Poverty in Britain

Chief Medical Officer ‘ashamed’ as rickets makes a comeback

40 per cent of English children have some kind of vitamin D deficiency

the Independent,

24 October, 2013

The Victorian-era disease rickets has returned to England, the country’s Chief Medical Officer has said, and should be fought off through a universal handout of vitamin supplements to all children under five.

In a damning report on the state of children’s health, Dame Sally Davies said that the country should be “profoundly ashamed” that child mortality rates in some of the poorest parts of England were three times higher than rich regions.

Warning that today’s children face a far more uncertain future than her own generation, she set out a range of recommendations to tackle urgent problems such as rising child obesity rates, a lack of effective mental health services for children and growing rates of vitamin deficiency.

In her report, Our Children Deserve Better: Prevention Pays, Dame Sally said all children with a long-term condition should have a named GP responsible for their ongoing care, and the National Institute for Health and Care Excellence (Nice) should look at the cost-effectiveness of extending vitamin supplement provision to all children under five.

She said the growing problem of vitamin deficiency was illustrated by the return of rickets, a childhood disease that effects bone development and causes bowed legs, which is caused by a lack of vitamin D. “We know that many children, and not just in vulnerable groups have vitamin deficiencies,” she said. “We are seeing rickets again. I used to see rickets when I trained in the late Seventies, and it’s coming back again.”

Dr Claire Lemer, a consultant in general paediatrics at the Evelina London Children’s Hospital, said that 40 per cent of children have some kind of vitamin D deficiency. However, current figures for rates of rickets are not available.

The disease was common in Victorian England, but largely disappeared from the Western world in the latter half of the 20th century thanks to vitamin D being added to everyday foods such as margarine and cereal. There has been an observed rise in cases in recent years.

Supplements of vitamins A, C and D are already offered to some pregnant women and parents of children under four under the Healthy Start scheme, but only to those receiving certain state benefits. Pregnant women under the age of 18 can also receive them.

The UK has fallen behind many other European countries in caring for its children, Dame Sally said. While in the Eighties our mortality rate for to 0 to 14-year-olds was among the best in Europe, it is now among the worst, with five more children dying every day than in the best-performing country, Sweden.

Within England, death rates for people under 17 vary between 7.9 deaths per 100,000 in the five best-performing local authorities, and 21.1 deaths per 100,000 in the five worst-performing local authorities. The highest death rates are seen in deprived areas of the North-west, northern cities and some of the poorer boroughs of London.

Dame Sally said: “I think this is something, as a country, we should feel profoundly ashamed about – I do.”

The report also recommended that trainee GPs should have extended paediatric training and the transition between child and adult health services should be made easier. Dame Sally said that improvements could save the economy billions, with estimates suggesting £1bn could be saved each year if obesity rates among children and young people were reduced by just 1 per cent.

Dr Hilary Cass, President of the Royal College of Paediatrics and Child Health, said: “Investing in children is not only an investment in today’s young people; it’s a sound investment for the future. Healthy children are much more likely to become healthy adults. So in the run-up to the next election, as the political parties prepare their manifestos, the challenge is to ensure that child health is high on the agenda. We have a duty to this generation of children, to the next generation and to generations to come.”