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Doctors’ leaders call for more regulation on public health

BMA says government is too familiar with commercial industry

Adrian O'Dowd

Friday, 21 December 2012

Public health must be improved through more regulation and legislation rather than leaving it up to people’s freedom of choice, claims the BMA.

In a blunt new position statement Behaviour Change, Public Health and the Role of the State, the BMA said it had significant concerns about the coalition government’s public health policy for England, saying it was too close to commercial industry.

Given that obesity, alcohol misuse and smoking-related illness have reached epidemic proportions, it is time to get tough, says the report, which argues for a more stewardship approach and regulation to combat the biggest risk factors for health such as poor diet, lack of exercise, smoking and alcohol consumption.

The government was too reliant on voluntary partnerships with business, corporate social responsibility, and a drive to nudge individuals towards taking greater responsibility for their health, said the BMA.

The report says: “For the government, as people are ultimately responsible for their own private decisions over what they eat, how much physical activity they do and whether they smoke or drink alcohol, centralised interventions and initiatives that restrict choice or lecture people in these areas are unjustified and ineffective.

“Instead, the coalition favours a more localised and individual approach that respects the rights and freedoms of individuals and commercial organisations.’

Problems were growing, however, such as the predictions that as many as 40% of the UK could be obese by 2025, causing heart disease, high-blood pressure, arthritis, type-2 diabetes and some cancers, while alcohol-related harm was costing society £21billion a year.

BMA director of professional activities Vivienne Nathanson said the BMA had seen some success in securing a number of regulatory measures designed to create a healthier environment such as minimum pricing for alcohol and limiting tobacco sales.

Dr Nathanson said: “Even when governments are in favour of legislation and regulation, they face these accusations of nanny state, so having a paper out there is useful. It helps the government as well,” she says.

Publishing the position statement at this time, she added, was partly to help policy makers by setting out the ethical arguments for curtailing some freedoms.

The state “should put the well-being of its citizens before commercial freedoms”, the paper argues, adding that merely leaving people to their own devices risks further entrenching deep social inequalities.

The report is critical of the decision in 2011 by the coalition government to set up five public health responsibility deal networks covering food, alcohol, physical activity, health at work and behaviour change. These included representatives from firms such as PepsiCo, Tesco, Mars and McDonald’s.

The BMA believed there was a fundamental conflict of interest in expecting businesses to take steps which could impact upon their profits and last year, the BMA and others withdrew from participating in the alcohol network, saying that pledges were not specific and the process had prioritised the views of industry.

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