September 9, 2020

expert reaction to the National Audit Office’s publication of the childhood obesity report

The National Audit Office have published their childhood obesity report for the UK.

Dr Mars Skae, Consultant Paediatric Endocrinologist, Royal Manchester Children’s Hospital, said:

“This is an accurate representation of the overall approach taken by the government over the course of the last decade and the current state of affairs. The research has included most of the relevant key documents and publications that have led to changes over the years. I don’t think the report demonstrates any new revelatory findings but sums up extremely well the lack of progress that has been made over the years despite investment.

“The report suggests the lack of audit and accountability feedback for programme directives both at government level and local authority level. However it does not go as far as outlining the lack of a central authoritative government body to coordinating a whole-systems approach to tackling the obesity problem in the UK (like that seen in Amsterdam or the CDC in the US). Nor does it quite link this directly as a causal factor to the lack of progress in meeting targets that have been set over the years to reduce numbers.

“It identifies the fact that there has been new calls to improve weight management schemes for T2 diabetes and more awareness that there needs to be more targeted focus on obesity-related medical problems. However it does not quite outline the fact that hardly any notice is being paid to the sharp rise which has been nearly exponential in T2 diabetes in the paediatric population and the lack of directed work toward tackling this as well. In addition the government’s expectation that it will be treating a further 1,000 children for severe obesity-related complications is almost definitely a gross underestimate of numbers. This really requires NHS data to be pulled on this to monitor the rise in numbers over the last 5 years.

“The financial findings are not quite tied together but essentially suggest that the sugar tax has effectively generated approximately £240million and yet local authorities across the country have only spent approximately a quarter of that on childhood obesity. In addition, there has been an overall reduction in the budget allocated to local authorities between 2018-19 and 2019-20. There has been little accountability again for monies spent with linked outcomes of success (as with the Trailblazers funding) with little effort to ensure results are monitored to drive informed change in other areas that are less well funded.

“The government is just picking up from where it left off with the second chapter of the Obesity plan. The only new thing introduced as of the autumn is the introduction of low calorie diet availability in certain regions on the NHS for reversal of T2D. This is a proven successful measure however without the support structures in place and inadequate training of healthcare professionals to deliver these packages, unfortunately sustainability of this measure is guaranteed to be limited.

“I do agree with the report’s conclusions. COVID-19 has brought a new lease on life to the obesity effort however any new efforts are still bound to have little impact without central, clear and coordinated programme structures with a singular government body with the authority to coordinate the whole-systems approach and hold stakeholders to account. The strategy also still fails to provide a seamless communication between health care, which is forced to lead treatment efforts for the worst affected, with local authorities who are responsible for gate keeping and population reduction efforts.”

Professor Russell Viner, President of the Royal College of Paediatrics and Child Health (RCPCH) said:

“This report highlights what we’ve known for a long time, that childhood obesity is strongly linked to disadvantage and poverty. Access to healthy food, financially and logistically, is a huge challenge for families in our most disadvantaged communities. Life is getting harder, not easier, for these families.

“Undoubtedly, we have made some progress. The ban on pre-9pm junk food advertising will be very important, if implemented, and we broadly welcomed the government’s commitment to make obesity a public health priority, although we need to see actions as well as promises.  

“However, it ultimately comes down to money and resources. Local authorities hardest hit by year-on-year cuts cannot be expected to deliver vital services from an ever-shrinking pot. As ever, the communities that need these services most are those that have faced the most severe funding cuts. Some local authorities say they will struggle to even deliver statutory services in the coming years.  

“It is time for the money to follow the commitments. Government should restore the £1 billion of real-terms cuts to the public health grant for local authorities. Similarly, we need to know what happens to the vital programmes delivered by PHE, which was abolished without any consultation, that will not move to the new National Institute for Health Protection.”

https://www.nao.org.uk/wp-content/uploads/2020/09/childhood-obesity.pdf

Declared interests

None received.