Shift in spending needed to shift public health away from a crisis

In the run-up to the independence referendum in 2014, a question I posed pretty regularly at town hall debates across Scotland was what kind of country do we want to live in. I find myself posing that question again this week in response to a report by Cancer Research.

The report says that during the last decade almost 83,000 Scots children started primary school overweight or obese. We have one of the heaviest populations in Europe, with two in three adults overweight or obese. We spend more than a quarter more than other UK nations on sugar-laden fizzy drinks.

Obese children are around five times more likely to become obese adults and the condition is linked to cancers including bowel, breast and pancreatic. The cost of obesity to the NHS in Scotland is already estimated at £600 million a year.

People who are overweight or obese are more likely to develop diabetes, which has been described as Scotland’s “bellwether” condition, our leading health trend. A quarter of a million Scots already live with it. How we respond matters. Diabetes Scotland has rightly called on the Scottish Government to make it a national outcome, a measurement of our collective health and wellbeing.

Health and wealth are closely linked, and with new powers over income tax and social security we can start to address the root causes of poverty and poor health, but there are areas where we could have seen action before now. There’s been a notable lack of enthusiasm from the Scottish Government to confront the corporate interests who hold too much sway over what we eat and drink. And there’s been an utter failure to invest meaningfully in making active lifestyles the easy choice.

The food campaign group Nourish has a great idea which I was pleased to see included in the Scottish Greens’ Holyrood manifesto: a supermarket levy. Big retailers provide us with the bulk of our shopping and most of our meals. They have huge power over us and with that power must come responsibility. A supermarket levy would require them to report the nutritional composition of their sales and pay depending on how far they strayed from nationally-agreed standards.

The effect would be to drive down the availability of poor-quality food and drive up the availability of good-quality food.

Even the Scottish Government has acknowledged the issue, with a report in 2010 stating: “Overweight and obesity cannot be tackled by just relying on individuals to change their behaviour. We have to reshape our living environment from one that promotes weight gain to one that supports healthy choices.”

Yet little has been done.

The irony is there’s no shortage of good food in Scotland. We’re a land with two food cultures. One is the shopfront the export buyers see, glistening with fresh fish, meat and soft fruits, while the other is the everyday reality of multi-buy packs of crisps and processed ready meals.

We also take perverse pride in the Sick Man of Europe tag. We chuckle at Irn-Bru adverts and laugh off our reputation for deep frying anything. They say a little of what you fancy does you good but a little has turned into a lot. Professor Nigel Hunt, dean of the faculty of dental surgery at the Royal College of Surgeons, has warned of workplace "cake culture" fuelling our obesity epidemic. It’s a brave colleague who brings a fruit platter to meetings rather than a box of doughnuts, but again this is about not having control over our environments. Responsible employers should be taking a lead, and helping employees eat a balanced diet while also giving them opportunities to be active rather than sedentary.

Back in 2012, I led Holyrood’s first debate on cycling and warned then that we’d need to up our game if we wanted to meet the target of one in 10 journeys being made by bike by 2020. Well, we’re no further forward. The Transport and Travel in Scotland report shows cycling accounted for only 1.2 per cent of all journeys in 2015, down from 1.4 per cent the previous year.

The Scottish Government’s big transport priority appears to be growing international aviation, putting its energies into a cut in Air Passenger Duty and another runway at Heathrow. Both policies would be disastrous for the climate, and for social justice, and would do nothing to improve our health.

We need to see a shift in spending if we’re to shift public health away from a crisis. We need to make being active on a daily basis easier for all. We need to make sport affordable for all. And we need to develop these good habits at an early age.

As Judy Murray said this week: “A healthy population underpins a better, more prosperous Scotland.”

This article first appeared in the National