Why does this not surprise me!




The Times
London, UK
28 February, 2006

Children grow fatter as the experts dither

By Nigel Hawkes, Health Editor


RED tape and a lack of leadership is jeopardising efforts to tackle Britain’s growing childhood obesity crisis, an influential report by three government watchdogs says today.
Nearly two years after ministers promised to halt the rise in the number of the nation’s children classed as obese by 2010 they have yet to publish key parts of their plan to tackle the problem.

It has already taken 31 experts 18 months simply to agree how obesity should be measured, the National Audit Office, the Healthcare Commission and the Audit Commission found.


That delay means it is likely to be 2007 before children are routinely weighed and measured for obesity, just three years before the target is due to be met.

Among those under 11 obesity increased from 9.6 per cent in 1995 to 13.7 per cent in 2003.

“This generation of children could be the first for many decades that doesn’t live for as long as their parents,” Steve Bundred, the chief executive of the Audit Commission, said.

The report identified:

- five government departments, dozens of quangos and hundreds of local bodies responsible for implementing the obesity strategy;
- insufficient frontline staff with the right skills;
- numerous “initiatives” but no specific money to implement them;
- no clear evidence of which strategies will work.

“Given the number of programmes and bodies involved in reducing child obesity, it was clear that indi-viduals could not entirely understand the purpose and functions of those from other agencies,” the report states.

“Teachers commented on the lack of formal structure for sharing best practice, a lack of communication with other agencies and a lack of communication between agencies.”

One teacher is quoted as saying: “The frustration is with initiative overload — another initiative with no money to do it, which I find insulting and it makes me angry.”

The report also gives warning that there is little evidence that the programmes launched by the Government will work.

At present, a number of different initiatives have been launched, including reform of school meals, a strategy to increase involvement in sport, a Healthy Schools programme, better provision for play, and a campaign designed to encourage people to lose weight.

The risk is, says the report, that the children most in need of involvement will be the least likely to volunteer. “Children who like sport will do it and the overweight ones won’t” said Mark Davies, of the NAO.

“The target is achievable but the clock is ticking and things need to be in place.”

Michael Whitehouse, of the NAO, said: “We would like to have seen departments moving more quickly, and to have seensome initiatives on the ground sooner. There is confusion at the local level, with teachers and healthcare professionals uncertain about their roles. There is also scope for improving the efficiency with which money is being used. There is duplication of effort and duplication of costs.”

The report gave warning that a “lack of timely guidance” had meant that organisations supposed to be working together had been unclear about their roles. Without greater clarity from the leading bodies, those further down the delivery chain may be wasting resources on ineffective or inappropriate interventions that fail to target the most at-risk children.

Anna Walker, chief executive of the Healthcare Commission, said: “If we are serious about tackling childhood obesity then all government agencies must work together more effectively.”

“Those of us involved in inspection and assessment must ensure that this partnership working really takes place nationally and locally.”

Sir John Bourn, head of the NAO, said: “Central Government must set a clear direction if we are to tackle obesity in children.

“Given that the target was established in 2004, the three Government departments could have been quicker in co-ordinating their own actions and making sure that those in the frontline were fully informed and supported.

“There is now a need for the three departments to work closely together to provide the leadership and direction that the whole delivery chain requires.”

Caroline Flint, the Public Health Minister, said: “We recognise we need to do more. We will continue to develop our work across government and the public sector to ensure that we stay on track to meet our target.

“Our public health agenda is the first concerted attempt to seriously tackle rising obesity. We know that leadership and co-ordination are going to be crucial, as is giving people information and support in making a difference to their lives.”

Jacqui Smith, Schools Minister, said: “We have already made the first payments from the £220 million available to help schools and local education authorities implement local strategies to transform their school lunches.

“The School Food Trust is now established and will be working intensively with schools and local authorities to support them in implementing the new minimum standards for school meals and increasing demand for healthier food,” she said.

Richard Caborn, Sport Minister, said that the Government was investing more than £1.5 billion in creating a sustainable structure for school sport.


http://www.timesonline.co.uk/articl...2061643,00.html





Series of wasteful initiatives end up doing fat lot of good

Health editor analysis by Nigel Hawkes



A QUICK search on the Department of Health’s website reveals that worries about obesity have been a staple of ministers’ speeches since at least 1999.
In that year Tessa Jowell, then Minister for Public Health, said that “a wide- ranging plan of action” was being put in place to tackle obesity, including the Healthy Schools programme, the Safe and Sound Challenge, Healthy Living Centres and exercise on prescription.



They had little effect and have now, mostly, been forgotten. Healthy Living Centres absorbed £300 million of lottery money before subsiding unhealthily into oblivion. Exercise on prescription never appealed to GPs and has been little used.

Since 1999 obesity has continued to rise, prompting the promise made in 2004 that the upward curve would be halted by 2010.

This was one of the Public Service Agreement targets, meant to involve several departments in cohesive and determined action.

The reality has been more prosaic, as today’s report makes clear. Not only is nobody sure what works, but also it has taken the Department of Health 18 months to work out how obesity in children under 11 should even be measured.

It is easy to mock, when the answer turns out to be the simple task of weighing and measuring them once a year. This used to happen with complete reliability in schools, without the need of targets or working parties, because parents expected to read it in their children’s reports. No longer, apparently.

Primary Care Trusts (PCT) have been given the job, to add to the many that they shoulder already. Given that the plan is to reduce the number of PCTs by a third, and that many of them are wrestling with deficits, they may not welcome the new responsibility.

The report emphasises the complexity of the issue, but in truth obesity is not complex. It is simply a matter of consuming more calories than you burn.

What is complex is trying to change established habits, in schools and in society generally, using the limited leverage at the Government’s disposal. The charge of nannying is never far away.

The report commends the Government for setting a target, but cannot say whether any of the planned measures will achieve it; and because responsibility is shared between three departments, it tends to dribble away with nothing achieved and nobody held responsible.

The three watchdogs responsible for the report bend over backwards to be fair, so much so that their conclusions verge on the bland; but between the lines there is a strong dose of criticism, of confused lines of command, lack of leadership, shortage of evidence and sheer drift.

Nobody asked the Government to take on such a tricky task: it volunteered. So it must expect to be judged on what has been achieved, which is very little.

Will today’s plans be any more effective than Ms Jowell’s? They may, but the trouble with a Government addicted to initiatives is that it lacks stamina.

If an idea does not deliver instant results, it is consigned to the out-tray, because there are always lots of new ideas awaiting their moment in the sun. The same happens after a ministerial reshuffle.

The result is that nobody really owns the idea or pursues it with the kind of dogged determination it requires. So we never really discover what works, and what doesn’t.

That is a wasteful way of spending public money, as the report might have said — but didn’t.


http://www.timesonline.co.uk/articl...2061582,00.html