RSPH has set out a manifesto of policy recommendations it believes political parties campaigning for next month’s UK general election should commit to, in order to improve and protect the public’s health.

The recommendations include:

• Statutory universal personal, social, health and economic (PSHE) education
• Tighter junk food marketing restrictions, including an end to junk food sponsorship of sporting events
• Minimum unit pricing (MUP) for alcohol
• The decriminalisation of drug use as part of a public health approach to drug policy

Shirley Cramer CBE, Chief Executive, RSPH said: “The UK is currently going through a period of enormous political upheaval, with a snap election and impending departure from the EU presenting an uncertain future. Set against the ongoing backdrop of restricted public spending, it may seem like a time when it may be hard for the public’s health to receive the consideration it deserves.

“However, politicians of all parties should be in no doubt that health is an issue that is always of the utmost importance to voters. They must look for progressive and creative ways to improve and protect health for all, seizing whatever opportunities may be presented by the UK’s future outside the EU while seeking to minimise its potential negative consequences.”

The recommendations in full

The basics: health everywhere

The challenges facing the UK public’s health at a time of restricted public spending are too great to be met by the core public health workforce in traditional settings alone. Steps must be taken to ensure health promotion is embedded throughout society:

• Activate the wider public health workforce: RSPH’s Rethinking the Public Health Workforce report has already identified an additional 15 million professionals, ranging from pharmacists and opticians to housing professionals and police officers, who have trusted contact with the public and the opportunity to promote healthy behaviours. They must be given the necessary training and support to do so
• Provide universal Personal, Social, Health and Economic (PSHE) education at all key stages: high quality PSHE is critical to empowering our young people to tackle all manner of health issues, from drugs and sexual health to healthy eating and social media addiction, but provision is currently patchy. The current government made a positive step in March 2017 by announcing that sex and relationships (SRE) education is to be made compulsory in all English schools, but the next government must ensure this acts as a stepping stone to full, universal, statutory PSHE across the whole of the UK
• Legislate to help make our high streets more health promoting: the environments we live in have a huge shaping influence on our health, and RSPH’s Health on the High Street report has demonstrated that more needs to be done to make our high streets more health promoting. Steps to improve this could include planning controls that limit the ‘clustering’ of unhealthy business such as junk food shops and bookmakers, using business rate relief to incentivise healthier businesses, and making impact on the public’s health a criteria for licensing applications

Obesity

RSPH recognises obesity as the greatest public health challenge of our generation, with half of all adults predicted to be obese by 2050 at a cost to the NHS of £10 billion a year. While the government’s recent childhood obesity plan included some promising moves, it also made a number of critical omissions, and further action must be taken:

• Deliver and (if necessary) extend the sugar levy: the sugar levy on soft drinks announced by the Chancellor in March 2016 has already had a positive effect, with a number of manufacturers reformulating their products to avoid the tax. The new government must commit to seeing through the implementation of the levy, reviewing its effectiveness and extending to other products if necessary
• Tighten junk food marketing restrictions: RSPH welcomed new rules announced by the Committee of Advertising Practice (CAP) in December 2016 banning the advertising of junk food products in non-broadcast media aimed at children. However, further action is needed on marketing, and RSPH supports a proposed ban on such advertising during any TV programmes shown before the 9pm watershed (not just those specifically defined as children’s programming)
• End junk food sponsorship of family and sporting events: the sponsorship relationship between junk food manufacturers and sporting events continues to promote the false suggestion that these products are compatible with a healthy, active lifestyle and undermines efforts to combat obesity

Drugs and addiction

Alcohol and tobacco remain two of the leading causes of preventable death and disease in the UK, while other (illegal) drugs continue to cause considerable harm among some of the most vulnerable in our society, exacerbating health inequalities. These challenges require not only education but strong legislation as well:

• Introduce Minimum Unit Pricing (MUP) for alcohol: Public Health England’s (PHE’s) recent evidence review demonstrated that MUP is the most effective tool available to tackle alcohol harm. The next UK government should follow Scotland’s example and introduce an MUP of 50p per unit
• Require calorie labelling on alcohol: alcohol calorie labelling not only fulfils the consumer’s right to be informed about what they are drinking, but also offers a potentially powerful tool to reduce consumption by drawing the link with obesity. Despite strong support in the European Parliament, efforts to introduce this labelling at an EU level have stalled. Brexit provides an opportunity for the UK to go further, faster in providing comprehensive health information on labels
• Lower the drink driving limit to 50mg: with the news announced in October 2016 that Malta is to lower its drink drive limit from 80mg to 50mg alcohol per 100ml blood, England and Wales will soon be left as the only part of Europe with such a high limit. With initial data from Scotland suggesting lowering the limit there has reduced drink driving, the UK government must again follow Holyrood’s example
• Introduce outdoor smoking exclusion zones: following the success of the UK’s indoor smoking bar in helping encourage people to quit, RSPH believes the introduction of bans in selected outdoor areas, such as beer gardens, parks and public square, would represent a further important step in the denormalisation of smoking. However, any such exclusion zones must exempt e-cigarettes
• Decriminalise illegal drug use: in June 2016, RSPH’s landmark Taking a New Line on Drugs report set out the case for the decriminalisation of illegal drug use, as part of a wider package drug policy reform measures focused on public health and harm reduction. RSPH believes any new government must make a serious reassessment of the UK’s approach to this issue, in line with progressive international developments
• Reduce the maximum stake on Fixed Odds Betting Terminals (FOBTs) from £100 to £2: FOBTs have been described as the ‘crack cocaine’ of gambling, and present a serious addiction and wellbeing issue. Accordingly, RSPH supports the call of the All Party Parliamentary Group on FOBTs for the maximum stake to be reduced to £2 to minimise harm

Sexual health

• Extend the human papillomavirus (HPV) vaccine to boys: RSPH welcomed recent news from Scotland that the vaccination of girls has led to a dramatic drop in prevalence of the sexually-transmitted HPV virus. However, the female-only vaccination programme is an imperfect solution which leaves many, including men who have sex with men (MSM) unprotected, and should be extended to all boys as well as girls across the UK

Commuters

Commuting accounts for a significant proportion of the lives of many in the UK, and in August 2016 RSPH’s Health in a Hurry report highlighted the negative impact this is having on our health, whether through the anxiety and stress of delays or the knock on effect on time available for healthy behaviours such as exercise. Action must be taken to make the commute a healthier experience, including:

• Make health and wellbeing a specification for the award of rail franchises: to ensure no company is awarded a contract without making a proactive effort to improve and protect the health of commuters
• Remove first class carriages on commuter lines at peak times: to reduce overcrowding and stress