Our elected officials are supposed to lead and if they don’t lead then they should be responsible for their actions or in this case their inactions.
I have written to the Honourable Michael Ferguson regarding hospital food and public health policy on more than one occasion. Zero response from him and zero action.
Does this make him responsible for the next limb I need to amputate? Should he be responsible for the next complicated diabetic patient with poorly controlled blood glucose? My patients this week think he should be responsible. A well-controlled patient managing his diabetes outside of hospital has been out of control the moment he only had choices of high carbohydrate foods that the hospital provided. He asked me why, how come hospitals do not lead by example?
We need to reduce our sugar consumption and guidelines are recommending that, but our hospital food remains hopelessly overloaded with sugar (and carbohydrates).
The kiosks, cafeterias and vending machines are negligently stocked with junk food that are outside the Occupational Health and Safety guidelines.We have had an effective call to action from the World Health Organisation this year for a reduction of sugar consumption to less than 6 teaspoons of sugar per day. More than that is served up to my patients EVERY time the food services team come around – breakfast, morning tea, lunch, afternoon tea, dinner and supper.
Australian Dietary Guidelines recommended cutting down sugar in 2013. There has been no such change in hospital food since then. I keep being told that the hospital Dietitians are responsible but they won’t communicate.
Hospital food options should reflect up to date research and guidelines. They fail miserably in Tasmania and as far as I can ascertain, the rest of Australia is just as bad.
This whole topic needs some leadership and it’s not coming from the top. That makes the Minister of Health responsible and by his inaction, negligent. The longer this goes on the more farcical it becomes. If it wasn’t so serious it would be comical.
“Health Minister Michael Ferguson wants to make it easier for Tasmanians to be healthy.”
“It’s deliberately ambitious because in many cases we’re getting the worst outcomes, we’re in many cases some of the unhealthiest Australians,” he said.
“We are willing to invest in this space but it needs to be evidence-based”
So far it looks like a zero investment from my aspect.
Any thoughts from the voters out there?
Here are my last 2 letters to the Honourable Michael Ferguson.
March 9 2015
Dear Minister Ferguson,
There have been some landmark papers in the last few weeks that warrant consideration from a public health perspective.
Last week, the World Health Organisation released a recommendation for a reduction of sugar to less than 5% of calorie intake. That equates to about 6 teaspoons of sugar for adults and 3 for children.
Current Australian average consumption is in the vicinity of 40 teaspoons per day. Current hospital food guidelines are still recommending 3 desserts per day (even for diabetics) plus fruit juices, biscuits and snacks. My patients are consuming over 20 teaspoons of sugar with breakfast alone. My diabetic patients have poorer blood glucose control in hospital and that equates to complications and poor education by condoning poor food choices.
I have been recommending for the last few years that we need to reduce our sugar consumption and that as hospitals, we should be practicing best practice and current evidence. There has been an ongoing resistance to the basic consideration of this from a hospital practice.
Professor Hamdy from the Joslin Institute (the preeminent Diabetes research unit in the world) recently published a statement document that is rocking the ‘Diabetes’ world. It backs up many articles and debates in the last 12 months.
“It is clear that we made a major mistake in recommending the increase of carbohydrates load to >40 % of the total caloric intake. This era should come to an end if we seriously want to reduce the obesity and diabetes epidemics. Such a move may also improve diabetes control and reduce the risk for cardiovascular disease. Unfortunately, many physicians and dietitians across the nation are still recommending high carbohydrates intake for patients with diabetes, a recommendation that may harm their patients more than benefit them.”
I have been prescribing for some time that I want my patients and particularly my Diabetic patients to have the option of Low Carbohydrate food choices in the hospital. That option has been refused.
I have recently returned from the First World LCHF Summit (Low Carbohydrate Healthy Fat) in Cape Town, South Africa. South Africa and Sweden are embracing the LCHF concept from a public health perspective. It was an honour to be the only Australian doctor invited to speak at this international symposium and I attach the mission statement.
“The mainstream dietary advice that we are currently giving to the world has simply not worked….that this incorrect nutritional advice is the immediate cause of the global obesity and diabetes epidemics…acknowledge the presence of insulin resistance (carbohydrate intolerance) as the single most prevalent biological state in modern humans…Persons with insulin resistance are at an increased risk of developing a wide range of chronic medical conditions if they ingest a high carbohydrate diet for any length of time (decades).”
You will be aware of my ongoing request for a review of Hospital Food policy. I believe we are providing inadequate nutritional advice and service in the hospitals and this has both short and long term individual, societal and financial consequences.
The longer we as a medical profession and Government from a community leadership aspect ignore the current science, the more foolish and negligent we become. This is not just an issue of sound governance and financial responsibility, it is a matter of individual health.
I remain, once again, available for discussion on ways that we can implement choice and change for the health of the people. A simple offer.
World Health Organisation Sugar release March 2015
http://www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/
http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/
2015 LCHF Health Summit Mission Statement
Yours sincerely,
Gary Fettke
April 7 2015
Dear Minister Ferguson,
I see that you have been quoted in the press recently with the following:
“Health Minister Michael Ferguson wants to make it easier for Tasmanians to be healthy.
“It’s deliberately ambitious because in many cases we’re getting the worst outcomes, we’re in many cases some of the unhealthiest Australians,” he said.
“We are willing to invest in this space but it needs to be evidence-based.”
If you are serious about these statements then please liaise as you can initiate some immediate changes with benefit to all.
I recently corresponded with you regarding the WHO’s endorsement of cutting sugar intake.
The hospital food situation remains unchanged with regards to what is served to patients and what ‘junk food’ is made available to patients, staff and visitors.
The Legislative Council in November 2013 passed a resolution in relation to junk food availability in the hospital system. That resolution for action has languished on your predecessors’ desk and now yours. I know that you are aware of it as I have raised that topic with you directly in the past.
The motion passed the legislative Council on November 29, 2013
“That this House calls upon the government to order a review of foods prepared, and/or sold in hospitals, including their canteens, kitchens, or vending machines, with a view to considering similar legislation which has been enacted in South Australia controlling the sale of ‘junk’ food in hospitals.”
From my previous correspondence:
You will be aware of my ongoing request for a review of Hospital Food policy. I believe we are providing inadequate nutritional advice and service in the hospitals and this has both short and long term individual, societal and financial consequences.
The longer we as a medical profession and Government from a community leadership aspect ignore the current science, the more foolish and negligent we become. This is not just an issue of sound governance and financial responsibility, it is a matter of individual health.
I remain, once again, available for discussion on ways that we can implement choice and change for the health of the people.
I think the public should be aware of this inertia within the system and I will interact accordingly.
I anticipate your earliest reply.
Yours sincerely,
Gary Fettke
Hansard November 29 2013