Intended for healthcare professionals

Rapid response to:

Head To Head

Can we leave industry to lead efforts to improve population health? No

BMJ 2013; 346 doi: (Published 17 April 2013) Cite this as: BMJ 2013;346:f2426

Rapid Response:

Re: Can we leave industry to lead efforts to improve population health? No

Why go for taxation that is largely punative when there are easier and likely more successful strategies through tax incentives? Over three quarters of food sales go through 5 supermarket chains and loyalty cards are in common use. Data mining companies routinely extract shopping data to generate profit through incentives. Why not look at this in a different way?

Governments could draw up a list of healthy foods and provide tax breaks to supermarkets if they could show that they had sold a high enough percentage of these. Rather like a food QOF. If the incentive was attractive enough, all of the marketing and advertising would be geared to this effort. Supermarkets would have to choose their suppliers based on healthy food and redesign their stores around this incentive.We would see a different type of supermarket based on promoting healthy food, advertising and marketing would drive this change. Legislation would be light. Tax is negotiable after all. Some successful UK companies pay no tax at all. And far better to spend tax money on prevention rather than treatment, which is estimated to cost several billion pounds a year. League tables would further drive the incentive.

The last sentence in the last paragraph of the article by Derek Yach pretty well sums up where we need to go with this. As a GP who has an interest in preventative health and has worked with a large supermarket chain to provide a weight management scheme, I can only say that the legislative approach through mostly punitative taxation is reactive and doomed to fail. It seems to have been effective with smoking and attempts are being made with alcohol, but diet and lifestyle are too complex to handle in this way. The example in Denmark where taxation on fat has been dropped and future legislation on sugar shelved should give us an idea how difficult all of this is. The food industry lobbying around European food labelling shows us the power of the industry to protect it's interests. And why not? It is all within the law. The industry spin about responsibility is in my opinion more about going for profitable market share than any concern about health. If they were truly bothered they would design their stores differently. There is huge talent in the food and advertising who would love to take this challenge on. What I have suggested is a pragmatic and practical way of harnessing this power and put it to use in a positive way.

Competing interests: No competing interests

23 April 2013
Ian Lake
Regent Street Surgery
Stonehouse, Glos GL10 2AA