The National Food Strategy and public health, House of Commons, 15 December 2021

• Everyone should have access to healthy and affordable food. The LGA welcomes the work of the National Food Strategy and want to work with Government to take forward the recommendations as part of a whole-systems approach to improving communities’ health, wellbeing and resilience.
• Obesity and diet-related health issues are one of the biggest public health challenges we face, with the cost of treating obesity-related ill health forecast to rise to £9.7 billion a year by 2050. The Office for Health Improvement and Disparities has a vital opportunity to refocus efforts on prevention and provide a coordinated strategy to improving public health across national and local government, and wider partners.
• Throughout the pandemic, council public health services have demonstrated their immense value and should be given the tools and resources they need to deliver on pressing public health challenges, now and in the future. As a minimum, the Government should invest £900 million in the public health grant to restore it to its 2015/2016 levels in real terms.
• Councils are uniquely placed to deliver whole-system approaches to tackling health inequalities at the local level, by bringing together the range of services and support that are needed to address the underlying causes of poor health.
• Lack of income, rather than food scarcity, is the main driver of hunger, food poverty and food related health inequalities in England. Councils have worked tirelessly to support people with a range of vulnerabilities to continue to access food during the pandemic, which has pushed more people on low incomes into poverty and food insecurity.
• While initiatives such as Free School Meals and the Healthy Start Scheme have a vital part to play in helping families and children to access nutritious food, they must be supported by a long-term, integrated approach to addressing poverty and disadvantage. The most effective routes out of poverty depend on ensuring that people can access secure, well-paid employment, affordable housing and inclusive financial support and services.
• It is also essential that there is an adequately funded national and local safety net to support those on the lowest-incomes, and those who cannot work, to live well. We want to work with Government to ensure councils have the long-term funding they need to do more planned preventative work to address underlying causes of hardship and disadvantage and support all households who need it.

The LGA welcomed the publication of the National Food Strategy. The strategy focuses primarily on escaping the junk food cycle, reducing diet-related inequality, making the best use of land and creating a long-term shift in our food culture to achieve more sustainable food production and the UK’s net zero ambitions. The Government are due to respond to the National Food Strategy by February 2022. 

The National Food Strategy follows the Government’s commitment to halve child obesity by 2030, and the publication of the strategy, Tackling Obesity: empowering adults and children to live healthier lives, in 2020. In ‘Tackling Obesity,’ the Government announced plans to introduce new measures, such as the inclusion of calorie information on food from restaurants, cafés and takeaways; restrictions on promotions for high fat, salt and sugar (HFSS) and a 9 pm watershed for TV and online advertising of HFSS goods by the end of 2022.

The LGA are keen to ensure any implementation of the National Food Strategy’s recommendations include support for a local first approach led by councils, with a clear focus on tackling health inequalities and issues such as childhood obesity.

Health inequalities in England are stark and have deepened as a result of the economic impacts of the pandemic. Poor diets are often driven by financial insecurity and poverty, as they are, per calorie, cheaper than healthier options. As a result, the prevalence of obesity in children in the most deprived areas continues to be more than double that of those in the least deprived areas. 

The National Food Strategy recommends various measures to reduce diet-related inequality, including:

• Expanding the free school meals and extending the Holiday Activities and Food programme for the next three years to support children during the term time and holidays
• An expansion of the Healthy Start Scheme to support the diets of young children before they start school 
• The trial of a “Community Eatwell” Programme that enables GPs to prescribe fruit and vegetables to people suffering, or at risk of suffering, from diet related illness or food insecurity.

The Free School Meals (FSM) system, the Holiday Activity and Food (HAF) programme and other initiatives are an important component of the support that is provided to low-income families and the broader work to tackle health inequalities. We would welcome further discussion of how FSM and the HAF can be integrated as effectively as possible with wider approaches to supporting low-income households, reducing health inequalities and tackling poverty and disadvantage.

An adequately resourced national and local safety is essential to supporting low-income households, and those who cannot work, to live well and access nutritious food. It is the LGA’s view that the national benefit system should provide the principal safety net for all low-income households. While the adjustments to Universal Credit announced at the Budget will help some working households, discretionary local support will continue to be needed to support those who are unable to work as well as councils’ work to mitigate crises and promote longer-term financial inclusion and resilience. The LGA continues to work closely with the Department for Work and Pensions, councils, voluntary and community sector partners and others to press for a more sustainable local welfare safety net.

The National Food Strategy recommends introducing an additional tax on sugar and salt that is used in processed foods and hospitality, to encourage manufacturers to make foods healthier and disincentivise consumers from choosing unhealthy food products. 

Given their public health responsibilities and wider role as local conveners, councils are best placed to invest in whole system approaches to obesity and healthy lifestyles. Councils should therefore have greater say over how revenue from the current sugar levy, and any additional sugar levies, are spent, to target funding where it is most needed.

Obesity, and health issues related to unhealthy diets such as diabetes and heart disease, are one of the biggest public health challenges we face. Reducing growing levels of obesity is a key priority for councils, and they have spent over £1 billion on tackling child and adult obesity since responsibility for public health transferred to councils in 2013. 

All efforts to tackle health inequalities and food insecurity needs to be part of a whole-system approach. The Office for Health Improvement and Disparities should renew the focus on prevention and provide a coordinated strategy for public health across national and local government, and our wider partners. 

Council’s public health services play a vital role in reducing health inequalities and supporting people to live healthier and more active lives. They run a range of targeted services including healthy food schemes in schools, specialised weight management and social prescribing services. As local conveners, councils’ also play an essential role in building local partnerships and bringing together the range of services- public health, public sport and leisure services, social care, housing, education, skills and employment support- that are needed to take a holistic approach to addressing health inequalities. With the right tools and sustainable funding, councils could do more to intervene earlier to ensure both children and adults have the right support to stay healthy and active.

At the recent Budget, Government announced an additional £34.9 million of new funding to support the expansion of local authority weight management services in 2021/22. This included a £4.4 million to test the expansion of behavioural weight management services for children and families, and the introduction of a Childhood Obesity pilot programme. Eleven local authorities have since been awarded grant funding to begin a pilot project and the LGA continues to work with Department of Health and Social Care (DHSC) colleagues to ensure these pilots are as beneficial as possible to the wider sector and help to make the case for longer term funding for local authority weight management services.

While the extra specific funding for public health will help address some short-term pressures, we need a clear plan for the future which recognises the public health challenges we face as a country, addresses the current and future pressures on the public health workforce and supports the links with other parts of the health and care system.

Local authorities’ public health grant has been cut by 24 per cent on a real-terms per capita basis since 2015/16 (equivalent to a reduction of £1 billion). The lack of a real terms increase in public health grant funding at the recent Budget and Spending Review, despite this incredibly challenging period is very disappointing and makes it harder to address the stark health inequalities exposed by COVID-19 to level up our communities. Keeping people healthy and well throughout their lives reduces pressure on the NHS, social care, criminal justice and the benefits system.

As a minimum, we are calling for a £900 million investment into the public health grant to restore it to its 2015/2016 levels in real terms. Councils should also be given increased support to work with schools and other education settings to follow the Healthy Eating Standards.

Councils would benefit from greater powers through the licensing and planning system to help address long-term public health challenges. For example, councils should have additional powers to tackle the clustering of existing takeaways and restrict junk food advertising near schools. 

The LGA are also calling for the Licensing Act 2003 to be updated to include a public health objective. Under the Licensing Act, councils can only currently consider four issues when deciding whether to grant licences – the prevention of crime and disorder; public safety; prevention of public nuisance; and protection of children from harm. When considering licenses for new premises, such a take-away or pub, councils are unable to take into account whether a new license could exacerbate an existing localised public health issue, such as obesity.

Amending the Licensing Act to include a public health objective would give councils the tools to act on local public health issues and place a legal requirement on businesses, to consider public health. To assist in decision making, council licensing teams would also benefit from greater access to NHS data, to understand where additional protections may be needed.

Megan Edwards

[email protected]