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Tackling Child Obesity – First Steps

Without clearer leadership from Departments there is a risk that the Government’s target to halt the rise in obesity in children under 11 will not be met. This is a key finding of a joint report published today by the Audit Commission, the Healthcare Commission and the National Audit Office. The report investigates the strength and efficiency of that part of the delivery chain that aims to reduce obesity in children between the ages of 5 and 10.

This is the third in a series of reports which examines the effectiveness of the mechanisms to deliver government Public Service Agreement (PSA) targets.

The child obesity PSA target was set in July 2004, but the key ingredients of the delivery plan will not be published until May 2006. Tackling Childhood Obesity–First Steps warns that a lack of timely guidance has meant that the various organisations that will need to work together to deliver the target have been unclear about their roles. Without greater clarity, those further down the delivery chain may be wasting resources on ineffective or inappropriate interventions that fail to target those children most at risk.

The Government has in place a range of preventative programmes, particularly around school sport and children’s nutrition, through which it aims to address child obesity. The Department of Health recently published guidance on measurement of children and plans further advice for health professionals on weight loss and how obese children may best be helped.

The target ‘to halt the increase in obesity among children under the age of 11 by 2010‘ was set in 2004 as a Public Service Agreement in response to a jump in the growth of childhood obesity. The incidence of childhood obesity grew from 9.6% in 1995 to 13.7% in 2003. The target is jointly owned by Department of Health, Department for Culture, Media and Sport, and Department for Education and Skills.

Obesity now costs the NHS around £1 billion a year and the UK economy a further £2.3 billion of indirect costs. If this trend continues, the annual cost to the economy could be £3.6 billion a year by 2010.

The childhood obesity target is far-reaching and complex, requiring significant changes in the lifestyles of many children and their families to improve their diet and to exercise more. This target is tougher to deliver because it requires the coordination of many diverse organisations at regional, local and front line level, who all have a key role to play in tackling child obesity.

The report recommends:

  • greater clarity and direction from central Government: it is essential that the three Departments work closely together to provide strong leadership;
  • better definition of regional roles and responsibilities: Government Offices for the Regions could play a greater role in bringing together the various elements of the delivery chain;
  • strengthening local partnerships: local structures and mechanisms, such as local strategic partnerships and children’s trusts, exist to promote joint working and have the potential to reduce the risk of duplication of activities by bringing together funding around agreed priorities;
  • more support for front line staff: better information and training on roles and responsibilities and improved dissemination of advice and guidance.

It will be important to build on progress to date and to act quickly on the report’s recommendations to support the target being met and to reduce the risk to children’s health.

"Childhood obesity is a serious health problem that can follow people much later into life. It is a causal factor in a number of chronic diseases and conditions including high blood pressure, heart disease and type 2 diabetes. If we are serious about tackling childhood obesity then all government agencies and organisations must work together more effectively. Those of us involved in inspection and assessment must ensure that this partnership working really takes place nationally and locally."

Audit Commission Chief Executive, Steve Bundred, said:

"The Government is facing a significant challenge on a serious social problem, but it is tackling it head on. To succeed, children must be engaged in the home, at school and when being treated by the NHS. It is no surprise that it is very complicated to address because the various government agencies involved are trying to bring about changes to the lifestyles of children and families. The recommendations in this report must be embraced urgently to give the Government the best chance of achieving its target."

Sir John Bourn, head of the National Audit Office, said:

"Central Government must set a clear direction if we are to tackle obesity in children. Given that the target was established in 2004, the three Government Departments could have been quicker in co-ordinating their own actions and in making sure that those on the frontline were fully informed and supported in their efforts. There is now a need for the three Departments to work closely together to provide the leadership and direction that the whole delivery chain requires."

Healthcare Commission Chief Executive, Anna Walker

Notes for Editors

  1. This is the third of three joint studies on particular Public Service Agreement (PSA) targets. The first examined the use of buses and light rail. The second examined the building of more affordable homes. The NAO and Audit Commission will also publish an overview report drawing out wider lessons.
  2. Press notices and reports are available from the date of publication on the NAO website at, the Audit Commission website at or the Healthcare Commission website at Hard copies can be obtained from The Stationery Office on 0845 702 3474.
  3. The Comptroller and Auditor General, Sir John Bourn, is the head of the National Audit Office which employs some 800 staff. He and the NAO are totally independent of government. He certifies the accounts of all Government departments and a wide range of other public sector bodies; and he has statutory authority to report to Parliament on the economy, efficiency and effectiveness with which departments and other bodies have used their resources.
  4. The Audit Commission is an independent body responsible for ensuring that public money is spent economically, efficiently and effectively, to achieve high quality local services for the public. Our remit covers around 11,000 bodies in England, which between them spend more than £180 billion of public money each year. Our work covers local government, health, housing, community safety and fire and rescue services.
  5. As an independent watchdog, we provide important information on the quality of public services. As a driving force for improvement in those services, we provide practical recommendations and spread best practice. As an independent auditor, we ensure that public services are good value for money and that public money is properly spent.
  6. The Healthcare Commission exists to promote improvements in the quality of healthcare and public health in England and Wales. In England, we are responsible for assessing and reporting on the performance of both NHS and independent healthcare organisations, to ensure that they are providing a high standard of care. We also encourage providers to continually improve their services and the way they work.

PN: 14/06