Encouraged by government's commitment to public health

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MEND looks at the different proposals put forward in the public health white paper

With one in three children overweight and obese in the UK by the time they begin secondary school, we're encouraged to see a commitment from government to improving public health. The approach outlined in 'Healthy Lives, Healthy People', and the assurance of a ring-fenced public health budget, acknowledges that investing in prevention is essential, even in the face of spending cuts, to save money and lives, and ensure the survival of the NHS.

Local authorities in the driving seat

We welcome the transfer of public health commissioning to the remit of local authorities. As the bodies that control the delivery mechanisms on the ground, such as schools, leisure centres, social care and planning, they are well placed to assume this responsibility.

Given our experience of working extensively with Primary Care Trusts (PCTs) and other delivery partners across the country, it is, however, important that we flag the potential pitfalls. In the past, there has been a lack of effective commissioning at scale, which failed to take advantage of potential cost savings. We have also seen a lack of direction in the way that PCTs and local authorities work together. Efforts must be made to ensure that the same does not become true for GP consortia and local authorities going forward.

In addition, whilst MEND welcomes the ring-fenced public health budget, we hope that in practice this budget will be used solely for public health and will not be swallowed up by other areas such as social care.

We hope that the government will take these points into consideration when preparing for this transition.

A cross-governmental, cross-sector approach

MEND is pleased that the forthcoming strategy on tackling obesity will be informed by a cross-government perspective. As the Marmot Review highlighted, improving health requires us to tackle the determinants of health, which we know are impacted by many areas of government policy.

We are also encouraged to see the government's continued commitment to working with business and the voluntary sector through the public health responsibility deal. It is important that the responsibility deal is given the opportunity to deliver, although it is also vital that outcomes are carefully measured so that the responsibility deal 'carrot' is balanced with a time-limited regulatory 'stick'.

A response to the Marmot Review: Tackling health inequalities

MEND is particularly encouraged that the government's approach to improving public health is underpinned by a commitment to tackling health inequalities, and that the important work carried out by Sir Michael Marmot and his team is to be acted upon.

Reducing health inequality is vital if we are to create a fairer society, where every child is given a healthy start in life. MEND works effectively with families from right across the 'social gradient', and we therefore welcome the commitment from government that funding will reach the communities that need it most.

A ladder of interventions and the 'nudge' approach

MEND advocates the 'nudge' approach towards improving public health. The MEND Programme works in this way, providing participants with the tools they need to make the healthy lifestyle choices which work for them.

We also, however, welcome the recognition that a 'ladder of interventions' is necessary to fully address the problem. The 'nudge' approach does not imply a disregard for education, or the use of well thought-through legislation. We know from our local delivery partners that in the case of obesity, some individuals will require more support than others, and funding should be directed appropriately at a range of interventions.

Doing what we know works – evidence, evaluation and innovation

We applaud the government's continued emphasis on investing in interventions which are known to work and are backed by a strong evidence base. It is also important that the government leverage those interventions which have demonstrated potential for economies of scale, achieving up to 50 per cent reductions in unit cost.

MEND has a 20-year research partnership with Great Ormond Street Hospital and the University College London Institute of Child Health. We have the largest body of evidence in the UK demonstrating positive outcomes in child weight-management.

MEND works with 108 PCTs and hundreds of other community partners across the country to deliver 1000 child weight-management programmes each year.

We therefore look forward to lending this knowledge and experience and working with the government to shape the forthcoming obesity-specific strategy, setting out how we can tackle the alarming obesity epidemic through innovative, localised and cost-effective solutions that are proven to work.