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Views & Reviews From the Frontline

“Maggie, Maggie, Maggie . . . ”

BMJ 2008; 336 doi: (Published 12 June 2008) Cite this as: BMJ 2008;336:1380

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Are we still feeling the effects of "Thatcher the milk snatcher" today? A personal comment on the possible future public health effects of government cuts today

Des Spence[1] commented on the impact that Margaret Thatcher's 1972 abolishment of free school milk[2] had on his status as milk monitor. The abolishment of free school milk was justified as a money saving scheme for recession-stricken Britain. Has Margaret Thatcher's abolishment of free school milk impacted on more than the status of many a former milk- monitor? Has this money saving scheme impacted on the health of those adults who didn't receive free school milk?

We used the results of 9,021 bone densitometry scans between 1992 and 2010 to investigate for significant differences in bone density between adults who did receive free school milk (born between 1946 - the date that the School Milk Act was passed - and 1965) and those that didn't (born after 1970). As expected, logistic regression analysis indicated that the younger population that didn't receive free school milk (n= 512) were less likely to be osteoporotic, compared to their older counterparts that did receive free school milk (n= 8509): OR 0.69 (95% CI 0.54, 0.87); this observation being confounded by differences of age between the two groups. However, when adjusting for differences of age, logistic regression analysis revealed that those that didn't receive free school milk were more likely to be osteoporotic, compared to those that did receive free school milk: OR 18.59 (95% CI 7.35, 47.04). We concede that other causal factors can be attributed to this relationship; however, it is plausible to hypothesise that Margaret Thatcher's denying school children free milk has contributed.

The effect of the presently proposed cuts and reformations to the NHS and other public services[3] upon the future health of the country's inhabitants must be considered. Indeed, with the UK's ageing population, prevention, as opposed to treatment, of costly and high-morbidity diseases, such as osteoporosis, should always be the aim.

1. Spence, D, "Maggie, Maggie, Maggie..." BMJ 2008;336:1380 doi:10.1136/bmj.39608.434734.59 (Published 12 June 2008) 2. Education Act 1946. 10/50/contents 3. Godlee, F, NHS reforms, why now? BMJ 2011; 342:d552 (Published 26 January 2011)

Competing interests: None declared

Competing interests: No competing interests

24 March 2011
Alexander G.S. Oldroyd
Medical student
Marwan Bukhari, Cathy Greenbank
Royal Lancaster Infirmary