112.Local authorities now have responsibility for public health. Their potential contribution to tackling childhood obesity spans actions as diverse as reforming the built environment to promote active transport and preserving open spaces for active play, taking action to prevent the clustering of unhealthy food outlets and encouraging reformulation to take place at a local level. They are also responsible for administering the National Child Measurement Programme, which is discussed more fully in the following section.
113.Jeanelle de Gruchy of the ADPH described the work of local authorities as a central one of influencing and system leadership around shaping the environment to promote health:
They are doing that by influencing the places where people, where children, live, so walking and cycling, planning around fast-food takeaways, 20 mph speed limits and looking at play areas and green spaces.
114.We heard that this is labour intensive, with a significant amount of time from both staff and local councillors going into “each little positive improvement”. The ADPH gave the specific example of trying to limit the proliferation of takeaways, and argued that changes were needed in this area, to enable councils to address these issues more easily:
As to planning, we are having to put a lot of energy and effort into that. There are a lot of steps one has to go through to try and limit the proliferation of hot-food takeaways in a local area. We have to put things into planning documents … it takes a lot of processes and steps and you do have representation. Last week we tried to do that in my borough. We had representations from KFC and McDonald’s, a lot of very legalistic documents that need officer time at a local level to address. As to the evidence base …. it is quite tricky to prove if a hot-food takeaway is directly linked to childhood obesity and so on. If the legislation was done differently at a national level it would make it a lot easier for us at a local level to try and address some of these issues, such as a proliferation of hot-food takeaways
115.In the ADPH’s view, while childhood obesity is now a higher priority within local authorities, funding constraints are limiting what can be done:
The problem we are coming into now is a reduction in funds and funding. We do not have a lot of money in public health, certainly … If you look at our budgets, there is no big pot that says “obesity” in the way there is for sexual health and drugs. There is not. It is a very small amount of money so it is about influencing and implementing what is done nationally, making sure it happens locally. It is about providing that system leadership, making the join-up. We need people to do that. The in-year public health cut of £200 million has impacted badly in terms of that. I would be quite concerned that people are talking about school nurses and weight management programmes going. We do not have that in my borough. Again, that would be variable across the country. There is some great innovative work happening on that front, but that is all in jeopardy now.
116.We have been told that while local authorities are well placed to influence local environments in an attempt to tackle childhood obesity, funding constraints threaten their ability to do this effectively. A simple way to boost local authorities’ effectiveness in this area would be change planning legislation to simplify the processes for limiting the proliferation of unhealthy food outlets in local areas, which we have heard can be time-consuming and difficult. We recommend that this change should be made. In particular, health should be included as a material planning consideration.
117.The ADPH also pointed out the work that local authorities are doing to promote the availability of healthy foods within NHS buildings and leisure centres.
Then there is the food environment. There is system leadership at a local level. We also are working with our schools, with the hospitals, the hospital trusts and the GPs. There is a lot that still happens in a hospital trust environment that you would want to question such as the vending machines and the kinds of foods available. It is just remarkable that you still have those. It is a bit like selling cigarettes in the past. As you go into hospitals, you can buy chocolates and crisps and all of that. With our leisure centres, we are trying again to influence the offer, such as vending machines.
118.In its earlier report our predecessor Committee flagged the availability of unhealthy foods within NHS hospitals as an issue requiring urgent action, and since then, NHS England have taken a number of steps in this area. Public Health England’s evidence review reiterates this recommendation:
Adopt, implement and monitor the government buying standards for food and catering services (GBSF) across the public sector, including national and local government and the NHS to ensure provision and sale of healthier food and drinks in hospitals, leisure centres.
119.We endorse Public Health England’s recommendation that clear national standards for healthy foods should be adopted, implemented and monitored across the public sector, including national and local government and the NHS.
131 , NHS England news release, 2 September 2015
Prepared 27 November 2015