Last year I wrote about why I fought hard for London’s devolution deal. Work to strengthen partnerships and to turn the potential opportunities of devolution into tangible improvement in the quality of life of all Londoners is now well underway, and we have seen some positive changes in the capital over the past 6 months. While the London Devolution Memorandum of Understanding (MoU) brings with it many benefits, the most exciting aspect from a public health perspective is that it places prevention at the heart of decision making, providing new opportunities to act early in preventing some of the city’s biggest health challenges.
How are we taking action on the MoU commitments and what does this mean for Londoners?
- Illegal Tobacco and Alcohol
Our ambition is for London to be free from illegal tobacco. To do this we need effective city-wide working, based on coordinated action and information sharing to tackle the supply of illegal tobacco. To take a step towards this, London has committed to work closely with HMRC to establish a pan-London illegal tobacco and counterfeit alcohol enforcement team.
- Sugar & schools
After the successful introduction of the Soft Drinks Industry Levy, funding raised will be directed to schools by way of the Healthy Pupils Capital Fund. For schools and boroughs to make the most of this opportunity, they will be supported to invest this one year capital grant in effective interventions to improve child health and wellbeing, such as water fountains and improved school food environments. This supports our ambition for primary schools in London to become ‘Water Only’.
- Healthy urban environments around schools
London partners will be piloting ways to improve the environment around schools by focusing on areas around schools, developing 400m ‘super zones’ where the food environment, advertising, gambling, smoking and air quality will be tackled to give children a much healthier environment to learn and live in. We will be actively supporting pilots in areas with the greatest inequalities.
Londoners have told us that they would like to see a reduction in the unhealthy food and drink products that are advertised to children, and the MoU provides us with an opportunity to make a difference to the advertising that children are exposed to in London. The London Mayor has shown great leadership by proposing to ban all junk food advertising across the TfL network. We will work to expand this even further in boroughs and NHS sites.
Gambling is emerging as a public health issue and is closely linked to health inequalities. We want to reduce the harm caused by gambling, particularly in communities with the greatest inequalities. In May, the Government pledged to cut the maximum stake for fixed-odds betting terminals to £2, and London partners are working to support boroughs further in reviewing their gambling licencing statements so that the proliferation of these terminals and gambling shops can be halted. We will place a particular focus on areas around schools.
- Mental Health and Employment
Keeping Londoners in work and keeping working people healthy will bolster a productive economy for the city as well as supporting people's health. We will help the long-term unemployed and those with health conditions or disabilities get back into work, or even start work for the first time. We aim to optimise health and welfare services to keep the workforce healthy.
- Fiscal Levers
Fiscal levers provide an opportunity to raise funding that could be invested in health promoting initiatives for the city. We will be exploring ways to develop new or enhance existing fiscal levers to support city-level action to address the wider determinants of health, and will ensure that any money raised is invested to best benefit health.
Evaluating this work
The evaluation of this work will not only demonstrate the impact of our efforts but will also provide the opportunity to add to the evidence base for other cities, both in the UK and internationally.
Our next steps will be to present progress on all of these areas to the London Prevention Partnership Board this summer, and communicate our strategic intent to use the impetus that the devolution agreement provides to:
- with help of supportive boroughs, trial better overall environments in and around schools in order to protect children from the onslaught of toxic influences on their health
- explore how we can augment fiscal and other resources for health in London
- keep Londoners in work, particularly supporting those who are struggling with mental distress
- align these projects with our big ambitions to tackle childhood obesity, support parents, enhance mental wellbeing and keep a sharp focus on prevention in the city.
Only in that way can London make more progress towards being the healthiest global city.
Over the next months I look forward to sharing more of this work with you as we continue to see results.
Read our first blog on London's devolution deal here.