The government’s voluntary Public Health Responsibility Deal (PHRD) may not yet be dead, but it is clearly in need of intensive care, according to the chairman of Consensus Action on Salt & Health (CASH) Professor Graham MacGregor.
Without further progress, legislation to force change was almost inevitable – both at home and around the world, said MacGregor.
However, he didn’t think taxes on salt, sugar or fat were the answer. The aim of campaigners was not to destroy the food industry, as it was for those campaigning against the tobacco industry, said MacGregor.
“There is a general view now within the UK and internationally that [food and drink manufacturers] have to do something and if they don’t, things are going to start happening both on a UK basis and globally,” said MacGregor.
‘If industry doesn’t respond … there will be regulations’
“If the industry doesn’t respond, I think there will be regulations. Many other countries are considering it … there are about 10 examples now internationally of where salt levels have been regulated for particular products.”
Salt reduction has been the only really successful part of PHRD and much of the credit for that should go to Food Standards Agency, which began the campaign before responsibility for nutrition and health was transferred to the Department of Health in 2010, said MacGregor.
Even for salt, certain food categories – such as ham and cured meats – failed to meet the 2012 salt reduction targets, with the result that these targets are likely to be retained for 2014.
“With the new minister for health [Anna Soubry] we have set new targets [for salt reduction] and there has been a renewed push to say, although this is a voluntary programme, ‘you’ve got to do it’. And Anna Soubry did actually threaten [the food industry] with legislation.”
Critical of Andrew Lansley
MacGregor was highly critical of Andrew Lansley, the former health secretary when the PHRD was first set up. He believed Lansley took the pressure off the food industry to go further in reformulating its products to make them healthier.
“The best thing that ever happened to public health was when Andrew Lansley was moved from the Department of Health,” he said. “I am perfectly prepared to say that because he held up the salt reduction policy for a long time and there was considerable uncertainty about it.”
Although MacGregor supported the aim of encouraging the food industry to reformulate its products, he thought progress elsewhere in the PHRD had been poor. “If you look at the other areas of nutrition in food and the Responsibility Deal; I haven’t looked at them all but I don’t think there is any evidence they have had any effect at all.”
MacGregor referred to the resignation of many academic experts from the PHRD’s Alcohol Network, following the government’s U-turn on minimum alcohol pricing.
Change4Life: ‘transient effect’
He also questioned the efficacy of the National Health Service’s Change4Life programme designed to encourage the nation to adopt healthier lifestyles. “Change4Life may have a transient effect, but long term I very much doubt that spending all this money on advertisements – particularly in conjunction with the fast food and soft drinks industry – is going to have any effect whatsoever.”
There are plans under the PHRD to raise activity to reduce the sugar content of foodstuffs, said MacGregor.
“If we could do the same thing for sugar [as has been achieved for salt], which is something you will be hearing about in the next few months, that would be fantastic as we could take the calories out slowly and unobtrusively.”
He hoped that whoever was in power after the 2015 general election, that pressure on the food industry to reformulate its products would continue. “Hopefully we would want to do something about public health because the fact is the food industry has to get its act together; it can’t go on killing us all off with these awful food products.”