After a year of waiting, the government’s Childhood Obesity Strategy has at last been published. But this lightweight document contains little to excite those who want to see the UK taking a lead on addressing a health problem that threatens to make our children’s lives shorter, clouded by avoidable disease, and to engulf our national health service.
The government’s introduction to the long-awaited childhood obesity strategy (now downgraded to a mere 'plan') states that it has been devised in the light of “economic realities”. This perhaps gives an insight into their distinct lack of gusto for challenging the junk food and advertising industries or the underlying causes of a junk-food environment that currently promotes obesity and ill health, writes Sustain's Coordinator, Kath Dalmeny.
The government’s obesity plan acknowledges that the UK spends more each year on the treatment of obesity and diabetes than on the police, fire service and judicial system combined. It also estimates that the NHS in England spent £5.1 billion on overweight and obesity-related ill-health in 2014/15, with the burden falling hardest on children from low-income backgrounds, increasing the likelihood of their suffering higher rates of diabetes, heart disease and diet-related cancers.
Sugary drinks levy
The one bit of stand-out news is that the government confirms its commitment to introducing a sugary drinks levy across the UK, as promised by the previous Chancellor of the Exchequer in his spring 2016 budget. Yet this confirmation comes in the same week that major industry players from the retail and food and drinks manufacturing sectors have come together to state how bitterly they oppose a sugary drinks levy. In the obesity plan, almost all of the government’s policy commitments that have a price-tag attached – school sports, after-school activities and breakfast clubs – are built on the expected income from the levy. This has all the makings of a house of cards, built on the rather shaky sand of “economic realities”.
An encouraging thought is that the Sugary Drinks Levy wasn’t even a twinkle in the government’s eye three years ago, when Sustain first published A Children’s Future Fund setting out how this could work. Sustain’s powerful alliance and long-established Children’s Food Campaign, working with the Jamie Oliver Foundation and many others, has achieved this now being a central plank of UK government policy to tackle obesity. But it was never meant to be pretty much the only plank.
Product re-formulation
The government also states that, “All sectors of the food and drinks industry will be challenged to reduce overall sugar across a range of products that contribute to children’s sugar intakes by at least 20% by 2020, including a 5% reduction in year one.” This is yet another voluntary industry measure, echoing the ill-fated Responsibility Deals launched under the previous Coalition Government. The only possible silver-lining is that this will sit with Public Health England, who have at least shown that they have the independence, scientific credibility and pluck to challenge industry. There are some commitments to setting targets and publishing progress, which is hopeful. But with no punitive measures up their sleeve to enforce change, there's not much carrot and hardly any stick.
Food marketing and promotion
So much for the relative upsides. The plan has nothing about pricing, nothing about curbing junk food marketing, nothing on controlling price promotions of the least healthy foods by supermarkets. Nothing about helping farmers grow and promote more fresh, healthy horticultural produce, and to secure fair-trading retail outlets for their goods. We know that the horticulture industry, which could be part of our true 'national health service' is in trouble and that unfair trading practices prevail that make farmers' jobs so much harder and less profitable than they need to be. And we know that food marketing and promotions contribute significantly to a culture of over consumption of calorie-laden “food-like substances” (to quote food writer Michael Pollan). Is this part of the “economic reality” that government is implying we must simply accept? These are issues that citizens, farmers and the NHS cannot address alone, working ‘downstream’; they need the support of government policy ‘upstream’ to tackle the systemic causes.
Food labelling
For those interested in food labelling, there is a loose exploration of the idea that leaving the European Union might give the UK more freedom to explore options such as graphical labelling as 'teaspoons of sugar' (championed brililantly by Jamie Oliver in his Sugar Rush series). However, some commentators are already indicating that the UK is unlikely to have much influence on the labelling practices of major snack-food and sugary drinks brands that trade internationally, and have always resisted anything that smacks of revealing that a product is “high sugar” and hence less healthy than the alternatives. Much sought-after new trade deals with the US and the Far East, exemplified by the TTIP trade deal, are also unlikely to favour unilateral food labelling requirements. Such policy proposals have been met with resistance supported by gargantuan industry lobbying budgets when put forward in the UK and European Union in the past.
Without concerted government effort to face up to industry, and probably new legislation, there is likely to be heavy resistance to such measures, and a continued patchy and voluntary approach to nutrition labelling, with traffic-light labelling taken up mainly by supermarkets for own-brand foods, and by those manufacturers who can see a genuine advantage in identifying their own products as healthier than others. In short, unless government is genuinely gearing up for a fight with industry, we are unlikely to see 'teaspoons of sugar' labelling on biscuits, cakes, pastries, puddings, breakfast cereal, confectionery, sweet spreads and sugary drinks, the main sources of sugar in the UK diet.
School food standards
On school food standards, the government's obesity plan feels like a poor re-hash of the School Food Plan, established in 2012, with much that was good simply reiterated, and a new ‘healthy rating’ for schools, more promotion of physical activity, and inspection requirements for Ofsted. All of it OK, but not much of it sense-checked with the School Food Plan, makes no mention of the inspirational Food for Life schools programme, and hence not much to write home about. Meanwhile, “The Secretary of State for Education will lead a campaign encouraging all schools to commit to the standards” – namely, the academies and free schools that the government let through the net of School Food Standards last time round. Wouldn't it be good to see the Secretary of State charged with the goal of getting ALL academies and free schools to sign up, clearing up the government’s previous mistake? That would surely be good house-keeping.
From here on in, the one word that stands out in the obesity plan is “encouragement”, and the commitments begin to sound increasingly feeble.
Industry investment
There is some retrospective mention of investment in the Agri-Tech Strategy and Innovate UK grants to industry. The Agri-Tech Strategy is mainly about boosting farm outputs, innovation and productivity, hence important, but barely relevant to obesity (apart from a paragraph or two on super-broccoli). And Innovate UK's £10 million has funded some companies to look at reformulation for health, but mainly – as far as we can tell - for boosting higher added value products and exports, so only distantly relevant to low-income children and their families.
Public sector food procurement
On reading the paragraphs on public sector food procurement, it’s hard not to lose the will to live. Sustain has worked on public sector food standards for nearly 20 years, and – frankly – it sometimes feels like one long episode of the film Groundhog Day. According to the obesity plan, all government departments will need to meet Government Buying Standards (GBS). However, this has already been a mandatory requirement since 2011, so this is a hollow commitment at best. Local authorities will be “encouraged” to take up healthy eating promotion in local areas, and in hospitals, through voluntary uptake of GBS standards – with no money, no practical support scheme, no reporting requirements or measurables, and with local authority budgets having been cut by as much as a third over recent years. Sustain's research has shown that previous “encouragements” by government to improve public sector food over the past 15 years have included at least some practical support and budget, but not this time around. The message seems to be – let’s do less with less.
Early years food
What might seem a positive step – “new guidelines for early years food” also rings hollow. These exist already, written expertly by Dr Helen Crawley and the Caroline Walker Trust, a member of Sustain. But why are these not being enforced as mandatory standards, for very young children, at such a critically important period for nutrition?
Local authorities and hospitals
It seems a shame that there is no credit given to the initiatives already underway in local authorities to tackle food poverty and health inequalities, notably through the innovative Sustainable Food Cities network and its Beyond the Food Bank campaign, and by several local authority health declaration initiatives around the country. It is also a shame that there is no link to the much better efforts by NHS England – the current (but sadly temporary) CQUIN standard that provides substantial financial incentives for improving hospital food in vending machines and retail outlets on hospital premises (where outlets such as Burger King, Costa Coffee and WH Smith proliferate). Such incentivised measures could be made more permanent and given the status of national policy, but sadly no such luck in the government’s obesity plan. Feeble “encouragement” prevails.
Healthy Start vouchers
Government does helpfully state that it is “re-committing to the Healthy Start scheme”. But hang on, was the Healthy Start voucher scheme ever under threat? What an unnecessarily penny-pinching possibility. Vouchers will continue to be available for low-income families to enable them to get free milk, fruit, vegetables and vitamins. This is a thoroughly worthwhile initiative, but notoriously badly promoted. There is no mention of government increasing the value of vouchers, nor of working hard to improve awareness or uptake by low-income families, nor to build on innovations such as the Rose Voucher scheme, piloted by the Alexandra Rose Charities and Food Matters, both members of Sustain, that boosts the value of Healthy Start vouchers, working with local providers such as SureStart Centres and allowing vouchers to be used in familiar neighbourhood food outlets.
Once you get down to reading paragraphs on “new apps” and a “hackathon”, it’s worth pouring yourself a strong coffee, and considering whether you really concur with the government’s stated opinion that: “The actions in this plan will significantly reduce England’s rate of childhood obesity within the next ten years.”
In its closing paragraphs, the government returns to the statement that the childhood obesity plan has been drawn up in light of “economic realities”. It’s hard not to feel that the government implication is that children will simply have to get used to being sick, because that’s the way the economy works. Well, we expect better, particularly from a government and new Prime Minister that came in on a promise to improve everyone's life chances.
Kath Dalmeny is Coordinator of Sustain, which runs the Children's Food Campaign, the Sugary Drinks Levy campaign, also the Children's Health Fund, working in partnership with the Jamie Oliver Foundation
Published Thursday 18 August 2016
Sustain: Sustain The alliance for better food and farming advocates food and agriculture policies and practices that enhance the health and welfare of people and animals, improve the working and living environment, enrich society and culture and promote equity.
