Voluntary public health measures 'can only go so far’: UK Responsibility Deal chair

21-Jan-2015 - Last updated on 21-Jan-2015 at 14:07 GMT

'What I have always said and continue to say is that there is a limit to how much you can do through voluntary means,' says Dr Susan Jebb

We need a strong portfolio of voluntary and mandatory measures to tackle the huge burden of diet-related diseases, according to the chair of the UK Responsibility Deal food network.

Dr Susan Jebb, also professor of diet and population health at the University of Oxford, said whilst she was proud of what had been achieved by the voluntary scheme in the last four years, the process had also revealed that some areas like promotional activities could require mandatory action.

She said individual companies had made some changes on this, but nothing broader had been secured. “I think that having tried to do that through a voluntary mechanism it’s now absolutely right to say, well, actually if you want to take action in this area you need to look towards harder policy measures.”

“What I have always said and continue to say is that there is a limit to how much you can do through voluntary means.”

'Nuanced' and 'sophisticated'

She said the issue was so complex that a “nuanced” and “sophisticated” strategy that also took into account the will of society was required, and this had been reflected in some of the successes and challenges within the Deal.

“I think it’s very unlikely that we would have achieved reductions in portion sizes in sugary drinks and confectionery, which we have done through the Responsibility Deal, if we had tried to mandate that because of the time and negotiating and lobbying and the issues that would have come up. And, frankly, do we really want parliament debating how big a biscuit should be?"

"However, there are other things which we’ve seen in the Responsibility Deal are very hard to get agreements on through voluntary means. We’ve been trying to get collective action on promotions and that’s proved to be just about impossible.”

She said promotion covered a multitude of different activities from advertising to buy-one-get-one-free and voucher deals to in-store product placement.

An easy target?

Discussing the Labour party's recent election run-up promise to crack down on unhealthy products aimed at children, Jebb said this was a "step in the right direction but a very, very small step".

"People tend to focus on marketing to children and of course that’s part of it. Sweets at the checkout, that’s part of it too, but that’s not just about protecting children that’s about protecting

all of us."

She added that if you looked at the proportion of foods eaten by children that fall into this category of those specifically targeting children, this made up a tiny part of their overall diet.

"I don’t want just want action on products specifically marketed to children, I want action on reformulating products across the board. Of course we all want healthier children. But I want healthier adults too. And I think it’s an incredibly partial step to just limit it to children."

The pledge from Labour came as part of the run up to the country's elections to be held in May this year. Shadow health secretary Andy Burnham pledged to introduce limits on the levels of fat, salt and sugar allowed in food marketed to children. If Labour were voted in, this could mean a diversion from the Conservative party ethos Jebb said had centred very much on a philosophy of change through voluntary mechanisms.

The Responsibility Deal was set up by the centre-right Conservatives when they came to power four years ago. Despite criticism from public health lobby groups like Action on Sugar for its dribs and drabs approach, Jebb said its achievements had been important.

"It’s very, very easy to criticise and I’m a naturally impatient person so yes I would like to achieve more. But I look at what we have done in four years of running the deal and actually we’ve done pretty well. Front-of-pack labelling on two-thirds of manufacturers’ products. 70% of high street fast food chains are showing calorie labelling on menus. Nearly two-thirds of the market signed up to challenging salt reduction targets. 40 companies signed up to reducing calories. Half the market reducing saturated fat."

She said the question moving forward would be: "How can we build on that and accelerate that? Either by strengthening the systems around it or introducing other policies."

Labour had used a similar structure to secure changes to salt levels in foods in the past, without the formal title of the Responsibility Deal, but she said where differences might have been seen was within the amount of resources dedicated to the task.