Open letter to the Mayor of London as London's Child Obesity Taskforce term concludes
part of 'Every Child a Healthy Weight - Still a Critical Priority for London' report issued April 2023: here.
For four years, I served as the Chair of London's Child Obesity Taskforce.
The taskforce was set up as an independent body by the Mayor to London, Sadiq Khan, to make recommendations to transform the opportunities for all London's children to achieve a healthy weight. At the time 40% of the city's children did not achieve this. The taskforce has today issued its final report, reflecting on the changes, achievements and work that remains following its Call-to-Action plan in 2019 'Every Child a Healthy Weight' (here) - in which we recommended 20 actions, across ten aspects of children's lives, needed to achieve the transformation required.
As an introduction to our final report, Vice-Chair Professor Corinna Hawkes and I wrote a letter to the mayor, setting out a review of the last 4 years, a plan for work yet to be done and reflections on our learnings from leading the taskforce, in how transformation change can be achieved. Our letter reflects that the three ingredients vital for any sustained, systemic transformation are: Relationships, Resources and Recognition. Here is our letter:-
Dear Sadiq Khan
In 2018 you established London’s Child Obesity Taskforce, with an open remit and a 2-year term. We have had the privilege of leading the taskforce, defining its remit with our colleagues and extending its term to January 2022. In September 2019 we published our recommended ideas and actions in Every Child a Healthy Weight: 10 Ambitions for London, containing 20 specific calls-to-action to the capital’s leaders.
Since issuing Every Child a Healthy Weight the COVID-19 pandemic has impacted life for families and children in London in ways unimaginable back in 2018. The pandemic has fundamentally changed lives and opportunities across public health, personal health and wellbeing, education, the economy and infrastructure across the city, both nationally and globally. It has also brought into sharp focus the direct link between poverty and health inequalities and between environment and public health. All Londoners have more to think about in their daily lives because of the pandemic. The city’s leaders have many more challenges and calls on priorities in their policy and action plans across every sector. It is self-evident that public health and personal wellbeing - be that related to COVID -19 or unhealthy weight (and there is correlation between the two) - are central to the solutions to a better life for all living in the city. The pandemic has tragically shown, in clear focus, yet another reason why it is critical to tackle the causes of unhealthy weight and of obesity in our city.
As you know, the aim of the taskforce, set from its earliest days, was to unleash a transformation so that every child has every chance to grow up eating healthily, drinking plenty of water and being physically active wherever they live in the city. This goal led us to deliver Every Child a Healthy Weight and the 20 specific actions we believe are necessary to begin that transformation. The 20 actions were based on the understanding that change will only come when the whole system in which children live their lives is shifted in a healthier direction. To do so, we need to understand the realities of children’s lives. So, drawing on the fantastic relationships between taskforce members and the communities they serve, we talked to young people and parents about their lives, setting out what we found in What makes it harder for London’s children to be healthier?
Each of the 20 actions in Every Child a Healthy Weight was based on this understanding of these children’s lives. In the almost 2.5 years since its publication we have shared these actions with every leader that would listen; and have listened equally to those that spoke with us. We have engaged leaders across government, business and civic society, helping put the healthy weight of our children centre stage. So many have listened and have shared the actions they are already taking at a local level and have offered the opportunity for these to be brought to a bigger audience.
Councils, businesses, charities, schools, nurseries, communities and parents have shared with us their thoughts on our proposals, and many have begun to take up the initial actions we’d targeted to start before our term ended.
This report sets out an update on the status of the city, and the actions we recommended with respect to unleashing that transformation to improve the health and weight of our children. It shows progress has been made, that there is forward momentum - but still a long way to go. How will we get there? As a final personal sign off - we wanted to share our reflections on our learnings from leading the taskforce and serving the city on what practical actions everyone who wants to live in a healthier city can easily take. We have learned that if the city is to build back after the pandemic with healthier children, three things will really matter:
Relationships: London’s Child Obesity Taskforce was constituted by a diverse range of people, many of whom had close relationships in the communities they serve. This proved critical in enabling us to understand those communities better. While these relationships already existed, we quickly realised we would need to build more relationships to encourage and inspire everyone who needed to act to do so. We began to connect people and show how they could contribute to whole systems change while also learning more about the constraints they faced. We did this as much as we could, but truly building a culture of dispersed leadership and aligned, trusted relationships takes time and, within our remit timeframe, has proved beyond our reach to fully achieve. We hope as part of our legacy that the process of building relationships across the diverse array of London’s leaders need to truly deliver the whole system approach required will continue. It will be essential to enable the systems shift London’s children deserve.
Resources: One of the first things we learned was just how much incredible work is already going on in London. It’s frankly humbling and staggering just how hard professionals in local government public health and food teams, early years settings, schools, civil society, communities and businesses are working to help children have a healthy weight. But it’s also clear that far more resource is needed to really leverage the potential of this committed workforce. The 20 actions we recommended were about step changing existing work - yet we could see that there is barely enough capacity and resource funding for what is being done already. Despite this, and the additional impact of COVID-19, great progress has been made, as this report shows what has been achieved in spades. However, the availability of more human and financial resources will be essential for comprehensive implementation of the changes we need to see in scaling actions that have begun with, for example, the initial city’s water foundations and first champion schools to across the whole city. We ask those that follow us to make sure they focus on capacity and resources on the ground to get things done. Otherwise, action will remain on paper, not in children’s lives.
Recognition: We found that people working against the odds to make things happen often didn’t really recognise just how well they were doing. Often indeed, they were overwhelmed by what needed to be done. We have seen that small actions do build and their stories of change inspire. We can and should tell positive stories - as we try to do here. We wanted to share one experience from many that helped us to see this:
We developed profiles of the lives of children we met that showed it is hard for London’s children to be healthier. But when we went back to one of the communities where we had built a profile to make a video, in partnership with UNICEF, we found they didn’t want to talk about what these children couldn’t do. They wanted to talk about what they could do! They wanted to show the agency, spirit and action they had in their schools, communities and families. They were so right, and their video is so powerful. Focusing on the positive can often be so much more powerful than dwelling on the negative. Creating opportunities to share such stories will inspire not just the rest of London to act, but the rest of the UK and indeed, given London’s global status, the rest of the world. They show that much is possible, despite the odds and we call on our successors to find and constantly tell such stories.
As COVID-19 starts to move backstage in 2022 we believe that child obesity must now headline political, societal and civic programmes of the coming years, as the challenge to seriously tackle health inequalities takes centre stage in our collective, city wide psyche and culture.
Our calls to action still show that unleashing a transformation that supports London’s children’s health and weight is possible, probable and powerful. Looking at future work planned by partners across the city we are encouraged to see our calls to action reflected. We are hopeful that through the successful delivery of the London Vision and London Recovery Programme positive changes will continue to be seen across the city. Together, let’s put children’s health and weight centre stage going forward, and continue to deliver brave and bold action for London’s families.
Paul and Corinna