Ten years ago this week, Andrew Lansley’s Public Health Commission published its report into the long-term health of the nation. With the Government announcing plans for a national food strategy, one of the authors of the 2009 report, George Gordon, shares here what he learned from the attempt at an integrated food and health policy – and why the tough part is about delivery, not deliberation.
Last week, DEFRA announced plans to develop a National Food Strategy by next year. It will be led by Henry Dimbleby, who has as good a heritage as any when it comes to moderating the inevitable outpouring of expert opinions which accompanies almost any debate about food.
There’s no doubt a fresh look at food policy is a smart move. The announcement last week talked about the “first major review of the UK food system in nearly 75 years” – which overlooks the fact that it’s only 11 years since the Cabinet Office attempted something similar, with the excellent “Food Matters” strategy in the final year of Gordon Brown’s premiership. But the need to actually deliver a joined-up plan and collaborate to make it happen is as urgent as it has ever been.
There’s certainly no shortage of thought and proposals out there. Academics, NGOs, policymakers, retailers and food manufacturers, as well as the occasional celebrity chef, have shared their own views on how we need to make our diet more affordable, sustainable and healthy. So we are well versed in talking a good game. We just aren’t as adept at delivering it.
My own experience is shaped by helping the Public Health Commission deliver “We’re all in this together – improving the long-term health of the nation” report, which was published 10 years ago this week.
The Commission was established by Andrew Lansley, when he was Shadow Secretary of State for Health, to develop a Responsibility Deal between government, business and the third sector to improve the nation’s health. It was chaired by my then boss, Dave Lewis who at the time was head of Unilever UK & Ireland, and had a range of academics (covering nutrition, cardiovascular and liver diseases and occupational health), health charities, business leaders (retailers and manufacturers), consumer groups, as well as the fitness and advertising associations involved.
It took a rather conventional draft policy and re-imagined it as a holistic approach to public health – based on six, inter-connected chapters – educate; improve what we eat and drink; eat and drink appropriate quantities and increase activity; maximise prevention while maintaining cure; evaluate for continuous improvement; and build genuine partnership. At its heart was a genuine focus on helping people to stay healthy.
Andrew Lansley couldn’t commit to agreeing to everything recommended when he got into office, but it’s interesting to see that Change4Life continues as the primary vehicle for public health campaigning and, for a time, we had enough funding to give free school meals a try. Something I’m pretty sure Henry Dimbleby will be keen to revisit.
However, looking back at my experience with the Commission, I am struck by three things that make or break reviews of this kind.
First, the power of getting the right people in the room and trying to extract meaningful consensus from what Dave Lewis described as the “95% we agree on, not the 5% we don’t”. You need real expertise and experience, not merely representation. Crucially, you only know it’s working when you start to feel that it’s falling apart. That’s when you’re pushing people beyond their usual comfort zones and stated starting positions to come up with something meaningful.
Second, we need a more progressive view of how to bring about lasting change. The Commission was a great attempt to get all the players, or at least the progressive ones, to act voluntarily. In the years since, we’ve reverted to old ways. Regulations and taxes, for example on sugar. It’s a time consuming and costly way to bring about change and will be limited by our old and creaking Parliamentary processes, which in the meantime will still be dealing with Brexit.
We need to get back to the days of a strong better regulation agenda, something I worked on myself in Cabinet Office at the turn of the century. The food business and third sector need to have an active role in making change – with the full support, encouragement and trust of the machinery of government. In this regard we may find inspiration from progress other countries, including Sweden and Finland.
Third, you need sustained leadership. In the case of “Food Matters”, Gordon Brown was gone within a year of its publication and Hilary Benn never really got time to take it far enough forward. Tim Smith, former CEO of the Food Standards Agency who was involved at the time, thinks we need a plan that looks at least a generation ahead. In the case of the Public Health Commission, I’ve always felt sad that Andrew Lansley got so lost in the wider issues of the NHS to prevent him taking forward the public health agenda he had genuine passion for. It’s all very well DEFRA developing plans for a National Food Strategy – but unless Michael Gove stays in post to deliver it, has the buy in from the Prime Minister and from across the entire cabinet table to progress it and their successors, in turn, prioritise and drive it, the whole thing will go the way of so many others…Worthy but worthless in the end.
So as we await a new Prime Minister, let’s hope the food strategy is genuinely near the top of their agenda and they will ensure – this time – we don’t just make a plan, but we see it through. It’s certainly no easy to task to bring together experts and find a progressive consensus. If anyone can do it, maybe a Dimbleby can.
This is a guest blog by George Gordon who led the Secretariat to the 2009 Public Health Commission. He is Communications and Corporate Affairs Director at TSB Bank, and a former Communications Director at both Tesco and Unilever.