Joining Forces to Tackle Obesity, 21-22 January 2002

 

Transcript : Preventing Obesity Through Physical Activity Strategies

 

Nick Cavill

Department of Transport, Local Government and the Regions

 

DR WILLIAM DIETZ: The final speaker this afternoon is Nick Cavill, consultant in health promotion and travel awareness in the

Department of Transport, local governments and the regions.

 

NICK CAVILL: Thanks very much Bill and it’s great to be here. I’m glad there are some people left out there. There was a small exodus just now. It is rather daunting (1) to follow the minister and (2) to come at the end of such a stimulating and interesting two-day conference. I’d like to look back to my very brief days a few years ago when I was in a rock band for a hobby and we used to argue over who went last. We all wanted to go on last at gigs and that was because of course the audience was very drunk and they’d be more appreciative. I think they’d mainly been on Highland Spring. This is unlikely to be the case today so I’ll try and keep this short and sweet.

 

But what I’d like to do is to take us back a couple of presentations to transport and briefly outline some of the key issues around transport and physical activity and to outline what the Department of Transport is doing to tackle this enormous and important problem.

Some people in the DTLR may have heard about the Obesity Report and thought, well what’s it to do with us? But happily that wasn’t the majority response and the DTLR was very, very centrally involved in responding to the National Audit Office reports and in making representations to the PAC -- to the Public Accounts Committee and of course right at the heart of Department of Transport, local government and the regions raison d’être if you like, is better transport and thriving, prosperous, safe communities and of course those words of ‘prosperous’, ‘safe’ and ‘thriving’ are all about health and quality of life.

 

And we’ve had lots of data over the last couple of days and lots of terrific charts and Adrian Davis already referred to some of this data but look at the steady year-on-year rise in the distance travelled by car. From 1975 when the DTLR first started it’s National Travel Survey in this form through to the current day, a year-on-year-on increase in the miles travelled by car and a corresponding decrease of course in human powered transport; like using food as fuel. I very much like that analogy. A year-on-year-on decrease in the miles walked.

It doesn’t really take a genius to add on to that - although it does take a genius in PowerPoint I must say - you know the corresponding increases in obesity to which all speakers have referred over the last couple of days and clearly this isn’t a causal link and we can’t look at this chart and say, "Well you know the car is to blame. It’s all down to transport" but there clearly is a relationship. We’re using cars more; we’re walking less and this is having an impact on our health.

 

The transport policy as Adrian outlined so clearly just now has changed quite a bit in the last few years and the new deal for transport in 1998 set out a new vision for transport and they’ve said the way we travel is making us a less healthy nation. This document, this key document, acknowledged the role of transport in enhancing our ability to move and enhancing many aspects of our health and this white paper set out the vision for transport; reducing traffic growth; trying to tackle car dependency; integrate transport modes better and set up this idea of local transport plans as the key way to take transportation planning forward.

 

And really in terms of the way that - I just want to take you briefly through the key issues - obviously diets’ encouragement of cycling and walking is one way that a transport department can have an impact in this area. But also we need to think briefly about public transport and every public transport journey involves a walk to some degree; a walk to the bus-stop; a walk to the train station or if you’re lucky being able to get your bike on the train and integrating two particular modes.

 

But also we need to think about the way that the DTLR has an impact in terms of sort of broader policies reducing the need to travel particularly through you know encouraging development on brown field rather than green field sites and particularly through planning policies such as PPT13 that encourage developers to locate people closer to employment, shops and so on and also planning policy in terms of regenerating areas and effecting leisure provision and so on.

And of course all this has to be seen in the context of safety; another very, very key responsibility of the DTLR and as the road safety strategy set out, we have to think of the way that children walk and cycle in safety, whether they have freedom to move around and develop.

 

As I said the transport white paper set out these new things called local transport plans and these were pretty important in terms of taking a new approach if you like to transport, transport planning. These are seen to be the sort of local plan; the basis for funding at a local level and setting out 5 year programmes for transportation and the 10 year plan - Transport 2010 - sets out the funding plan based on provisional local transport plans that local authorities put in and the local transport plan settlement gave £8.4 billion over 5 years and £27 billion over 10 years for local transport plans and this is about double the amount that we’ve seen in previous years for local transport policy and development of local transportation and much of this covers things like walking and cycling strategies.

 

So I’ll look briefly at cycling and walking in turn. I thought I’d wake you up with a picture of me on holiday on my bike and this is to underline the difference really between utilitarian cycling - you know the sort of cycling that perhaps they do in the Netherlands or Copenhagen, and the difference between that and leisure cycling. Certainly what I see in Richmond Park near where I live is the people who take their four-wheel drive or the car, put their bike on the roof rack, drive to the park and then cycle round and round the park; put it back in the car and drive home again and there clearly is a big difference at the moment between the way the bicycle is being used for leisure purposes and the way it was used previously and could be used more for transport and certainly there’s a big difference between cycle ownership and actual cycle usage. You know there were only around 2% of all journeys are by bike, pretty short average distance - 2.3 miles; and only 11% of adults ride in a month.

Now clearly the bicycle has really changed its role as a mode of transport in post-war years. (Reference to visual aid) I discovered this data from the transport research lab that go right back to the 1950s and look at this decline. This really is a significantly different role for the bicycle in the last 40, 50 years and we’ve seen steady decline in the last 10 or 20 years but nothing really compared to the post-war years when clearly the car took over and the bike became marginalized.

 

So what’s been happening since that and how is cycling policy trying to take this on? Well, I think one of the better examples of joined up government, if you like, has been the approach taken to cycling and the national cycling strategy. In 1996 the national cycling strategy was launched and this is one of these first genuine sort of cross-party agreements that we saw when they agreed targets, at that time, to quadruple cycling from 1996 and these targets may have been taken up in the transport 10 year plan to treble cycling by 2012 from a year 2000 base. And it got public sector agreement targets and plans to promote the targets to local authorities and to the public.

 

One of the most important ways - you know it’s okay to have a national strategy and to say good words and get agreement across government about something - but how is that filtered down locally? Well, it’s all to do with local transport plans, and there’re very clear criteria for minimum and good travel plans when it comes to cycling. And the local transport plan guidance that Adrian Davis referred to, sets out this sort of criteria, and the minimum criteria for a good local transport plan so that it must have a cycling strategy; establish clear local targets; see cycling and all their policies throughout the transport arena; review the road network and look at safety for cyclists. And then there is also good criteria set out that the many local authorities are able to reach. Like I’ve said a significantly enhanced local transport plan funding and this is allowing for up to 4,300 kilometres of new cycle routes throughout England over the next 5 years. So many of the local transport plans really are looking at very local issues and really are looking at trying to increase the proportion of people cycling and walking.

 

So onto walking then and we’ve heard very much a key mode of physical activity, as Ken Fox and others have said. It’s really one of the key ways that we are able to integrate physical activity into our lives. Sport has a place of course, PE has a place, but if you can’t walk anymore to get around then that takes out a major mode of physical activity from our daily life. As I showed in the first chart, the distance walked has fallen from 255 miles per year probably 5 years ago, down to 186 miles per year per person last year.

 

We’ve heard already that around about a quarter of households have no car, so perhaps for them walking is more of an enforced issue, as indeed we need to think about the 10% of people who have mobility difficulties that we can’t encourage to necessarily walk everywhere. But there clearly is a great deal of untapped potential in terms of walking, in terms of increasing the proportion of people walking and the distance that they walk as well, particularly things like walking to work, where currently only 15% of women and 7% of men regularly walk to work.

 

So again the local transport plan guidance set out advice to local authorities on how this should be taken forward and this was also encapsulated in the document encouraging walking which is looking at a strategic approach to promoting walking. This gave advice to local authorities on benefits of walking including the health benefits; planning a partnership to encourage walking; practical actions that could be taken and then the sort of promotional ideas too. And those who have been following the politics of this particular issue and the politics of walking will note that the recent select committee report on walking in towns and cities recommended that this document be upgraded to a national strategy on walking and that each area has accepted this and will be working on producing a national strategy on walking in the next year or so.

 

When we look at things like promotion of walking, of course it’s not all just down to government. There are many, many agencies that can actively get involved with promoting walking - either walking to school or walking to work or walking more generically and you may have heard of the British Heart Foundation countryside agency Walking the Way to Health Scheme, that’s funded by the New Opportunities Fund. This has done a great deal across the country to set up local walking schemes and they will be planning on the 6 April 2002 to launch their new campaign which is encouraging people to use pedometers - you know these little things that you clip on your belt - to actually measure how far you walk in a day and to keep a note of that and to use that to monitor your distance and to encourage you to walk more, so I think that’s a really good development and something to look out for in April.

 

And again, local transport plan guidance sets out both minimum and good criteria for how walking should be tackled in local transport plans, from the minimum criteria that you see here through to criteria that’s already given in the transport plan, such as that in York, where they have a road user hierarchy where pedestrians are always considered first when any transport scheme is being considered.

We’ll just look briefly at some of two main destinations if you like, two main places to which we may travel: the school and workplace, and look at some of the issues there.

 

Travel to school has changed quite significantly over the last few years and you see - this is for 5 to 10 year olds - and we see that the proportion of walking has declined quite significantly in recent years as car travel has increased. I can’t quite see - bus and road isn’t it? The bus is a significant and relatively stable mode of transport and for this age group the bicycle has virtually disappeared as a valid mode of transport to school.

 

Notice if you will a small and encouraging upturn in the proportions walking in the last year and that corresponding downturn in the proportions going by car. The statisticians tell me it’s too early to get excited about this but I think this is something to watch over the next six months if last year’s MTS data comes out and certainly over the next couple of years to see if this trend is confirmed. And with 11 to 16 year olds we see the same - a small upturn in proportions walking in the last year and a small downturn in the proportions going by car. But clearly, as I said, we need to wait to see if these are bucking the significant trend, and here you see that the bicycle at least still retains a small role for 11 to 16 year olds although that’s significantly decreased in the last 10 or 15 years.

 

And again I think a really good approach has been taken in terms of joined-up or cross-government working to school travel because it’s clear that how kids get to school is an education issue, it’s an environmental issue, it’s a health issue and so on, and the STAG - the School Travel Advisory Group - tries to take this cross-government approach to looking at this issue involving Department for Education Skills, Department of Health, it’s convened by the Department of Transport and it’s trying to bring together these different agendas and I think it’s done so very effectively both through looking at research, producing joint guidance and helping to encourage school-based travel planning. And this has been pretty much the cause, of the VTRs approach, this idea of a travel plan, this idea of focusing on the destination that you are going to and encouraging that destination to look at travel planning as a strategic issue.

 

So how can a school get a travel plan that reduces school gate congestion, that reduces pollution at the school gate, that encourages more kids to walk and cycle but looks at cycle parking and so on in a strategic way, and 111 travel plan co-ordinators have been employed across the country to try to do just that - working within local authorities but reaching out to schools and workplaces, trying to get them to look more strategically and produce travel plans.

 

And a final issue then - travel to work. 7 out of 10 journeys to work are by car so a significant issue to be tackled. And again travel planning is the approach that DTLR is trying to take, you know, working with employers’ to say, "Can you tackle this issue strategically, reducing car usage to travel to work and for travel on business?" you know what about the car mileage and how that relates to bicycle mileage for example, reducing the environmental impact of travel to work and as part of work, and reducing the need to travel at all for work through IT use for instance - things like teleconferencing and so on.

 

And this is taken as being pretty variable across some sectors with travel planning. Local authorities - where they’ve employed travel plan co-ordinators - there’s been a significant increase in travel plan take-up. In the private sector it’s been particularly challenging to try to get travel plans taken up there but 39 of the new detail are funded posts, are working specifically with employers in the private sector and so that’s very much a challenge for these new people.

Adrian Davis gave a little plug of his latest resource, which is a joint production from the Department of Health and the Department of Transport, local government and the regions. Again I hope for a small example of joined-up working which is called "Walking to Workout" - difficult to say - and this is about encouraging walking and cycling to work. And this is based on that chart that Adrian showed you that said that for quite a few people exercise is a good motivator, a good reason to encourage them to cut their short journeys and if we can talk to people who want to change their mode of travel, who have said through staff travel surveys that they want to walk or cycle, and stress the health benefits and present that in a non-judgemental manner then it can work. Indeed, a pilot project in Scotland did work and it doubled the rates of walking to work in a randomised controlled trial. It specifically targets contemplative or preparative in the jargon, in other words people who say they want to walk or cycle to work, so it’s not kind of old-fashioned health education literature, it’s working with people who want to make a difference and working with them with personalised advice. And the idea is that this sort of intervention is used through mediators, through people like travel plan co-ordinators and others who can work within the workplace and encourage others to walk or cycle to work.

 

So even if you’re not in the transport arena don’t dismiss this and think I won’t bother sending off for one of these, have a look at the flyer in the front of your pack because in your workplace you could be the one person that makes a difference. You could be the one person that encourages your bosses to put in new bike sheds or bike racks, or showers or whatever, and makes conditions better for cycling or walking.

 

The final slide, I think you’ll be glad to know, the final slide of the conference perhaps, and really in this session I think one of the most important because clearly transport as I’ve said has an important influence on our likelihood to be able to be physically active as part of the day and therefore on our health, including particularly obesity levels. But if we don’t work together, we simply say this time and time again in the last couple of days, if we don’t work together it won’t make any difference. Now the National Audit Office report was relatively kind to DTLR and it said that this National Level joint working was taking place to an increasing extent and they were able to draw on some evidence of that going on, and then to see some partnership working.

 

And things like this document produced in 1999 I think it was, "Making the Links" pointed out some of the ways that the transport and health agendas were coming closer together both nationally and at a local level. But it’s key that this joint working, and joint policy making if you like, needs to filter down, and needs to really happen at the grass roots, where things really do make a difference - particularly local authorities working closely with NHS partners to make a real difference on the ground, not just at policy level. The mechanisms for that sort of joint planning are there in the things like the Health Act 1999, which provided the local authorities and health authorities, powers to actually work together and on behalf of one another, actually taking each other’s budgets and working on the issues of joint interest; and the Local Government Act 2000, which provided local authorities with the powers to extend this partnership approach to others with whom they may have an interest in addition to the NHS.

 

So the mechanisms are there, they can work together, they’ve got guidance on how to do so, and it just remains to be seen how many examples of good practice that we’ve seen so far can be built on. In particular, the link between the LTPs with local transport plans and hence self-improvement programmes and how they can be enhanced, because those are the two key local planning mechanisms for the transport and health side that need to be co-ordinated. In the very near future, local strategic partnerships of course will be the key mechanism for important bodies to develop community strategies, looking at all aspects that contribute to quality of life and of course, transport and health are key aspects to be considered and there’ll be agreeing parties for action and co-ordinating partnerships across neighbourhoods and looking at specific issues. And I would hope that transport and its’ effects will be one of the key issues that they’ll consider.

 

So I’ll leave it there. I just hope I’ve given you a quick run through some of the key issues around transport and health to complement Adrian’s talk, but also to show that the Department of Transport is trying to tackle some of these issues and clearly in the face of what are clearly some difficult trends. The car really has had a bit of a takeover if you like in transport policy in the last 20 or 30 years but there are some very significant actions being taken to try to encourage a move towards more walking and cycling, and towards more sort of food-powered, food-fuelled transport if you like. Thank you.

 

WILLIAM DIETZ: Adrian, would you join me up here please? Questions? Yes?

 

QUESTION FROM FLOOR: Hello, Jude Manford from Nottingham City Council. It’s a question to anybody really, but picking up on Ken Fox’s points earlier on about 2 kg weight loss coming from 20 minutes of activity a day, and that being necessary you only need to not have that over 10 years and you can go from being average weight to obese. And one of the things that interested me - I work in the transport strategy team for Nottingham - is that if you look at the statistics, transport is one thing that people do for at least 20 minutes a day. Virtually everybody travels but the amount of time people spend travelling seems to be virtually unalterable. We all travel on average the same amount of time as our parents and our grandparents, just as it’s become mechanised we travel farther, but if you look at all the DLTR statistics, year after year after year after year average journey time is the same and the average amount of time people spend travelling is virtually unaltered.

 

So realistically it is our best chance of getting people to build into their lives the required amount of physical activity. So the two questions are: what would need to be done to get a national advertising campaign as extensive and as relentless over the years promoting walking and cycling for health reasons as we have had about drinking and driving? And secondly, what would need to be done to get every GP to say to every patient they see on any visit or to give them a prescription with on it "walk and cycle for half an hour every day"? Thank you.

 

DR WILLIAM DIETZ: There appears to be some indecision on the panel about who wants to handle that. Ken, I think the question was directed at you? But others may come.

 

KEN FOX: The implications were transport.

NICK CAVIL: I guess that’s me then. I think it’s an interesting point about advertising campaigns. Just last year there was the "Are You Doing Your Bit?" campaign that’s run for two to three years and this was a really significantly funded campaign that was looking at the environmental issues. It principally covered environmental actions such as saving water, recycling and so on. But it also covered transport, and I thought one of the very interesting things about that campaign was that it focused very closely on encouraging walking and cycling as transport, and in doing so realised, as we saw some of the data that Adrian showed, that health was quite a key motivator to encourage people to travel more sustainably, and it wasn’t so much about trying to save the planet.

 

So you may have missed it but there was recently quite a significant investment in advertising and it was pretty close to the levels that we saw for drinking and driving, but I think there are difficult issues about transport mass communications and I don’t think any minister would want to say that we will stop advertising against drinking and driving because it’s had a particularly significant effect in terms of reducing casualties. In terms of the GP issue perhaps I could hand that question over to someone.

 

ADRIAN DAVIS: Well, I’ll just make a brief note about GP issues although I learned the evidence I think from the old HEA that many GPs in their training had very, very little training about the value of physical activity so many GPs are out there in the field now, their levels of knowledge about physical activity and it’s benefits are perhaps lower than they should be and maybe for those now in practice one of the ways around that is to get the Faculty of Public Health Medicine and the other associated professional bodies to put more effort into highlighting the importance of these very things. You know one of the very best ways to get physical activity into people’s lives is because many people have to travel on a daily basis and an obvious way of doing some of that at least, is walking and cycling and I think that’s probably part of the answer and the other part is the current trainees need to be taught by their lecturers the value of walking and cycling as well and I just hope it’s something that will happen in the expanded medical colleges that are being opened up now in England and the UK.

 

DR WILLIAM DIETZ: Thank you. Mrs Nixon?

 

QUESTION FROM FLOOR: Unfortunately the minister isn’t here to answer the question I’ve got. You mention that we’ve got a complex and physical problem of obesity in children as well. You mention that there’s a plan for two hours per week of exercise for PE - we’ve not seen that. We’ve actually seen a reduction in the amount of PE that’s offered to children. The child’s quite often given the opportunity to opt out of PE, "Oh, I have another language lesson" - you’ve got him excelling in that area instead of where we’ve seen as well children who are poor performers in academic subjects, they get extra help, but in PE, no. They just get, "Oh, we’ll leave that one alone, that one’s a problem one". I say it’s unfortunate the minister isn’t here to say anything.

 

DR WILLIAM DIETZ: Does someone want to respond?

KEN FOX: I could respond on that. I share your sentiments - I’ve been a PE teacher for eight years in the past and I’ve trained or educated PE teachers down at Exeter University. And it’s been a problem throughout my experience that Physical Education always takes place at the back end of the school, it’s always last on the curriculum and it always suffers when there’s a particular political agenda for academic achievement - it gets knocked on the head. So it is encouraging that the Prime Minister has said two hours and hopefully that will come on line, so it’s a very positive move forward. Having said that, if you work out the figures, even with two hours a week, I think it adds up to less than 1% of the child’s waking time. So we’re talking about energy expenditure here, so if you’ve got the child for 1% of its time you’d better damn well use it well, and that’s the point I was trying to make in my talk that we’ve been very good at switching people off the sport in the past. We’ve switched as many off certainly as we’ve switched on, and that might be the nature of competitive sport. It’s exclusive in its own - intrinsically exclusive. If we don’t learn how to use Physical Education and sport - coaches as well as teachers - in a way that really makes it a rewarding experience for children of all abilities, shapes and sizes, then it won’t succeed, so that’s the critical issue. Yes, we’ve got the time coming on board but we’d better really make sure we can appeal to overweight children, small children, weak children, embarrassed children, girls in particular, and I think we could do very well with that and certainly much better than we have in the past.

 

MALE SPEAKER: Could I just add that in school we’ve also found that kids are actually getting quite de-motivated in PE? They’re singled out as examples of how not to do sports and we also noticed around the area where we live that it’s actually quite difficult to find provision for kids that are obese. They’re not encouraged to join, in fact they’re actively discouraged to join, football teams, swimming lessons - they’re not allowed to wear T-shirts, you know, to cover their bodies because they’re embarrassed, and we’ve actually found there’re curfews where they’re not allowed to use certain facilities after 4.30pm. So you know it’s difficult for them to get to sports centres before 4.30pm and they live quite a way away from sports centres. There just doesn’t seem to be any encouragement to do exercise. I know that most of us are saying that we’re doing quite a lot to promote sport but none of it seems to be targeted at obese kids - it all seems to be targeted at kids with ability.

 

JAMES ROBERTSON: There’s very little understanding out there of problems that those kind of youngsters face but on the bigger picture there are very good examples of schools that really have done well, and Brian Hawkins yesterday from a school in Ipswich, really described the programme that’s engaging a high percentage of youngsters in physical activity and they are sensitive to those youngsters who have special needs such as obese kids, so it can be done but it really has some road to travel yet I think, in terms of becoming widespread. There are good examples, I think they’re mentioned in the report; there are case studies available.

 

DR WILLIAM DIETZ: Thank you, James.

QUESTION FROM FLOOR: On the assumption, Chairman, that we may be coming vaguely towards the end of the conference I wondered if I could challenge the three speakers in a slightly more general way. We’ve heard and we’ve had two days where there’s been a great discussion about different components and so on. We’ve had a couple of ministers saying they are really solely committed and they’re working brilliantly across government departments and declaiming that in fact local initiatives should be very useful and so on, and we’ve really got a sense that they’re become a little more strategic. When I - with others - ran the United Nations commission on how and what determines the cycle change in the solving of a problem, what we discovered whether we were talking about dropping heart disease fast or whether we’re talking about the combating of malnutrition in children as in Thailand, not only did you need extraordinary inter-governmental action but you needed a major public dimension with a group of people in the public domain who were not only validating but challenging so that both your national and local authorities were having to do it because the community was involved. If you don’t involve the community you won’t get it. Now it seems to me from the discussions that we’ve heard that we’ve heard on the food side that in fact the obesity world is in, as a medical entity, in chaos; that the food, we have big problems on the food front as was beautifully illustrated by our discussions on the supermarket approach. In the transport field we’ve got one or two groups who are very keen on the cycle paths and so on but I sense that we don’t have any coherent national external group creating hell if things are not being carried through. Is that true or only just my hopeless ignorance in these affairs, and if it is true, what would the three panel members suggest as a potential mechanism whereby we create that outside government public entity that can challenge demand and force the political pressure for change? Is that an issue or are you well aware?

 

KEN FOX: Well I’ll just try and tackle one of the transport parts of your question. In the transport world there has been for many years and some of you will know of them, a number of key transport pressure groups in the UK and they have sister organisations in other parts, at least in Europe - Transport 2000 is probably one of the most widely known ones; Friends of the Earth; more recently Children’s Play Council’s become active in campaigns for children’s rights in transport. There are a number of organisations and at a national level they are well co-ordinated together but their relative weight in the argument against the major road lobby, the road lobby has been stated to be the most powerful lobby in the UK, I mean Tim might say the food lobby are more powerful, I don’t know, but they are very, very powerful, have been very, very powerful and shaped transport policy since the second world war and so you have a David vs Goliath syndrome where the environmental movement has been fighting very hard and very effectively as it can. But I am, echoing what I said in my speech, that I think the public health movement needs to engage far more with supporting environmentally led transport and coming behind and supporting and defending environmentally led transport policy and really forming perhaps an alliance with organisations like Transport 2000 in a much more formal way than they ever have done before to show government that there is a very strong public health movement behind the things that will lead to active transport.

 

NICK CAVIL: I think it’s very interesting, because you mentioned cycling, Phil, and I think it’s very interesting to look at the case study of cycling and the way that the cycle pressure groups were able to come together and develop a very coherent and valid voice for cycling and I think make a big difference and I’m sure it’s many of the cycling groups coming together that led to the implementation of a national cycle strategy, and in particular led to action by people creating these great networks of routes right across the country and ever-growing, I hope. And I think it’s of interest that we don’t have a parallel in terms of walking. There are the Ramblers and there are the Pedestrians Association who are changing quite a bit and modernising but they aren’t as much of a voice. Now maybe that’s because they don’t feel they’re able to argue for facilities in quite the same way, because you don’t want to segregate walkers and you don’t want to segregate cyclists, but that’s a different argument. You don’t need to build specific tracks for walkers - there are pavements and walking tracks all over the place. But there are so many clear issues when it comes to walking to do with the way that we interact with each other, the way that we use space, the way that we develop ourselves and relate to each other and build social capital and become part of communities and it’s reclaiming the streets if you like, reclaiming open space, and I think the walkers’ should learn a lot from the cyclists and get noisy.

 

KEN FOX: I’d just like to say something very briefly and that I think you’ve hit on an absolute crux issue and that is we could easily go away from this and everything fall apart simply because there is no co-ordinated response to physical activity. There never has been, there’s no academic organisation, which is totally responsible for different domains in which it takes place, there’s sport, there’s exercise. None of this has been brought together into one body, either inside government or outside. At least for food we’ve had responsibility for food within government. There is no single responsibility for physical activity within government or outside government, so that we suffer from the problem of it’s everybody’s responsibility and it very easily becomes nobody’s real responsibility. I would love to see your past idea of a Ministry for Lifestyle, would be wonderful, or an agency like Bill’s over here where it combines physical activity and nutrition into a single unit which can really tackle the problem at source. We’ve not been, and I’m not sure how we get there. The national activity, physical activity, alliance might be the seeds of something that could develop into that.