Childhood obesity: treading on eggshells

This month Selfridges put on sale a giant five-stone Easter egg - weighing the same as an average nine-year old boy, and providing enough calories to sustain him for more than two months. As the Daily Mail put it, 'it won’t win any fans at Weight Watchers’.

With a price tag of £499, none of this solid chocolate egg is likely to find its way into the mouths of many British schoolchildren. But lots of other similarly unhealthy food will. Sweet shops and fast-food outlets, often scattered across routes to schools, are presenting healthy eating initiatives with obstacles right outside the school gate.

With recent figures showing that by the age of 10-11 (or year 6), 31.6% of children are overweight or obese, is banning sweet shops and fast-food outlets from selling products to children the answer to childhood obesity? What can central and local government do to limit their impact?

Dr. David Haslam, clinical director of the National Obesity Forum suggests that such outlets should be made to close for half an hour or an hour until 4.30. And the government is not unreceptive to such interventions - in January reminding councils of their powers to prevent fast-food restaurants being built near schools and parks.

Such measures could, however, backfire. The Scottish Council Foundation has warned that punitive anti-obesity measures risk alienating the public by seeming "mean-spirited". Devoting resources to recreational areas and making people feel safer outside would be more fruitful, thereby increasing people’s willingness to let their children play and exercise outside. London-based think tank Demos has made the same point, arguing that the public realm needs to be more ‘playable’.

As Guardian education correspondent John Crace concluded earlier this month, promoting physical exercise through community initiatives and facilities is the key to combating childhood obesity.

This will require sustained government support – but is more likely to be useful than banning chips and sweets. We will be bringing you much more on the difficulties presented by the obesity pandemic threatening the UK with Pocket Issue: Fat, out in Summer 2008.

What's bugging the NHS?

Numbers of deaths linked to the bacteria Clostridium difficile have soared in England and Wales. Between 2005 and 2006, death certificates mentioning C. difficile, a hospital-based infection, have risen by 72%, to 6,480, according to new figures released by the Office for National Statistics.

It was hoped that stricter surveillance and the hygiene code introduced by the Health Act 2006 would reduce infection rates, but a quick fix was never likely. C. difficile is difficult to eradicate from wards. It is resistant to alcohol wipes, requiring surfaces to be cleaned with bleach and nurses to wash their hands between every contact with patients.

With a recent cleanliness survey of England's 394 NHS trusts finding that a quarter failed to comply with hygiene regulations, Conservative peer Lord Mancroft accusing nurses of being ‘grubby and promiscuous’, and general cries to ‘bring back matron’, can high infection rates be blamed on nurses?

Not really. Healthcare Commission reports have found that staff shortages and poor management, rather than nursing staff, are to blame for dirty wards. Cleaning is fundamental. Public sector union Unison estimates that the number of NHS cleaners has fallen from 100,000 twenty years ago to 55,000 in 2004, and the Patients Association says that budget deficits have led many hospitals to cut their cleaning contracts.

So increased NHS funding is all well and good, but making it conditional on efficiency and productivity is unhelpful if it encourages neglect of hygiene and patient safety. And short-term measures such as Gordon Brown's one-off deep-cleaning initiative are no substitute for funding greater numbers of daily cleaners.

Want to know more about C difficile and other health threats like MRSA and Bird Flu? Pick up Pocket Issue: Pandemics, in the shops from next week.

Privacy and Internet Piracy

The government recently published a Green Paper on the creative economy. It contained an addendum at odds with the bubbly tone of the rest of the report; a proposal for Internet Service Providers (ISPs) to monitor user activity for copyright infringement, warn them against downloading copyrighted material, and block their internet access after three warnings.

Why? Pressured by the entertainment industry, the government is moving to stem the tide of filesharing. Filesharing is an amoral distribution method. It can drain artist and company profits by allowing users to own material for free, and at its extremes, it chips away at the economic viability of artistic endeavour. But it also offers myriad opportunities for publicity and distribution - think of the iTunes store, BBC’s iPlayer and Kate Nash. Yet while many companies are adapting to new possibilities, others are pushing for restrictions.

The government’s proposals will interfere with civil liberties. While mitigating a situation in which downloaders are subject to enormous fines, they give rise to a host of new problems. Maintaining nationwide user bans would require the constant monitoring of online activity and the sharing of data on individuals between corporations and government.

On top of ethical objections (rights to privacy), there are many practical problems. These include; users encrypting data, issues of liability when internet connections are shared; and the fact that such moves would criminalise millions.

So will the proposals come into force any time soon? European Human right legislation states that such interferences with individual privacy are only justified if 'proportional' to their good effects.

Given practical, legal and ethical objections, the government's measures are unlikely to pass this test. The Internet Service Providers Association (ISPA) has already indicates its opposition. Sensitive to the unpopularity amongst consumers that stricter monitoring would bring, ISPs have been resisting the entertainment industry’s calls for some time.

Clear government support however, heralds a new development. Pocket Issue: Big Brother will bring you much more on this in Autumn 2008, discussing the balance between technology, surveillance and privacy. It will be interesting to see how the situation develops.