Plans to tackle childhood obesity in England are behind schedule and may miss the Government's own target of halving the proportion of obese children in England by 2030, a report said.
The National Audit Office (NAO) called for the Department of Health and Social Care to be given more powers to ensure measures were taken across Whitehall to deliver solutions.
It said the failure by successive governments to reduce obesity was putting children from deprived and ethnic backgrounds at a disadvantage.
In 2018 to 2019, 26.9% of children aged 10 to 11 in the most deprived areas were classified as obese compared with 13% in the least deprived.
Just over 18% of White children aged 10 to 11 were classified as obese in 2018 to 2019 compared with almost 29% of Black children.
In 2016 ministers launched a childhood obesity plan, which included a soft drinks industry levy, sugar targets, and promotion of healthier food and more exercise. Efforts were concentrated on children because evidence showed that obese children were more likely to grow up to become obese adults, resulting in significant health risks.
Government estimates put the cost of obesity to the NHS at £6.1 billion and £27 billion to society as a whole.
'A Struggle to Implement'
However, the NAO report said the DHSC had not fully evaluated the success of past strategies and was likely to struggle implementing its new approach.
Many aspects of its programme relied on other government departments, such as sponsorship of sporting events by the food industry, which would make it difficult to ensure they were compatible with the overall aim of reducing childhood obesity, the report said.
The Soft Drinks Industry Levy, which became law in 2018, had encouraged a reduction in sugar in some drinks, and raised £240 million in 2018 to 2019.
However, since that year there had been a 4.5% real-terms decrease in the grant from central Government to local authorities in the public health grant.
While Public Health England had made progress in encouraging industry to reduce sugar levels in some products, the Government's ambition of reducing sugar by 20% by the end of this year would not be met, according to the report.
In July this year, the Government announced a new strategy to reduce obesity in adults and children. The plan was partly in response to evidence indicating that people who were overweight or obese who contracted COVID-19 were more likely to be hospitalised and to die from the disease than those of a healthy weight.
The strategy included a ban on TV and online adverts for food high in fat, sugar, and salt before 9pm, an end to 'buy one get one free' deals on unhealthy foods, and a campaign to help people lose weight.
However, it did not include other elements of the programme which had not been implemented at that time, for example, the ban on selling energy drinks to children, which the DHSC had pledged to implement, the NAO said.
'Slow Progress'
Gareth Davies, the Comptroller and Auditor General, commented: "Tackling childhood obesity is a major challenge, and one that governments have struggled with since the 2000s. It is clear that children living in deprived areas or from ethnic minorities are far more likely to be obese and the problem is worsening.
"Progress with the childhood obesity programme has been slow and many commitments are not yet in place. The new strategy announced in July has signalled a greater intention to tackle obesity but the Government will need to follow through with more urgency, commitment, and cohesion if it is to address this severe risk to people’s health."
Dr Mars Skae, consultant paediatric endocrinologist at the Royal Manchester Children's Hospital, said the report suggested that "the sugar tax has effectively generated approximately £240million and yet local authorities across the country have only spent approximately a quarter of that on childhood obesity".
She said that while COVID-19 brought "a new lease of life to the obesity effort", it was clear that "any new efforts are still bound to have little impact without central, clear, and coordinated programme structures with a singular Government body with the authority to coordinate the whole-systems approach and hold stakeholders to account".
'It Comes Down to Money'
Prof Russell Viner, president of the Royal College of Paediatrics and Child Health, said the solution to childhood obesity would ultimately come down to money and resources. "Local authorities hardest hit by year-on-year cuts cannot be expected to deliver vital services from an ever-shrinking pot," he said. "As ever, the communities that need these services most are those that have faced the most severe funding cuts. Some local authorities say they will struggle to even deliver statutory services in the coming years.
"It is time for the money to follow the commitments. Government should restore the £1 billion of real-terms cuts to the public health grant for local authorities."
Caroline Cerny from the Obesity Health Alliance, said: "We agree that progress by the Government to address childhood obesity has been slow and we would strongly welcome the introduction of procedures to ensure other government departments are held to account to deliver this vital programme – improving children's health must be everyone's responsibility.
"However, it's wrong to suggest that the policies to address childhood obesity may not [be] the right ones based on such a brief analysis. There is a strong and consistent body of evidence regarding the highly influential role marketing of all kinds plays in steering children’s food choices. That's why leading health charities, medical colleges, and health experts all support regulation to limit unhealthy food advertising and promotions, as the Government has committed to introduce by 2022."
The DHSC said it would study the NAO report closely. A spokesperson said: "We are determined to tackle obesity across all ages and we have already taken significant action – cutting sugar from half of drinks on sale, funding exercise programmes in schools, and working with councils to tackle child obesity locally.
"We are also taking bold action through our new and ambitious obesity strategy – banning unhealthy food adverts before 9pm, ending deals like 'buy one get one free' on unhealthy food, and introducing calorie counts on menus – to help families make healthy choices."
