Cllr Chris Whitehouse is Chairman of The Whitehouse Consultancy, and Secretary of the Conservative Group on the Isle of Wight Council.
As many of us return from short summer breaks, we notice the additional midriff folds: too much pasta in Italy, too many tapas in Spain, far too much wine wherever, and way too many fish and chips in Skegness. We are living proof of the truth of the warning that it is all too easy to pile on the pounds and pile on the burdens of the National Health Service as it groans under the weight of obesity, diabetes and their co-morbidities. The public health tsunami that is upon us is now widely recognised and the financial costs to the NHS are now accepted as unsustainable unless radical change is delivered.
Against that background, the recent railings of Simon Stevens of NHS England (an otherwise excellent appointment to the post of Chief Executive) against fast food chains and coffee shops on NHS premises are, frankly, futile and misguided. His criticism of the 700,000 NHS employees who are overweight risks being counterproductive.
His comments are unfortunate because in some cases fast food chains are acknowledged to use good ingredients, to provide valuable consumer information, and to provide a range of salads and fruit alongside their more traditional fare. What is more, on NHS premises they provide choice, a sense of normality, and a welcome release from the sometimes poor quality NHS food options – to say nothing of the commercial income without which many NHS facilities would collapse financially.
What is worse, his remarks miss a chance to drive forward a public health improvement agenda that can be delivered immediately, at almost no cost to the exchequer and with no need for legislation.
In January this year, National Obesity Awareness Week, managed by my agency, The Whitehouse Consultancy, secured extensive publicity in the national print and broadcast media, promoting awareness of the scale of the problem; and it rightly had Ministerial support, was welcomed to 10 Downing Street for a Reception hosted by Samantha Cameron, and saw substantial investment in school activity resources funded by Disney through a major national children’s healthy eating competition.
But the event, to be repeated in January 2015, also highlighted a number of practical steps that can be taken to address this crisis in the face of which we are not impotent. Yes, the Government’s existing “Change 4 Life” programme and its “Responsibility Deal” have made some progress, but more needs to be done.
First, Ministers and health policy influencers should be giving the clear and straightforward public health message that if consumers wish to consume a sweetened beverage they should consider a low calorie version. This is the single, most effective step that could be taken to reduce obesity over the coming years by reducing the consumption of hundreds of millions of calories. It also has the advantage of being consistent with the direction of consumer choice in beverages, a sector in which several of the main brands now find their low calorie version outsell their original sugar-sweetened products.
Secondly, under the current arrangements, general practitioners are financially incentivised to list and count the number of obese patients on their lists, but they have no subsequent financial incentive then to point them in the direction of some means of addressing their problem. Government Ministers should be heeding the campaign run by the expert, practitioner-led National Obesity Forum to reform the Quality and Outcomes Framework, or to find some other means to shift the incentives from listing, to acting, even if that action is only to give dietary advice and issue a list of third sector and commercial providers of weight loss support in the local area.
Thirdly, consistent with the above point about signposting to providers of support, Directors of Public Health all around the country should be encouraged to compile and publish (online if it’s all they can afford) a directory of effective weight loss support organisations in their area which could be promoted through pharmacies, libraries, sports centres, Health Watch, community health facilities and all local authority public contact points.
Fourthly, work with organisations such as freight hauliers, the lifestyle of whose employees tends to life-threatening obesity. Being seriously overweight contributes significantly to sleep apnoea, and the road safety consequences of tired HGV drivers are so obvious, and are sadly so frequently reported, as to hardly merit repeating. That reducing serious road traffic accidents will benefit the industry, the innocent road user and the public purse is beyond challenge to say nothing of the improvements to the quality of life of truckers.
Of course, there are vested commercial, professional and political interests hampering and hindering the taking of all the above steps and many others as well; but it’s time that Ministers stopped talking about obesity and started instead using the public health levers that remain under their control to deliver action and results. And the current campaign for ever more bariatric surgery on the NHS is simply a counsel of despair. It should be the last resort, after all other approaches have failed.
Above all, the obese should not be demonised or stigmatised. The seriously over-weight no more eat because they are hungry than alcoholics drink because they are thirsty.
It will soon be five years since the last general election, during which period the adult obesity rate has stubbornly refused to reduce. We need a narrative for the electorate that describes progress, not just concern, in this vital area of public health.