Examination of Witnesses (Questions 420-439)
18 SEPTEMBER 2003
MR LEN
ALMOND, MS
JEANETTE LONGFIELD,
MR PAUL
OSBORNE, MS
KATH DALMENY
AND MR
PAUL LINCOLN
Q420 Mr Burstow: My son climbs trees
and all sorts of things on the way to school.
Mr Lincoln: I think it is both.
I think you have got to encroach on the structured time as well
as making use of the extended time.
Ms Dalmeny: I think probably the
advice that your school has given out is partly to do with the
great deal of confusion among teachers and teaching staff about
what it is that the consensus science is supporting. A lot of
the teachers who contact us say they have had completely conflicting
information from all sorts of sources—including the media,
including discussions with parents—about what constitutes
a healthy diet, about what individual items contribute to a healthy
diet, what kinds of physical activity and what amount of physical
activity is the kind of thing we should be encouraging. That idea
of consistency of message for the public health approach is terribly
important. I am going to come back to my bugbear which is to do
with commercial messages, encouraging the consumption of particular
foods for health and those being given to schools, for instance
things like Snickers bars being promoted as a very good thing
to eat before physical activity. That information was sent out
by the Football Association and approved by the Medical Council
to lots of different football academies around the country. This
kind of message is the sort of thing that gets through, it has
got the marketing budget, it goes directly to the people who are
working with young people and that is the kind of thing that can
undermine people's confidence that physical activity and good
food are terribly important for young people.
Q421 Chairman: On that particular
example, was there a commercial tie up somewhere between the Football
Association and that company?
Ms Dalmeny: Yes, a financial transaction.
Q422 Chairman: What a surprise!
Mr Lincoln: I would like to go
back to Dr Naysmith's point which was about supporting people
who are worried about children in schools. I think we have to
concentrate on the fact that we will have to do something about
the obesity environment in the schools and I come back to the
point about vending machines and their inappropriate marketing
and all the rest of it. That is not supporting those children
or the parents who are trying to support those children or the
schools. We have to be very sensitive to that.
Q423 Dr Naysmith: My area of questioning
really was about the damage to confidence of the youngsters who
are obese or certainly overweight and what the adults they may
come into contact with can do to help them so as not to make they
feel even more damaged.
Mr Lincoln: I totally agree with
that, but the environment is a crucial factor. I have details
of a vending machine in Scotland where for every carton of milk
sold there were 900 fizzy drinks sold. If the choice is there
that is what is actually going to happen. A simple policy would
be to say that if you have the vending machines then let us have
some healthy options in them because you can still income generate
from it.
Q424 Dr Naysmith: It is not just
in schools. When we were in Yorkshire last week we came across
an overweight lad who had tried to join a rugby league club and
he had been more or less told by the people running it that it
was not worth bothering about, there was no point and he might
as well go away and do tiddlywinks rather than think about becoming
a member of that club. How do we address that kind of attitude?
Mr Almond: We have to educate
the sporting clubs to recognise that it is not just elite young
people they want because in reality they will probably go for
well-developed young men or women who are going to be good for
a number of years, but everybody else catches up eventually. What
they should be having is a policy for all children and making
opportunities available to them because they might find some of
the little tiny rabbits down there become exceptionally good runners
and rugby league could benefit from those.
Q425 Chairman: I was very surprised
at this example as I am a rugby league supporter and with your
accent I would imagine you know a little bit about the game.
Mr Almond: I went to see the Bradford
Bulls on Sunday.
Q426 Chairman: It concerned me that
this lad had had this experience and I was very surprised to hear
it as I am somebody who believes that sport is generally inclusive.
I think the Bradford Bulls felt that that was an unusual example.
It struck me that most clubs could have turned that kid into quite
a useful prop forward.
Mr Almond: They could have done.
Q427 Chairman: It made me think about
the emphasis on excellence in every sport now. Have you any thoughts
about the way in which we are tending to develop excellence? We
are looking at participation and particularly the health benefits
of participation for kids who like this lad may never actually
make it.
Mr Almond: I think you have hit
the nail on the head. Excellence can be the buzz word and people
want to find the best children that they can mature and develop
into fantastic players, but if they are going to invest in that
then lots of other children are going to be pushed to one side.
I think clubs have got to have an inclusive policy because unless
they have an inclusive policy they are going to miss out on a
tremendous amount of talent and I think a lot of talent in this
country is wasted because of this emphasis on getting them early
and teaching them and I think they miss a lot of very good young
children. The declining numbers in schools is going to perpetuate
the fact that there is going to be more and more competition by
sporting clubs for a smaller number of people and if they are
going to be more aggressive in that approach to excellence that
would be a shame. What we need to do is encourage them to have
an inclusive policy which takes on as many children as possible
and some clubs still do that because I think that is in their
interests. They are also going to be spectators, participants.
There is massive potential there if they take an inclusive policy.
Ms Longfield: I also think the
sports clubs have a real responsibility to be very careful about
their sponsorship deals. There is a distressingly large percentage
of very high profile sports clubs that are sponsored by alcohol
companies and who have sweet drinks as their official drink. Those
are completely inappropriate associations when you are trying
to support either excellence or participation. Joining those kinds
of foods and drinks with that kind of sporting image is just wrong.
Q428 Chairman: I would agree entirely
with what you say. However, trying to get them away from tobacco
sponsorship is not always easy to do. It is ironic that the Rugby
Super League is sponsored by Tetleys, but the Autumn League Series
against Australia is the "Don't drink drive" test, it
is a cross-section of messages.
Ms Dalmeny: I would agree with
you that it is difficult with adult sports like that, but there
are specifically children's education programmes with football
clubs that are sponsored by the fatty and sugary types of products.
We have had examples of free samples of the products being given
out to kids who are participating in stuff that is organised by
the school with the local football club. That is where there is
something specific going on of linking the idea of the physical
activity with the particular product.
Mr Osborne: On your point about
how do we help these children who want to do something, I think
there is a danger in focusing too much on sport. The health guidelines
on reducing your weight talk about one hour of moderate physical
activity and that has been shown to be the most effective way
of getting people's weight down. Sport does alienate an awfully
large proportion of the non-obese population in schools as well.
There is this important task of encouraging obese children to
do things both inside and outside school in ways which do not
raise the awareness of other children in the school, for example
where someone is told to play football to lose weight. It may
be embarrassing. It is about doing it quietly, whether it is the
journey to school, what they bring to school in their lunch box
and rewarding them quietly for that process.
Q429 Dr Naysmith: The other area
I wanted to explore a little bit is the question of involving
and engaging children from ethnic minority backgrounds in sport.
Is there an issue there? Is this something that we need to talk
about?
Mr Almond: There is an issue in
terms of girls and young women. We have not won that battle yet.
If you look at Leicester, which has a large population of ethnic
groups, there are more people in leisure centres from ethnic groups
than the white population. So they are taking exercise and they
are recognising the value for men and women. I think what we have
to do is to get the schools to recognise that there are cultural
things to take into account, particularly for women and they must
address that. There is a massive project run by the British Heart
Foundation based in Leicester with over 10,000 ethnic children
trying to reduce obesity levels and that project would be worth
visiting so as to find out how they are doing it. They have been
extremely successful in changing the cafeteria system at lunchtime
after the children voted for fresh fruit and vegetables and staying
away from chips and burgers. So there are a lot of interesting
things happening there.
Mr Lincoln: I think a lot has
got to be done in raising awareness of the risks of these chronic
diseases and their origins with communities themselves. The evidence
is that there is still very low level awareness of the increasing
susceptibility of those groups and that is important for those
communities and supporting schools and young people.
Q430 Dr Naysmith: I take Mr Osborne's
point that it is not just sport. However, there do seem to be
some areas of sport where there is much more engagement than others
and I wondered whether that is an area we need to explore a bit
further and make recommendations on. Athletics has lots of ethnic
minorities involved but that is not the case probably in rugby
union. There are young people of West Indian origin playing football
but there are not many of Asian background. Is this an area that
we need to explore further and make recommendations on?
Mr Almond: We certainly need to
explore it further. Athletics is an interesting activity because
we have just done a survey and there were more veterans taking
part in club competitions than young people. That has never happened
before. More older people are taking part in athletics than young
people as there has been a massive decline there. I think people
like UK Athletics need to have a very careful look at how they
can do that and ethnic groups may be one area to have a look at.
Q431 Jim Dowd: Is that difference
that you highlight more than a change in the population at large?
We do have an older population and it is going to get older as
the proportion of older people compared to younger people rises.
Mr Almond: I would like to think
that those people in athletics who are post-60 ought to carry
on doing it and I think that probably is a factor. You do not
see it in other sports. You see it in swimming. You do not see
it as much in games because they probably have had too many knee
injuries, back injuries, arm injuries, etcetera. It is an observation.
I do not think it is simply that. I think there has been a reduction
in the number of children wanting to commit themselves just to
taking part.
Q432 Jim Dowd: I want to pick up
what Ms Dalmeny was saying about the role of the commercial sector
and the business pressures. We will be speaking to the manufacturers
and the supermarket people later in the inquiry and we are very
keen to hear what they have got to say. We are getting two distinct
messages. One is yours, which is these are the familiars of Satan
and we should have nothing to do with them. The other is that
there is no solution to this without their active engagement.
Is it not better—I accept what you say about what you would
see as inappropriate—that they actually encourage responsible
use of the product in a broader lifestyle than simply saying our
job is to sell the product?
Ms Longfield: I do not think they
have a role in schools. I think that educational institutions
are educational institutions and I do not think there is a role
for commercial sponsorship, commercial engagement and commercial
influence in schools. As for the engagement of industry in the
wider environment, yes of course Government has to engage with
manufacturers and retailers and producers of various sorts in
trying to cajole, persuade, regulate codes of practice and so
on to try to encourage them to run their business in a way that
is both profitable and healthy. I do not think those efforts have
been very successful to date. Engagement in the broader political
context is right and proper, but I just do not think it is appropriate
in schools.
Q433 Jim Dowd: So where the snack
manufacturers have had tokens to collect in order to get equipment
for schools or where sweet manufacturers have been involved in
encouraging activities in school, you would not agree with that,
would you? There is nothing we could do to prevent that. If any
individual organisation wants to pursue that there is nothing
that can be done to stop it, but you would oppose it entirely,
would you?
Ms Longfield: I think there is
something that can be done to stop it. I think it is the Government's
responsibility to fund education properly.
Q434 Jim Dowd: If somebody wants
to do it they will be able to do it, no Government will be able
to stop them.
Ms Longfield: Surely it is within
the Government's remit to say there are certain areas in our society
where you will be protected from commercial pressures and surely
schools is one. You could argue that hospitals are another. You
may argue that there are other areas, I do not know. It is our
collective responsibility. Surely to say to our elected representatives
that there are places where we do not want to have commercial
pressures is right.
Ms Dalmeny: If a commercial company
is promoting a product in a school what nutritional messages come
with that? One of the things I have been looking at recently is
the advice given on sugar consumption. Eurodiet, which is an European-wide
academic network designed to translate scientific evidence into
advice to people for the benefit of public health, says that eating
sugar four times a day is about the right level to maintain the
percentage level of sugar in the diet and to maintain healthy
teeth. Mars says six times and Nestlé says six times. How
is a school supposed to know whether or not the advice is correct?
Do they have the nutritional knowledge or information to be able
to say that that is inappropriate? Is anybody checking that the
information that is coming with these commercial materials bears
any relation to public health advice? If it were the case that
society accepted that schools have to have this kind of commercial
sponsorship, which I find very problematic, then there needs to
be some system that says that some things are not appropriate
and incorrect information is one of them. Another thing is the
Cadbury's scheme which I know you have spoken about already in
this inquiry. That was explicitly called an anti-obesity measure
and it was endorsed by the Minister for Sport. Linking the high
consumption of fatty foods and an anti-obesity measure in my book
falls into this kind of category of incorrect information. Most
people think it is okay to have a chocolate bar occasionally as
a treat. How often is occasionally? What is a treat? Most chocolate
bars that are promoted under that scheme are 200 or 300 calories
and a highly fatty, sugary product. They do not deliver much else
in terms of nutrition—not nothing else but not much else.
What is the role of a 300 calorie snack in a young child's diet?
Some of those products were aimed at six, seven and eight year
olds. That information is not going to the schools and you are
not going to get it from the company because it would say "Limit
the consumption of these snacks", it would say "occasional",
but it will not give a definition of what that means. Coming back
to this problem of the physical activity outside school, the school
has to be confident in what it means by healthy eating and good
levels of physical activity and for that not to be undermined
by a commercial imperative.
Mr Lincoln: Basically the situation
is industry has had a free-for-all, it is unregulated in all the
formats, whether it is TV advertising or marketing to schools.
We have to look at what has happened over the last 20/25 years.
What we should be asking ourselves is what would we have done
differently 20/25 years ago. Why are we in this situation? You
have got massive increases in marketing to children by the industries
and huge changes in the consumption of these particular types
of foods that are high in fat, salt and sugars. It is an absolute
priority to look at this and to look at appropriate modes of regulation,
as is being done in many other parts of the world.
Mr Almond: I agree with Jeanette
and Kath, and also Paul, but I would like to make a suggestion
on this. We are approached weekly at the university by food companies
who want to associate themselves with physical activity and we
have to say no, the British Heart Foundation will not accept that,
and I think that is absolutely spot-on right. However, I just
wonder if we are really going to invest in physical activity,
because there is no real investment at the moment to do it, why
could we not ask all of those food companies to invest into a
blind trust which might be co-ordinated by something like the
National Heart Forum and ensure that physical activity is seriously
promoted, not apparently on the back of promoting a chocolate
bar.
Q435 Chairman: Do you think they
would put money forward?
Mr Almond: If we do not ask, we
will not get it.
Mr Lincoln: We also have to be
aware about industry changing the nature of the scientific debate.
They have to address the issue that they have a responsibility
here and there is lots that they can do but little evidence that
they have moved in those directions so far.
Q436 Jim Dowd: I think when we get
to see the manufacturers we will put precisely Mr Almond's point
to them.
Mr Almond: I think the Heart Forum
would be an absolutely ideal broker.
Ms Dalmeny: I think it might be
useful to remember a phrase that is on the Cadbury's packets in
relation to the token scheme, which is "Further purchase
necessary". I think that is one of the key elements of that.
Q437 Jim Dowd: You are not sponsored
by Pepsi, are you, by any chance?
Ms Dalmeny: No, I will put it
away in case anybody misinterprets.
Jim Dowd: Have the cameras caught that?
Chairman: It was a visual aid before
you came in, Jim.
Q438 Jim Dowd: Mr Osborne, you mentioned
the report yesterday—I have not read it in detail—on
transport. One of the most puerile expressions thrown around government
these days is "joined-up", an idiotic idea but clearly
departments need to connect what they are doing. Do you feel that
the mechanisms are strong enough between departments? A lot of
issues relating to obesity are just seen as a Department of Health
lead, yet it is Transport and others that need to deal with that.
Do you think those mechanisms are strong enough?
Mr Osborne: In terms of the school
journey, it has been really very encouraging, the lead that Charles
Clarke has taken in education. Hitherto, I think we have had only
a slow recognition that they have a role to play, it has been
very much a transport led initiative. I think that the recent
document is a sea change in that it has got joint endorsement
with education money behind it, which is excellent news. I think
the NHS, the health sector, is one that we would like to see playing
a greater role. The Primary Care Trusts are supposed to be looking
at preventative issues as well as treating poor health and I think
the progress is still slow, particularly the budgets that are
being put into poor health prevention. That is where I think we
would like to see some more progress. The Healthy Schools Initiative
has been tremendously valuable bringing departments' work together
and I would endorse that very strongly.
Chairman: Paul, do you want to come in
on that?
Mr Burstow: I want to follow that on
with something else in a minute.
Q439 Jim Dowd: On that one point
first. When you mentioned earlier that only the US has a lower
proportion of going by bicycle to school, they do have a somewhat
more sophisticated bussing system to school than we have here.
There is pressure in this country for us to introduce a kind of
US-style yellow school bus scheme. From what you said earlier,
and clearly the Department of Transport are looking at that, would
you say that should be resisted?
Mr Osborne: Sustrans' view is
that we want to approach the yellow bus with a great deal of caution.
The way we see it in the UK, we have a high proportion of children
walking to school, it is 50% here and 10% and less, and going
down, in the USA. So 90% of them are either being taken by car
or yellow bus. The other issue in the USA is they have a much
poorer road safety record for child casualties than European countries,
so quite why we are looking for our transport solutions to the
USA when we have perfectly good solutions in Europe—Denmark,
the Netherlands, Germany—and when our country is so much
closer to them, I would not say politically but certainly in terms
of geography and our set-up in terms of schools, I do not know.
There is a real threat that yellow buses will not only attract
children out of cars but they will take a lot of walk journeys
and I am sure that has been the experience in the USA.
Chairman: Simon, our expert on the USA.
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