IN ALL THE critiques of the health service, no mention is made of where all these sick people are coming from.

Whether it’s the beleaguered Minister Varadkar, frustrated clinicians or story-hungry journalists all make the assumption that the demands on the health service will continue to grow unchecked.

They are trapped in a medical mindset, which blocks any hope of us finding sustainable solutions to our national health problems. Doctors are trained to make us better, not to keep us well.

The Health Information and Quality Authority (HIQA) do not strategically manage nutrition. Indeed, HIQA only announced their first review of hospital food nutrition in the summer of 2015.

For the first time in human history pathogens are no longer the biggest killers. According to the Lancet, non-communicable ill-health now accounts for some two-thirds of deaths worldwide. The list of factors creating this explosion in chronic diseases is a relatively short one.

Policy needed to stem the flow 

From smoking and alcohol to poor diet and obesity, we know what’s filling our hospital beds, but seem unable to comprehend a policy to stem the flow.

The concept of universal health care as formulated in post-war UK included wellness clinics as an equal part of the concept. Their function was to maintain the health of people rather than just cure illness.

Needless to say, this concept was soon dismissed – the payback was way beyond the lifetime of a government, even though it reached through the lifetime of citizens governments were supposed to be protecting.

The radical changes to food production and the western diet over the last 50 years have created a world where hidden malnutrition and poor diet is found across all social classes. Ireland has simply traded the hunger of previous times for malnourished obesity in the twenty-first century.

Shutterstock / D7INAMI7S Shutterstock / D7INAMI7S / D7INAMI7S

Nutritionally shallow diets 

By malnourished I don’t mean thin and ill-looking people, I mean overweight and indeed average weight people, with nutritionally shallow diets. These diets are the pathway to chronic ill health manifested in both elective and emergency hospital care.

The result is a creaking health service where a malnourished population even impacts on the daily running of hospitals. Bed stays in hospitals are increased by four days for people who are malnourished.

According to research by Niamh Rice and Charles Normand of The Department of Health and Management at TCD, malnourishment cost the health service €1.42 billion in 2011 (€13.1 billion was allocated to the Health budget in 2015.)

At a national level our nutritionally shallow diets are filling hospital beds across the country. From smoking and alcohol abuse to poor diet and obesity, we know what the causes are and have taken some action to tackle tobacco and alcohol abuse,  but why have successive governments failed to tackle food supply and food consumption.

These are policy areas where early twentieth century governments would not hesitate to intervene.

Shutterstock / Robert Kneschke Shutterstock / Robert Kneschke / Robert Kneschke

The explanation is simple enough and it is two-fold: the stranglehold big food business has on our food policy has combined with successive governments’ religious zeal for the so-called ‘free market’ to create a mass food monopoly, which squeezes out smaller quality, nutritionally complex food producers.

There are solutions, but they have a 10 to 20 year trajectory and will require a combination of short, medium and long term of policies which should include:

• Legislation rather than guidelines on salt reduction in food as the UK has done, delivering healthcare savings of £1.5 billion a year for our neighbours
• The temporary fortifying of food with higher levels of nutrients.
• Urgent and radical reform of the primary and secondary education system from Home Economics to making laudable food programmes like Incredible Edibles and Food Dudes compulsory across all schools
• In the longer term breaking the stranglehold big food businesses have on our food supply by balancing their heavy lobbying with the voices of smaller food businesses.

The most radical change we need to make is a conceptual one, which will in itself lead to structural and cultural change. We need to accept that food is medicine, or indeed poison.

The continued separation of the two policy areas of food and medicine is the key barrier to this change. The Department of Health and the Department of Agriculture and Food need to be merged into a super-department under one minister instead of the present situation whereby one department is wheeling patients into another’s hospitals.

Ross Golden-Bannon is a member of the Irish Food Writers’ Guild and writes here in a private capacity. You can follow him on Twitter @Goldenshots

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