Public health the loser in fast-food bunfight

'What McDonald's stands for is inconsistent with the values of health services treating a growing number of children with obesity and weight-related problems such as type 2 diabetes.'

I had so much optimism for the new Labor state government. I believed it held great promise of standing for progressive and responsible governing; that it would value science and working for the public good. So with it only six weeks into its first term, I was frustrated and disappointed to hear Premier Daniel Andrews backing the inclusion of fast-food giant McDonald's in our public children's hospitals.

Mr Andrews said McDonald's was "here to stay" at the Royal Children's Hospital. Furthermore, he told public health experts to "get over themselves" regarding their concerns at having a fast-food outlet at the hospital in part due to the "healthy halo effect" it creates around the food. He also opened the door to the American multinational being included inside the new publicly funded Monash Children's Hospital due to open in 2017.

Doctors, including myself, have consistently argued that what McDonald's and other fast-food chains stand for is inconsistent with the values of health services treating a growing number of children with obesity and weight-related problems such as type 2 diabetes. Hospitals in Britain, US and Western Australia have dumped contracts with fast-food retailers for this very reason.

As a medical doctor and as a public health scientist working internationally, I can assure Victorians that there is good scientific evidence to support our concerns. This is not about banning or taking away choices in a nanny state. Excluding a US multinational from selling junk food inside our public hospitals is simply sound health policy. It is about sending a clear and consistent message to the community, and particularly young people, about what is healthy.

But Mr Andrews does not see the sense in this. When asked about his view, the Premier sided with the commercial face of our global obesity epidemic rather than leading health advocates by saying that a McDonald's inside the Royal Children's Hospital was in the best interests of our community. For a number of reasons, this is dangerously misleading.

First, having a McDonald's embedded in a respected, taxpayer-funded institution like the Royal Children's Hospital does wonders for its brand power. McDonald's spent more than $1billion in 2013 alone on advertising junk food and any parent will tell you how powerful the golden arches are when children see them.

There is good research showing that having a McDonald's next to hospital clinics makes people think its food is healthier than it is and that eating it will support the hospital. On a clinical level, it is counter-productive, too. Shouldn't we be providing the best food possible to ensure a speedy recovery for our sick young patients, rather than having the very foods onsite that are fuelling the growing burden of obesity-related disease? For our government to ignore the power of this dangerous and confusing message is naive and irresponsible.

Second, the public health community does not use the word "crisis" lightly. We are not in the business of grandiose statements. But when one in four Australian kids and two-thirds of Australian adults are overweight or obese, we do have a crisis. Obesity costs us $21 billion a year directly and $35 billion indirectly – a tab that all taxpayers must all pick up. In an age when we have less and less to spend on education, healthcare and public infrastructure, doesn't it make good economic sense to support measures that plug this fiscal hole?

Finally, Mr Andrews argues that he and the health community have no role influencing what parents eat or feed their children. But that is precisely the role the government must take on. McDonald's spends billions of dollars on advertising for a reason: to influence parents and their children and encourage them to eat at its stores. Counteracting this persuasive influence is about the public good.

Boiling the public debate down to reductive rhetoric, Mr Andrews said "people who would like to tell parents every single thing they ought do and not do" is "nanny statism" that undermines legitimate government warnings for parents. Australia, and Victoria in particular, has a history of introducing progressive public health policies that have benefited the community enormously, including health promotion in workplaces, smoke-free public spaces, warnings on food labels and plain packaging of tobacco. Does Mr Andrews really want to attack the very public health professionals who helped achieve these measures?

Food in our hospitals must be good quality, accessible at all hours, affordable, exciting for young people and in a form that patients want. I just know we can do a lot better than McDonald's. Why not invite the vibrant Melbourne food community to provide something healthier, more local and more appropriate for people who are sick and need support?

Mr Andrews has missed the point. This was never about a ban, or creating a "nanny state", or about telling parents what to do. This was and is about a consistent message, defending our world-class public health-care system, and protecting the health of families across our state. It is about having a proper public debate and considering the health of the children in these hospitals, but also the health of the millions of young Victorians increasingly at risk from obesity-related disease.

I had hoped for a mature discussion. Instead, Mr Andrews has attacked experts in the health field. Many people look to our leaders for guidance. When these leaders publicly defend, and even endorse, the junk food industry and stoop to emotive, populist politics, in the process ridiculing and undermining the work of public health experts, they do a disservice to our community. We can do better for our patients than McDonald's, particularly in a city celebrated for its food culture.

theage.com.au 12 Jan 2015

To put it quite simply, McDonald's 'food' is carcinogenic.

Hospitals are supposed to be places, the heal people, and not places where one can purchase cancer.

According to law, politicians are supposed to be public servants, enacting the will of the people, but they do not.

Politicians are Corporate Whores working for 'Big Business', with a variety of kickbacks, 'golden handshakes' or straight out bribery.