Select Committee on Health Minutes of Evidence

Examination of witnesses (Questions 581 - 599)




  581. Colleagues, can I welcome you to this morning's meeting of the Committee, and particularly welcome our witnesses. Can I begin by thanking you all for your willingness to come along this morning, and in particular for your very helpful written evidence, which is a useful basis for our discussions today. Could I begin by asking you each to introduce yourselves briefly to the Committee; Professor Biddle, would you like to start?
  (Professor Biddle) Yes; good morning. I am Stuart Biddle, from Loughborough University, where I am Professor of Exercise and Sport Psychology, and associated with the British Heart Foundation National Centre for Physical Activity and Health.
  (Mr Almond) I am Len Almond, at Loughborough University, and I am Director of the British Heart Foundation National Centre for Physical Activity and Health.
  (Mr Laventure) I am Bob Laventure and I am an associate consultant to the British Heart Foundation National Centre at Loughborough University.
  (Mr Worthington) I am Andy Worthington. I am representing Sport England. I am a member of Sport England, but my main job is Director of Leisure Services and Tourism in the Metropolitan Borough of Wirral.

  582. Thank you. Can I begin with a broad, general question. I have a wider concern that in Britain we tend to separate our policy issues into segments and often do not think in a holistic way, and I see this very much in relation to the links between sporting activity and health. Would you agree that we have not made these links, and, if you do agree, why is that the situation, and what do we do about trying to address the problem?
  (Mr Almond) That is a very important question. It is only over the last few years that research evidence has now come to light that demonstrates quite clearly that physical activity has an important role to play in health; until then the evidence was very unclear, but now the evidence is extremely strong. I think that is why physical activity has not had a very high profile, and it is very important that the National Centre enables us to demonstrate that exercise has a very significant role to play in the health agenda. I think it is important for a number of reasons. In terms of coronary heart disease, diabetes, bowel cancer, osteoporosis and mental health, there is a very important role that we can play. For example, the British Heart Foundation, and I am happy to provide the evidence on this, have shown quite clearly that, in terms of the attributable risk, in terms of heart disease, inactivity represents 37 per cent of attributable risk, which is twice as much as smoking, which is only 19 per cent, and yet we put smoking very high on the agenda. And if you ask GPs they will say, "Smoking, that's the most important," yet the British Heart Foundation have demonstrated quite clearly that we are talking about, in terms of population and prevalence, 37 per cent, that is quite significant. I think it is only recently that evidence has been made available. What we have got to do is publicise and demonstrate the significance of these findings and then demonstrate how we can go about making the change from inactivity to active behaviour.

  583. Right. Mr Worthington?
  (Mr Worthington) I think, at a local level, there has been increasingly a tendency to join things together, particularly in the joint working between health authorities and local authorities, I do not think the practice is perhaps as good around the country as it is in some particular parts of the country; but I think clearly that is the future direction, bringing together the two sides at the local level. And I think, ultimately, there will be a greater drive to do that, as we go forward with community strategies and local strategic partnerships; if not, I think we are going to end up with a plethora of initiatives which are not actually interlinked and related. I think Sport England has done a lot in trying to promote, for example, the whole process of `exercise on prescription' schemes, which tends to be a joint initiative between the local authority's leisure department and the health authority through the PCGs and the GP practices.

  584. If I can press you further on the kind of practical aspects of this. I take a fairly close interest in sport, in my own area. I have seen, in my area and elsewhere, no relationship whatsoever between organised sporting activity and formal structures of health. For example, I have certainly pushed two Rugby League clubs in my area to look seriously at the Healthy Living Centre concept, but there does not appear to me to be any real connection, policy-wise, between what the Culture, Media and Sport Ministry are doing and what the Department of Health are doing, in making meaningful connections of that kind at local level. Is it that I am looking at an area that perhaps we are not as far forward in, in respect of this, as some other areas, and are you saying that there are some concrete examples of where these connections are being made? If that is the case, why is it that this example is not spreading throughout the UK?
  (Mr Worthington) I think the answer to your question, basically, is yes; perhaps your authority has not gone quite as far along this line as others have. Places like Harrogate, I know in my own authority, Wirral, we have done an awful lot in this area, but many authorities have moved in this direction. I think the message has not been evangelised to the point whereby it is universal. But, again, Sport England joined together with the Health Development Agency in promoting the conference just before Christmas, when there were a number of examples of good practice. I think it needs more of that kind of activity around the country to make sure the gospel is spread.

  585. Do you think the connections are there at central government level, in an effective way? Obviously, one of the issues that we will be raising with the Minister is about the location of her own role, just as we are raising the location of the Public Health Minister's role, whether it is appropriate to be within Health. Do you feel that the responsible Departments are connecting in a way that is meaningful at grass-roots level, we are seeing some movement in linking up sport with Health, in a way we have not done, up to Press?
  (Mr Worthington) I think, in the past, I would probably have to say, no, I do not think there have been good links.

  586. What do you see; do you see some positives? What are those positives?
  (Mr Worthington) One of the things that will emerge from the Government's new Sport Strategy is a recommendation, for example, that they should perhaps take on board another adviser, in the way they have done to link the DCMS with the DfEE, in education, a similar post, actually to link together sport and the DCMS with the Department of Health. So that is a recommendation I think that will emerge from the Strategy. So clearly there is a drive in that direction, and I think that is a move to the good; but, hitherto, I think there have been disparate approaches. I am conscious of the fact that, even within my own authority, and working with the health authority, PCGs and GPs and consultants are not as concerned about prevention as they are about cure; there is a vested interest, in some respects, perhaps, within that side of the equation, to continue with the curative side rather than investing in prevention. And I think what we are about is prevention.

  587. The emphasis of Government policies is very much in relation to primary care. Do you see that that emphasis might enable stronger and more important links locally with sports functioning and facilities than we have had up to Press?
  (Mr Worthington) Indeed. If I could give one example, and it is from my own authority. We have actually got all the health promotion in our authority, a metropolitan borough of 330,000 people, is actually done on a joint basis, it is jointly commissioned and it is jointly purchased. The unit that actually undertakes it is currently based in a Trust, but under the new NHS restructuring arrangements, the indications are and the proposal is that the unit should actually come back within the local authority, into the leisure department, but still managed jointly by a group which represents all the interests, the PCGs, the health authority and the local authority. That is just one example, but it is an example that I think will be mirrored perhaps round the country, in time to come.

Dr Stoate

  588. Mr Worthington, if I can start off with you. Sport embraces a very wide range of disciplines; my own fetish, for example, is marathon running, which is practically at the extreme end of physical activity, but then it goes right down to snooker. Can you tell us how you would define sport, in relation to physical activity, and what you perceive the benefit of that to be? Can you give us some broad idea of which sports you think are the most appropriate?
  (Mr Worthington) I think Sport England recognises probably over 60 sports, and as you say it is a great range. I think the benefit of sport is clearly, in the main, in those which have an active element to them, a physical benefit, but the tremendous mental benefits as well from perhaps even chess and darts. And so I think it would be difficult to home in and say that one was more important than another, although, clearly, from my perspective, if you are a marathon runner, I am a fell runner and a marathon runner too, so I tend to err towards the end of the spectrum that you would. But I think that it would be quite interesting to hear my colleagues' views on the question about the amount of exercise that produces a physical and a physiological benefit, and I think that that would be an interesting view to have.

  589. I do agree. I will come on to that in a minute. But, just to go back, you said that GPs perhaps are more interested in cure than in prevention. As a GP myself, I spend a lot of time trying to encourage people to take up sport, but they do say to me, "Well, what sport is the most appropriate?". Now I am very pleased that you mentioned the effect on mental health, and in fact the effect on psychological well-being and social well-being, from things such as even chess; but, as we are talking at the moment about public health, could you explain what GPs should be doing, and how is it they can actually encourage people to take up more physical activity?
  (Mr Worthington) It is not just GPs, is it, as well it is the health authorities; an authority with an expenditure on health of about £300 million often will have a health promotional budget of perhaps £200,000 or £300,000. So it is not just GPs, it is across the whole health authority spectrum. But I think GPs can get involved in the exercise on prescription schemes, I think it is a very fruitful way of encouraging involvement. I think there are ways in which they can actually promote physical activity by evangelising the subject within their own surgeries. But I think, in essence, it is about getting on board and working together with partners in the local authority, utilising the facilities there and encouraging people to take advantage of them.

  590. To move on to the British Heart Foundation, how do you see the physical side of sport, because, clearly, from your point of view, I would imagine you are going to promote the more active sports; perhaps you can give us some thoughts on that?
  (Mr Almond) I think, first and foremost, sport is a contributor to health, it is one aspect of physical activity, and I am sure my colleague, Stuart Biddle, will be able to reinforce this in a moment. As far as I am concerned, sport is one feature that we ought to promote, including a great deal of other things, particularly walking. Walking is the most realistic and feasible way of increasing the number of people who are active. So I would want primary care teams and GPs to recognise the value of physical activity for health. If I may interject here and say that the Health Education Authority did a survey of GPs, and only 11 per cent of GPs could actually recognise what the public health message was for physical activity. When I say that leisure centre staff couldn't recall the message, then it is quite significant that we have a long way to go in convincing primary care that exercise should be increased, in terms of priority. I think that the role of the British Heart Foundation National Centre, through the new Tool-Kit we are producing, will raise that profile, but, at the same time, demonstrate how we can reduce the burden on primary care and introduce practical and realistic ways of promoting more physical activity for more people. Professor Biddle may want to add a word to that.
  (Professor Biddle) Yes, certainly. I think, if I could just say, given my background in psychology, we need to see physical activity as a behaviour that people choose or do not choose to do; one aspect of which is sport, and that could be done at various levels, and levels of seriousness. One could be more structured exercise, which is not sport, because it is not competitive or rule-bound, or whatever, and one could be much more what we call active living, which is really walking to work or climbing the stairs, whatever, and you generate the necessary amount of physical activity that is beneficial for health through day-to-day activities that really you would not call exercise or sport. And I find that a helpful way of packaging this whole thing. So to go back to your question about how much is enough, current recommendations are that you should accumulate about 30 minutes a day, on most days of the week, so five days of the week, 30 minutes, of so-called moderate physical activity, and that can be done in any one of those forms; so you could walk 15 minutes to work and walk back again, or you could choose to play a sport which has the same amount of activity. That is the way we tend to package it.

  591. Are you saying then that that type of exercise would be a reasonable target for everybody, or is that the optimum target? What I am trying to get at is, is that a realistic optimum?
  (Professor Biddle) That is a public health target, in the sense that public health is about maximising the health benefits across the population, rather than affecting one or two individuals, and to maximise public health benefits I think we need to find amounts and types of physical activity that people are likely to do, so it is not necessarily going to be very vigorous. I admire you for your marathon running, but, regrettably, not that many people will finish marathons, in the big scheme of things. And so this five times 30 minutes is both physiologically and, if you like, behaviourally, I think, a very good target for optimising public health.

  592. If that is the case, how wide then is that message? It is like the sort of eat five bits of fruit and veg. a day. How widely is that message known, particularly amongst teachers, the medical profession and the public?
  (Professor Biddle) I do not know whether Bob Laventure might like to come in on that, having had some feel; but if not, Bob, I can take it.
  (Mr Laventure) I think, in terms of public awareness, there are two or three things, one is public awareness of the half an hour a day moderate activity message, and also professional awareness, which has already been referred to. The Health Education Authority's former campaign `Active for Life' was set up to disseminate that work, and there is three or four years' research, which we can make available to the Committee, which evidenced the level and the increasing level of awareness of that moderate message as a public health message. In respect to teachers, and more particularly young people in schools, there is also an additional message, because the research evidence around young people's activity levels gives obviously great cause for concern, is of national importance. The evidence in relation to young people suggests to us that most young people are fulfilling the half an hour a day moderate activity message, and yet we can still see increasing levels of weight and obesity, and so forth. So the recommendation that the Department of Health and Government have accepted in relation to young people is an hour a day of physical activity, for young people in school. So there is a distinction there.

  593. How many schools therefore are achieving it, because your report makes very sobering reading, and clearly the message is not getting across somewhere?
  (Professor Biddle) One thing we ought to recognise is, if we go back historically, on messages, on physical activity, and how much is enough, this has been bandied about for many years. The old message was three times a week, vigorous, for 20 minutes, get the heart rate up, aerobics, sweating, etc., and that is still beneficial, absolutely beneficial, physiologists would agree 100 per cent on that, but, from a public health point of view, it was only tapping about 10 to 15 per cent of the population. Fortunately, the evidence is now, and it is much newer evidence, that these five times 30 of more moderate activity is very beneficial, and, as such, I think that is a much more optimistic message, for me. Now, of course, it is relatively new, and so we are still in the process, I think, of getting this message through, and it is fair to say it still is not through to everybody.

  Dr Stoate: No. My point is though that if the target now is one hour of active exercise for kids each day, and your report is really very worrying indeed about what is happening to our kids, then clearly that message is not getting across, because clearly they are not achieving that level, because we are seeing a very large increase in obesity, a very large increase in kids stuck in front of the television for several hours a day, and most adolescents getting nowhere near the targets that we should be achieving. So what is going wrong?


  594. Can I just broaden this out a bit, to look at how this balances with the wider pressures on schools, in terms of academic achievement, because this is, to me, a fundamentally important area. Can I just quote from evidence that we have had submitted to the Committee. The Yorkshire Post, a newspaper in my area, has done a major campaign, which Mr Worthington may be familiar with, called `A Sporting Chance', where they did a survey of some 400 Yorkshire teachers on the issue of involvement in PE in schools, and it said some 55 per cent were either pessimistic or very pessimistic about the future of their subject, i.e. PE, 88 per cent said pressure on curriculum time, because of the emphasis on maths and English, was a major factor in the subject's decline, and 76 per cent said the current time allowed was not enough to give children a proper grounding in sport and PE. And, from your point of view, Mr Worthington, 39 per cent had not heard of the Government's Sport Strategy, 41 per cent of those who had heard about it thought it would have only a minor impact. And what they are saying is, clearly, there is a huge problem in schools, and, following on from Howard's point, how do we get a grip on it, because, clearly, at the moment, and your report indicates this, things are getting worse and worse, and we are going to store up a major health problem in years to come unless we address it seriously?
  (Professor Biddle) If I can make a quick comment on that, and then I will pass to Len Almond, who has got vast experience of the relationship there with schools. I think one point we ought to recognise is that there are many factors affecting the behaviours that we choose to take part in, and whether a message gets through or not can sometimes not necessarily be related to whether that behaviour is enacted. And, to put it very succinctly, physical activity will be influenced by a whole range of different environments, one that starts in our own head, as to what we like and dislike, through to physical environments of convenience, attractiveness, and so on. So I would just like to preface those remarks, because we study the determinants of physical activity, why people do or do not, and it is an incredibly complex area, and physical education is one part of that bigger jigsaw. Now maybe Len might like to add to that.
  (Mr Almond) Before I do that, can I just refer back to one point. Only 27 per cent of the general public recognise the five times 30 minutes a week message, and, as I said earlier, 11 per cent of GPs, so we have a long way to go yet of getting over this message. If I refer back to schools, I think the important thing is that the British Heart Foundation and the National Centre would welcome the news, last Friday, that the Government is supporting two hours of physical education in every school in the country as soon as possible. I think that is admirable and we would welcome that. The problem is, if you look at 1999, only 21 per cent of primary schools were actually able to achieve this target; so there is a long way to go in terms of promoting that, and we must help the Government by making very concrete suggestions about what could be done. As far as we are concerned, we need to promote more activity outside of the school, the school can only do so much; that means we must encourage activity in the playgrounds. The playground is an unproductive time at the moment, when there is bullying, anti-social behaviour and a lack of physical activity; what we have got to do is demonstrate to schools that playgrounds can be a productive use of time and can contribute as much as 30 minutes of additional physical activity. But the problem is, most young people do not know what games to play or how to play. Playgrounds are not designed in a way which encourages activity, and, therefore, one of the first steps will be to increase the amount of play in playgrounds. The second thing we ought to do is use the out-of-hours learning, which is really underused as yet, and develop strategies for increasing the number who voluntarily want to take part in sport and physical activity after school; but I think the real increase has got to be in communities. At the present moment, many young people will go out to play, but there is nowhere to play, or, in my case and my daughters', they were refused access to play on grounds which were available to play on, on green space, because people complained, "Children are playing on the grass," and the council stopped them from playing. I think what we have to look at is the whole notion of youth forums, where young people provide their advice, consultation and their thoughts on how we can increase more play spaces, how they can have activity which is more amenable to them, and provide facilities that they actually want; the vast majority of facilities are not what young people want.

  595. Can I just press you on one point. You said that sometimes children do not know what to do; are you telling me that we have got a generation of kids coming up who cannot work out that a round ball if for kicking and an oval ball is for throwing around? I am not quite sure what you mean by that?
  (Mr Almond) No, I do not mean that. I think that is a fair question. If you think of the traditional games and activities you can play in the playground, hop-scotch, skipping, for example, the vast majority of boys cannot skip, for example, it is seen as a girl's activity, and yet this is a most superb activity for promoting aerobic capacity but also improving bone strength, it is probably the best sort of activity, but very few people do it. It is only the British Heart Foundation's campaign that actually tries to raise the level of skipping, hop-scotch, playing with balls against walls. Many schools do not have walls to play against any more, and many areas do not designate new games they can devise themselves. In successful schools they have produced books of playground games, devised by the children and played by the children; some schools have even provided books on what kind of games you can play. But the link must be with the curriculum, so young people are exposed to activities they can play in the playground, but, more important, they can take them home and play at home. What we have got to do is provide individual activities that are amenable in your local environment, your local community, your locality, that are simple, easy and cheap, rather than going for very expensive activities. In this way we will increase the population who are at the present moment sedentary, and I am afraid that there is a vast amount of sedentary behaviour amongst young people that is really causing us problems; we have to address that problem. There is strong evidence to suggest, for example, if you reward the reduction of sedentary behaviour, that is far more powerful and reinforcing that rewarding, increased activity; so there is a lesson to be learned from that idea. What we have got to do is provide them with ideas, both through the curriculum but through using young people as a resource, showing them what they could do, and I think we would definitely improve physical activity levels.
  (Mr Worthington) I would like to look at some of the practical implications of what Len is talking about now, because there have been many reasons as to why physical education and sport in schools have reduced. They have touched on the squeezing of the curriculum, there has been a lack of an involvement within primary school teachers' training programmes in sport and physical education, perhaps the loss of some school playing-fields as well, that has helped to push it along that way, and the couch potato culture, which I think one of your own members has raised in the past, has exacerbated that problem, this is why kids perhaps do not know how to get involved in activity, they are too concerned with computers, or whatever it is at the moment. But, to redress that, and I think we have got to look positively, a number of initiatives are now coming forward from the Government, together with Sport England, which I think will have a massive impact. The whole business of School Sports Co-ordinators, there are 140 in post now, ultimately there will be a thousand in place, and these will be the people, as Len is suggesting, that we have got to encourage and help youngsters to know what to do and how actually to get involved, and to link with sports clubs in the community as well; so there are going to be a thousand of those in schools up and down the country eventually. There is £750 million going to go into the building of sports facilities in secondary schools. That is going to have a massive impact; that is almost as much as actually is given out as part of the National Lottery over three years. So a huge amount just going into schools. The `Space for Sport and the Arts' programme, as well, is another one, in primary schools, which is going to bring in almost £150 million. So I think they are all positive issues which cannot help but skew the priority back towards sport, having had it possibly skewed in the other direction for the last, say, eight, nine or ten years.

Siobhain McDonagh

  596. I just want to look at areas of social inclusion, because a lot of these messages get through to the people who need them less, quickest, do they not? Significant barriers prevent certain groups from participating in sport or exercise, e.g. mothers of pre-school children. What policies could be implemented to help such groups?
  (Mr Worthington) Again, looking at it from Sport England's point of view, the way in which the Lottery grants are being applied at the moment, and in the future, will require certain conditions for applicants to satisfy, that will address many of these issues. There are 5,000 grants going to be dispensed that will actually require an improvement in social inclusion elements, particularly for disabled people; there are going to be 350 capital schemes that are actually put forward that will ask for improvements in ethnic minority participation because of their geographical location. So there are going to be conditions attached to the grants, that will ensure that these social inclusion objectives are being met. Sport England are also going to introduce a new scheme, which is the Active Communities Development Fund, which will concentrate on relatively small grants, to encourage the involvement of people from the socially excluded areas, and divisions of the community. One thing I feel quite passionately about is, we have kind of overcomplicated this, we are looking through all these programmes for agencies, authorities, to bid for grants and special challenge funding, for, it might be, Healthy Living Centres, or it might be some of the programmes that we are offering through Sport England, and yet there are some very simple things. I know within our own authority we have been talking about free use, it was a GP that raised it, he asked at a seminar that we were holding on the issues of coronary heart disease and how we can jointly address it, he asked the question, what would it cost to give free use of all our facilities, because poverty is a real excluder for people, what would it cost to give free use of our facilities. In fact, in an authority like mine, to give free use to everybody would be about £2 million to £3 million, that is the bottom line on our leisure centre spending, but you would not want to give it to the whole community; actually to address all those people who are genuinely socially excluded, it might only require say £500,000. Well, when one thinks we have actually just landed a Healthy Living Centre bid, which is about £300,000 a year for three years, it is easy to see that, with a relatively simple approach, providing the will is there, you could actually genuinely encourage a great deal more use through those kinds of initiatives, instead of maybe overcomplicating it with the major bidding processes that we have got for sexy schemes.
  (Mr Almond) I think the social inclusion agenda is important. Sport England have done a great deal in terms of promoting physical activity for disability; what we have not done is promote activity for disabled people in terms of particular impairments. So there is a great deal of work to be done there. I think that there are barriers within the ethnic communities, maybe cultural, religious barriers, that have stopped a great deal, particularly women, from participating in activity. In Leicester, where we are exploring this in greater detail, there are strategies about to emerge which would help us a great deal. But, if I just go back to the schools for a moment, as a kind of exemplar, we produced `The Active School' for the British Heart Foundation and with Sport England's support. The important thing about it is, that provided people with resources, ideas and a map and compass through the many ways of promoting physical activity in schools; what we have got to do is do the same in communities. So, in other words, local authorities are able to draw on a menu of possibilities, like your example of young women, young married women with families, who feel restricted in terms of the opportunity to take part in physical activity; but we have got to show people ways in which this can happen. That is a major task simply to make that available, but we have to do it, because you cannot expect people to think up new ideas all the time; so we must provide the resource, within communities, and perhaps use the Sport England's notion of active communities, to really generate ideas that are going to work. We are going to see many of these in the next two years. If I can just return to schools, because it is a very important one, in schools there is a problem. Over the last three years, there are something like 27 new initiatives emerging that people have got to take into account. What we have not done is provide the tools to help people through those initiatives and demonstrate how they could be effective and appropriate in their school; we have to do that for schools, we must also do it for communities, so we can give them the tools to solve problems in their own community, and I think that is possible.

  597. Thank you. The next question is first to yourself and then to the British Heart Foundation. Your agenda is three-fold; more people participating in sport or exercise, more places where it can take place, and more medals. To what extent is there a tension between the first two of these objectives and the third, and how do you encourage people to become involved in all physical activity, rather than just recognised sports? Because, just from a very personal point of view, it strikes me that the less PE you have, formal PE you have in school, the more you might make people participate, but actually it is PE that puts people off. That is a woman's perspective on it.
  (Mr Worthington) If I could address the first part of your question. If one takes the conventional way in which we look at sports development, we talk about a pyramid; the pyramid has to have a very broad base, the more people you can actually involve in sports activity then, inevitably, the higher up the performance spectrum you will be able to take people, so that at the top of the pyramid you should be able to produce more champions if you have actually got far more people involved in the base. So I do not think there is a major tension, because, if you look at the resources that Sport England applies across the board, the greater proportion of its resources are actually applied at the base of that pyramid, through local authorities, through its community programmes, and so on, and a relatively smaller proportion is applied to the top end. So I think the balance is about right. I think the other thing, of course, is that you do have to look at the whole process, because the impact of a Steven Redgrave or a Tanni Grey-Thompson, the impact in terms of the Pied Piper effect, of encouraging others to take part, and there are many, many examples down the years of where people like Torvill and Dean, when they had their success, generated a great deal of interest in ice-skating, and so on, so I think it is important the two are linked. Your other question, which is about how we actually get the message over, I think, is very true. My own belief is that sport should be the corner-stone within promotion in a local authority, for example, of a holistic approach, because there are different avenues through which people are attracted into activity. If somebody wants actually to get themselves fit because they want to lose weight and wear better clothes, that is a great reason for getting involved in activity; but it is perhaps not appropriate to sell the message of sport, per se, to that individual, you might have to sell the message based around health and perhaps about their diet and their nutrition. So I would prefer to see programmes which are genuinely holistic and cover sport, diet, nutrition, stress management, and a vast range of other issues, of which sport is a corner-stone and sport is part of it, so that there are many different ways people can approach and get into activity.


  598. Could I press you further on this difficulty between the `excellence' emphasis and participation, because, as somebody who has been interested in sport all my life, I genuinely worry that the emphasis on excellence and achievement and the best is leading to a situation where a lot of people who would have gained a great deal in terms of their own personal health through sport are, to some extent, losing out and being put off. I think the best example in recent years has been what has happened in Rugby Union, where, since Union officially went professional, in 1995, you have seen, certainly in areas like mine, a huge decline, probably about a 25 per cent decline in the number of people participating in the lower levels of involvement in that sport. Now I think that is bad news from a health perspective, because those third, fourth, fifth teams, who turned out, people who would never make it anywhere, but they were engaged in some meaningful exercise, which was of benefit to their health and to their community. And what I have seen, certainly in my area, where clubs have gone, as I say, officially pro., is that they are down to one or two teams of excellent, top players and the average participant is no longer around, they are no longer engaged in the game, and that to me is a worry from a health point of view?
  (Mr Worthington) I think one would have to be certain of the causal relationship there though between the professionalisation of Rugby Union and the reduction in people playing it. There are so many other factors in the community at the moment, the couch potato culture is one, the fact that people have far more opportunities, a vast range of different activities, and, if we are saying generally there is not as much sport being played in schools, you probably have not got the same players coming through the school system and coming into rugby. So I think we would have to be clear about that. But I think you are right, generally, I think you have got to get the balance right in the way you actually promote the message. From a local authority point of view, it is quite simple, from my perspective; our job is to provide opportunities for people to participate, at whatever level they want to participate, and to encourage them to come in, on a broad base, and if all they want to do is do it at a very, very recreational, informal level, terrific, fantastic. But we have to give them an opportunity, if they want to join a club and take it more seriously, and if ultimately they want to aspire to get into a regional and international squad, we have to help them, along with partners, the governing bodies and Sport England, and so on, to go in that direction. There is no question that if you can actually get people at the very top of the tree; Chris Boardman is a cyclist in our borough, who has had tremendous success over the years, and for the population that we have cycling is incredibly strong in Wirral purely and simply because of Chris Boardman's involvement, and that has got to be a benefit and a positive and a plus.

John Austin

  599. Can I come in on that and ask whether you feel that the professional end of sport is, therefore, doing enough, and what can it do more to put stuff into the community and into schools, into youth organisations, etc., and to what extent have you supported initiatives of that kind?
  (Mr Worthington) I think, again, it is like a lot of these things; hitherto, I do not think it has been particularly strong, but, again, in recent months and years there has been a tremendous improvement in the involvement of professional sport at the community level. If I can just pick up on football; particularly, in the past, I think, football would have had a pretty poor record at the professional level, but, of course, again, aided by grants that are coming in from the Football Foundation now, but previously Sport England, there has been a massive increase in the establishment of sports academies and centres of excellence, many, many clubs are now involved with community coaching schemes, with women's football, and so on. In my own authority, again, we are very closely involved with Tranmere Rovers, who do an awful lot, of going into schools, helping to sell anti-smoking messages and anti-drugs messages, and so on, and we are not unique, that is happening in many other areas; and I think the more it happens and the more others see it and other sports get involved in it, it will grow.

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