Culture Health

    Lump sums

    5 May 2016

    George Osborne’s budget announcement that there is to be a UK tax on sugary soft drinks took everyone by surprise. The industry admits it was blindsided, and public health practitioners — who had not dared to hope for such staunch support from the Conservative Chancellor — were stunned.

    ‘I was in a meeting with some of the authors of the report that made the case for taking action on sugar when the news broke,’ says one academic. ‘They were astonished, and very pleased that the government had taken such a radical step.’

    Now that the dust has settled, both ends of the sugar-tax spectrum are suspicious of the Chancellor’s motives, and conspiracy theories are spinning like candyfloss.

    Industry sources suggest that the tax was pretty much plucked from the ether to grab headlines and draw attention from controversial benefits cuts; more Machiavellian proponents of the levy suspect a sop thrown in to stymie further reform. Either way, battle has been engaged over how best to tackle dangerously rising sugar levels in our national diet. That there is a problem is not in doubt. The UK tops western Europe’s obesity league, with one in four adults classified as grossly overweight, while obesity among British children has been described as an epidemic because it now affects more than one third of young people. Obesity levels here have trebled since 1980, and if nothing is done to halt the increase it is predicted that more than half the UK population could be morbidly overweight by 2050.

    Jane Abbott, clinical director for Benenden, has first-hand experience of the effects of a sugar-heavy diet. ‘I see children coming into our hospital to have all their teeth removed,’ she says. ‘It is vital that we all start to recognise just how much sugar is hidden in the food we eat.’

    Benenden believes that better information is vital, so has commissioned research on the sugar content of popular foods and its effects on the human body. This is presented graphically on its website. ‘Children, on the whole, don’t get to choose what they eat, so we have to target adults,’ says Abbott. ‘There has to be far better understanding of what you can do to promote health and wellbeing.’

    The health consequences of overconsumption of sugar include type 2 diabetes, heart disease, cancer and even dementia. It is reckoned that dealing with diet-related illnesses costs the NHS £5.1 billion each year.

    Stemming that preventable haemorrhage of public cash and the devastating impact of sugar on people’s lives is a national priority. However, argument rages over how it should be done.

    Last October, Public Health England (PHE), an executive agency of the Department of Health, published its report ‘Sugar reduction, the evidence for action’. This comprehensive review of the case against dietary sugar levels concluded: ‘No single action will be effective in reducing sugar intakes. This is too serious a problem to be solved by approaches that rely only on individuals changing their behaviour in response to health education and marketing, or the better provision of information on our food. The environmental drivers of the poor diets we face are just too big.’ So PHE presented eight steps that government could take against high-sugar food and drink products, including tackling price promotions, controlling marketing across all media, and using tax to increase the price of full-sugar soft drinks by 10–20 per cent.

    A national obesity strategy for England is due to be published in July, laying out how the government intends to respond to the PHE challenges, but George Osborne’s tax announcement jumped the gun.

    ‘This is a soft-drinks tax, not a sugar tax,’ says Gavin Partington, director general of the British Soft Drinks Association. ‘We do feel that it is unfair, given that we are the only category in the food and drinks sector that has been demonstrably taking sugar out of our product for years.’

    The soft-drinks sector says it is on track to fulfil the promise it made last year of cutting out out a fifth of the calories in its products by 2020. ‘We do not believe that imposing a sugar tax is the right thing to do,’ says Partington. ‘In other countries where it has been tried it has either not worked to reduce obesity, or it has adversely affected trade and commerce.’


    That is disputed by public health professionals, who cite emerging evidence of success in sugar-intake reduction in France, Mexico and Berkeley, California, where similar taxes have been imposed.

    According to calculations by the British Soft Drinks Association, enacting the tax announcement will cost the Treasury £1 billion in its first year because of a negative impact on the retail prices index. And to top it all, they say, the tax will hit the poorest hardest — nanny stateism at its worst.

    ‘Why is the nanny state so bad?’ says Professor Laurence Moore, director of the Social and Public Health Sciences Unit at the University of Glasgow, which is funded by the Medical Research Council and Scotland’s Chief Scientist Office. ‘Looking after the health of the population is surely a government’s job? In the past, they took action to clean up water and clear out slums, realising that public health is not about individual agency. Now, the big threats are non-communicable diseases, the effects of poor diet and sedentary behaviour. If they left the response entirely to individuals they would not be biting the bullet as a government.’

    Professor Moore believes that people need to be protected from the worst effects of big business, whether these involve alcohol, tobacco or high-sugar food. ‘It is the environment that people live in that has to change: the marketing they are exposed to, the price promotions they are faced with, the information they receive,’ he says.

    His colleague Dr Shona Hilton is about to start a research project looking at the messages issued by the anti-sugar tax lobby. ‘I have examined the media coverage around aspects of alcohol and tobacco control, and you start to see similarities in the arguments,’ she says. ‘Our work is about trying to add pieces to the public health jigsaw. If we improve understanding of how the industry operates, we can develop counter-tactics.’

    For his part, Gavin Partington accuses the public health lobby of being just as big as big business. ‘Except their campaigning is funded by the taxpayer,’ he says. ‘Surely there’s some sort of vested interest there?’

    Limiting the ability of vested interests in the charity sector to lobby for legislative change was the purpose of new Cabinet Office rules, which may also have prevented scholars from receiving public grants had they been perceived to be attempting to ‘influence’ the government. Across the UK, academics have been alarmed, and a recent editorial in the British Medical Journal argued that this ‘seems to conflict with the pursuit of public health goals, which often require ensuring policy makers are aware of the implications of research’. It concluded: ‘The need to improve the use of scientific evidence in policy making is clear; this clause limits government-funded researchers’ ability to help achieve this, privileging those working to influence policy on behalf of commercial interests.’

    The scientific backlash forced universities and science minister Jo Johnson to confirm that the government do not intend that research councils and other academic bodies are covered by the clause. Work is continuing to unravel the implications for what has been described as ‘academic freedom of speech’.

    With two years to go before the tax is due to be imposed there is still room for manoeuvre. The industry will be hoping to minimise the impact on soft-drinks producers, and public health people hope that (at the very least) the debate will raise public awareness and influence changes in behaviour. The battle with ‘big sugar’ has begun.