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Dr Jonathan Carr-West Headshot

Fat Is a Local Government Issue

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On 3 January, the LGiU published a new report on public health with Westminster City Council. Of all the recommendations in the report, which ranged from improving the supply of fresh fruit and veg to promoting use of public transport, the one that grabbed the headlines was our suggestion that local authorities could consider varying local benefit levels to reward and incentivise those people who sign up to exercise programmes.

Everyone likes the sound of incentives. The flip side, of course, is the fact that people who failed to complete an exercise programme would lose out on the additional money. It's this issue that the press got their teeth stuck in to. Over on the Guardian, obesity campaigner Charlotte Cooper argues that we want to "withhold benefits" because of our "loathing for poor people with the wider medically sanctioned disgust of fat."

That's not quite where we were coming from. The suggestion that councils could think about varying benefit levels stems, rather, from a recognition that going along to a leisure centre can be expensive and that, by taking steps to improve their physical health, residents ultimately save the public sector money. The point is to remove barriers to people who want to get healthier and fitter. That's about supporting, not loathing, poorer people.

As an organisation, we're committed to the kind of public policy interventions that help local people take control of their own lives. That means local councils making positive, healthy behaviour as easy as possible. We need to recognise that, even in a global, modern city like London, there are communities where people struggle to access fresh fruit and vegetables and afford to pay for leisure facilities. Local councils should tackle this exclusion head-on.

Charlotte Cooper rightly draws attention to the significant risks that overweight people take to get a "normal" body. The bigger game, of course, is ensuring that people never get in to the desperate position where surgery, or even the prescription of an exercise programme, is necessary.

Surgery, and other clinical interventions, are ruinously expensive and damaging for individuals. The NHS has a lamentable record of investing in programmes, such as healthy diet and exercise, that prevent poor health. Instead, it's pouring £5.1 billion in to treating a largely avoidable condition. When local councils assume responsibility for public health in April, there'll be a chance to turn this damaging approach on its head.