Friday, 15 December 2006

The lifestyle police are on the prowl again

Between the overweight, smokers and those who are fond of the sauce the social moralists are busy these days. Indeed, they’ve still managed to find time to berate parents, the indolent and various other groups too. It seems there is no rest for the self-righteous.

Today it is fat people whose lifestyles are under scrutiny. A team of public health professionals including Sir George Alberti, the Government’s national director for emergency care, and Laurence Gruer, director of public health science at NHS Health Scotland, have written in the British Medical Journal that large-sized clothes should have a fat-help line phone number printed on the label, sweets should not be available at checkout counters, fatty food should be taxed, urban roads should only be allowed if cycle lanes are built in, and a centralised agency should be set up to coordinate all aspects of obesity.

This is a shame. The issue that the report addresses is a serious one: while obesity is a sign of the success of our society – far fewer people die of diabetes than of malnutrition in the world – it is now one of the major health risks in Britain. Some of the proposals make a degree of sense but need thinking through better. Others, however, are misjudged, paternalist and judgemental.

Regular health checks for primary and secondary school leavers make some sense, but it would be better to ensure that children saw their GP regularly (and more than twice) than to send health inspectors to schools. Prohibiting all road building that does not factor in cycle lanes looks good on paper, but cycle lanes of the sort most common in Britain – a painted strip 18 inches from the curb – are unsatisfactory. Real cycle lanes need to be as distinct as the road is from the pavement, but this would incur huge costs. It is unlikely that the presence of a British-style cycle lane is going to tempt many out of the car and onto the bike; carbon taxes are more likely to achieve that!

While both these suggestions are worthy, however, others are less so. Creating a centralised agency is the knee-jerk reaction of the prominent bureaucrat, the professional expert and the righteously indignant. Far from centralising policy and decision making, what is needed is more focus on the individual and more tailored local provision. Taxing fatty foods is an example of nannying: the State’s role is to protect people from one another, not from themselves, and the taxes will be either ineffective or punitive, serving nobody but the Chancellor and probably hurting poor people who are best placed to decide how to allocate their own meagre resources.

As for sowing health advise into clothes above a certain size, one might as well print the word “Fatso” on the label, and ask the buyer to apologise for using up so much space as they hand over payment. The labels, far from providing useful information to those who do now know where to look for help (WeightWatchers and the family GP are both pretty well known), will act merely as a badge of shame, undermining people who are happy with their shape and further depressing those for whom it is a cause of upset.

The authors of this report are correct to say that “pull yourself together” is not an adequate response to obesity. Neither is finger-pointing. The responses that this problem requires are far more complex and far more subtle than can be achieved by a creating a new quango and handing down policies from the centre.

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