Select Committee on Health Minutes of Evidence


Examination of Witnesses (Questions 380-399)

18 SEPTEMBER 2003

MR LEN ALMOND, MS JEANETTE LONGFIELD, MR PAUL OSBORNE, MS KATH DALMENY AND MR PAUL LINCOLN

  Q380  Dr Taylor: You have mentioned that in your evidence, the free exercise books.

  Ms Dalmeny: Would you like to see some examples? Sometimes it is difficult to imagine what this actually means. A lot of parents will write in and say, "While we talk in the home about some of these things being not so appropriate, these are exercise books that are given out in schools, they have branding for highly sugary, fizzy drinks." Here is an example of such a fizzy drink. This shows Robbie Williams, who is one of the most popular pop stars for young children, promoting Pepsi. This is a standard size bottle of Pepsi. That has 10/11 teaspoons of sugar in it—which is something like 150/180 calories. The kinds of changes in weight in children and in the general population can be attributed to an energy imbalance of round about 100/150 calories a day. If that is what is in a single drink like that, and that is maybe in the vending machine in schools, it is being promoted through sponsored exercise books . . . Some of the breakfast clubs have sponsored foods that are given out, because the school needs to find funding for the breakfast club, so particular manufacturers will sponsor them. I have seen Burger King sponsoring some of the breakfast clubs. While it might not mean that there will Burger King foods being supplied necessarily to the schools, the fact that branded goods—which may be high in fat, high in sugar, high in calories—are associated with those healthy eating schemes and associated with the endorsement of the school is problematic, I think, because it gives the message to children that these are good options to choose, that they are a regular part of their lives. And I have seen marketing materials that explicitly say that these products have the implicit endorsement of the school staff—and of course the children put the trust in the school staff in that respect.

  Q381  Dr Taylor: You also mention free gifts, including fatty and sugary snack products.

  Ms Dalmeny: There is a company called Jazzy Media who runs the scheme with the sponsored exercise books. They also run a scheme called Jazzy Lunchbox, which is giving out free samples to kids in schools as young as four years old. The marketing materials for that again say that that will come with the implicit endorsement of the canteen staff. As a marketing company if you wanted to go into a school and work with children as a focus group, you would have to spend thousands and get parental consent. However, if you go into the school and the school gives consent, then of course you have children in the captive state of being in the canteen, you have children being in an open mode to learn, with people that they trust (in terms of the canteen staff and the teachers), being handed products to discuss, so that it becomes a cultural thing between them about what is good and what is not. Frequently the products have cartoon characters on which are the kind of things they are attracted to. The companies are very good at choosing characters that are popular; for instance, I have seen league tables of the cartoon characters that are most likely to make children ask for them. All these things are quite sophisticated means of getting to children and asking them to try products. As we know from things like the Grab 5 project, the way to get children to like foods is to get them to try them and to repeat that trial, even if they do not like it the first time—to keep on coming back to it. That is obviously undermining the good work that is being done with fruit and vegetable consumption, and the school ostensibly is doing it for fund-raising purposes.

  Q382  Dr Taylor: You cannot blame the schools for doing it for that reason, for fund raising. That is the problem.

  Ms Dalmeny: That is partly why some kind of national look at what is going on would be very helpful. We are going to write to the National Audit Office to request that something like that is done. In the States—I think in 2001—the General Accounting Office has done a major report on all the different promotional activities in schools, looking at the full range, and that has been extremely helpful in school districts beginning to see what the national picture is and what sorts of things are problematic,

  Q383  Dr Taylor: Could we go on to the Five-a-Day/Grab 5 initiatives. How successful are these being? Are they being taken up widely? I know some of the schools in my patch are certainly doing them. Have you any idea of the effect?

  Ms Longfield: Again, no central monitoring of the schemes. The Grab 5 project is only Sustain's project. There are other initiatives going on with other organisations and also the Government's own initiative. We had our initiative independently assessed and evaluated to show that it did actually increase children's fruit and vegetable consumption—which it did—which was a great relief—not to have to do all that activity only to find it did not work, when it did. And people are very keen and enthusiastic but, as you have pointed out, schools are hard-pressed, underfunded, have lots of things that they have to do statutorily, and so an extra thing to do is just one more burden. We found it helped enormously—as we did with our project—having somebody local who could help: who could chase up the suppliers, arrange the visits, help buy the produce, organise the school markets—all that kind of stuff. If you are asking teachers to do it on top of what they already do, that is very difficult. So we are talking about extra help, which means extra money again. We are absolutely certain that it does help—because, as I say, we have had it independently evaluated and it does increase children's consumption of fruit and vegetables—but it is going to cost for all schools to do it. I do not think we can expect them to do it without that extra help and on top of everything else they have to do. It would be hugely helpful, however, even if it is going to take a long while for extra money to come through, if Ofsted could be persuaded to have food as one of the criteria that they check for, having a whole-school policy, having mechanisms to implement the whole-school policy that covers the kinds of things that Kath was talking about—so not just school meals but all the school food that is provided at any setting, what is in the curriculum, how many pupils take it. If it is in the Ofsted inspection criteria, then that is a huge incentive for schools to do it, but they are still going to need help.

  Q384  Dr Taylor: That is another very powerful recommendation that we could make and it seems absolutely obvious.

  Ms Longfield: Yes.

  Q385  Dr Taylor: Turning to tuck shops and vending machines. One of the schools I went to on the visit was a special needs school. They have a school council of not selected kids in the special needs, and amazingly they had decided the tuck shop would only sell healthy foods. It was absolutely amazing. Should vending machines be banned? Should tuck-shop sales be controlled?

  Ms Dalmeny: I believe the Food Standards Agency is doing some research at the moment with the Health Education Trust into finding out how vending machines could operate if they had healthier products in them. As you are implying, most vending machines will have the sugary, fatty, salty kind of products. That kind of research is looking into refrigeration, supply-chain kind of issues. I think that will be a very interesting piece of research to look at to show what best practice could be. It is not saying that vending machines have no place in schools.

  Q386  Dr Taylor: Would it be theoretically possible to have fruit in vending machines?

  Ms Dalmeny: It is theoretically possible. There have been several initiatives in Scotland like that. But also, as you say, having school councils look at making tuck shops more healthy and that kind of thing.

  Q387  Dr Taylor: Is there any evidence that when kids have got into the Five-a-Day thing at school it spills over into their habits at home?

  Ms Longfield: There seem to be indications—not powerfully strongly, but certainly there are indications—that if you do, as I say, involve children in decisions, involve parents, involve teachers, involve school meals' staff and members of the community, if you do all of that, then, yes, they go home and say to their parents or carers, "Can I have this at home, please." They seem to be indicating that they actually eat fewer fatty snacks as well as eating more fruit and vegetables—so you get a double benefit. Everybody assumes, I think, that if you involve children in decisions about their own food choices, they are going to say, "I want chips and burgers"—and they do say that sometimes—but if it is done well and carefully and it is made good fun and it has educational benefits and all that kind of thing, it can be done in a way which surprises people, which has children literally clamouring for more and different types of fruit and veg.

  Dr Taylor: Thank you.

  Q388  Mr Burns: I am going to move on to physical activity. Mr Osborne, how does the proportion of children travelling to school by bicycle in this country compare with other countries of a similar socio-economic grouping?

  Mr Osborne: We are bottom of the pile, essentially. Less than one per cent of school journeys are made on bicycles in this country. That compares to about 15 to 20 per cent in Germany and 50 per cent of children cycle to school in Denmark. I think the figures are actually worse in the USA, where they hardly record bicycles at all in schools.

  Q389  Mr Burns: Why do you think our record is so poor compared to those countries which you have mentioned have an infinitely better record? Or, putting it the other way round, why do you think those countries are better than us?

  Mr Osborne: I have just come back from Denmark from a field trip visit two weeks ago. I think it is quite telling, just looking at the essential differences. In somewhere like Odensa, which is Denmark's third largest city—it is 200,000 people, so it is a big city and it has a good mix of industrial development and retail development, just like ours—they have had a long-term programme over 20 years to invest in safe cycle routes alongside footways. I think the big difference, though, is the extent to which traffic is forced to give way to vulnerable road users at junctions and also the degree to which you are regarded as a proper traveller as a cyclist: you have priority at traffic signals, with green lights in advance of cars to get you through safely. In the city centre now they provide secure cycle storage throughout the city, with points where you can put air in your tyres if you need to. The station has secure cycle parking, with showers/toilets that can be used by people cycling to the station. I think the investment is a key factor and the important thing is that this has happened over a long period of time

  Q390  Mr Burns: Presumably it is not something that can be achieved overnight, by somebody saying, "It would be a good idea to get more people to cycle to school."

  Mr Osborne: No, although I think something radical like reducing speeds in all urban areas to 20 miles per hour or changing the legislation in terms of rules of the road, so that at minor junctions you as a driver do have to give way to a pedestrian or cyclist, could make an enormous difference and make a difference literally overnight.

  Q391  Mr Burns: It may for a variety of reasons, not simply for the health of the population, be good to reduce speed limits in built-up areas but there is little point in doing that if you do not have proper enforcement.

  Mr Osborne: That is true, although I think it has been mooted that you could look at the insurance liabilities placed on a driver. I think in this country—and this is where we do differ enormously from the Continent—if there was an accident involving a car and a pedestrian, the fault is laid at the door of the pedestrian: who has to prove otherwise. That situation is reversed on the Continent, where the driver has to prove that they were not guilty in the event of that accident. That of course puts a lot more onus on the driver to defer to cyclists and pedestrians at junctions and improves the perception of safety enormously.

  Q392  Mr Burns: Can you share with us your organisation's views on the merits of increasing the proportion of people walking to school?

  Mr Osborne: Walking is the main means of transport in this country to school: currently half of all journeys are on foot. I think they are the most sustainable journeys, in that they require no equipment beyond shoes and clothes to wrap you up against the weather. I think that is the area where we should certainly be putting a lot of effort. I think it is worth wrapping up walking and cycling together because cycling does increase the distance you can travel, and of course for a lot of cycling journeys they are a combined mode.

  Q393  Mr Burns: How are you going to persuade the mothers of children that it would be a sensible idea to walk?

  Mr Osborne: I think the health benefits are a very important motivator for parents. From the message that is coming through from the findings of this Committee and general media coverage about the rise of obesity, I think it is a big motivator for parents. Importantly, now there is research that is coming through that shows that the more physically active you are as a child at school, the greater attainment you are likely to have in the classroom. Of course that is a big motivator for a parent too.

  Q394  Dr Taylor: On walking to school, I think you said about 50%. It seems to me, from figures from my area, that probably more than 50% going to the senior schools walk but a very much smaller proportion going to the first and middle schools walk. It is those, the really tiny ones, that we have to get walking. Have you any experience with walking buses? Can you tell us anything about this and the practicality of this? On some of our visits we have heard that walking buses started and then faded out because they could not keep the volunteers going to keep them going.

  Mr Osborne: The Government, you may be aware, just brought out this document yesterday,

  "Travelling to School: An Action Plan" which promotes school travel plans. I think that is the important thing that schemes like walking buses and secure cycle storage and safe routes are wrapped up within, because that sets out what the school's intentions are in terms of persuading more people to travel actively to school. Walking buses do come and go, as parents come and go in school. I think it is inevitable that some will fail, but others have gone on to encourage other walking buses to start at that school. I think that for every piece of bad news you hear, there is more than one piece of good news, and it is often the starting point just to get other parents, who have not even thought about the issue, to take it seriously. So it is a very good profile raiser to start the process going.

  Q395  Chairman: Do you have any figures as to the number of schools who are actually employing people to run the walking buses? I came across a school in Yorkshire where they are paying people from their own budget to do this. That seems unusual. I have heard of examples where schemes have failed through lack of volunteers and, obviously, if you can pay then you have a guaranteed support for that mode of transport. Is this common?

  Mr Osborne: It is not very common at the moment. I think some schools are considering using teaching assistants and people like that to help with setting up these walking buses. The school travel plan coordinators who will be employed with some of this new money may be able to help too. Every school is different and I think every local authority has a different situation too.

  Q396  Mr Burns: It is interesting that in Yorkshire the schools are able to employ people, but certainly in the Home Counties, like Essex, that is not possible because, since the Government changed the funding formula to move money to the Labour heartlands at the last local elections, our financial settlement has meant that we do not even have enough money to employ the teachers to teach! One other thing, did you by any chance hear on the Today programme this morning the story of the school down in South Devon which has banned pupils from bringing bicycles on to school premises?—which seems rather a contradictory message for an education establishment to implement. I suspect—and maybe you have more knowledge than I—that is a fairly unusual occurrence, is it not? Most schools presumably are anxious to help encourage their pupils to come into school by walking or bicycling, as a healthier way to get to school than by being driven. Or do they frankly not care that much how their pupils get to school as long as they get to school on time?

  Mr Osborne: I think there is a fair amount of indifference. I think the proportion of primary schools who have banned cycling to school is higher than you would think. Again, I do not have figures, but I would say at least one-third of primary schools do not currently allow cycling to school—or do not allow children to bring bicycles on to the premises, which is essentially their way of saying do not cycle to school.

  Q397  Mr Burns: If we can move to the London congestion charge, do you have any evidence of what sort of an impact it has on the number of school car journeys within the area that it covers?

  Mr Osborne: I do not have that information, no. I understand there has been an increase in cycling journeys and I would anticipate that that has impacted on school journeys too, although I do not have the figures.

  Q398  Chairman: Could I come on to Mr Almond and possibly one or two of your colleagues. One of the areas I wanted to explore with yourself and some of the other witnesses was the level of fitness of school children. I certainly have had anecdotal evidence from my own constituency of head teachers' very strong belief that the level of fitness of young people in secondary schools is much less than it was even a decade or two decades ago. One head teacher spoke to me about taking a field trip with some secondary school pupils and climbing up a waterfall in Yorkshire. His pupils were out of breath, but he, who is 55, was okay. He was apparently fitter than the average pupil. What are your views on how we measure levels of fitness? One of the issues that we have been talking about has been the whole question of screening. I have remarked on several occasions that I recall, when I was at primary school, annual health checks: teeth, hair, eyes, etcetera. We wondered as a Committee whether there is merit in looking at this in respect of obesity.

  Mr Almond: You are asking the wrong person, because I do not find there is any evidence to suggest that fitness levels of children have changed over the last 50 years, mainly because of the way we assess fitness. A large proportion of that assessment is genetically based. In effect, a better measure would be how active they are. That is a far better measure, I think. What we can definitely point to, quite clearly, from lots and lots of surveys, is that activity levels have decreased substantially, to the point whereby they will have no impact at all on the levels of fitness. The argument at the present moment could be that perhaps we have not made any attempt to increase the fitness levels, and that may be one of the reasons why we have not seen a slight increase. I would have to conjoin on that and take an opposite point of view and say that perhaps if we promoted higher intensity activity and it was prolonged by all schools in the country then we may very well see an increase that we have not seen before. Some of the research at the moment may be reflecting what we have not done. However, the strong point I would like to make is that it is extremely clear that activity levels are substantially reduced and are continuing to reduce, and we have to do something about that.

  Q399  Chairman: In terms of the school setting, would you like to say what you feel are the key reasons for that and what role schools should have in addressing this particular problem.

  Mr Almond: The first one is that we have seen a reduction of walking by about 10%. That is only a small amount. There are two big factors where there has been a major reduction in playing. During the time when the school is not in force—so in play times and lunch times—there has been a substantial decrease in activity levels; in fact some schools have even put seats in so that children can sit down for the whole of the lunch break.


 
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