Lynne Neagle AM: And you've got a structured programme, have you, to roll that out? Okay. Thank you. We've got some questions now on leadership, and the first questions are from Siân Gwenllian.
Sian Gwenllian AM: Good morning. I'll be speaking in Welsh. The Minister for health said yesterday, in answering a question from me on the Chamber floor, that you gave him advice not to have a target in terms of reducing obesity among children. Could you confirm that that's what your advice was and tell us why you don't think that a target is needed?
Dr Frank Atherton: My advice was not that we don't need a target—we may well need a target, and that's one of the issues we need to consult on—but that the target that had been adopted in England and in Scotland to halve the prevalence of obesity in children was more aspirational than deliverable, and that if we are to choose a target in Wales, then we need to balance deliverability with challenge. We need a challenging environment. So, there is something about performance management, because I would be looking to not just the health system but the health and care system and to public services boards to think about how they're delivering on this, and I think we can use targets to that. But they are one tool in the box that I would think we could use, and part of the consultation is to ask that question—'If we are to go down a route in Wales of choosing a target, what might that look like?'
Sian Gwenllian AM: Okay. So, to be clear, you're not ruling out that maybe we would need a target.
Dr Frank Atherton: It's certainly something that we could consider in terms of the final strategy.
Sian Gwenllian AM: And is that your opinion too?
Nathan Cook: Yes.
Sian Gwenllian AM: Okay. Well, that is contrary to what I was told yesterday on the floor of the Chamber by the Minister, but there we go. I'm glad to hear that you're not ruling out having a target, because without a target, without something to aim for, how do we know that we're getting there?
Dr Frank Atherton: I think your point about evaluation is really important. Whatever we produce at the end of this process—and we're looking to produce a final strategy towards the autumn—we do need to have a strong evaluation. So, some metrics in there, it would seem, would be appropriate, but what those are, what the nature of those are, do we frame them as targets or ambitions—that's the point we need to consult on.
Sian Gwenllian AM: Okay. And the other point, of course, is the investment. If the Government is going to be successful in terms of the aim of reducing childhood obesity, then it needs to fund and support the actions. Have you made an assessment of the level of investment needed to implement this plan?
Dr Frank Atherton: Resourcing will be important. We currently do make investments in a number of areas that relate to child health generally, and, of course, obesity and overweight in particular. So, the question of resourcing is important. Now, we can't quantify an absolute amount of resource that will be needed to deliver until we know exactly what's going to come out of the consultation and what actions we might want to deliver to a greater degree in Wales. A figure of £8 million to £10 million a year has been banded around as a broad kind of area of what we might need to invest, but that would need to be drawn from existing programmes. We need to look at existing programmes, how effective they are. Can we make them more effective? Can we get better value from them? And there may well be a case for new investment, and that's a question, of course, that would need to be discussed with Ministers when we're producing the final strategy.
Nathan Cook: But I think a key consideration as well is we already know there is investment across health boards in some kind of obesity-related services. So, I think what we really need to think about across Wales is how we can drive greater scale, how we can look at current programmes in terms of making sure that they're better evaluated, and how we can make sure that we're also drawing up on the existing resources and capacity out there as well.
Sian Gwenllian AM: And does the level of investment depend on what the target is—what the goal is?
Dr Frank Atherton: I don't think you can necessarily just link the two. The issue of resourcing is one that's there irrespective of whether we choose to put a target in place.
Sian Gwenllian AM: But how would we know that it's being used effectively if there isn't something to aim for?
Dr Frank Atherton: Which brings you back to the question about evaluation. We need proper evaluation of the various programmes that we have.
Sian Gwenllian AM: Yes, but without a target, how can you properly evaluate? If you don't know what you're trying to do, how can you properly evaluate? Anyway, you're open to suggestions about having a target, which is great. Would you agree that Government could use the revenue that's being produced through the levy on soft drinks towards some of these efforts to—?
Dr Frank Atherton: Well, of course, there are some consequentials that are coming to the Welsh Government as part of the levy on sugary soft drinks. That funding, of course, is less than we had anticipated, and that reflects, actually, a success story because industry is reformulating, and so the amount of sugar in soft drinks is already starting to decrease, which is a good thing. But to your question: should we use the funding? Well, of course we should use funding. I'm not personally in favour of hypothecation, I think I'm more interested in the totality of resource that goes into public health programmes than into marginal resource. There are, of course, a number of initiatives that we currently fund through the general revenue. And when I think about obesity, I don't just think about the relatively small marginal amounts of money that come in through whatever source, but I think about the totality of the £7 billion we spend in health and social care and how we can divert and channel some of that towards broad prevention initiatives in general, and towards tackling being overweight and obesity in particular.
Sian Gwenllian AM: You're saying that it's less than expected. Could you give us any kind of figure?
Dr Frank Atherton: I'm sorry, could you repeat the question?
Sian Gwenllian AM: You say that there is less money that's come in through these consequentials from the levy, can you mention some sort of figure?
Dr Frank Atherton: The figure that I have in mind is about £56 million that's coming in in terms of revenue over a two-year period. But I'd have to confirm that with the committee. What the anticipated—. When the sugar levy was first brought in, there was some modelling at UK level about what level of revenue that would bring, but it was based on the amount of sugar that was currently then in drinks and the fact that the sugar has reduced in drinks, I mean, the total amount available to the UK is less and hence our consequentials are less. Nathan may have some precise figures.
Nathan Cook: Yes, I was going to say, there was a mid-year report done where the levy has raised £150 million to date since coming into force in April, and the original forecast was £520 million a year. So, I think that shows the amount of work that's been done by industry around reformulation.
Sian Gwenllian AM: And the consequentials of that? That is the consequential—£150 million.
Nathan Cook: On a UK level.
Sian Gwenllian AM: Yes, so what's the Welsh consequential?
Lynne Neagle AM: Fifty-six.
Sian Gwenllian AM: Fifty-six? Gosh, that sounds a lot. Anyway, it's a good sum of money and you're talking about investing £8 million to £10 million. So, obviously, you know, we can be more ambitious because there is money in that pot if that money was ring-fenced for this particular scheme.
Dr Frank Atherton: Well, the resource is going to be a real issue that we need to address, and I think as Nathan has said, there is funding of various initiatives currently in the system, and we need to look at that and make that as effective as possible. Will there be a need for some additional resource? There may well be, and that's a question that we'll have to look at in terms of the strategy when we develop it and have a discussion with Ministers about the level of resourcing.