Time for an NHS smart card?

Abstract

We select the letters for these pages from the rapid responses posted on bmj.com favouring those received within five days of publication of the article to which they refer. Letters are thus an early selection of rapid responses on a particular topic. Readers should consult the website for the full list of responses and any authors' replies, which usually arrive after our selection. Obesity Stop all further research-and act How many studies into obesity does it take to build one cycle path for children to get to school on? I believe we have now reached saturation point as to how many studies and articles it takes to convince us that we are too fat as a nation. 1 2 What good does it do to advise people that they need to walk/cycle/ swim when the infrastructure is doing its best to prevent exactly this? Given all the suggested health assessments, dietitians' advice, government guidelines, and supermarket labels there is something missing: action to force planners, developers, councils and local authorities to end totally unsustainable, fat-making practices. These practices include building roads without cycle lanes (or trying to get away with painting a thin white line on a 70 mph road and declaring it a cycle path) and putting up a nice little "walk to health" road sign beside a traffic jammed road heavy with exhaust fumes. Councils have "cycle to work days"-knowing that the best that cyclists can hope for on most roads is that they have a decent, soft ditch to fall into. The worst is to run out of cycle path and find yourself between a bus lane and two lanes of heavy traffic. I suggest that all research stops now, all advice stops now, and all infuriatingly patronising labelling stops now. The money must now be spent on buying land from private owners, farmers, developers-and on building cycle paths. The only way we will be able to tie our laces in the future and not need cardiopulmonary resuscitation at the age of 35 is to demand and build a functioning, cyclist and pedestrian centred, integrated, reliable public transport network. Having witnessed the government's transport policies in the last decades, I would say: fat chance.