Sugar-related illness could bankrupt the NHS 
An open letter from 15 key medical representatives and health campaigners has called on the government to impose a tax on sugary drinks. The writers claim that the costs associated with obesity and diabetes will bankrupt the NHS. Signatories include members of the British Medical Association, the Royal College of Pediatrics and Child Health, the Royal Society for Public Health, the British Dental Association, the Royal National Orthopedic Hospital, the Association of Directors of Public Health and the Institute of Health Visiting.

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With just weeks to go until David Cameron launches his Childhood Obesity Strategy, plus growing evidence that senior ministers are now considering a tax on sugary drinks to help tackle the obesity crisis, we urge the Government to include the tax as part of its plan (report, 8 January).

The Government has the opportunity to produce a coherent, evidence-based plan to prevent obesity, type 2 diabetes and tooth decay – conditions which are preventable if the food environment is changed. Current policies are simply ineffective.

Unequivocal evidence from other countries has shown that a sugar tax duty on soft drinks will reduce sales of sugar-sweetened drinks, particularly among the more socially deprived who are more likely to develop obesity and type 2 diabetes. The tax will encourage behaviour change for those who drink such soft drinks to either artificially sweetened drinks (lower in calories) or water – an even better option.

The NHS has confirmed it is to impose its own “sugar tax” in hospitals and health centres in England to help tackle the growing problem of obesity, with a 20 per cent tax on all sugary drinks and foods in NHS cafés by 2020. We urge MPs to take similar action and impose a 20 per cent duty on all sugar-sweetened soft drinks.

Put simply, the annual cost to the NHS of obesity alone is a staggering £5.1bn and Diabetes UK estimates that the NHS is already spending about £10bn per year on diabetes – costs that are not sustainable and will bankrupt the NHS.

Jennifer Rosborough, Action on Sugar

Dr Ram Moorthy, British Medical Association

Dr Russell Viner, Royal College of Pediatrics and Child Health

Shirley Cramer CBE, Royal Society for Public Health

Jo Ralling, Jamie Oliver Food Foundation

Mick Armstrong, British Dental Association

David Haslam, National Obesity Forum

Malcolm Clarke, Children’s Food Campaign

Stephanie Wood, School Food Matters

Nicola Close, Association of Directors of Public Health

Tam Fry, Child Growth Foundation

Robin Ireland, Health Equalities Group & Food Active

Modi Mwatsama, Health Forum

Dr Roger Wolman, Royal National Orthopedic Hospital

Dr Cheryll Adams, Institute of Health Visiting

Consuming too much sugar has been widely blamed for the sharp increase in obesity and type 2 diabetes across the UK in recent years and the Automatic Vending Association (AVA) agrees that this is a situation that the Government and collective stakeholders should address.

In our view it’s most important that a strong focus is placed on educating the nation about maintaining a healthy, well-balanced diet where sugary snacks like fizzy drinks, sweets and chocolate can be enjoyed in moderation.

Recent improvements in product labelling have already helped the public to better understand and therefore more effectively control calorie and sugar intake. Defra recently reported that our average intake of sugar that has been added to food and drink or released through processing dropped by 9.7 per cent between 2011 and 2014.

Further transparency on product labelling and better education on nutrition is the approach we support most, as we believe this will achieve long-lasting results, ultimately helping consumers to make educated, well-informed choices and maintain a healthy diet.

Jonathan Hart, chief executive, Automatic Vending Association

Saunderton, Buckinghamshire

Language opens doors for workers

It’s not a joke, Mr Steel (Mark Steel, “Immigrants learn a new language? How thoroughly un-British”, 22 January). Last year I spent some time working in a dreadful part of London. I was told by one of the contacts for the project, who claimed to be a local councillor, that there were “131 languages spoke here”. Whatever Mr Steel thinks, inability to speak the language of the country in which they work leaves a person open to exploitation and abuse.

One of the contractors took on a gang of 12 Eastern Europeans who, unfortunately, spoke three different, mutually incomprehensible, languages which led, perhaps inevitably, to fighting. They were not literate or numerate in any language. The contractor observed that the £25 per day, cash in hand, that they were being paid was hardly providing value for money.

It’s not as though this hasn’t happened before. A large number of unskilled Irishmen came to work in the building industry and worked for cash in hand (called “the lump”) and have found themselves ill and poverty stricken, being unknown to the benefits system to which they had never contributed. Real people are being set up for lives of poverty and deprivation.

Rod Bulcock

Bingley, West Yorkshire

Birmingham vs Manchester

Mancunians occasionally manifest a myopically provincial loyalty to their fine city (Letters, 22 January). To suggest, however, that it rather than Birmingham is Britain’s second city is risible.

The CBSO is one of the world’s great orchestras, and Symphony Hall boasts the best acoustics in Britain. Both the City Art Gallery and the Barber Institute have collections of unexampled quality.

Those employed at Birmingham, Aston, and the other universities that testify to the unimpeachable scholarship so beloved of Brummies would be surprised to discover it possible to consider them inferior to their peers in Manchester. New Street Station is the sleekest and most modern in the country, and the city boasts a vibrant manufacturing base without which the national economy would wilt.

Birmingham has five Michelin-starred restaurants. Manchester’s soccer teams may be doing quite well, but they are, in effect, foreign imports, and to valorise sporting over real cultural achievement is perverse.

Michael Rosenthal

Banbury, Oxfordshire

Gender-fluid school is reason to celebrate

Richard Cairns, headmaster of Brighton College, should be congratulated for his forward thinking regarding gender fluidity when it comes to school uniform (“Girls can be boys, and boys can be girls at top secondary”, 21 January).

In my previous job running an information and counselling service I got to know the mental anguish which young people with gender issues have to deal with on a daily basis. To hear that a school is taking positive action concerning the welfare and happiness of its pupils is music to my ears. Well done Brighton College and I sincerely hope that other schools follow suit.

Jack Cockin

Gauldry, Fife

Child abuse: no lessons learned

How much has changed since the inquiries that examined the deaths of Victoria Climbié and Peter Connelly? (“MPs call for inquiry into Poppi Worthington case”, 21 January). I suggest that anyone calling for an inquiry into Poppi’s miserable life and appalling death should simply dig out all the papers and reports relating to the two previous cases, change names and dates where appropriate, and republish.

The great and the good will then claim to have a new opportunity to learn lessons, review procedures, processes and protocols and otherwise fail miserably to persuade those of us who end up paying for all this guff that “it will never happen again”.

Shelagh Gardiner

Dundee

Water companies failing to invest

Whatever their windfall profits (report, 13 January) they still refuse to invest. Thames Water told Islington that the north London borough’s water infrastructure was only sufficient up to 2015. The Islington Core Strategy states: “As well as maintaining and improving existing sewage infrastructure, future development will require additional investment in new sewerage infrastructure.”

Since that document was written in 2010 the population of the borough has seen major growth. One sewer has already burst, but despite multiple appeals Thames steadfastly refuses to engage in any activity which would eat into profits.

At Archway we are seeing a surge in new housing. Combine heavy rainfall with the morning visits to the bathroom and the outcome will be all too predictable.

Kate Calvert

London N19

The legacy of Savile’s crimes

In the 1950s fellow pupils and I were briefly but regularly abused by the visiting school doctor during medical examinations; he cunningly interwove legitimate undressing with his own predilections. The deputy head who got rid of him explained that a public stink would only make matters worse. That made sense but we were left with no supportive counselling.

North Yorkshire Police gave me a telephone interview last year with rigour and humanity – half a century after the events, but nonetheless very welcome.

If Jimmy Savile’s crimes constitute a dark chapter in BBC history, how do those he assailed regard their personal scars? At the very least could not church and state revoke his hollow honours, conferred in ignorance?

Rev Richard James

Harrogate