Lord Bethell was Minister for Innovation at the DHSC during the pandemic.
My most harrowing memories as a health minister during the pandemic, sitting in the daily early-morning session with the Covid response team, were the gruelling frontline updates by NHS colleagues from the Covid wards.
As each wave hit the country, it was a white-knuckle experience as hospital ICU units numbers edged upwards towards their capacity, and we tried to avoid a total collapse of the healthcare system.
One wanted to cry. Why were so many Brits ending up in the ICU units? The answer was often the same. It was those with existing conditions like obesity, heart disease and diabetes who were hardest hit by the virus.
And it was the hospitals with populations with the worst existing health, the worst housing, the highest levels of smoking, obesity, and poverty that were straining the most.
For me, that has led to a commitment to levelling up the massive health inequalities across the country. That means addressing access to healthcare, better housing, tackling deprivation and a number of social and environmental causes of poor health. The commitment to “five more years” of healthy life in the Government’s recent Levelling Up white paper is an encouraging start.
But we should not duck from the fact that it was obesity that was the greatest avoidable risk factor.
Countless reports detail how obesity causes impaired immunity, chronic inflammation, and blood that’s prone to clot. This weakens the body’s response to any disease but particularly something as nasty as Covid.
There’s also a physical aspect: fat in the abdomen pushes up on the diaphragm, causing that large muscle, which lies below the chest cavity, to impinge on the lungs and restrict airflow. This was a constant problem in our ICUs where intubating obese people was particularly tough for the exhausted NHS teams.
The Prime Minister had personal experience during his nearly fatal three-day hospital battle with Covid. As he said in a video to promote the new obesity strategy, “… when I went into ICU when I was really ill… I was way overweight. I’m only about 5ft 10 at the outside and I was too fat.”
He has become our greatest evangelist for a fitter, slimmer nation.
“Losing weight is hard but with some small changes we can all feel fitter and healthier,” he tweeted with characteristic candour at the end of July. “If we all do our bit, we can reduce our health risks and protect ourselves against coronavirus – as well as taking pressure off the NHS.”
The same is true for the whole country. We are overweight and obese as a nation, and that caused too many loved ones to suffer or die from this terrible virus.
So, as we emerge from the pandemic and look with hope and optimism, we mustn’t forget what we learned about public health in those darkest moments. We must now redesign our food system with urgency, for the sake of our own health, our children’s health and for the resilience of the NHS in the future.
Fundamental to transforming public health will be taking seriously the targets we set ourselves to halve childhood obesity by 2030. We should be making it as easy as possible for our young people to live healthy lifestyles.
When it comes to food, choosing the healthy option should always be the easy option. But right now, this just isn’t the case. Unhealthy food dominates young people’s lives – on the streets, in schools and on their screens.
I heard from some young people at Bite Back 2030 recently, who told me junk food advertising was “overwhelming”, “like the wild west”, and that they feel “absolutely bombarded” by unhealthy options.
With this disturbing reality, it is no surprise that two in five children now leave primary school above a healthy weight, and that childhood obesity is increasing at the fastest rate on record. Children with obesity are five times more likely to become adults with obesity, and this has huge implications for public health and the cost to our NHS.
Obesity related diseases are costing the NHS in excess of £6bn per year and are calculated to impact wider society to the tune of £27bn per year. We have seen the devastating impact that excess weight has already had, and the situation is only getting worse.
I was immensely proud to see Boris Johnson recognise the challenges we face to reset the nation’s health when he announced world-leading and visionary measures in the Obesity Strategy in 2020.
He could see that the only way we were going to break the cycle of overweight and obesity was to take definitive action to change the way our food system operates. The relentless flood of unhealthy food and drink products pushed on our children in stores and on their screens had to stop.
In October this year, new restrictions on predatory “promotions” will come into force in shops and we hope by January 2023, the TV and online advertising restrictions will also be implemented once the Health & Care Bill clears parliament.
But yet still, a minority of loud voices, some from within our party, and many backed by the advertising industry, are trying to derail these vital policies, on the grounds that no other country has implemented policies like these before.
Yet this is exactly what is needed with our obesity crisis, as Lord Simon Stevens argued so elegantly in his contribution to the most recent Health & Care Bill Debate, when he said that “we are a world leader in childhood obesity. It therefore falls to us to take world-leading action to respond to that.”
The exciting news is that now we are beginning to see these world-leading interventions on obesity are working where they have been tried at a local level.
Last week, an independent report from the London School of Hygiene and Tropical Medicine found that the policy restricting the advertisement of unhealthy products on the Transport for London network has led to a significant decrease in the average amount of calories purchased by households every week from these products.
Far from leaving empty billboards and dwindling revenues for TfL, businesses quickly adapted to promote their healthier products, and TfL’s ad revenues increased during the first year of the policy.
The Government must take renewed confidence from these findings. It must hold its nerve. In the Prime Minister’s obesity strategy, we have evidence-based policies that will have an impact, that are overwhelmingly supported by the public and that can be implemented effectively.
We cannot miss this opportunity – for the health of our children, and to protect the NHS.