Hansard

I am pleased to open the debate by exploring the significant challenge that obesity presents to Scotland and the Scottish people. I will also set out how physical activity contributes to tackling the problem.

Obesity levels are rising internationally, and Scotland is not alone in facing what has the potential to be one of the most difficult health challenges that we will see in our lifetime. I will put the issue in context. We have made good progress on a number of public health interventions, from smoking cessation to our approach to reducing alcohol consumption. Obesity is one of the next challenges for us, because our obesity levels are the third worst among Organisation for Economic Co-operation and Development countries, behind the United States of America and Mexico. That is the stark reality that we face.

I am sure that all members will agree that the rationale for addressing obesity is compelling, not just for our national good but for the health of every individual in our communities. If we were to do nothing, the direct cost to Scotland by 2030 would be around 70,000 more type 2 diabetes cases, 400,000 cases of hypertension and 21,000 more heart attacks. Those are frightening statistics, but it gets worse because as well as obesity having a direct impact on the health of individuals, it is likely that if obesity levels continue to rise the cost to the Scottish economy will be around £3 billion, or 2 per cent of Scotland’s gross domestic product by 2030.

That is why we set out our approach in 2010 in the preventing overweight and obesity route map, which outlines our commitment to addressing the main challenges of obesity through four themes: energy in, the working age population, early years intervention and energy out, which is the focus of this debate. It is more than two years since we published the route map, and I intend to bring back to Parliament a full and comprehensive update report next year on the progress that we have made.

Although our progress in a relatively short time is welcome, we need a transformational change to shift our culture. We aim to achieve our aspiration of the majority of Scots being in a normal weight range by 2030. Our national strategy will help us to deliver that, but it is important to re-emphasise that it will not be achieved overnight or even within the lifetime of this Parliament.

The report “Growing Up in Scotland: Overweight, Obesity and Activity”, which was published last week by the Medical Research Council, reinforced the challenge as it showed that 22 per cent of six-year-olds have been found to be overweight. The report also showed that the majority of them had already been classed as overweight at four years old, which underlines the importance of addressing the issue.

Members will be aware that we introduced a child’s healthy weight health improvement, efficiency, access and treatment target in 2008 in recognition of the seriousness of the problem. More than 8,000 children have been engaged in locally based interventions and we have established a new target of more than 14,000 children coming through programmes over the next three years. That builds on and complements our recent take life on campaign, which targets families. We know that habits that are formed in childhood and adolescence continue into adulthood. Interestingly, evaluation of last year’s take life on campaign resulted in 76 per cent of parents encouraging their children to be more active and 59 per cent doing more physical activity with their children. We hope to build on that successful model in the future.

It is recognised internationally that overall physical activity levels are declining, but Scotland is bucking the trend—albeit with small increases—in the number of adults who are active. Scotland has made every effort to push ahead with international best practice, and I am pleased to inform members that we have taken action in all the areas that are recommended in the European Union policy guidelines on physical activity.

Increasing physical activity on its own is not the solution to obesity, but I firmly believe that, as part of a wider programme of interventions, it will go a significant way towards achieving lasting results and will improve health outcomes. Physical inactivity is one of our major health challenges and contributes to nearly 2,500 deaths in Scotland each year. The cost to the national health service is around £91 million each year, and a further £58 million is associated with the cost of medicines to treat conditions that are associated with physical inactivity. I find it astonishing that, although many other health risks are commonly understood, physical inactivity, although one of the major causes of mortality, is largely overlooked. I will return to that later.

According to the World Health Organization, physical inactivity is the fourth leading health-risk factor and accounts for 6 per cent of all deaths globally, placing it behind hypertension, tobacco and high blood sugar. Last year, the four United Kingdom chief medical officers published their guidelines, which stated that adults should be active for at least 30 minutes at least five times a week, and that children should be active for 60 minutes every day. Evidence tells us that meeting the minimum target in the guidelines will reduce overall mortality by 30 per cent and that 30 minutes of walking daily provides more protection against death than any preventative medication. Put simply, if physical activity could be bottled and sold as a drug, it would without doubt be a superdrug.

We are making progress, with 39 per cent of adults now meeting the recommendations in the guidelines, which is up from 37 per cent in 2009. However, the biggest progress is being made among teenage girls, for whom the figure has steadily increased from 64 per cent in 2008 to 70 per cent in 2010. That demonstrates that our targeted investment in that group is delivering results.

Let me turn to what we intend to do to drive forward progress. Resources are crucial to achievement of results. I am delighted to announce that, despite the difficult financial environment and budgets being under pressure, we are maintaining the physical activity budget at £3.3 million per year for the next three years. We are also working with our delivery partners to introduce a more creative and innovative approach in this area. That builds on the success that we have delivered so far and includes continued investment in Scottish Athletics to support the jogscotland programme, which has over 430 jogging groups with almost 22,000 members. That approach is consistent with improving the alignment of sport and physical activity.

We are also providing a substantial investment of £1.2 million each year to the Paths for All Partnership, which delivers a walking programme throughout Scotland and has a proven track record in engaging older Scots in particular. That recognises the tangible benefits that arise from providing older people with opportunities to be active and builds on the evidence of previous investment. We are also delivering efficiencies by aligning the Paths for All Partnership’s activity with other walking projects to build on their ability to deliver more than 11,000 people regularly taking part in the 440 community walking schemes throughout Scotland.

I have been taken with the overwhelming evidence of the health benefits that come from walking, which is why I am delighted to announce the development of a national walking strategy that will set out our ambition and aspiration to ensure that the support and infrastructure is in place to maximise the opportunities for everyone to walk.

We have also listened to the people of Scotland and increased the sustainable transport budget. That will help to develop the infrastructure of the national cycle network, which covers 2,000 miles and was responsible for 40 million journeys in 2010. The network is important because it connects communities and provides cycling opportunities. That is why I am happy to accept Alison Johnstone’s amendment.

We will continue to use the excitement of the Commonwealth games and other events to deliver a legacy and to build on the success that we are already achieving. A major plank of the work is our focus on schools and the early years, and our commitment to deliver two hours of physical education for every primary school pupil and two periods for every secondary school pupil is only part of the story. Although we are making progress, with 64 per cent of primary schools and 67 per cent of secondary schools meeting the target, we are determined to do more. That is why we have made available to local authorities nearly £6 million of additional support to ensure that the gap is closed by 2014.

The work forms an important part of our approach to early years intervention. It is designed to raise awareness and to educate young people about the importance of being physically active. The work includes dance, swimming and education projects and it builds on lessons that have been learned in our successful active schools programme, which has delivered 5 million opportunities to children and more than 79 different activities.

We are also developing an active girls programme, which will be supported by about £1.5 million over the next three years, to build on the success of a number of dance-related projects that are aimed at teenage girls.

Community sports hubs also play an important part, and the 57 that are in place, many of which are based in schools, are increasing opportunities to be active. That is consistent with our desire to open up the school estate and ensure that all communities have access to local school facilities. We aim to build on the good progress through the new school sports award that will be launched shortly to recognise and celebrate best practice in schools.

However, I want to do more. Although about 43 patient referral mechanisms are already in place throughout Scotland, there is an opportunity to formalise the links and pathways between NHS referral and physical activity opportunities at community level. To that end, we will work with the Royal College of General Practitioners to develop a patient centred high-quality general practitioner intervention that will build on and complement existing referral systems. Up to £100,000 will be made available to support an exciting new approach to a health intervention that will seek to adopt a more intensive approach that will test a mix of rural and urban models. It will explore individual health risks and lifestyle choices and it will be delivered alongside an appropriate referral mechanism to community sports hubs, leisure centres, walking groups and sports clubs. It will also inform our approach for future referral and support.

I can also announce that work is being done to draw up an implementation plan for the Scottish version of the Toronto charter, which is the gold standard of international best practice for investment in physical activity. That model was published in 2010 and it is internationally recognised as being revolutionary because it systematically explores the evidence to inform public policy investment by determining what works and what does not, through the lens of physical activity. The charter has the potential to deliver lasting results and to achieve the culture shift that we need in order to reduce both the financial costs and the human costs of inactivity.

We all enjoy a lifestyle and an environment that encourage us to be inactive and to overconsume. It will require a shift in culture and thinking to translate that into a position in which being active becomes normal for everyone. I want Scotland to be transformed and to become internationally recognised as an active society, but that has to start with how we see ourselves and Scotland. The work that I have described should be open to scrutiny and review, and that is why I am committed to coming back to Parliament regularly to report on how we are progressing with the challenge of obesity. I am pleased to commend the motion to Parliament.

I move,

That the Parliament notes the detrimental health impact that obesity can have on individuals, including an increased risk of type 2 diabetes, heart disease and some cancers, and the strain that it places on NHS resources and the wider economy; acknowledges the key contribution that physical activity can make to tackling these issues; recognises that, in Scotland, levels of participation in physical activity are increasing, defying the international trend; welcomes the Scottish Government’s commitment to and initiatives promoting and encouraging physical activity across all Scottish communities; notes the scale of the challenge in getting people more active, and supports the drive to create a lasting active legacy for the 2014 Commonwealth Games.

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