27 July 2020

There’s something missing from the government’s anti-obesity strategy

The levers pulled by the British government are similar to those being eyed by the devolved governments – but what has been left out?

By Stephen Bush

LONDON, ENGLAND - JULY 27: A family member of the photographer is seen as a government-backed NHS advert plays on a television screen on July 27, 2020 in London, England. The advert aims to promote healthy eating and promote exercise, and is part of a new campaign to improve the health of the nation and tackle obesity. Government figures have shown just under 8% of critically ill patients in intensive care units with COVID-19 have been morbidly obese, compared with just under 3% of the general population. (Photo by Leon Neal/Getty Images)

The government has today published its anti-obesity strategy, which aims to address the public health crisis caused by the fact that 28 per cent of adults and 20 per cent of all Year 6 pupils in England are obese.

This complements the two anti-obesity strategies being advanced by the devolved parliaments: Healthy Weight, Healthy Wales, and the Scottish government’s A Healthier Future.

In some cases, the new UK-wide policy makes significant advances. The two biggest measures are the restriction of advertising for sugary snacks and fast food to after the watershed, and the banning of some promotional offers. The anti-obesity strategies of the devolved governments have been limited, because this is a reserved matter, to “working with partners” to achieve such results (asking central government and/or businesses if they wouldn’t mind complying). And both the Welsh and Scottish government suggested restrictions or outright bans on “buy one get one free” deals, and the removal of prominent displays of sugary sweets and other products targeted at children at supermarket tills, in their own policy papers.

Covid-19 has allowed the British government to steal a march on both devolved administrations in actually implementing these proposals. The Welsh government’s consultation on such measures, planned for the summer of 2020, has, of course, been delayed by coronavirus, while the Scottish government’s Restricting Food Promotions Bill will no longer be brought forward this side of the next set of Scottish elections in 2021.

Boris Johnson is benefiting here from the large amount of research on this subject done both by the Scottish and Welsh governments, and by the government of Theresa May. That’s why there is a broad commonality of approach.

But comparing the conclusions drawn by the three governments also allows us to say what’s missing from today’s announcement.

There are two interesting omissions in the British government’s anti-obesity strategy: transport and agri-food. The British government has a very good package of pro-cycling measures, reflecting the commitment Johnson and his long-term adviser on transport issues, Andrew Gilligan, have to expanding cycling. But because Johnson is a relatively recent convert to the idea that the government should be fighting obesity at all, these two issues have been treated separately. Healthy Weight, Healthy Wales treats these issues as linked, with targets on new transport projects and anti-obesity measures both included in the Welsh government’s strategy.

Does that matter? In most countries, I’d say yes. The cost of giving everyone in the England a money-off voucher to buy a bicycle and widening cycle lanes is almost certainly lower than the cost to the National Health Service of a population in which a quarter of people suffer the debilitating effects of obesity. But the centrality of the NHS to British life, its importance to voters, and the habit of the Conservative Party since 2010 to use its generosity to the NHS as a rhetorical and political shield against attacks on its reputation and cuts elsewhere mean that these savings will always remain theoretical.

The political debate around health spending in Wales is in a better position. This meant that when the Welsh government faced reductions in its grant from Westminster at the start of the last decade, it was able to cut NHS spending and protect other public health priorities outside the NHS from cuts. Although this has impacted NHS performance, it has in my view been better for overall health outcomes. It’s good that the Welsh government sees “health” as a more complicated policy issue than simply allocating more funding to the core NHS. However, I think it is highly unlikely that the political incentives and bad actors in English politics that prevent this from happening in England will be displaced anytime soon.

Scotland’s Healthier Future, in contrast, doesn’t have much on transport, which is a shame. Like the government in England, the Scottish government does have a set of ambitious and impressive policies on increasing walking and cycling. My concern here is that, in the event of future financial pressure on the Scottish government, having these transport measures sit outside the government’s health strategy means they will lose out.

But Healthier Future, like Healthy Weight, Healthy Wales, does cover in detail a topic on which the British government’s anti-obesity strategy is silent: agriculture and the business of making British food.

The Scottish government wants the country to become a “Good Food Nation” – a place where people care a great deal more about what goes into their food, and in which working in food production, from field to supermarket, is more rewarding, and food is of a higher quality.

This is useful because it means that as well as the punitive levers they and the British government are pulling, the Scottish government has a clear idea what it wants Scotland’s food producers to move towards.

Whether it involves linked transport policies or plans for the eventual shape of fishing and farming in the United Kingdom, then, this is what’s missing from the British government’s anti-obesity strategy: a wider view.