Government’s public health responsibility deal is met with scepticism

A national agreement between the UK government and the food and drinks industry launched today has met with a sceptical reaction from health professionals and charities.

The “responsibility deal,” an agreement between the government, the industry, and health organisations, contains a series of voluntary pledges aimed at improving public health in England, but several health bodies and charities have refused to sign up to it.

In addition to the likes of the BMA and Alcohol Concern, which have already pulled out of the deal (BMJ 2011;342:d1659, 14 Mar, doi:10.1136/bmj.d1659), Diabetes UK and the British Heart Foundation have now also withdrawn.

The health secretary, Andrew Lansley, launching the deal, said that joint working meant that the deal could deliver faster and better results than a regulatory route to improve poor diet and alcohol misuse.

Mr Lansley, who unveiled more than 170 signatories to the first phase of the deal, said that since September of last year five networks—working on food, alcohol, behavioural change, physical activity, and health at work—had developed a series of pledges for action.

Among the pledges are:

• Including calorie counts on menus from September this year

• Reducing salt in food so that people eat 1 g less a day by the end of 2012

• Removing artificial trans fats by the end of this year (agreed to by fast food outlets including McDonald’s and Kentucky Fried Chicken)

• Achieving clear labelling of alcohol unit content on more than 80% of alcoholic drinks by 2013

• Increasing physical activity through the workplace, and

• Improving workplace health.

Mr Lansley said, “Public health is everyone’s responsibility, and there is a role for all of us, working in partnership, to tackle these challenges.

“We know that regulation is costly, can take years, and is often only determined at a European Union-wide level anyway. That’s why we have to introduce new ways of achieving better results.”

Several leading organisations, however, are not convinced, including the BMA, the Royal College of Physicians, Alcohol Concern, and the British Liver Trust, which have withdrawn from the deal’s alcohol network and refused to sign up to the overall deal.

Sceptics also exist in the food section of the deal. The chief executive of the charity Diabetes UK, Barbara Young, said, “Diabetes UK cannot consider signing up to the responsibility deal in its present form.

“We agree that government, the health service, industry, and the voluntary sector all play an important role in achieving healthier lifestyles. However, we are disappointed that the responsibility deal is not more ambitious in its vision, as many of the pledges replicate existing standards.”

The British Heart Foundation has also refused to sign up to the deal for the time being. Its chief executive, Peter Hollins, said, “We hope to be able to sign up to the deal once further progress is made in developing a robust monitoring system for the pledges.”

The UK Faculty of Public Health, the UK’s standard setting body for public health specialists, rejected the alcohol pledges but said that it supported the overarching commitments in the responsibility deal, particularly those on food and occupational health.

Its president, Lindsey Davies, said, “We are profoundly disappointed that the alcohol pledges do not go further. We do not see any evidence that industry has moved as far or as fast as it could to address the huge and increasing burden of alcohol related harm.”

David Haslam, chairman of the National Obesity Forum, said that he was broadly in favour of the agreement. “It might not work,” he said, “but potentially it’s progress. It should be monitored and be a rolling programme of support, changes, and progress.”