Dolly Theis: Ask her to stand – a guide to elections

8 Mar

Dolly Theis is the Co-Founder of 50:50 Parliament’s #AskHerToStand Campaign. She is completing her PhD at Cambridge University’s MRC Epidemiology Unit and contested Vauxhall in the 2017 general election.

A guide to standing for election

Step 1. Ask you/her to stand

Hello – in the wake of International Women’s Day, and this ConHome series that follows it.

If you are reading this article, then you are either:

  • A brilliant woman – in which case I am thrilled to ask you to stand for election. “But where do I even begin?!” you ask. Well, this article should help set out exactly that. I know how daunting it can feel first considering standing for election. I did it myself a few years ago.
  • Someone who knows a brilliant woman who would make a superb elected official – i.e: an MP or councillor. Or perhaps you know many such women? In which case, please send them this article and tell them why you think they would be superb.

If the latter, don’t forget to include women you know who are currently living and/or working in the UK, but who may not necessarily always live in the UK.

Many women living and/or working here now may move to another country in the future, where they could stand. Given that only four countries in the world have 50 per cent or more women in Parliament, why not inspire women to stand globally and help as many countries as possible achieve proper representation in politics?

You would be surprised how many women, even those actively engaged in politics, haven’t thought about standing or haven’t been asked, and been told by others why they would be great. You asking them could be the difference that makes them seriously consider it.

Step 2. Consider standing for election, even if you are unlikely to win

I have stood for election twice. Once as the Conservative Party’s parliamentary candidate in Vauxhall, London, during the 2017 general election, and once as the Conservative Party’s city council candidate in Newnham, Cambridge at the 2019 local elections.

Both times, I was one of the least likely to win candidates. Indeed, in Newnham I came last.

But that did not mean I treated the opportunity as a write off. Being a candidate, even if you are unlikely to win, is a powerful opportunity to raise issues you care about, and be listened to by a wider audience.

It is a chance to hold the candidates who are likely to win to account and encourage them to adopt good policies and make commitments to solving certain issues.

It is a chance to engage with, listen to and represent the voices of people locally who perhaps have not felt listened to for a long time.

And it is an exciting opportunity to build up your party’s activity in the area so that, longer term, the chances of your party winning can be increased. Even if only a handful of people vote for you locally, it is still your responsibility to represent them as well as everyone else, and you never know, your ideas and engagement could go a long way.

You will also learn so much simply by standing. Whether that is learning about issues or how our political system works,] you will come away from the experience with a wealth of knowledge, and greater certainty about how you would like to be politically active going forward.

Step 3. Sign up to 50:50 Parliament, even if you are not ready yet or certain you want to

Signing up to stand on the 50:50 Parliament website does not automatically lock you into a commitment. We know that many people who are interested in finding out more may not feel ready to stand yet, or may not be certain they want to stand at all – and that is completely ok.

50:50 Parliament will show you all the different ways you can be politically active in addition to standing for election. By being part of the community, you will be able to learn from others, including from those who are or have been elected, and gain access to all the information you need to understand how things work.

Everyone’s political journey is different. It’s important to know that there is no one set path – so do not spend too much time comparing yourself to others and focus instead on what you have to offer.

Perhaps your life and work experience mean you know about a particular issue in greater detail than others, or you feel particularly strongly about something, and could seek to campaign on that and raise awareness about it, or maybe you bring something entirely new to the table.

Many people think they need to know everything about how politics works in order to stand. You do not! 50:50 Parliament and many other organisations will help to educate you on the bits you don’t know about. All you need to know right now is why you want to be politically active and what issues you care about most.

Step 4. Ask all possible questions (there’s no such thing as a stupid question)

This is critical. Many people are put off by politics because it can seem people know much more about it than you do. Don’t worry – you are not alone.

Always ask questions, even if they sound like the most obvious or “stupid” ones. Whether that is “what is a constituency?” or “what is the difference between an MP and a councillor?”, these are critical questions and too often people skip over them.

50:50 Parliament is the perfect place to ask everything, and know that you will never be judged. We should never stop learning and reflecting – and this includes asking ourselves questions like “why am I a Conservative?” or “why do I think this way about that issue?”. Embrace asking the “obvious”!

Step 5. Enjoy getting stuck in, be kind and bring others with you along the way

I feel strongly that being active in politics and standing for election should be enjoyable, especially given you are likely to be trying to solve tough issues and will deal with many people who do not agree with you.

Politics is sadly considered toxic in many ways. In order to change this, we all must ensure that we engage in it with kindness. Holding others to account and disagreeing with people does not require nastiness, toxicity or aggression.

In fact, the nastier we are to people in politics, the more likely we are to end up with candidates who are less open to put good quality people off entirely. To help improve things, we need to make it enjoyable by being kinder to one another and bringing others with us along the way. If this is the start of your political journey, then welcome and we can’t wait to help you –

Dolly Theis: It is the Conservatives who have brought about the big opportunities for women in Parliament

21 Nov

Dolly Theis is the Co-Founder of 50:50 Parliament’s #AskHerToStand Campaign. She is completing her PhD at Cambridge University’s MRC Epidemiology Unit and contested Vauxhall in the 2017 general election.

Today marks 102 years since Parliament passed the Parliament (Qualification of Women) Act 1918. Thanks to a Conservative, Lord Robert Cecil, who introduced the Act, women in Britain had finally won the right to become Members of Parliament for the first time. The Act is remarkable, not only for what it did, but it is the shortest British statute at just 27 words long. Us women do not need many words to make stuff happen. As Thatcher said, “if you want anything said, ask a man. If you want anything done, ask a woman.”

Regarding women in Parliament, we Conservatives have a lot to be proud of.

First woman MP to take her seat in Parliament

It was a Conservative woman who was the first woman MP to take her seat in the House of Commons. Nancy Astor won her Plymouth Sutton seat in a by-election in December 1919 and served as MP until 1945 when she stood down. Her husband, Waldorf Astor, had also been an MP and worked hard to advocate for the admission of women to the House of Lords during the 1920s. (Countess Constance Markievicz was technically the first women elected, but as a member of Ireland’s Sinn Fein party she did not take her seat in Parliament.)

First women Leader of the House of Lords

It was a Conservative woman who was the first woman Leader of the House of Lords. Baroness Janet Young served as the first woman Leader between 1981 and 1983. Unfortunately, it was another Conservative woman, Margaret Thatcher, who asked her to stand down from the position, writing in her memoirs that Baroness Young “had turned out not to have the presence to lead the Lords effectively and she was perhaps too consistent an advocate of caution on all occasions.” That is not to say they did not have great respect for one another.

When Baroness Young died in 2002, Lady Thatcher said:

“Janet Young was not only a good friend but she was one of the most courageous and effective woman politicians of her generation. She devoted her whole life to public service, and public life is diminished by her loss.”

First woman Prime Minister

It was a Conservative woman who was the first woman Prime Minister. Lady Thatcher requires no introduction. She made history, not only for being the first British woman Prime Minister, but for many other reasons too. I believe she will remain up there as one of the most highly cited Prime Ministers in British history and being the first woman Prime Minister was far from what was defining about her. However, it is no less important. It paved the way for women and girls around the country to not only dream of becoming Prime Minister one day, but to know that that is an achievable dream.

In fact, ALL women Prime Ministers

It was another Conservative woman who became Britain’s second woman Prime Minister. Theresa May won the Conservative Party leadership contest in 2016 (beating another woman, Andrea Leadsom MP, who was the other candidate in the final two) and became Prime Minister in July that year.

First woman Leader of the Scottish Conservatives

I imagine many of you will be expecting me to write about Ruth Davidson here. In fact, Ruth was the second woman leader of the Scottish Conservative Party. Annabel Goldie was the first, serving as Leader from 2005 to 2011, when Ruth then took over. However, Ruth was the first woman Scottish politician to be a panellist on BBC One’s ‘Have I Got News for You’ show, so that’s a pretty big deal.

Women in Cabinet

Theresa May’s government was one of two in history to have the most women in cabinet positions at one time: eight (the other being under Gordon Brown). Other cabinet firsts include Dame Cheryl Gillan who became the first woman Secretary of State for Wales in 2010 and Liz Truss who became the first Lord Chancellor in 2016. The numbers are still pretty bad though. Only 45 women have been appointed to cabinet positions since 1929 and currently, only six out of the 25 members who attend cabinet are women.

Future firsts

The new intake is full to the brim with talented women MPs and I have many predictions about where many will end up, but for now, I put my money on Claire Coutinho becoming the first woman Chancellor.

Much to be proud of, but we still have a lot of work to do

As proud as we should feel of the above, we are still lagging woefully behind the other major political parties in terms of women MPs. While we have 24 per cent women MPs, Labour has 51 per cent, SNP has 33 per cent and the Liberal Democrats have 64 per cent women MPs. Yes, some parties have reached this with mechanisms the Conservatives are unlikely to adopt, such as all women shortlists, but that does not mean we should sit back and do nothing. With just 24 per cent we need to more than double this to reach proper representation.

To ensure we make this meaningful rather than a tick box exercise where we end up scrambling to find women, any women, to stand at the last minute, we must start early. We need to be reaching out to top women who may not be ready now, but they could at least begin learning about the process of becoming a candidate and building up relevant skills. We must ensure our candidates process develops candidates to the highest possible level and does not let top women slip through the net. We cannot have a truly meritocratic system that elects the best of both men and women, if women are not in the selection pool in the first place. Outreach is key and it is easier said than done. When was the last time you asked an incredible woman you know to stand for election? I mean seriously ask her.

Well, today could not be a more perfect day. Send an incredible woman you know this link right now and tell her that 50:50 Parliament is here to support her. Or are YOU a woman reading this and interested in politics? Well, of course you are interested in politics. You wouldn’t be reading this if you were not! I am asking YOU to stand. Whether you’re ready to stand now or you’re curious to find out what getting more involved entails, 50:50 Parliament helps women at every stage. There is no expectation for you to know anything about standing either. More often than not, we find that women will assume they need to have all sorts of political knowledge and experience under their belt before they can even get involved. It is not true! We just want passionate women, keen to have a positive impact.

Now what are you waiting for? Click the link, sign up to stand and let’s work together to achieve a Parliament full of the very best men and women MPs.

Dolly Theis: Obesity policy. We need no magic solutions – just to implement what’s been proposed. And re-proposed…

29 Oct

Dolly Theis is completing her PhD at Cambridge University’s MRC Epidemiology Unit. She contested Vauxhall in the 2017 general election.

This article is the last of the mini-series of three I have written about obesity policy for Conservative Home this week.

First, I set the scene and explained why obesity policy affects us all.

Then I rummaged around in the Conservative Party’s own history, beginning with Sir Robert Peel, to find out what previous Conservative Party “greats” have done to solve nutrition problems and see what we might learn.

Finally, today I will set out why I think we have failed to tackle our broken food culture and system, and what I think Government should do going forward, which I don’t think will be what you expect.

Believe it or not, there have been almost 700 obesity policies proposed by the UK Government since the early 1990s. Despite this, obesity rates have continued to increase.

Given that government has proposed so many policies, why haven’t they worked? And what exactly should happen next? I am a final year PhD student examining obesity policy in England, and believe that I may have identified some of the potential answers.

To anyone who thinks a PhD makes me some kind of expert, let me say now that the main thing one learns completing a PhD is…just how much one doesn’t know.

However, I think it is critical, especially at a time when we are bombarded by statistics and differing “expert advice”, to communicate research live, as transparently and as much as possible.  So here are my findings and thoughts on these whopper questions so far.

A Conservative Government under John Major first recognised obesity as a problem government should seek to reduce in 1991. The following year, that government published its Health of the Nation public health strategy, which included the first ever government obesity reduction targets – to reduce the proportion of obese men to six per cent and obese women to eight per cent by 2005. Clearly, these were not met.

Since then, 13more government obesity strategies have been published, and yet obesity rates continue to rise. Given this failure to successfully tackle the issue – despite almost 700 policies in 14 government strategies – what should happen next? And can we really hold out any hope?

As an optimist, I will immediately answer the second question with a firm yes – but what I think should happen next requires a little bit more explanation.

The obesity policies proposed by government over the past three decades have been far more repetitive than one might expect. These include: nutritional guidelines for the catering sector, planning powers for local authorities relating to outdoor spaces, the provision of nutritional information, reformulation of food and drink and the development of healthier marketing practices.

You would be as likely to find these in a strategy today as you would have been in 1992. Indeed, you do. Just compare policies in Health of the Nation to the Government’s more recent Childhood Obesity: A plan for action strategies (2016, 2018 and 2019) and Tackling obesity: empowering adults and children to live healthier lives (2020).

So why do we keep proposing the same thing? From what I can see there are three possible explanations.

  • Government proposes policies but doesn’t necessarily implement them. It then ends up reproposing the same ones.
  • When government proposes policies that require action from other actors/sectors (industry, schools, workplaces etc), it doesn’t appear to create conditions conducive to high compliance – so they don’t do what has been suggested; and
  • Government rarely seems to evaluate often, consistently or well.

These are pretty major policy making problems and each one alone could explain why government has failed to tackle issues such as obesity.

What government should do is start with doing the above better.

It currently proposes obesity policies in a way that does not readily lead to implementation, which is likely to be why it does not then implement its own policies. Could you imagine the same happening in business? No, you couldn’t imagine that because it just wouldn’t happen.

Yet obesity policies are often proposed without a clear responsible agent, timeframe, theory of how they will achieve the intended change, cited evidence on which the policy is based, an independent evaluation plan (self-evaluation cannot always be relied upon) and more shockingly, the majority of policies are proposed with no cost or budget.

In some cases, policies are reproposed in a laughably short amount of time. For example, Chapter 2 of Childhood obesity: A plan for action was published in 2018 under Theresa May. It contained a number of policies, including a 9pm watershed on unhealthy food and drink advertising, and committed to legislating mandatory calorie labelling in the out of home sector.

Consultations were conducted. Individuals and organisations submitted their evidence, reflections and advice. Then poof! Two years later, instead of having implemented the policies, the Government, now under Boris Johnson, publishes another obesity strategy containing those exact same policies and another consultation process.

They say madness is doing the same thing over and over again and expecting different results. Well, hello…

So here we have government proposing the same things again and again. We also have it proposing many policies for other sectors to implement.

Three cheers from anyone not keen on government regulation and legislation. But, hold on! Don’t get too carried away – because government proposes policies in such a way that does not readily lead to high compliance. The result is that sectors don’t do enough or don’t do anything at all, so government is pushed more and more into the regulation and legislation corner. It could potentially address this by meeting the compliance conditions set out by Australian academic, Professor John Braithwaite – who is basically the king of compliance and regulation.

I know regulation and compliance are sexy subjects – so strap in everyone.

Braithwaite argues that to increase chances of high compliance, governments should start with capacity-building – i.e. learn about the issue of interest, what needs to be done, who needs to act, what they need to make that happen etc.

Then, it should escalate to suggesting those actions to the responsible actor(s)/sector(s). Governments can name and shame, depending on progress, and state how they will move to more deterrence measures (e.g. taxation, laws, etc) if not enough progress is made.

As a last resort, an actor(s)/sector(s) could be fully incapacitated where action/inaction is deemed harmful.

So as government escalates up from capacity-building to stronger deterrence measures, the order of action ishould always be:

  • Building strong relationships with the responsible actor(s)/sector(s).
  • Ensuring consistent and independent progress evaluation.
  • Building legitimacy (i.e. make sure every actor involved enjoys a full understanding of the purpose and consequences of complying).
  • Support capacity building to ensure the responsible actor(s)/sector(s) can actually do what is being asked; and
  • Ensure the whole process is transparent so third parties/sectors can hold those responsible to account.

Ok, everyone take a breath.

The problem of evaluation is addressed in achieving compliance, but I will make the point again here just in case. Policies should always be evaluated, ideally by an independent body.

Rob Baggott analysed various public health policies in England in 2012, and found that government evaluation was either tightly controlled to minimise criticism, conducted in way that made lessons for future policy ambiguous, or not conducted at all.

Government must stop this. How is it supposed to know whether something worked if it is not evaluated properly? We also do not always have high-quality evidence about certain interventions and, in some cases, can only build this by introducing the intervention first.

For example, to really know what the impact will be of a taxation policy such as the sugar tax, government must first introduce it, and then monitor the various impacts closely over time in order to build high-quality evidence.

Government must therefore be bold in introducing interventions that have the potential to make it easier for us to live a healthier life, and then build the evidence through high quality evaluations.

In Amsterdam, the city authority refers to this as “learning by doing”, whereby they tweak and adapt interventions, rather than dichotomously declaring “it worked” or “it failed.”

You may have expected this article to contain a list of obesity policies for government to introduce such as nutrition education in schools or cooking lessons for the general public – but, as I say, there are literally hundreds of recommendations already proposed.

The policies to tackle obesity are all there in the 14 government strategies already published, from reducing the bombardment of unhealthy products while also increasing the provision, convenience and appeal of healthy products. Henry Dimbleby’s 2020 National Food Strategy is also one of the most comprehensive, “oven ready” policy packages ready for implementation.

We must stop searching for more magical solutions – and instead begin implementing and evaluating policies already proposed. Only then will we move closer to creating a world in which it is easy for us all, regardless of circumstance, budget or where we live, to enjoy a healthy life.

Dolly Theis: What can Conservative history teach us about tackling obesity?

28 Oct

Dolly Theis is completing her PhD at Cambridge University’s MRC Epidemiology Unit. She contested Vauxhall in the 2017 general election.

This article is the second of three I have written about obesity policy for ConservativeHome this week. Yesterday, I set the scene and explained why obesity policy affects us all.

Today, I am excited to dive with you into the Conservative Party’s own history, beginning with Sir Robert Peel, to find out what previous Conservative Party “greats” have done to solve nutrition problems and see what we might learn.

Finally, tomorrow I will set out why I think we have failed to tackle our broken food culture and system and what I think Government should do going forward – which I don’t think will be what you expect. I am hugely looking forward to reading your comments, from the brutal to the thought-provoking.

Obesity returned to the government agenda with a bang in May 2020, when Boris Johnson’s own experience of ending up in intensive care with Covid-19 convinced him of the urgent need to do something about it. The fourteenth government obesity strategy was published two months later. Given we have had so many obesity strategies, why are ministers still struggling to solve it? And can history teach us anything?

In the first year of my public health PhD, I drew up a timeline of all public health policies related to diet and nutrition in Britain from the early 19th Century to the present day to gain some sense of the trajectory leading us here. What struck me first was how repetitive public health policy debates are. Then it was how long-standing and rich the Conservative Party’s own public health policy history is. Writing this at the time of a global pandemic, with a Conservative government feels fascinatingly meta.

The third thing was that what we refer to as “obesity policies” today are largely food and nutrition policies, which link to a long history of such policies preceding obesity becoming a political problem. Food and nutrition policies affect us all. Calling them obesity policies can misleadingly imply they only affect certain people. By understanding this, we can turn to history and, I hope, learn many more insightful lessons.

Before turning to food policy in the early 19th Century, I emphasise that obesity is a complex issue. Although I focus on food policy here, let us not forget that transport, environment, physical activity, housing, education and many other policy areas are critical to the obesity policy debate too.

Right then, over to history. The modern Conservative Party was founded and quickly split up by a food policy: the Corn Laws. Many of you will be familiar with the story which, to embrace concision, goes something like this.

Sir Robert Peel, founder of the modern Conservative Party, becomes Prime Minister for the second time in 1841. In 1845, the disastrous Irish Potato Famine strikes, hammering the nation’s food supply and more than doubling the price of potatoes.

Peel is convinced that repealing the Corn Laws – which artificially elevated grain prices to protect British landowners to the detriment of the urban poor who were forced to spend most of their earnings just to eat – would solve the crisis by opening the trading gates to cheap US corn imports. So repeal them he does. But he isn’t supported by his Party.

One way to remember the split up is by thinking of those who backed Robert Peel’s free trade move as “peeling away” with him from the Conservatives. This group, known as the Peelites, later join forces with the Whigs and Radicals to establish the Liberal Party in 1859.

Why is this relevant to today’s obesity policies? Because it raised the pertinent question of who should be prioritised when it comes to food: food producers and manufacturers or consumers? Peel prioritised consumer access over protecting British food producers. Today we are debating whether to allow cheap US food imports under post-Brexit trade deals and how to prioritise local British-grown produce.

The Corn Laws ignited an ideological division which remains alive and well in the Conservative Party today between free marketeers and those who prioritise other concerns. Today’s neo-liberals believe government intervention and Conservatism are incompatible, and obesity exacerbates this ideological divide more than most issues. Cries of nanny-statism reach operatic levels the moment a politician speaks about it.

Yet if the Corn Laws are often heralded as a free market success story in terms of food access, food access is one thing. Quality is another.

Thirty years later, Benjamin Disraeli’s Government enacted the Sale of Food and Drugs Act 1875, which has been called a “legislative milestone” that set the “foundation of modern food law.” It recognised that food access was only a good thing if it was good quality. Harmful food could be as detrimental as no food at all.

The act dramatically improved food quality, prompting the almost complete disappearance of adulterated tea and bread, and was part of a major set of public health reforms at the time including legislation to improve housing, work conditions, sanitation, and water. Disraeli’s prioritisation of health and food quality over more simplistic celebrations of free market access was beautifully communicated in his 1872 speech in Manchester:

“Sanitas sanitatum, omnia sanitas [health above everything]. Gentleman, it is impossible to overrate the importance of the subject. After all, the first consideration of a minister should be the health of the people. A land may be covered with historic trophies, with museums of science and galleries of art, with universities and with libraries; the people may be civilised and ingenious; the country may be even famous in the annals and action of the world, but, gentlemen, if the population every ten years decreases and the stature of the race every ten years diminishes, the history of that country will soon be the history of the past.”

The Covid-19 pandemic could not be a more relevant context for this quote. Britain’s poorer state of health, including having one of the highest obesity rates in Europe, makes us more vulnerable and is likely to have contributed in part to needing stricter lockdown measures, which in turn has meant we have been unable to maintain (let alone grow) our economy. To echo Disraeli, we can strive for and build the most vibrant free market economy in the world, but if we are unable to cultivate our economy due to being in such poor health then what is the point?

That is not to say that a healthy population and vibrant economy is a zero-sum game. In fact, quite the reverse. Good health should be recognised as something that enables us to build, maintain and enjoy a strong market economy. Same goes for our environment. Healthy planet plus healthy population equals healthy economy long term.

Onto the Second Boer War, 1899-1902. Under Lord Salisbury, the British Army assumed it would be a doddle to defeat the lightly-armed Boers (Dutch settler farmers). They were wrong. One reason for what turned out to be a long, painful and expensive battle was the struggle to recruit healthy soldiers. More than half of the volunteers (mainly working class) were rejected because of their poor physical state. In some towns, almost all were rejected.

The Unionist Government (first under Salisbury then Arthur Balfour) established the Committee on Physical Deterioration in 1903, which identified this cause and recommended introducing regular measuring and weighing of people, mandatory school medical inspections, free school meals for the poorest, and mothering training for working-class women. Poor diet had become a defence issue. Unhealthy soldiers do not win wars.

Flick forward to another war – World War II – and food was back on the policy menu. Instead of famine leading to food scarcity like in Ireland, war was the cause, but this time the government prioritised access and quality. Lord Woolton was put in charge of the Ministry of Food, set up in 1939, to keep the population fed. He recognised the long-term health benefits of good feeding, so never compromised on nutrition. Addressing the Warwickshire Women’s Institute, he said, “the young need protection and it is proper that the state should take deliberate steps to give them opportunity…feeding is not enough, it must be good feeding. The food must be chosen in light of knowledge of what a growing child needs for building a sound body.”

Woolton’s food policies included his ‘Dig for Victory’ campaign, which encouraged people to grow their own food and turned gardens, waste land and even bomb craters into allotments, and publishing recipes for nutritious foods such as the veggie-packed Woolton Pie. Woolton’s policies meant that many people consumed a more nutritious diet than in the pre-wartime years, and they indeed had profound impacts on health outcomes including lowering infant mortality rates.

What can these wartime governments teach us? As before, what the Government does now regarding food policy at a time of crisis will have long term health outcomes. For example, Rishi Sunak could have channelled Woolton when he introduced ‘Eat Out To Help Out’ by making it conditional on restaurants committing to certain long-term health and environment goals, such as offering more healthy than unhealthy options to make it easier for consumers when eating out, and for us to shift towards a healthier eating out culture longer-term (I note that healthy should mean delicious so please don’t fear limp salads replacing your Nando’s chips). For restaurants needing time to make these changes, a feasible timeframe and necessary resources could be worked out transparently, in partnership with the sector.

Brexit also presents a panoply of opportunities to prioritise long-term planetary and population health, of through our trade deals. The first food minister since Woolton was appointed in 2018 to devise post-Brexit food trade deals. He has since been replaced by Zac Goldsmith, so we never found out if David Rutley, a former senior executive at Asda and PepsiCo International, would have gone down the nutrition-above-all route. That’s up to Goldsmith and Liz Truss, the Trade Secretary, now, and since Parliament just voted against amendments to the Agriculture Bill which would prioritise food standards, animal welfare and the environment, their leadership in prioritising health is critical.

Back to history, and there’s little doubt that Winston Churchill’s Government prioritised health at a time of crisis. In the middle of World War II they introduced school food standards, mandatory fortification of margarine with vitamins A and D, and commissioned the first food labelling order. Under his post-war Government the first nutritional recommendations were set by the British Medical Association and rationing came to an end in 1954 (much to the delight of Churchill himself, who consumed more than his ration allowance – which he may well have justified as being for “me, myself and I”).

Focus in the 1960s and 70s shifted towards building the evidence on the link between diet and disease outcomes, most notably heart disease. Several Committee on Medical Aspects of Food Policy (COMA) reports were published, including under Edward Heath’s Government, and a low-fat diet was strongly recommended as a way to tackle increasing heart disease rates.

Yet in 1979, Margaret Thatcher became Prime Minister and it was pretty clear the population’s nutrition was not high on her agenda. In her first term, Thatcher tried to bury the 1980 Black Report which recommended how government could reduce health inequalities in diet, and she cut funding for free school milk, earning her the nickname “Thatcher, Milk Snatcher”. In her second term she scrapped school food standards and free school meals for thousands of children. In terms of population nutrition, Thatcher’s Government was a Conservative low point.

In fact, today people such as Manchester United footballer Marcus Rashford and celebrity chef Jamie Oliver are still fighting to correct Thatcher’s culling of school meal provision, and not long ago in 2014 a new set of School Food Standards commissioned by Michael Gove were published.

The lesson? Short term savings on population health aren’t great long-term and government ends up introducing the same policies it did before scrapping them, creating a sad and repetitive policy cycle.

Rising obesity rates in the 1980s led the Conservative Government under John Major to announce the first official government obesity policies and obesity reduction targets in 1992. Despite diet remaining high on the policy agenda over the last three decades – with David Cameron making childhood obesity one of his flagship agendas as Prime Minister, George Osborne introducing the sugar tax, and even Johnson introducing one before him in City Hall as London Mayor – obesity rates have not been reduced and a poor diet is tragically still all too common.

If we do not lace long-term health outcomes into all government decisions now, we will not be fit or well enough to fight the next crisis. Poor health undermines our national resilience. We cannot forget that our own leader was not healthy enough to lead the country, ending up in intensive care and temporarily handing over his prime ministerial duties. If history can teach us one thing, it is to prioritise long-term health above all else. When government does that, we end up fighting fit.

Food access is not enough. Access to healthy food must be the minimum standard for all. By channelling the likes of Disraeli, Salisbury, Balfour and Woolton, politicians today can put our health first and ensure we’re ready for anything, from building a vibrant sustainable economy to fighting the next crisis

Dolly Theis: Why Government policy on obesity affects us all

27 Oct

Dolly Theis is completing her PhD at Cambridge University’s MRC Epidemiology Unit.  She contested Vauxhall in the 2017 general election.

This article is the first of a mini-series of three about obesity policy that I have written for Conservative Home this week.

Today, I want to set the scene for you and explain why obesity policy affects us all.

Tomorrow I hope you’ll join me in an exploration of the Conservative Party’s own history, beginning with Sir Robert Peel, to find out what previous Conservative Party “greats” have done to help solve nutrition problems, and to see what we might learn.

Finally, I will set out why I think we have failed to tackle our broken food culture and system, and what I think Government should do going forward.

I am hugely looking forward to reading your comments, from the brutal to the thought-provoking. So without further ado, here is why I think obesity policy affects us all.

I have a strong image of my dream world. In this world, it would be easy for everyone to live a healthy life, regardless of where we live, our budget, our circumstances and, ideally, without having to think too much about it.

It would be easy to eat well, and to be fit and active. Indeed, it wouldn’t just be easy; it would be enjoyable too. In my dream world, we also wouldn’t judge people based on their weight, and we would all have a positive relationship with food.

Tragically, we currently live in a world where it is not easy for everyone to live a healthy life. For some, finding a meal is hard enough – so whether it is healthy or not is irrelevant.

We are all surrounded by constant reminders and/or opportunities to eat, mostly tilted in favour of unhealthier options – at the same time as being told that we need to lose weight, or feel we should aspire towards a certain body ideal.

We are then shamed, or may feel like failures, for not achieving this perfect body.  Or else we are celebrated for doing so, even if we reached it in an unhealthy way.

The more I listen to and read debates about food, health and body image, the more they confirm that my dream world, in which it is easy for everyone to be healthy, would help solve the situation.

So how could we get there? Before answering the question, let us explore the current situation further.

In England, 67 per cent of men, 60 per cent of women and more than a quarter of children aged two to 15 live with obesity, or are overweight.

Obesity and overweight are associated with many long-term physical, psychological and social concerns. A recent YouGov poll found that 46 per cent of British adults were “not very happy” or “not happy at all” with their body image, compared to just seven per cent who were “very happy”.

Pressure to achieve the perfect body has led to almost two thirds of British adults being on a diet “most of the time”, with between 1.25 and 3.4 million people in the UK estimated to suffer from an eating disorder.

We live in a world where the majority of people are not living a healthy life, and where far too many of us are unhappy with our bodies. I find this unacceptable.

I research obesity policy and, when I talk to people about it, many view obesity as being an inevitability of modern life – an issue of poor choice, bad parenting, a lack of education or less cooking.

But it is not. To understand and tackle the issue properly, we need to stop reinforcing these beliefs, and instead understand obesity as being just one of many consequences of our broken food culture and system.

Obesity is a stigmatising word – encouraging us to judge people based on their weight, and divide us up into those who are “the problem” and those who are not. It makes politicians squirm having to speak about the issue, for fear of offending people or being seen to tell us what we should and should not eat. However, obesity is an outcome of that unbalanced food culture. Indeed, this culture and system affects us all.

Food is everywhere. Not only in more obvious places like supermarkets, restaurants and cafes, but also in clothes shops, stationeries and pharmacies. We also see food in deliciously tempting photos and recognisable brand logos. Food adverts are on billboards and TV screens, online and in magazines, in sports venues and train stations.

So food cues surround us, yet we are mostly unaware of them. We don’t exactly go around counting the numbers of times we see a food advert or pass somewhere we could buy food.

However, where and how food is advertised and sold has a profound impact on our health, and so makes free choice-making very difficult, even if we believe that choice is technically present: there is a reason you can recite an entire list of crisp, chocolate and fast food brands without having to think too much.

Unhealthier foods are in the spotlight – despite the official UK national dietary recommendation for foods high in fat, salt and sugar (HFSS) being that these not needed in our diet, so should be eaten less often and in smaller amounts.

However, it is not easy to consume unhealthy foods in moderation when we are being purposefully drawn to them by targeted messages and easy availability. For example, Cancer Research UK analysed food adverts on major TV channels and found that around half were for HFSS products, increasing to almost 60 per cent between 6pm and 9pm. Fewer than five per cent of all adverts shown were for fruit or vegetables.

Despite reports showing people can have a cheap healthy diet (which, while true for some, is often based on unrealistic assumptions about people’s lives), research shows that in practice, healthier diets are more expensive.

This is partly because food policies favour the production, marketing and sale of inexpensive, high volume products such as highly processed foods.

When money and time are tight, people turn to these cheap, convenient and often unhealthier foods, which might be the only option for parents who quite literally cannot afford to have their children reject what’s put in front of them.

This imbalance has resulted in what many perceive as a vilification of unhealthy food – with the Government going after junk food. However, were our food culture balanced in favour of healthy foods, then I imagine that unhealthy products would not be vilified at all, since people would more easily enjoy them in moderation, which would reduce the damaging health effects we experience today, and we could all enjoy and celebrate them for what they are: treats, rather than day to day foods.

So how do we rebalance things in practice?

The Conservative Government under John Major during the 1990s first recognised obesity as a problem that it should seek to reduce.

In 1992, it published its Health of the Nation public health strategy, which included the first ever government obesity reduction targets: reduce the proportion of obese men to six per cent and obese women to eight per cent by 2005.

Clearly, these were not met. Indeed, 14 government obesity strategies containing almost 700 policies have been published since 1991 – yet obesity rates continue to rise.

This is due in part to four main problems:

  • Government has proposed hundreds of obesity policies during the last three decades, but many of these have never been properly implemented or evaluated
  • It struggles to reconcile its desire not to be interventionist with its responsibility to protect people’s health.
  • There has been a focus on telling individuals to change their behaviour without helping to create a context in which that is easy; and
  • Government lumps many different policies into the “obesity agenda” – despite there being an important distinction between them.

To solve points one, two and three, government should prioritise transparent policy implementation and evaluation. Most of the obesity policies proposed under David Cameron, Theresa May and Boris Johnson are still waiting to be implemented.

I believe that it is wholly unacceptable that policies are proposed, but not implemented and/or evaluated. Could you imagine the same happening in business – with Jeff Bezos saying “hey guys! I have this great idea for a delivery company”, but then never introducing it?

For those of you reading this article and thinking that government shouldn’t be intervening at all, there is an irony – namely, that it probably would’t need to be considering such interventions now if it had properly implemented and evaluated even a handful of policies proposed previously.

So how do we better hold government to account on this?

To solve my final point – that government lumps many different policies into the “obesity agenda”, despite there being an important distinction between them – there should be a distinction between “obesity policies” (i.e: targeted interventions aimed at helping people living with obesity, such as bariatric surger), and population health policies, i.e: policies that make it easier for the population to live a healthy life such as reducing the bombardment of unhealthy food advertising).

By referring to all policies as “obesity policies”, people not living with obesity may see these as “not my problem” – or may feel government is unfairly intervening in their lives, and is being anti-business if a policy affects them (for example, the Soft Drinks Industry Levy, also known as the sugar tax). Of course businesses – should make a profit.  But not at the expense of our health.

Introducing both obesity and population health policies would make it easier for everyone to live a healthy life. People living with obesity would receive effective and equitable treatment and support. They would then return to a context which facilitates and promotes a healthy life, thus making it easier to maintain their improved health.

Otherwise we risk Professor Sir Michael Marmot repeating his famous line: “What good does it do to treat people and send them back to the conditions that made them sick”?

The policies to deal with the problem are all in the 14 government strategies already published – from reducing the bombardment of unhealthy products while also increasing the provision, convenience and appeal of healthy products. Part One of Henry Dimbleby’s 2020 National Food Strategy is also one of the most comprehensive, “oven ready” policy packages ready for implementation.

We must stop searching for a magical solution, and instead begin implementing and evaluating policies that will help create a world in which it is easy for us all, regardless of circumstance, budget or where we live, to enjoy a healthy life without having to think too much about it.