The chair of the health select committee says the government must get its new strategy rightby Sarah Wollaston / June 7, 2018 / Leave a comment
When George Osborne announced the sugary drinks levy in 2016, contrary to the predictions of his critics, it was widely welcomed. Manufacturers were given time to prepare and, by the point it came into force in April this year, it had already driven significant reductions in the sugar levels of fizzy drinks.
Far from being a regressive tax, the money collected was earmarked for schools and sports (it has been so successful in lowering sugar that less has been collected than originally anticipated). Where retailers do decide to pass on a price differential at the point of sale that will be a further encouragement for people to choose lower or no sugar alternatives.
Accusations of “nanny statism” either ignore or minimise one of the most important public health issues of our time. Around one in five children are leaving primary school not just overweight but obese—and in every year since formal recording began, the gap between the richest and the poorest communities has widened. This is not only a problem with far reaching personal consequences for the children affected, but an unacceptable cause of health inequality and of avoidable costs for the NHS. By age 11, children from the poorest communities are three times as likely to be obese as those from the wealthiest.
The main criticism of the government’s first strategy to tackle childhood obesity, published in 2016, was that it did not go far enough. A red pen had been taken to the original draft, removing many important opportunities to turn this around. Health inequality was one of the “burning injustices” identified by the prime minister on the steps of Downing Street. But with a refreshed version of that plan expected soon there is an opportunity for government to look again and get this right in the updated plan. The health and social care select committee, which I chair, argues in its new report that it can be done. This is shown by the approach taken in Amsterdam, where they have focused on using a whole community and schools approach to healthy lifestyles alongside clear and effective leadership.
We need the same level of attention here in order to narrow the inequality gap but, given the catastrophic and rising costs of obesity, the government also needs to make sure that local government has all the levers it needs to put those changes into effect. This should include making health an objective in the planning and licensing systems. We also need to start earlier, including by improving our poor rates of breastfeeding and making sure that parents can access help for childhood obesity long before it has become established. We need to make sure that programmes designed to help children are not stigmatising. Blame cultures are not only harmful but counterproductive.
Physical activity matters too of course, but that applies to everyone whatever their age or weight. The government could do far more to support our local authorities to promote active travel to schools and workplaces and to encourage take up of programmes such as the daily mile, where children run or walk at the start of the school day for 15 minutes.
Few parents want to have to queue through chicanes of confectionery at the tills or to have adverts peddling junk food to their children before the 9pm watershed. Changing promotions away from sugary and fatty foods to healthier alternatives would help to make healthier choices the easier choices, without increasing the cost of a weekly shop. Marketing using cartoon characters, end of aisle displays and multi buy offers all drive higher sales and voluntary agreements with shops simply do not work. Retailers are prepared to do their bit but want to see a level playing field through regulation. Likewise for reformulation, we know that voluntary agreements have only resulted in a 2 per cent reduction in sugar content as opposed to the far more dramatic reductions as a direct result of the levy.
Ultimately, tackling childhood obesity is a complex issue with no one single action that will prevent it or turn things around for those who are already in difficulties. Rather than blaming this on parents or vainly hoping it will reach a steady level, it needs to be seen as a public health emergency that requires action in every area that can narrow the gap. In Amsterdam it is seen as everyone’s business to help children to thrive.
I believe it is the government’s job to provide leadership and the necessary funding and policy levers to help families, local communities, health professionals and businesses to work together to transform lives.