At a recent lunch for journalists in the House of Commons, Health Secretary Alan Johnson joked that under the new NHS Constitution ‘the broccoli police’ would not be sent in to monitor what people were eating.
It was a quip that went down well with the assembled guests, striking as it did at the very heart of that dreaded nanny-state Britain. After all, nobody wants to be told what to do or how to lead their lives, do they?
Politicians are especially conscious of this. The memories of Nanny Virginia Bottomley are still alive in the Department of Health after she presided over a document setting out, among other things, how many potatoes to eat each week and what size they should be.
On the other hand, another former health secretary, John Reid, struck a chord when he expressed sympathy for single mothers on council estates who chose to smoke.
Nevertheless, it is the duty of the government, and the DoH in particular, to disseminate the good living message. In this spirit, it kicked off the new year with a massive cross-sector anti-obesity drive — Change4Life — which warned that by 2050, four out of ten children and nine out of ten adults would be overweight or obese.
But in the DoH headquarters, there is a constant balancing act between wanting to be tough on public health issues, and the fear that the media will deride them for nannying.
This has meant that the power of the Change4Life anti-obesity message has been somewhat diluted by ministers going into partnership for the campaign with a number of food, supermarket and advertising companies.
What ministers could have done instead is told them to get their houses in order once and for all, stop adding so much sugar and salt to their products, stop targeting children with their advertising and lose the trans-fatty acids.
Just two weeks after the campaign was launched, it was revealed that children as young as two were receiving NHS treatment for severe weight problems. A dietician blamed parents for allowing small children to pick their favourite sugary and fatty foods rather than giving them a healthy range of food.
So when is the time to send in the broccoli police? Healthy eating used to be one of the subjects passed down through families, from grandmother to mother to daughter. There were domestic science classes. Now, young families do not always have access to that information, they are not taught how to produce a balanced meal and so begins a vicious cycle. Yet someone has to tell them and why not start at the top? Why not some nannying? After all, this is the country that grew up on ‘nanny knows best’.
It is not just eating. Last week it was revealed that pregnant women in Essex are to be offered £100 of shopping vouchers to give up smoking. Critics who attacked the pilot scheme failed to discuss the cost to the NHS of babies born underweight and asthmatic — £100 seems a small price to pay.
Then it was revealed that despite more money being put into services to help people stop smoking, there had been only a small increase in the number of people giving up cigarettes. The response of the TaxPayers’ Alliance was: ‘The nanny state is becoming more expensive and less effective by the day. If the authorities stopped heckling people so much, they might get a better reception.’ Where was the heckling? The scheme offered anti-smoking help, people did not take them up on it. Surely a failure to heckle?
Then there was the Daily Telegraph headline ‘Health police target evening tipple’ — over a report of a survey that found that one in four middle-class drinkers was drinking double the recommended daily limit.
With headlines like these, it is easy to see why health ministers are unlikely to say: ‘Yes, there is a problem, let’s regulate the alcohol industry.’ Yet, once again, there is equal outrage when there are reports of children needing liver transplants because they have boozed too long and too hard.
The cannabis reclassification from Class C to B is another example. Ministers, contrary to expert advice, said it must be reclassified largely on health grounds. Yet the punishment is a three-strikes approach, with the culprit going to court only for the third offence. Yet for every other Class B drug, the first offence results in an immediate court appearance. It is all so contradictory.
This week, England’s chief medical officer, Sir Liam Donaldson, is expected to take a hard line against parents allowing children under the age of 15 to drink. At the time of writing it was unclear how many ministers would publicly back him. The fear, according to the Observer, is that it would make Labour ‘appear out of touch and lead to claims of nanny-state interference’.
It is inconsistency at best or hypocrisy at worst that means the right message never gets across to the very people who need it — and usually that is not the middle-class comment writers in the nation’s media, except for those who are binge-drinking, of course.
Victoria Macdonald is political correspondent for Channel 4 News