A U-turn for May

The first Childhood Obesity Plan, published just weeks after May became Prime Minister, was strongly criticised by public health campaigners for diluting many of the recommendations contained in the original draft. The reportedly detailed strategy produced while David Cameron was premier was chopped down to 13 policy-light pages following a heavy edit by May’s advisers, who objected to health officials’ “nanny state” approach.

Since then, the political landscape has shifted dramatically. The 2017 general election left the Prime Minister short a majority and shorn of her closest political advisers. Spotting weakness at the heart of government, public health campaigners inside and outside of Westminster have regrouped and pushed for a renewed obesity plan that will restore the missing pieces of the original plan.

Within Whitehall the ground has also shifted. Jeremy Hunt had previously encountered opposition from successive Culture Secretaries to restrictions on advertising of HFSS foods given the potential impact on broadcaster revenue. He now finds an ally in Matt Hancock, who is willing to dismiss this as a reason to oppose advertising restrictions.

Keen to regain some domestic policy momentum, Downing Street has now seized on the obesity crackdown as something that can get traction with the public. As one Number 10 insider said, “the pendulum has swung back”.

Pressure for further action

The key measures in the original plan focused firmly on the content of the popular, sugary snacks consumed by children, leading to the introduction of a voluntary target for these to have 20% of sugar content removed by 2020. This came in the wake of the announcement of a mandatory levy on soft drinks during George Osborne’s final Budget.

Today the policy focus has shifted to wider factors that impact purchasing behaviour, particularly advertising and price promotions. Jamie Oliver, seen as a prime mover in the introduction of the sugary drinks levy, has returned to the campaign with gusto with his #AdEnough manifesto calling for a 9pm watershed ban on the advertising of HFSS products, restrictions on the use of characters in adverts, and mandatory colour-coded labelling to denote product content.

But this time he is not alone. Celebrity chef colleague Hugh Fearnley-Whittingstall has used his latest BBC series to point the finger at the promotion of sugary snacks around retailer checkouts and the unhealthy contents of children’s menu options on the UK’s high street. While the intervention of celebrities whose restaurant chains offer customers high fat and sugar meals may be galling to some, their policy suggestions are being taken very seriously. Labour has pledged support for #AdEnough campaign, the Scottish Government is due to publish imminently a plan that will include restrictions on promotions such as  multi-buy offers, and in London Mayor Sadiq Khan is consulting on a ban on adverts for HFSS products across the tube and bus network.

This week’s publication of Public Health England’s Sugars Report, revealing the results of the first year of product reformulation, has also generated calls for even further intervention.  The report found that across the board manufacturers, retailers and the out of home sector had not delivered the target 5% reduction in sugar content. The 2% average reduction achieved compared unfavourably with the 11% reduction delivered by soft drinks manufacturers when faced with the introduction of a levy.

Yet, it was notable that PHE Chief Executive Duncan Selbie told the Health Select Committee that he struggled to be disappointed in the missed target and that significant progress had been made. Deflecting the coaxing of committee members for him to name and shame the worst offenders, Selbie was clear that progress is being made in almost every category, contending that it is too soon for mandatory reformulation targets. One of the most vocal advocates for Government intervention in recent years, Selbie’s call for patience and more time for voluntary reformulation will not go unnoticed.

Further action is coming

Defending PHE’s programme Selbie was clear that the agency’s current work is ambitious. A lack of ambition was the chief charge laid against the first Childhood Obesity Plan, and May is unlikely to make the same mistake again.

Looking at the key pressure points being applied across Government we would expect to see the second chapter look very similar to previous recommendations from PHE and the Health Committee, as well as crucially to resemble the Cameron-era version of the 2016 plan. Specific measures likely to prevail this time around include:

  • Restrictions on promotions such as buy-one-get-one-free, or multi-pack deals on HFSS snacks
  • An ban on advertising HFSS foods before the 9pm watershed, or an extension of the current ban on programmes considered as children’s viewing
  • A ban or significant restrictions on junk food at checkouts

The definition of what is classed as HFSS will clearly be vital for industry in responding to such measures. A review of the Nutrient Profiling Model is currently being undertaken by PHE. Industry is expecting the outcome of this review to extend the definition of HFSS; yet the outcome was originally due in the spring. Delays may in turn impact on the Government’s ability to deliver any commitments within the new obesity plan in a timely fashion.

Finally, the staunch defence of PHE’s ongoing sugar reformulation programme and wider work on calorie reduction should ensure snack manufacturers a reprieve from mandatory reformulation targets at this stage. The Government may instead use this opportunity to confirm that a levy on sugary snacks will be brought in if the industry fails to meet the 20% reduction by 2020 target.

The mood within Government is for action and, in looking for guidance as to the right policy approach; officials are recalling the action taken around tobacco in the 2000s. Industry should be looking on with concern at the path the Government is on; if the experience of tobacco is an accurate guide, strong action is coming, and soon.