Jason Reed: Obesity rates are at a critical point. But campaigners’ plans to tackle the issue are deeply flawed.

28 May

Jason Reed is the founder of Young Voices UK and a policy fellow with the Consumer Choice Center.

More than one in five British children are obese by the time they leave primary school at the age of 11. That puts the childhood obesity rate at the highest it has ever been. It creeps higher still with each year that passes.

Having been asleep at the wheel on this issue for years, the public health lobby is now stepping up its game. A recent experiment, featured in a BBC One documentary, investigated the effects of “ultra-processed foods” on children’s brains. Dr Chris van Tulleken, who conducted the experiment and fronted the documentary, suggests unhealthy food does much more than make us fatter. He presents it as “addictive”, comparing it to drugs.

His thesis seems to be that private companies are maliciously getting children hooked on their unhealthy products and, therefore, that the state ought to legislate against them in order to safeguard children’s health.

We saw the same phenomenon with the hysteria over video game addiction. We were told for years that helpless, rosy-cheeked children were becoming hopelessly addicted to games consoles. That had the effect of making a relatively new technology seem sinister and threatening. All sorts of interventionist measures were proposed in the name of saving our children from this immediate threat which, in any context other than a health emergency, would seem like a gross overreaction.

Time and again, children’s health is weaponised as a justification for pushing through all sorts of unnecessary new punitive taxes and regulations which make life more difficult for consumers and fortify the nanny state.

Take, for instance, the plan to ban advertising for “junk food” on television before 9pm and online at all times. Just before the policy was confirmed as a part of the government’s anti-fat drive, shortly after a public consultation had closed, an anonymous government source welcomed the release of a helpfully timed “exposé” calling attention to the amount of junk food ads seen by children every day.

The paper was published by a group called Bite Back 2030 which boasts the support of celebrity chefs Jamie Oliver and Hugh Fearnley-Whittingstall. It was shameless in its use of children’s voices to make its case seem more compelling. The introduction to the report reads: “I’m a 16-year-old boy from Leicester. I feel like I’m being bombarded with junk food ads on my phone and on my computer. And I’m pretty sure this is getting worse.”

Note the use of “bombarded”, an unduly aggressive term designed to vilify the entire advertising industry. The paper is littered with similar rhetoric which, in the absence of a persuasive material case for new restrictions, takes a sentimental route instead, daring us to risk leaving our children exposed.

The problem is the disconnect between the rhetoric and the policy. If Oliver et al were truly invested in improving children’s diets, they wouldn’t be backing an ad ban policy which the Government’s own research has shown would remove just 1.7 calories from children’s diets per day – around half a Smartie.

While the health benefits would be miniscule, the policy’s effect on the advertising industry would be appalling. Research from the Institute of Economic Affairs and the Adam Smith Institute has shed light on the unintended consequences of an ill-considered blanket ban. For instance, it seems items which could never reasonably be described as “junk food” – honey, tinned fruit, mustard and yoghurt, to name but a few – will become collateral damage. Countless businesses will be affected.

Perhaps there is a case to be made that we should fight fire with fire. Those pushing these policies are willing to disregard the evidence and use stories of human suffering – albeit highly questionable ones – to advance their cause. In which case, consider the case of my mother, a single, underprivileged immigrant who runs a small baking business out of her kitchen. Under this new law, posting photos of her cakes to her Instagram account – the sole tool she uses to advertise her services – would become illegal.

An anonymous government source – the same one who warmly welcomed Oliver’s vital research into McDonald’s Facebook presence – explained that we needn’t worry because the policy is targeted at ‘the food giants’, as opposed to ‘small companies advertising home-made cakes online’.

It remains unclear how a ban on a certain type of advertising can be enforced against some businesses and not others. Last year, there was genuine legal ambiguity over whether it was a crime to sit on a park bench and people were arrested for the offence of “socialising outdoors”. A one-line briefing to a newspaper in which a faceless government representative promises that your livelihood will be somehow exempt from its new law is hardly reassuring.

The inescapable fact is that our public health authorities have been asleep at the wheel for years on this issue. Obesity rates have climbed and climbed. Now that the situation is approaching a critical point, they are pushing through tired, 20th century ideas to deal with 21st century problems.

The abolition of Public Health England was a step in the right direction. We can only hope its successor, a new agency led by Jenny Harries, will bring a fresh, considered view to this area.

David Davis: The Covid public inquiry should open in October, be held in two stages – and prepare for the unexpected

26 Mar

David Davis is a former Secretary of State for Exiting the European Union, and is MP for Haltemprice and Howden.

While the dedicated staff of our NHS and public services have managed superbly under extreme pressure, it is clear that mistakes have been made during the Coronavirus crisis.

No, let me rephrase that piece of Blairite prose. We have made mistakes. The whole British ruling class. Government, advisers (scientific and otherwise), Whitehall, the lot. And not just this Government, the previous one, and the ones before that.

So it is essential that lessons are learnt. Not just by this Government, but by future governments as well.

So we must establish a public inquiry on the handling of the pandemic.

Needless to say, the architects of our strategy throughout the crisis are nervous about the implications for them, and unsurprisingly they are saying “Yes, but not yet.” Not before the next election, or not before they retire, or move on to their next job.

Unfortunately, that will not do. The principal aim of the public inquiry is not recrimination about the past, it is preparation for the future. Pandemics come out of an apparently clear blue sky, or seem to. They are a peculiar class of threat, one whose eventual arrival is certain, but whose timing is entirely unpredictable.

The sloppy thinkers in Whitehall tend to imagine that if it is going to happen in the next 20 years, the most likely time is in about ten, so we have time to prepare for the next one. They are wrong. There is an approximately equal chance of a new pandemic in every year. There are “wet-market” style interfaces between wildlife and urban populations in Asia, Africa, and South America, and as the urban populations expand there are new opportunities for zoonotic pathogens jumping species all the time.

As public health services expand, depending too much on antibiotics, the risk of new drug resistant bacteria continues. It is probably only a limited time before we have a really virulent strain of multi-drug resistant tuberculosis, for example. We do not know whether the next threat will be bacterial, viral or fungal. We do not know whether it will be transmitted by air, by touch, or in our food. All we know is that there will be another pandemic at some entirely unspecified time in the future.

So we need to get a move on with the inquiry, and start as soon as possible. Of course the inquiry must be thorough, and must thoroughly review what went right and what went wrong in the Government’s handling of the pandemic. The public will expect it, and the Opposition will demand it. But the most important thing is that we learn the lessons and develop the template for the next crisis as soon as possible.

What is different from other inquiries is that there is a vast amount of data to design this rapid template for pandemic management, and most of it comes from abroad. Although we have had a spectacular success with our vaccination programme, and a lesser but important success with the RECOVERY programme (that delivered dexamethasone as a valuable therapy), the majority of the most successful strategies were in other countries, most obviously in East Asia.

There is a vast amount of data to evaluate all the national strategies and operational arrangements. There are reasonably accurate data on mortality, infection, recovery and excess other deaths on a daily basis for virtually every country in the world. Similarly there are accurate economic impact assessments available. Along with the genetic mutation data this allows us to track very accurately how the disease travelled, grew, was suppressed and was treated, and assess the effectiveness of dozens of different preventive and therapeutic approaches.

This argues for a two-stage inquiry. The first stage, which could start in October, should report on what the best template is within one year, giving us the best possible chance of dealing with another pandemic whenever it appears. The second stage can (and will) take years, and should review what we did right and what we did wrong.

While such inquiries are normally run by judges, the first stage of the inquiry might be better led by a leading scientist, possibly a past President of the Royal Society or some similarly recognised intellect. What it should not be is chaired by anybody who was an adviser to the Government in the crisis.

So this week the Health Secretary – Matt Hancock – announced that his Department will be setting out plans for a new UK Health Security Agency. The Agency will plan for, prevent and respond to external health threats, such as pandemics.

This is a welcome development to better protect the UK, our population, and communities from future external health hazards.

However, the Government has chosen Jenny Harries, Deputy Chief Medical Officer, to head up the Agency. I am not at all sure that this is wise. This is not a reflection on Harries, who may be brilliant. However the Prime Minister himself accepts that there were a number of missteps in the crisis.

These missteps taken by the Government were often based on questionable advice provided by the very same medical advisers who are now being handed the job of looking at what went wrong.

These public inquiries must be led in an unfettered way by an independent actor who is not consciously or unconsciously committed to the strategies that have failed in the past.

In due course the inquiry will review the errors that have plagued some of our Covid strategy. Before the current Government gets too nervous it should realise that many of the errors are rooted in the past, long before the current Prime Minister came to power, and often before the Conservative/Liberal Democrat government government took over in 2010.

So the advisory arrangements – SAGE et al – date back to the Blair years. They were first activated for the H1N1 swine flu outbreak in 2009. They frankly do not work very well. The idea of dumping all scientific advice into one committee is a bit bizarre, the sort of thing that liberal arts dominated Whitehall might do. It can often become dominated by a single strong character with a speciality that is beyond many of the members, as happened with Neil Ferguson and his poorly constructed and opaque mathematical model at the beginning of the crisis.

Similarly the Whitehall structures that are supposed to cope with crises are pretty poor too. The best demonstrator of this was the Operation Cygnus pandemic preparation exercise that was run a few years ago. This so-called command post-exercise was positively harmful, because it persuaded Whitehall that it was ready for a pandemic when all it rehearsed were the coping mechanisms – how many body bags you need, and should you have a mass mortuary in Hyde Park – rather than what you would actually do to minimise deaths. This is a generic problem, not just applicable to pandemics. Their “worst case” Brexit preparation was pretty poor too.

Some of the deep-rooted problems come a little later. The Public Health England structures were largely a product of the Lansley reforms, and they too were visibly not fit for purpose. It was their poor leadership that meant that we failed to hit the target of 10,000 test a day before the end of March, while Germany comfortably hit 15,000 a day in mid March. That incompetence denied the Government the strategies that worked so well for Germany in the first wave.

Then of course there were many decisions made on the fly during 2020. Obviously many of these were wrong, notwithstanding Matt Hancock’s cheerfully optimistic gloss earlier this week. But the public, and frankly anybody with any sense, knows that any government was making decisions based as much on guesswork as on hard data, and the public are very tolerant of that.

The primary area where an inquiry’s criticism is likely to fall is poor strategic management in, for example, the upper levels of NHS management. While their staff were doing a brilliant job, I am not too sure that the decisions on, for example, the deployment of the Nightingales and the private sector hospitals were entirely sensible.

These are the sort of things that will be unpicked over a few years by the second stage of the inquiry. The data will be complex and sometimes hard to establish, so it will take a significant time to resolve. Since it may be commenting on the decisions of individuals it is right that it takes its time. But that is all the more reason to start soon.

So my message to Boris Johnson is do not fear this inquiry: grasp this nettle soon, get the actionable insights quickly, reform and prepare accordingly, and then allow the commission to take its time doing a detailed inquiry over several years. History will judge you well for doing the right thing on this.

Robert Halfon: I’m not a lockdown sceptic. But I am a “school-down” sceptic – and fear for the impact of these closures.

27 Jan

Robert Halfon is MP for Harlow, a former Conservative Party Deputy Chairman, Chair of the Education Select Committee and President of Conservative Workers and Trade Unionists.

Media speculation in recent days has suggested that pupils may not be back into the classroom until after Easter. This is despite the previous indication that schools and colleges would reopen after the February half-term, when Lockdown III was announced on January 4.

To be clear, I am not a lockdown sceptic. In fact, I voted for all the Government measures to control the virus. However, I am a “school-down” sceptic. I worry enormously about the impact that prolonged school closures will have on the mental health, social development, academic attainment and safeguarding of children.

The Times this week published a letter from leading clinicians and paediatricians, warning that: “Anxiety, depression and self-harm are all at frightening levels” among our young people, and that: “Parents are showing signs of psychological stress and even breakdown as a result of the pressures of trying to home-school their children and sustain their jobs and businesses”.

At the end of December, Dr Karen Street, an Officer for Mental Health at the RSPCH, wrote about the harrowing 400 per cent increase in eating disorders among young people, in part due to school closures and social isolation.

Mental health is inextricably linked to children’s ability to learn and their attainment outcomes. The Department for Education’s own pre-pandemic study found that pupils’ wellbeing also predicted their later academic progression. For example, children with better wellbeing at age seven had a value-added key stage two score 2.46 points higher (equivalent to more than one term’s progress) than pupils with poorer wellbeing.

We know that education inequalities have been exacerbated by the pandemic. The IFS’s New Year Message report stated that “a long-term consequence of the pandemic will be to halt, or even reverse” the closing of the attainment gap.

So now, more than ever, children need to be in the right headspace to learn.

The Department for Education’s roll-out of more than one million devices for children on the wrong side of the digital divide will undoubtedly make a difference. But for all the laptops in the world, children need to have the motivation to open them, study independently at home, and have the support from parents, which may not always be possible if the parents are struggling with work, alongside looking after their kids. Millions of laptops also doesn’t necessarily mean we deal with the huge mental health problems now faced by many pupils.

So, what is needed? A mental health practitioner available to pupils, parents and school staff, stationed in every school, both online and in person. Place2Be, for example, worked with 33,000 children and young people last year and delivered 29,869 support sessions for parents. The charity’s impact assessment states that 81 per cent of those with severe difficulties showed an improvement in their mental health.

What’s more, those pupils receiving one-to-one support were able to keep pace academically with their peers (of the same attainment and background characteristics), suggesting that the possible negative impact of their mental health difficulties on their learning were mitigated.

While the Government has invested more in mental health, after the Coronavirus, there is going to be a radical rethink as to how children are supported with mental health and counselling.

A growing source of unease for many pupils, parents and school staff is the lack of certainty or a plan for school reopenings. We need an educational route map out of Coronavirus for schools and colleges.

No one expects a specific date for reopening. Of course, decisions should be guided by the scientific evidence on community cases and transmission rates.

However, school and college staff, pupils and their parents deserve a clear explanation of the criteria and the conditions that need to be met before the Government reopens schools, so that they can prepare.

Public Health England officials concluded this week from its monitoring of infections in schools that: “There’s a strong case for primary schools to reopen” after the February half-term, “once infection rates start falling and are sufficiently low to allow easing of national lockdown measures” and that the “evidence is building to show that primaries are a safe environment.”

Dr Jenny Harries, Deputy Chief Medical Officer, told my Education Select Committee last week that: “School children definitely can transmit infection in schools. They can transmit it in any environment. But it is not a significant driver, as yet, as far as we can see, of large-scale community infections. Rather it is the other way round, that if there is a rise in community rates, you will see a rise in children as well.”

For all these reasons, we must get schools open again and sooner rather than later. In areas of the country – or in primaries – where the science suggests it would be safe for schools to reopen, they absolutely must do so.

Regular testing of pupils and staff will be important to keep schools open safely. That is why I, alongside Miriam Cates MP, and nine other MPs, wrote to the Joint Committee on Vaccination and Immunisation should also look at making teachers and support staff a priority for vaccinations – purely, on the basis it will mean schools can open sooner rather than later.

Interestingly, there is a growing coalition to get schools reopen again – not just the parent group, UsforThem, but children and young people’s charities.

Anne Longfield, the Children’s Commissioner for England, has added to the calls for clarity, saying: “Children are more withdrawn, they are suffering in terms of isolation, confidence levels are falling, and some have serious issues…Families will need hope and clarity about what comes next, and that of course is what the speculation we’re hearing really feeds into, that confusion.”

It is worth noting that not all teaching unions are opposed to educational professionals being back at school. As Geoff Barton, General Secretary of the Association of School and College Leaders, told the Today programme on Monday: “Without anybody jumping the queue over vulnerable people… if you’re able to give the reassurance to those people working in schools and colleges that they’re not suddenly going to disappear into self-isolation because of vaccinations, starting with the staff, that would be reassuring I think so that we can get some continuity. Similarly, if we are able to do that with children and young people, the same thing.

“But, I don’t know that we need to wait for [vaccinations to reopen schools]. I think if we’ve got a very clear idea of what the scientific principles are, which then lead to the educational principles, could we not have more young people coming into school as appropriate, rather than this revolving door we’ve got at the moment?”

I recognise that the Government is firefighting in dealing with the Coronavirus, but surely one of the most important functions of the engine of the State is to get our schools and colleges open soon. The Secretary of State for Education and the Government should form an education “coalition of the willing” to get all children learning full-time again.