General Health Thursday January 10, 2013

Lose weight or lose money - are Westminster Council's proposals fair?

Eat healthily

From April, local councils are becoming responsible for public health in their areas. Since obesity has become such a major problem amongst the English population and such a financial drain on the NHS, it is an area that local authorities are prioritising. Last week, Westminster Council hit the headlines by saying that overweight people could be persuaded to get healthy and lose weight by linking the health of residents to their eligibility for housing benefits, but is this fair?

How bad is the obesity epidemic in the UK?

Obesity is one of the biggest strains on the health budget with around half of British adults being overweight and 17% of men and 21% of women being obese. It is currently costing the NHS £5.1bn a year.

What has been proposed by Westminster Council?

Westminster Council is proposing an initiative allowing GPs to prescribe overweight or obese benefit claimants in their area with an exercise package or bundle of activity sessions, which they must attend in order to remain eligible for housing and council tax benefit payments. If they refuse, they could have their benefit money docked.

Several councils have already introduced schemes that allow doctors to prescribe exercise at local facilities including swimming pools, gyms, yoga and walking clubs.

How will the initiative work?

The LGIU report published last week (03/01/2012) states that councils can use existing information regarding who is using sports centres and swimming pools to track the health of the local population. Smart card technology can also be used to track who is using council leisure facilities and for how long. Overweight claimants will therefore be given a smart card which will allow the council to track their attendance and monitor their use of leisure centres to ensure they are following their GP’s advice.

The introduction of the oyster-style cards is one of a number of radical proposals designed to tackle the rising levels of obesity set out in a report by Westminster council and a local government thinktank.

Reactions to the proposals

The Tory-run Westminster Council has said that a combination of ‘carrot and stick’ techniques would be needed to encourage people to exercise and they believe that councils have a great opportunity to improve lives by thinking how public health can be integrated in to existing local services. Financial rewards will be offered when overweight claimants make an effort to comply with prescribed activity routines.

Anti-poverty and disability campaigners have reacted in horror to the initiative, calling it a ‘sinister’ proposal and disability and welfare campaigner Sue Marsh was astonished, pointing out that obesity was often a complication arising from disabilities that limit mobility. She commented, ‘I don't know what to say, I think they've lost the plot’.

Looking to the future

It is clear that the rising levels of obesity in the UK are becoming a real issue, particularly in terms of the health risks it poses to individuals and the strain it puts on NHS resources. It is likely that we will see a number of government proposals over the next several years which will attempt to address the issue. It is, however, difficult to see how an initiative like this one could be truly successful. Obesity is a more complex issue than this proposal suggests, and reducing it will depend on more than essentially frightening people into losing weight.

The answer to lowering obesity levels is surely more of a long-term process, which will involve not just government initiatives but also health campaigns and better nutritional education in schools. The promotion of healthy, active lifestyles, with an emphasis on a balanced diet and plenty of exercise, is key.

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