(written may 2010)
Last week the health secretary Andrew Lansley sought to shift responsibility for improving diets and preventing obesity from the state to society. He blamed the problem on low self-esteem and deplored what he called “a witch hunt against saturated fats, salt and sugars”(1). In future poor diets would be countered by “social responsibility, not state regulation.” From now on, he announced, communities will be left to find their own solutions. The companies which make their money from selling junk food and alcohol will be put in charge of ensuring that people consume less of them. I hope you have spotted the problem.
This is care in the community for public health, whose outcomes will be similar to those of the previous Tory government’s care in the community for mental health. Volunteers have neither the power nor the motivation to fight slick, well-financed PR professionals working for big business.
Lansley would do well to read the analysis published by the Government Office for Science. “For an increasing number of people, weight gain is the inevitable – and largely involuntary – consequence of exposure to a modern lifestyle. This is not to dismiss personal responsibility altogether, but to highlight a reality: that the forces that drive obesity are, for many people, overwhelming.”(2) Advances in neurobiology, it argues, show that the hunger drive is far stronger than “satiety cues” (knowing we’ve eaten enough), and easily exploited by advances in taste technologies and presentation.
The same study points out that obesity rates are much higher among the poor than the rich; that they are likely to double between now and 2050(3), and that, by then, the problem will cost the NHS £10bn a year at today’s prices, and the economy £50bn. This was all before the food companies were let off the leash. So much for deregulation saving money.
So here’s what’s going to happen. The failure of big business to police itself will cause a series of crises: in public health, social provision, quality of life, the environment. The state will have to shell out billions to put them right. Eventually (think of BSE, the railways, tobacco advertising) the government will be forced to re-regulate, but not before large numbers of people have been hurt. In the meantime we’ll be instructed to pull our socks up and take responsibility for issues out of our control. It’s an age-old story from which governments learn the square root of nothing. It happens as predictably as a punch-up when the referee quits the pitch.