DEVELOPING
PREVENTIVE
STRATEGIES
LINKING
HIGHER
EDUCATION,
PHYSICAL
ACTIVITY
AND
HEALTHY
EATING
ACROSS
GOVERNMENT
25. The Comptroller and Auditor General found a substantial
amount of cross-departmental work in areas central to addressing
the rising prevalence of obesity - principally education, physical
activity and diet. Much of this activity was targeted at schoolchildren,
and both promoted the adoption of healthy lifestyles in childhood
and subsequently throughout adult life, as well as addressing
a section of the population in which obesity was becoming increasingly
prevalent.[20]
It includes:
- the provision of education on the risks of being
overweight, and the benefits of a healthy diet and physically
active lifestyle;
- the improvement of nutritional standards in schools,
including through initiatives to increase levels of fruit and
vegetables consumed;
- equipping children with important skills such
as cooking and the technical skills to enjoy sport and physical
exercise;
- encouraging school sport, including the provision
of improved facilities; and
- encouraging and providing the means for children
to travel safely to school on foot or by bicycle.[21]
26. The Comptroller and Auditor General recommended
that the Department of Health reinforce existing joint working
by establishing a cross-departmental advisory group to co-ordinate
all research on obesity and measures to prevent it.[22]
27. The witnesses confirmed that a considerable amount
of cross-governmental work was going on in these areas, particularly
in sport. Specific examples included the New Opportunities Fund,
Round 3 for PE, and Sport in Schools. The Departments of Health
and Culture Media and Sport were also planning to appoint a joint
departmental adviser. Those arrangements were intended to ensure
that, whatever machinery of government changes there were and
whatever the boundaries between departments, there was a proper
health element within the overall sporting strategy, with no cracks
between them.[23]
28. Against this background, our predecessors examined
in particular issues surrounding physical activity and diet.
Physical Activity
29. The Comptroller and Auditor General recommended
that the Department of Health should lead the development of a
new cross-Government strategy to promote the health benefits of
physical activity. This initiative should include work to develop
and support alternative approaches for groups where there were
specific barriers to physical activity, such as those imposed
by poverty, culture or fears about personal safety. He also recommended:
- continued encouragement to adopt local targets
for cycling and walking;
- joint work between central government and local
agencies to develop targets to increase the number of school journeys
undertaken by bicycle, on foot or on public transport;
- consideration of targets to increase participation
in sport and physically active leisure activities, building on
the strategic target set by the Department for Culture Media and
Sport to raise significantly, year on year, the average time spent
on sport and physical activity by those aged 5 to 16;
- continued encouragement to schools to achieve
the stated aspiration of at least two hours physical activity
a week for all pupils.[24]
30. The Government has established an inter-ministerial
group specifically on physical activity for children. The Department
of Health told our predecessors that they were waiting for information
from that group before taking a definitive decision on providing
a strategy for all age groups.[25]
31. Every child between the ages of 5 and 16 has
a statutory entitlement to physical education. The Government
had introduced into the curriculum personal, social and health
education. It had also made a commitment that every child would
have an entitlement to two hours of physical exercise a week at
school. There were pressures on curriculum time, and the target
covered time spent both in the curriculum and outside. Over the
past five years, there had been a reduction in physical education
within the curriculum, but an increase in exercise taken outside
it: in 1994, 74 per cent of children had been engaged in after-school
exercise and this had risen to 79 per cent in 1999. At the same
time, participation in lunchtime exercise had also risen by 5
per cent. There was, however, a mixed pattern around the country
in terms of making sure all children had opportunities to take
part in sport after school. For example, there was a wide range
in the number of children able to swim 25 metres at the end of
Key Stage 2, and some of that diversity depended upon where they
were going to school. In particular, some of the poorer neighbourhoods,
because they were under such pressure, were not providing the
same opportunities.[26]
32. The Department for Education and Employment were
therefore working with other departments on how best to meet every
child's entitlement to two hours physical activity a week. There
had been a substantial investment in initiatives like schools
sport co-ordinators, where they were spending £120 million
and expected to have 1000 in place by 2004. They had also invested
in Champions, where well known sports people went to schools
to encourage people to participate and raise the level of participation
up to two hours a week.[27]
33. The Department for Culture, Media and Sport had
deliberately focussed additional money and attention on opportunities
for sport and exercise for young people in schools, not least
because in the school environment they could have most control
over how children spent their time. However, the Government's
sports policy went much wider and dealt with the enhancement of
sporting facilities for use by all ages including Sports Council
and Lottery funding. They were investing, with the Department
for Education and Employment in a very substantial programme of
multi-purpose arts and sports facilities across the country. There
was also a joined-up initiative to increase the amount of time
people spent travelling to school by foot or bicycle, which had
included guidance on school travel entitled A Safer Journey
to School. The Department for Education and Employment said
that in two or three year's time, they hoped to have improved
their performance quite considerably.[28]
34. Our predecessor Committee was concerned that
the sale of school playing fields and pressure on the provision
of recreational facilities by local authorities would hamper the
planned increase in physical exercise in schools. The Department
for Education and Employment had not collected data on the number
of school playing fields, although local authority Asset Management
Plans would in future provide a clearer picture. Nor did they
have data centrally on the disposal of playing fields before 1998,
although they estimated that before 1998 disposals were running
at up to about 40 fields a month. However, Section 77 of the School
Standards and Framework Act 1998 was intended to protect school
playing fields. From October 1998, local authorities or governing
bodies of maintained schools had to obtain the Secretary of State's
consent to disposal or change of use. Since then, 81 applications
to dispose of sports pitches (about three a month) had been approved.[29]
35. The Department for Education and Employment expected
local authorities and schools to recognise the importance of providing
playing fields and opportunities for young people to participate
in sport, and to fill any gaps that existed at local level. All
local authorities had agreed to produce local sports strategies,
and in the Government's Plan for Sport, there were propositions
for each authority to audit the sporting and recreational facilities
in their areas. Through the National Lottery and the New Opportunities
Fund, the Department for Education and Employment and the Department
for Culture, Media and Sport were providing a very substantial
additional investment, which could be used for sports and arts
facilities of all sorts, including playing fields. Since 1995,
£1.2 billion had been spent, coupled with the new Sport in
Schools initiative. In the view of the Department for Culture,
Media and Sport, the provision of sporting activities throughout
the country was undergoing a transformation as a result of these
initiatives, encouraged by and normally in partnership with local
government.[30]
36. In addition, the Department of the Environment,
Transport and the Regions were consulting on draft planning policy
guidance on sport, open space and recreation. This guidance would
set out a new systematic approach for local authorities in establishing
provision and need for open space and recreational facilities.
The starting point was an assessment of need in each area, having
regard to the standards of provision recommended by sports governing
bodies, the National Playing Fields Association and other interest
groups. Local authorities would then set standards of provision
to reflect local circumstances and make provision in their local
development plans, and these would be the primary consideration
in considering planning applications.[31]
37. A key aspect of the Department of the Environment,
Transport and the Regions' work related to strategies for encouraging
walking and cycling across all ages. Within their Local Transport
Plans local authorities had to produce local cycling strategies
and local walking strategies in partnership with other agencies
and bodies like schools, health authorities and so on. There had
been a history of partnership working and the Department had collaborated
in the publication of a document called Making T.H.E Links
to try to emphasise the links between transport, health and
education. Local authorities were required to report on progress
and this would give the Department more information.[32]
38. As regards cycling, the Department of the Environment,
Transport and the Regions told our predecessors they had doubled
the resources in 2001-02 and provided a stable funding framework
for the next five years in the local transport plan settlement.
They had asked local authorities to consider giving cyclists and
pedestrians priority in their road planning, and had given them
powers in the Transport Act to designate home zones and quiet
lanes. They had probably underestimated, however, the amount of
investment needed in cycle paths, in separate cycle lanes on highways
and in traffic calming measures, which were important because
of high fatality rates among cyclists, especially young children.
As a result, they would probably not meet their target of doubling
the level of cycling trips by 2002, which was a key part of the
national cycling strategy.[33]
39. In addition, the Department of the Environment,
Transport and the Regions were working with the charity, Sustrans
(Sustainable Transport), to produce 8,000 miles of cycling paths
by the year 2005. They had also produced guidance on the use of
cycles on trains, including the provision of safe routes to the
stations. In some places Railtrack had established cycle tracks
adjacent to operational railway lines, with secure separation
between cyclists and the railway, and it was open to local authorities
to explore such opportunities with Railtrack.[34]
Diet
40. On issues relating to diet, the Comptroller and
Auditor General recommended:
high priority be given to implementing the initiatives
on nutrition listed in the NHS Plan, working with the food industry,
including manufacturers and caterers, to improve the balance of
diet;
- work to establish ways of monitoring the overall
impact of initiatives to improve the nutritional quality of food
provided in schools;
- strengthened guidance to schools on commercial
sponsorship to ensure that they take full account of the potential
disadvantages of participating in schemes that might run counter
to key messages on healthy eating.[35]
41. He noted in particular that consumption of fruit
and vegetables by young people between the ages of 4 and 18 was
well below World Health Organisation recommendations. In the NHS
Plan, the Department of Health had announced a series of proposals
to improve diet and nutrition by 2004. From April 2001, Regulations
introduced nutritional standards for school lunches for registered
pupils in all schools maintained by local education authorities
in England. The Regulations set out compulsory minimum standards,
including fruit and vegetables. Alongside those standards, the
Department for Education and Employment had introduced a requirement
for schools to provide school lunches where parents wanted them.[36]
42. In addition, the Department of Health had been
piloting a free-fruit-in-schools initiative in over 500 schools.
These pilots were looking at "gate to hand" issues in
33 schools in Leicester, Hackney and Southwark & Lewisham
and "farm to gate" issues in 510 schools across England.
Evaluations of these pilot projects would be available in the
summer and would be disseminated widely. Early results indicated
that the scheme was being extremely well received. Further pilots
would focus on "hand to mouth" issues. There were also
several community initiatives to promote fruit and vegetable eating.
There was a striking difference in the consumption of fruit and
vegetables across the regions. For example, in the North East
region average fruit consumption was 827 grams per person per
week, whilst in the South East it was 1,252 grams. A number of
factors could contribute, such as access to shops, availability
of produce, and price. Pilot projects were looking at the feasibility
of increasing consumption by a number of interventions.[37]
43. A key issue in giving people information and
choice about what they eat is the way food is marketed and labelled.
The Food Standards Agency have a variety of initiatives designed
to promote, on a voluntary basis, more helpful labelling for customers
and to ensure that advertising conveys a proper picture of the
results derived from eating the product. The Agency were seeking
to persuade the food industry of the real market benefits and
public demand for products that were more healthy because they
had less fat and less salt. For example, there was evidence from
Scandinavia that products could be changed from high to low in
saturated fats, whilst retaining their appeal to customers. And
they had been in discussion with the catering industry about the
desirability of offering lighter options.[38]
44. One concern was that much advertising aimed at
children on Saturday mornings appeared to relate to foods high
in fat, in sugar and in salt. Another was that schools were getting
into sponsorship deals, for example with Walker's crisps, which
could run counter to the emphasis on healthy eating. Both the
Agency and the Department for Education and Employment emphasised
that the individual foods were not harmful, and it was not a question
of banning particular foods or advertising. It was the balance
of diet, both in childhood and later, that mattered.[39]
45. The Agency were seeking a voluntary agreement
with the food industry on advertising. The Department were trying
to educate children on the choices available and the implications
of a badly balanced diet for their health. They were also trying
to educate parents at a much earlier stage, through initiatives
such as the Sure Start programme, to understand the importance
of these choices. As regards sponsorship in schools, the Department
believed it was for individual governors and schools to decide
whether or not they were content for particular products to be
sold to their children or content to accept particular forms of
sponsorship.[40]
46. Finally, our predecessors asked about the barriers
to participation in healthy living and healthy lifestyles, including
poverty and personal safety. The Department for Education and
Employment had targeted education initiatives on providing more
resources in disadvantaged areas, including education action zones,
excellence in cities, and the cooking for kids schemes. There
was also a concern that some of the poorer neighbourhoods were
not providing the same opportunities for sport after school. Through
the Sports Council, the Department for Culture, Media and Sport
were monitoring the use of sports facilities by those who in the
past considered themselves shut out or discouraged, including
women's and ethnic minority groups and the poorer members of society.
The Department of the Environment, Transport and the Regions had
asked local authorities to take account of personal safety issues
like good lighting in local walking and cycling strategies.[41]
Conclusions
47. Achievement of children's entitlement to two
hours of physical exercise each week requires an adequate and
equitable distribution of facilities. There is, however, a considerable
disparity in the opportunities for sport currently being offered
to children by different schools. The Department for Education
and Skills should move quickly to ensure that this entitlement
is delivered in schools and to establish arrangements to monitor
and publish progress towards achieving this entitlement in all
schools. Departments should gather and co-ordinate the results
of local authority audits of sporting and recreational activities,
and work with local authorities to address gaps in provision.
48. A number of initiatives have been started to
improve diet and nutrition, including nutritional standards for
school lunches, pilot schemes for free fruit in schools, and community
pilot projects to promote fruit and vegetable eating. In line
with the NHS Plan, Departments should take action to ensure that
the importance of fruit in a balanced diet is promoted in schools
and the Food Standards Agency should work with the food industry
to improve the nutritional content of the food produced and the
way it is marketed, to make it easier for all consumers to choose
a more balanced diet.
49. Commercial sponsorship schemes may serve to promote
the consumption of foods high in fat, sugar and salt. The Department
for Education and Skills should issue guidance for schools to
interpret locally on how to assess offers from sponsors, and how
to evaluate schemes which may for example encourage consumption
of snack foods.
50. The Food Standards Agency has taken a number
of initiatives to promote more helpful labelling of food products.
There is still room for concern, however, about the potentially
harmful effects of advertising products high in sugar, salt and
fat to children. The Agency should work with the food industry
to develop a code of conduct with regard to the amount and nature
of food advertising aimed at children.
51. If national strategies on obesity are to be implemented
effectively, there needs to be an emphasis on partnership working
between local authorities, local health bodies, charities and
the private sector. For example, within their Local Transport
Plans local authorities had to produce local strategies for cycling
and walking in partnership with other agencies and bodies like
schools and health authorities. The Department of Health should
promote such partnerships, assess and report on their progress,
and disseminate emerging good practice.
52. The Department for Transport, Local Government
and the Regions are working with the charity Sustrans to produce
8,000 miles of cycling paths by the year 2005. They have also
issued guidance on the use of cycles on trains, including the
provision of safe routes to stations. Noting that in some places
Railtrack have established cycle tracks adjacent to operational
railway lines, we expect the Department for Transport, Local Government
and the Regions to encourage local authorities to explore opportunities
to expand these arrangements.
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