David's speech in the Scottish Parliament debate
27 February 2018
I welcome the debate. Labour will support the Government motion and the Conservative amendment.
Obesity is a modern-day public health crisis that would be unrecognisable to Scots who lived through rationing in the second world war or a century before that, when church parishes from Shetland to Selkirk had to set up poorhouses to look after the hungry and the dispossessed.
I share the view of Martin Cohen of the University of Hertfordshire, who has stated:
“Obesity is not just a matter for the nutritionist; rather, it is a product of social inequality and requires a collective social response.”
As we have heard, obesity has been on the rise for decades.
Changes to our lifestyle have had inescapable repercussions for our diet: the increasingly fast pace of life means that we are more likely to buy quick and easy meals, and frequently to trade nutritious food for efficiency.
We are also more prone to eating on the go, grabbing a meal deal from the supermarket or—maybe even and—getting a takeaway for dinner.
That shift in our eating habits means inevitably that we are taking in more sugar, salt and fat than we need.
To compound the problem, as the minister said, the busyness of life means that fewer and fewer of us are active enough to burn off the calories.
It is estimated that, in 2016, only 64 per cent of people over 16 reached the recommended amount of physical activity each week.
The result is a country that has one of the worst records in the Organisation for Economic Co-operation and Development.
The consequences of endemic obesity are severe.
The issue is less a ticking time bomb than it is a grenade with its pin already pulled.
For individuals, being overweight comes with numerous increased chronic health risks and reduces life expectancy by an average of at least three years.
Like Miles Briggs, I commend the work of Cancer Research UK and obesity action Scotland, which are working extremely hard in Parliament and with the public to raise awareness of the link between being overweight and development of various cancers.
As a former diabetes champion of the Parliament, I am also encouraged by the focus in the Government’s consultation document on Scotland’s growing type 2 diabetes epidemic.
Being obese or overweight is a significant contributing factor to a person’s developing type 2 diabetes.
With our obesity crisis it is, unfortunately, no surprise that figures for type 2 diabetes make for bleak reading.
More than 257,000 people in Scotland have been diagnosed with type 2 diabetes, and a further 500,000 are at risk of developing the disease.
With type 2 diabetes can come serious complications, including the risk of blindness and amputation, besides the clear and grave implications for the individual’s quality of life.
Growth in that condition is just one example of the strain that obesity places on our national health service resources.
The NHS spends almost £1 billion on tackling diabetes, but about 80 per cent of that goes on managing avoidable complications.
The Government’s proposal to invest in weight-management programmes with long-term goals is, therefore, welcome.
Diabetes Scotland has raised with me concerns that budget cuts to teams that are currently collecting clinical data could significantly undermine assessment of the programmes.
Therefore, I urge the Government to consider seriously how it will support those existing resources.
Talk of precise targets and desired outcomes is useful only if evaluation is possible.
When we are faced with the complexity of our obesity problem, it is easy to feel overwhelmed.
Some people might longingly hark back to the good old days—I am sure that Stewart Stevenson could relate to that—when our food was less processed and children played outside rather than sitting indoors playing “Football Manager”.
However, nostalgia is not the solution.
The Government’s consultation proposals recognise that in order for it to be successful, a strategy must help people to make better choices by changing the environment within which we operate.
It is good to see the Government seriously considering how advertising and promotion of food that is high in fat, sugar and salt could be restricted.
Key to that approach will not only be negative restriction of unhealthy foods, but making the option of a balanced diet more practical.
Furthermore, the growth in out-of-home eating means that a strategy needs to have a consistently strong approach to labelling and marketing of foods by restaurants and takeaways.
However, the environmental shift needs to encompass more than just our food culture.
Although the nature of the public health challenge might look modern, under the surface the root causes are the same old story: poverty, social deprivation and inequality are significant contributors to a person’s being overweight, and the least well-off are most at risk.
For example, a quarter of children who live in the most-deprived areas are at risk of obesity, compared with only 17 per cent in the least-deprived areas.
The problem is captured in a Health and Sport Committee report from 2015, which stated:
“A boy born today in Lenzie, East Dunbartonshire, can expect to live until he is 82. Yet for a boy born only eight miles away in Carlton, in the east end of Glasgow, life expectancy may be as low as 54 years, a difference of 28 years or almost half as long again as his whole life.”
Therefore, our health inequalities are, in fact, just inequalities; they cannot be explained away purely as the food choices that individuals make.
As food prices have risen, it has become harder for families who are on a tight budget to buy meals that are both filling and nutritious.
Evidence shows that consumers want to buy healthier food, but think that it is more expensive to do so.
Therefore, the aim of regulation of product promotions needs to be more ambitious than merely to reduce the number of unhealthy foods that are on offer; it should also involve making healthy products more affordable.
Placing restrictions on the formulation, sale and advertising of food products is beneficial, but it is also complex and tricky.
The minister might want to respond on controlling the number of food outlets near schools, in particular with regard to local authority licensing of mobile traders.
Further, the planning system should consider how community spaces can encourage physical activity by being welcoming and safe.
Overall, the Government’s proposals for a fresh approach to tackling obesity are positive.
The hope is that the proposals will now be turned into a strong and practical strategy that has clear targets and systems of evaluation.
The key to tackling obesity lies in seeing it not only as a problem for individuals and families, but as a social problem that is similar to those around educational underachievement or criminality.
Poverty, not individual choices, is the driver of the problem.
Thus, only fundamental societal change that fights inequality will cut the Gordian knot of widespread overindulgence.
I move, as an amendment to motion S5M-10652, to insert at end:
“; notes the importance of an active lifestyle for maintaining good physical and mental health and wellbeing and calls on the Scottish Government to ensure that resources are made available to support increased physical activity programmes for all ages and backgrounds; believes that the case for action is clear, and therefore calls on the Scottish Government to consider bringing forward the timescale for the publication and implementation of its strategy as a matter of urgency.”
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