The biggest changes come from incremental steps not silver bullets

In the same week that the new mayor of London began the task of watering down his electoral promises the Government published its long-awaited “Plan for Action” for childhood obesity. The anti-obesity lobby attacked it because it lacked some of their favourite state interventions.

David Cameron’s biggest flaw as a politician was to promise actions for which he had either little knowledge as to their impact or little inclination to worry about these future problems. Even before he became Conservative Leader he showed this tendency when he promised the Eurosceptics that the Conservatives would pull out of the European People’s Party (EPP) grouping in the European Parliament. This was at a time when his party was exerting great influence in Brussels, through the EPP, when it had none in Westminster.  Of course the European Referendum was another electoral promise, with unknown consequences. On a smaller scale so was the promise of a high-profile action plan for childhood obesity.

The childhood obesity silver bullets that so many campaigners have been calling for would simply create new hostages to political fortune. At least the sugar levy will raise some money as a hypothecated tax, even with no direct effect on obesity rates.

The same cannot be said of the “junk food” advertising restrictions called for by obesity experts. A few years hence, once this has been shown to have no effect on obesity rates, what next straw does the regulator grasp for? It would certainly need to include greater regulation of social media.  Every time that the state takes action in this way it is also taking responsibility. It reinforces the message that obesity is the result of commercial practice by the food industry, with little to do with individual behaviour. In short, it is someone else’s fault, and the Government can fix it.

During my Department of Health days we were rolling out the first ever concerted public health strategy, the Health of the Nation strategy, comprising “key areas”, each of them replete with firm targets. We faced a powerful lobby by the National Asthma Campaign for a new key area to be created, to tackle the rising incidence of asthma. The Campaign had a very strong case, and it was very well made. But some of the existing key areas were already proving problematic in practice, particularly in mental health. Government simply lacked the appropriate knowledge at the time and the necessary policy levers over human behaviour to hit some of the targets.  Adding another key area on air quality and asthma could exacerbate this problem, raising excessive expectations of what the Government could achieve. There would be huge costs involved, but no clear indication of effectiveness. We had to say no. At the time I worked closely with the National Asthma Campaign to build another way forward that would make a real difference, amidst the disappointment around the rejection of their case. We needed to work on the cause rather than thesymptoms. The same is true of the new obesity strategy. It may not offer silver bullets, but it does indicate a determination to tackle the human problem behind the headlines.

Prime time advertising of “junk foods” is also just symptom of the lifestyles of today’s households. The Government has already gone a long way towards heaping blame on the food industry, and is right to be cautious about going much further in this direction. It is human nature to want to find an external reason for our problems, but it is damaging for politicians to manipulate this natural bias for short term popularity.

On the other hand it is right for politicians to step in when there are measures that it can take that will make a difference when confronted with complex, strategic challenges: The Climate Change Act is the most obvious example. It imposed a step-change in the regulatory burden on the energy sector that was probably unprecedented in the sixty years since the Clean Air Act of 1956, and willingly imposed new costs on all energy users. But the Act followed decades of incremental measures, responding to the evidence base as it developed, and to new capabilities in energy production. The Childhood Obesity Plan of Action signals that a similar, rational approach will now be taken in tackling the obesity epidemic. Most of the time the biggest changes come about in incremental steps.

First published on the British Politics and Policy blog.

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2 Comments

  1. Eleanor Lines says:

    I think I’ve read this carefully but don’t understand why clean air should not be seen as critically important to asthma sufferers – surely it is a root cause, so why talk about it as a ‘silver bullet’?
    Similarly, the food industry has far too much leeway in producing ‘food’ that is not nourishing the population, but rather kidding us into believing that high fat and high sugar content plus additional chemical sweeteners etc are not at the root cause of how we eat and how we perceive food? I would like to believe that the government is strong enough and keen enough to encourage healthy diets, but it doesn’t seem that way. The food industry is enjoying profits while making us sick.
    That can’t be right and must surely be a root cause of obesity – and worth changing?
    Eleanor Lines

  2. Tony Jewell says:

    I agree that this is a rather defensive pro food industry view. If we learn anything from the Tobacco control process (over the past 55 yrs) you do need a multifaceted approach and yes it can be incremental. However you do have to regulate the industry whose fundamental interest is always to sell products and profit from those sales. The public health objective is rather different – to protect people and promote health.

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