• Accessibility
• Email alerts
• RSS feeds
• Contact us

Recipe for health: a plan to fix our broken food system Contents

---

Chapter 2: Government strategy

The Government’s position

The outgoing Conservative Government

37.Rt Hon Dame Andrea Leadsom MP told us that the Conservative Government’s ambition was to halve childhood obesity by 2030.46 She said that any strategy to tackle obesity and overweight has to be multi-pronged, including measures to regulate the food sector to force it to reduce the fat, sugar and salt in the food that we eat.47 The Conservative Party’s General Election manifesto stated: “We will continue to tackle childhood and adult obesity and will legislate to restrict the advertising of products high in fat, salt and sugar. We will gather new evidence on the impact of ultra-processed food to support people to make healthier choices.”48

The incoming Labour Government

38.Preet Kaur Gill MP acknowledged that “tackling the obesity epidemic is one of the greatest public health challenges of the 21st century. … it is not an option not to act or do nothing. It is putting enormous strain on our NHS.” She highlighted the need to implement the planned ban on paid-for online advertising and the 9pm watershed on television advertising.49

39.In its General Election manifesto, Labour committed to a Child Health Action Plan, including implementing the 9pm watershed for “junk food” advertising on television, banning paid-for advertising of less healthy foods on online media aimed at children, introducing free breakfast clubs for all primary school children, banning the sale of dangerous highly caffeinated energy drinks to under-16s, and empowering local councils to block the development of new fast food outlets outside schools.50 The 2024 King’s Speech confirmed the Government’s intention to “legislate to restrict advertising of junk food to children along with the sale of high caffeine energy drinks to children”, and to require free breakfast clubs in every primary school.51 The Government has since confirmed that the “junk food” advertising restrictions will be brought in on 1 October 2025.52

Failures of government policy

40.Shortly after taking office, the Labour Government commissioned Rt Hon Lord Darzi of Denham to undertake an Independent Investigation of the National Health Service in England.53 It concluded in September 2024 that:

“It is apparent that where bold action has been taken, health has improved. This is notably the case for smoking where a succession of interventions have driven smoking rates down, with consequential positive impacts on cardiovascular disease and cancer incidence and survival. In contrast, bold action has been sorely lacking on obesity and regulation of the food industry. This means that childhood obesity rates for 10–11 year olds have risen and inactivity rates in adults have remained constant.”54

41.The Prime Minister, Rt Hon Sir Keir Starmer KCB KC MP, said that “the most damning finding” of Lord Darzi’s review was “the declining physical and mental health of our children”, including the soaring rates of obesity among reception-aged children. He warned that this was not just damaging the health of the nation, but “piling up the pressures on our NHS.”55 He had previously announced his intention to chair the new Mission Delivery Board on health and reform of the NHS.56

42.We were repeatedly told that that the policy of successive governments had fundamentally failed to tackle the obesity emergency. Several witnesses57 drew attention to the study conducted by Dr Dolly Theis and Professor Martin White58 of 14 government strategies published from 1992 to 2020.59 The study found that across that period, successive governments proposed 689 wide-ranging policies to tackle obesity in England but had not successfully and consistently reduced obesity prevalence or health inequities.

Figure 5: Percentage of the population living with obesity and overweight (BMI >=25 kg/m²), and government obesity strategies, England 1990–2020

Source: Dolly Theis and Martin White, ‘Is obesity policy in England fit for purpose? Analysis of Government strategies and policies, 1992–2020’, The Millbank Quarterly, vol. 99, (March 2021), pp 126–170: https://onlinelibrary.wiley.com/doi/10.1111/1468–0009.12498 [accessed 10 June 2024]

43.The Social Market Foundation noted that the study found no examples of policies that entirely eliminate choice, relatively little use of disincentives like taxes and only a few measures that aim to restrict choice (e.g. regulating promotions). By contrast, the vast majority of policies attempted to enable choice (e.g. providing vouchers for fruit and vegetables) or inform it (e.g. public awareness campaigns). Thus policymakers have been far more comfortable with less interventionist measures. However, these have manifestly failed, as we discuss below.60

Figure 6: Number of policies of each type in England—government obesity strategies, 1992–2020

Source: Written evidence from the Social Market Foundation (FDO0042)

44.Witnesses cited a number of specific failures in government policy.

Unhelpful focus on individual responsibility

45.Kristin Bash, Chair of the Food Special Interest Group at the Faculty of Public Health, said that the policy focus on individual responsibility over intervention “is like saying that we should all have responsibility for driving our cars safely, but ignoring the influence and purpose of traffic regulations and speed limits.”61 Dr Chris van Tulleken agreed that the argument in favour of personal responsibility “is morally, economically, socially, politically and scientifically dead and buried.”62 Professor Maria Bryant, Professor of Public Health Nutrition at the University of York, said that such strategies could increase inequalities because “it tends to be those people in a more privileged situation who take them up.”63

46.Professor Camila Corvalán, Institute of Nutrition and Food Technology (INTA), University of Chile, stressed that the problem was the obesogenic food environment people lived in, not a lack of willpower.64 Alice Wiseman, Director of Public Health at Gateshead Council, agreed, arguing that it was not possible for a whole generation of people to lose willpower at the same time.65 Health Action Research Group likewise noted that, while human physiology and psychology are unlikely to have changed significantly in a few generations, the food environment children are growing up in clearly has.66

Inadequate leadership and coordination

47.Dame Andrea Leadsom MP acknowledged the importance of cross-departmental working given the intractability of the problem,67 and highlighted the levelling-up inter-ministerial group bringing together “all the departments involved in tackling obesity”: the Department for Education, Defra, DLUHC68, DCMS, HM Treasury, and DHSC (which represents the interests of the Food Standards Agency as the departmental sponsor).69 Preet Kaur Gill MP said that Labour would utilise a cross-government committee that looks at all the issues.70

48.However, Anna Taylor said that there was a “complete disconnect” across Government departments.71 The Food Foundation argued that policy areas such as school meals, Healthy Start, dietary guidelines, land use and obesity policy are all affected by disjointed policymaking between departments. They called for an effective cross-government governance structure for food policy providing a means of delivering clear, immediate and coordinated action across the food system.72 Sophie Lawrence, Stewardship and Engagement Lead at Greenbank,73 and Intelligent Health74 agreed.

49.The British Heart Foundation said that there needed to be “a paradigm shift towards health in all policies, which can only be driven by a cross-Government approach.” They called for a Cabinet-level committee, under the leadership of the Prime Minister and Chancellor of the Exchequer, to coordinate and prioritise public health.75 Henry Dimbleby likewise called for overarching structural mechanisms.76

50.Witnesses including Preet Kaur Gill MP expressed concern that the Office for Health Improvement and Disparities (the successor to Public Health England) had been hollowed out.77 The Local Government Association (LGA) cited reports that DHSC had made substantial staff reductions and organisational changes less than three years after OHID’s creation. This has included the loss of senior officials and the scrapping of the post of director general of OHID.78

51.Another symptom of the problem was the lack of engagement between the Scientific Advisory Committee on Nutrition (SACN), which advises the Government on nutrition and health-related matters, and Government Ministers. The Chair of SACN, Professor Ian Young, said that SACN does not meet any of the four Ministers of Health across the UK Government and devolved governments. He noted that SACN recommendations are implemented by Government “to a variable extent”, there is no requirement on the Government to respond to SACN recommendations, and it is not part of SACN’s remit to report on how the Government is implementing its recommendations.79

No systemic oversight of the food system

52.We heard that successive governments had made piecemeal policy interventions rather than pursuing long-term, system-wide change. Professor Susan Jebb, Professor of Diet and Population Health at the University of Oxford,80 said that there had been “a failure of implementation”, and that policy interventions had only addressed “one little bit of the system” at a time:

“A long list of individual policies will take so much political capital to make them happen that I just do not see any Government being able to get through this on the basis of individual initiatives. … [There is a] need to step up a level and try to initiate system-level change.”81

53.Several witnesses argued that the system of oversight of the food system needed to be strengthened. The National Food Strategy stated that a strong framework of legal targets is essential to improve the food system and diet-related health. It recommended a new legislative framework requiring the Government to prepare and publish a Good Food Action Plan every five years, setting out interim food system targets and measures to meet them. This was not implemented.

54.The National Food Strategy also recommended expansion of the Food Standards Agency’s role and resources to cover healthy and sustainable food as well as food safety. Its specific new duties would include:

• Reporting annually to Parliament on national progress towards a healthier and more sustainable food system, including proposing potential government strategies;
• Collecting and analysing the nutritional and environmental impacts of foods sold by food companies;
• Developing an updated reference diet setting out recommendations for a healthy and sustainable diet, for use in policymaking and public procurement;
• Working with Defra and the Institute of Grocery Distribution to develop a harmonised and consistent food labelling system.82

55.The Food, Poverty, Health and the Environment Committee likewise recommended the establishment of an independent body with responsibility for strategic oversight of the implementation of the National Food Strategy, including monitoring and reporting on progress made against health and sustainability targets, advising the Government and reporting to Parliament on progress.83

56.Independent strategic adviser Priya Sinha Kenward also advocated the establishment of an independent regulatory authority accountable to Parliament to oversee the food industry and develop a long term, stable regulatory framework. She said that the Food Standards Agency (FSA) was well placed to take on such a role.84 The British Heart Foundation85 and Consensus Action on Salt, Sugar and Health (CASSH)86 argued likewise. The Food, Farming and Countryside Commission said that its Food Conversation surveys demonstrated public support for such proposals.87

57.Speaking in a personal capacity rather than in her role as FSA Chair, Professor Susan Jebb argued for a strong independent regulator to oversee a “new concordat” with industry and to report on progress. She said that many in the food industry were “calling on the Government to take that leadership position and to frame the environment in which they operate so that they can start to deliver the outcomes that we so badly need.”88

58.Professor Robin May, Chief Scientific Adviser at the FSA, said that his personal view (again, not reflecting his FSA role) was that devising standards, measuring standards and enforcing them were all tasks for a regulator, and that the FSA was ideally placed to do this.89

Failure of the voluntary approach

59.Dame Andrea Leadsom MP said that past policy demonstrated that “combining voluntary with regulatory approaches is the best way to go about it.”90 Preet Kaur Gill MP made a similar argument.91

60.However, Professor Eric Robinson, Professor of Psychology and Public Health at the University of Liverpool, asserted that “everybody in public health would agree that the voluntary measures have not worked. If we are serious about addressing obesity and inequalities in poor health in the UK, we desperately need legislation, and probably quite a lot of it.”92 Professor Franco Sassi, Chair in International Health Policy and Economics at Imperial College London, agreed.93

61.The Food, Farming and Countryside Commission pointed to survey findings from its Food Conversation that “the public overwhelmingly back state intervention to improve the food system. They don’t worry about a nanny state. … They want powerful (often multinational) food businesses to be more accountable.”94 Anna Taylor agreed that “policymakers are hearing, ‘Nanny state, nanny state, nanny state’, but … if you talk to the citizens, that is not their view at all.”95 The former Chief Medical Officer for England and Chief Medical Adviser to the Government, Dame Sally Davies, said: “I don’t think there’s anything that constrains people’s freedoms more than sickness that could have been avoided, treated, or otherwise better managed.”96

Conclusions and recommendations

62.Over the last 30 years, successive governments have proposed around 700 policies to tackle obesity. Yet in spite of all these initiatives, the obesity crisis has intensified during that period. At the heart of this failure of government policy are:

• A continued focus on failed policies founded on individual responsibility and voluntary regulation arising from an unjustified fear of the so-called ‘nanny state’;
• A lack of a coherent strategy to tackle obesity across the life course and embracing all dimensions of the food system;
• A lack of leadership and direction at the centre of government, resulting in inadequate coordination across key government departments; and
• A lack of a long-term strategic approach to oversight and regulation of the food system.

63.The Government should introduce a new overarching legislative framework for a healthier food system. This legislation should require that the Government publish a new, comprehensive and integrated long-term food strategy, setting out targets for the food system and the Government’s plans to introduce, implement and enforce policy interventions to achieve those targets.

64.As part of this new legislative framework, the Food Standards Agency (FSA) should be given oversight of the food system. This oversight role should be transparent and independent of industry. It should include monitoring and reporting annually to Parliament against targets for sales of healthier and less healthy foods,97 on the overall healthiness of diets, on related national health outcomes, and on progress against Government strategy.

65.The Secretary of State for Health and Social Care should be accountable to Parliament for progress made against these objectives, at the apex of an effective cross-departmental governance structure (including a dedicated Cabinet Committee) on food policy, supported by a properly resourced Office for Health Improvement and Disparities. The Prime Minister and the Chancellor of the Exchequer should play key leadership roles in enforcing and delivering this programme. In addition, an obligation should be placed on the Secretary of State for Health and Social Care to lay before Parliament a Government response to Scientific Advisory Committee on Nutrition (SACN) recommendations within two months of their publication.

---

• A-Z index
• Glossary
• Contact us
• Freedom of Information
• Jobs
• Using this website
• Copyright