Victorian diseases make a unwelcome return

In the worst cases, it results in bandy legs, bent outwards like bows, and can be crippling (think Tiny Tim in A Christmas Carol). Ragged children captured by Victorian and Edwardian photographers in Glasgow’s slumlands would very likely have been afflicted with both diseases – not to mention a litany of other complaints – living as they often did on little more than bread and dripping.

As we down our morning orange juice and slice the top off a boiled egg, few of us stop to think that we are staving off these harbingers of deprivation.

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Spare a thought, however, for almost 11,000 patients admitted to hospital in England in 2021 with malnutrition. Of these, 171 had scurvy and 482 had rickets, 405 of whom were children. Provisional figures obtained by The Times Health Commission under freedom of information laws show more than a doubling of cases of malnutrition in the past decade, and a quadrupling since 2007-8.

Even though some of these figures will include cases among newly arrived immigrants, this would not account for the steepness of the statistics. According to the President of the Royal College of GPs, the number of incidents of scurvy could point to the “tea and toast” diet of the elderly, who cannot afford to eat properly.

In addition to these scourges, thanks to the lower uptake of child vaccination, there is also a rise in measles, another serious Victorian malady that, in extreme cases, can prove fatal.

In an age when scandal has come to mean salacious celebrity misdemeanours, these facts are a true definition of the word. They should make all of us pause and look again at the world we live in, at what’s happening right on our doorstep.

Who passing you in the street is eating so poorly they are at risk of falling ill? Who is neglecting to feed themselves so their children won’t go hungry?

Don’t be fooled by appearances or accents: malnutrition is no respecter of class, only of income. At present, for far too many, there is simply not enough money to fill the fridge with nutritious food when there are other big bills to be met.

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One of the ironies of malnutrition is that eating badly can result in obesity rather than weight loss.

As everyone knows, this is an escalating problem, with a third of Scots, in 2021, falling into this category. Although the most overweight group were aged 55-64, there’s an alarming number of children affected too.

In addition, around a quarter of five-year-olds in the UK suffer dental decay, while children born during the years of austerity are shorter than their European peers. All this, despite us being the sixth wealthiest country on the planet.

It's all very well saying people should, by now, know the difference between a meal packed with vitamins and one rich in salt, sugar, fat and starch. Knowing is one thing, being able – or motivated – to purchase and prepare it is another.

According to the Food Foundation, a nutritious basket of goods costs three times more than one filled with junk food. They say that for the poorest fifth of society to meet government guidelines on healthy eating shoppers would need to spend half of their disposable income on food.

No wonder people bypass the fruit and veg aisle and head for sugary or fatty items that give the illusion of filling you up.

The depth of hardship and misery these figures hint at is sobering. The line, trotted out every winter in recent years, about those who have to choose between eating and heating, is not simply a catchphrase. It is the harsh reality. And, as these 11,000 hospital admissions show, serious consequences follow.

Is the gulf between the well-fed and the malnourished acceptable in a society that considers itself enlightened and humane?

The time period in which malnutrition has soared is in direct correlation to the austerity years ushered in by David Cameron and the cost of living crisis fuelled in part by Brexit, but overwhelmingly because of war in Ukraine and the global instability that has followed.

By almost every measure, this recent, protracted period has seen the chasm between the haves and the have nots deepen to the point where it feels as if society is split in two. Of course, some who know better and can afford good food prefer to opt for junk.

Other than trying to educate them, and put temptation beyond their reach, there is not much more that can be done. The most pressing issue, however, is one that should keep politicians awake at night. Namely, that for those on lower incomes, the price of wholesome sustenance has rocketed, making it not just expensive but unaffordable.

The proliferation of food banks is only the most visible manifestation of a malaise we have become inured to. The Conservative government has dithered over imposing restrictions on junk food offers, and does not offer universal free school meals.

In Scotland, the extension of free lunches in primary schools to all ages by 2024 will be a boon. However, the date for a proposed pilot scheme for the roll-out of universal free meals in secondary schools is not yet confirmed, and could be some time away.

Yet it is an urgent issue, because the knock-on effect of undernourished children, for their physical well-being, educational attainment, and ultimately for a fully functioning society, will be grim.

When people cannot afford to eat, the very foundation of society is shaken. What we are seeing, UK-wide, is approaching a national emergency. If our legislators and their families were to spend a week on the diet of those who end up with scurvy or rickets, it would swiftly focus minds on finding solutions.

Until that day, we could do worse than go back to reading Dickens: not just for what he tells us about the past, but as a commentary on our own times.