comment: Public health consultation puts focus on child health

Published: 05/02/2004, Volume II4, No. 5891 Page 15

If the forthcoming Wanless 2 report was in danger of confirming the Treasury's grip on the public health agenda, health secretary John Reid's announcement on Tuesday seems like an effective pre-emptive strike for the Department of Health (news, pages 4-5).

News of a public consultation followed by a white paper has been warmly welcomed by the public health lobby, as one would expect. Many will be particularly interested in Mr Reid's call to 'find the right balance' in rejecting both the nanny state and the 'Pontius Pilate state', which washes its hands of all the issues surrounding the wellbeing of the general population. It is a position which contrasts with the US government's recent pressure on the World Health Organisation to put absolute reliance on personal responsibility.

The other key issue that emerges from the announcement is the emphasis on consultation with ordinary people - and more specifically parents. This surely is the ground on which the 'fully engaged' scenario envisaged by Derek Wanless will be fought.

Child health is 'different' for two reasons. First, individual choice is much less relevant when you are talking about what a six year old eats at school or the quality of the air they breathe in a café. Second, evidence strongly suggests that parents, particularly new ones, are more open to public health messages, whether it is supporting regulation or changing their own behaviour.

Public health minister Melanie Johnson has shown little interest in a ban on smoking in public places, but more appetite for tighter controls on the food industry, whether in advertising, production or labelling.

It is notable that the one issue Mr Reid covered in any depth on Tuesday was childhood obesity. He asked a number of rhetorical questions around the issue of tighter regulation. Part of the so-called Big Conversation, Mr Reid's consultation seems sure to centre on making Britain a little smaller.