people's eating habits are an unwelcome intrusion into their lives. That's why it threw out the well regarded healthy eating guidelines for schools, the Healthy Action, Healthy Eating campaign, and other strategies aimed at promoting healthy food choices.

Over the past four years it has stuck to its guns and rejected calls to require food manufacturers to reduce the amount of salt and sugar in food, to tax high sugar fizzy drinks, introduce traffic light labelling, or get rid of advertisements for unhealthy food targeted at children, on the grounds that they constitute an unacceptable Nanny State interference.

But while the Government's Nanny State mantra makes for a good sound bite, it makes for poor health policy at a time when poor diet and unhealthy eating patterns have become the single biggest cause of disease in New Zealand.

According to the Ministry of Health, poor diet accounts for about 30 per cent of all deaths (more than alcohol, violence, cigarette smoking, and road deaths combined) and is fuelling epidemics of diabetes and other dietary related disease.

If this is the case, then logic would suggest that a public health strategy to encourage more healthy eating habits is essential, if we are to reduce our epidemic of dietary related diseases and their spiralling health costs.

But the Government has ruled out any intervention to improve our eating habits. So it finds itself without any tools to combat the rising tide of dietary diseases, and this is undermining its ability to meet its own health goals.

Take diabetes, for example. The Government claims that tackling diabetes is one of its top health priorities.

Yet the vast majority of the more than 200,000 New Zealanders with diabetes have type two diabetes, which is caused predominantly by poor diet and eating habits. Health experts around the world agree the only way to reduce the epidemic is to reduce the amount of high sugar, high fat food that people eat, and encourage more healthy eating habits.

There is growing international evidence, too, that improving diet can radically reduce the progression of pre-diabetes to diabetes.

But the Government won't take any steps to reduce the amount of high sugar, high fat foods that are so heavily marketed in New Zealand. It won't even support traffic light labels, which would show consumers the amount of fat and sugar food contains.

So while it's spending around $700 million a year treating people with diabetes, it has no strategies to prevent diabetes, other than a proposed pilot study to improve maternal and infant health.

The Government's top scientist, Dr Peter Gluckman, admits that not enough is being done to tackle obesity and diabetes, while New Zealand's leading diabetes researcher Professor Jim Mann has publicly criticised the Government for having no public health programmes to prevent people developing the disease. "It's almost like you are sitting looking at this disaster about to happen and not acting," he says.

Behind the scenes, health and Treasury officials are becoming increasingly worried about the Government's inaction in the face of our escalating rates of diabetes.

A recent survey of the blood tests of adult New Zealanders found that 50 per cent of those aged 55-64 have diabetes or pre-diabetes - a frightening statistic.

Diabetes can lead to other, even more serious and expensive health conditions, such as eye disease, foot ulceration, heart and kidney disease.

That's why a person with diabetes generates around 2.5 times the hospital costs of someone without diabetes. Costs are incurred by diagnoses, medication, hospitalisation, dialysis and other health treatments.

With the cost of treating diabetes projected to increase to several billion a year by 2021, or 15 per cent of health funding, the Government faces a serious dilemma. Will it continue to block any public health programme that encourages people to eat more healthy food, and watch helplessly as the cost of treating diabetes spirals out of control?

Or will it set aside its ideological aversion to public health programmes, and take some steps, such as reinstating the school food guidelines, to encourage more healthy eating.

For a Government that wants to reduce state spending on health, the choice is obvious. But I fear it may not be prepared to take off its ideological blinkers and make the right choice.

Sue Kedgley is a former Green MP.