Government health strategy highlights role of cycling but will they back it up with cash?

Government plans for the long-term future of public health in England published yesterday acknowledge the role of active travel and cycling in particular in improving public health. The news coincides with road safety charity 20s Plenty for Us highlighting research that calls for road safety to be treated as a public health rather than  a transport issue and also found that 20mph zones could not only prevent deaths but also reduce health inequalities.

Health Secretary Andrew Lansley revealed the government’s health strategy in a White Paper published yesterday called Healthy Lives, Healthy People: Our strategy for public health in England, which proposes the setting up of a new body, Public Health England, to co-ordinate programmes at national and local level.

The Department for Health says that in targeting health issues such as obesity, it aims to make it easier for people to lead healthier lifestyles, “for example through access to public exercise facilities, cycle paths, or safe playgrounds."

The white paper was givien a  "cautious welcome" by sustainable transport charity, Sustrans. Philip Insall, Sustrans’ Health Director, commented: “Walking and cycling for everyday journeys are recognised as the most practical, inexpensive and accessible ways for people to include physical activity into their daily lives.

“They are crucial elements in tackling the growing problem of obesity and related illnesses, and the huge costs that come with it – forecast to be £50 billion a year by 2050. The White Paper rightly recognises the importance of active travel, but it lacks detail on how the Health and Transport departments will make it happen. This is doubly disappointing given that walking and cycling measures are much cheaper, and much better value than traditional transport investment.”

The whole issue of funding for cycling has become clouded since the opposition government took office in May and particularly since the so-called bonfire of the quangos in which the government dispensed with Cycling England the body which had been overseeing efforts to boost cycling and target funding effectively. The government's Comprehensive Spending Review further muddied the waters by devolving powers over transport budgets to local councils and removing ring fencing around spending on certain areas while at the same time massively cutting council budgets. This has already led to cuts in road safety budgets and cycle project funding with speed cameras controversially being switched off across the nation.

Cycling will have to compete for funding from the government's new Sustrainable Transport Funds, details of which still haven't been announced – although they will be funded to the tune of £560m, cycling will however have to compete with other "sustainable" forms of  transport and if that includes charging points for electric cars recent precedent suggests the cars may get the cash.

Under the government's health plans ring-fenced health improvement budgets distributed to local authorities by the Department for Health will be used to fund initiatives designed to benefit public health and wellbeing at local level, led by new directors of public health appointed jointly by local councils and Public Health England.

Commenting on the white paper, Mr Lansley said: “Too often in the past, public health budgets have been raided by the NHS to tackle deficits. Not any more. The money will be ring-fenced to be used as it should be – for preventing ill health.

“People’s health and well-being will be at the heart of everything local councils do,” he continud. “It’s nonsense to think that health can be tackled on its own. Directors of public health will be able to champion local co-operation so that health issues are considered alongside housing, transport, and education.

Mr Lansley added: “Everyone should have services tailored for them, at the right times in their life from the professionals closest to them. With local authorities in the driving seat, supported by the latest evidence on behaviour change from Public Health England, we will start seeing significant improvements in the nation’s health.”

The white paper also proposes introducing a “premium” to recognise progress made towards meeting specific targets, with a greater amount being allocated to disadvantaged areas in recognition of the fact that they face the greatest challenges, with a seven-year difference in life expectancy found between the richest and poorest areas.

Certain aspects of the White Paper are now open for consultation through to March 2011, and it is envisaged that Public Health England will be established in April 2012, dependent on the passage of the Health and Social Care Bill.

Sustrans said that it was in agreement with Lansley’s observation that “active travel and physical activity need to become the norm in communities,” but underlined that “much more commitment and detail are needed, particularly in reducing traffic speeds and volumes and in shifting transport investment to healthy ways of travelling.”

Sustrans also pointis out that the London 2012 Olympic Games legacy has a target of helping at least 2 million people to lead more active lifestyles, Sustrans said that it had already demonstrated how this could be achieved, with 2 million people becoming more physically active last year alone as a result of ycling or walking on the National Cycle Network, which it maintains.

Sustrans also highlighted how it helps 130,000 children a year become more active by walking or riding their bike to school, saying that the number cycling each day has increased threefold, hopefully instilling travel habits that will remain with them for life.

Mr Insall added: “We are already demonstrating that if safe and attractive walking and cycling routes exist, people will use them. If schoolchildren are helped to overcome the barriers to travelling by foot or bike then they happily do so. Government policy needs to recognise this and respond to it with serious investment.”

Meanwhile, 20’s Plenty for Us highlighted comments made by Professor Danny Dorling of the University of Sheffield at the Parliamentary Advisory Council for Transport Safety’s Westminster Lecture which outlined how 20mph zones can lead to a reduction in preventable deaths as well as addressing health inequality.

In his speech – you can find notes, including audio clips and a Powerpoint presentation here – Professor Dorling, a human geographer whose research focuses on causes of death, said that road death was the major preventable health epidemic in modern Britain, and that the introduction of 20 mph zones was the most cost-effective method of bringing about an improvement in the country’s quality of life.

Professor Dorling, who said he was “shocked” at the government’s decision to cut road safety funding from £37 million to £17.2 million, said that the issue of road deaths should fall under the Department for Health’s competence, and pointed out that while the number of people being killed on the roads was falling, it was rising as a proportion of total deaths.

He added that traffic was the cause of half of the deaths from external causes of children and young people, especially boys, with children from less affluent backgrounds particularly at risk.

Citing research published in the British Medical Journal that said that 20mph zones led to a 41.9% reduction in deaths, Professor Dorling said: “Elsewhere in medicine, you’d get honours and funding for such an effective treatment for an epidemic. Yet there’s a collective blind spot on the enormous benefits of 20 mph limits - perhaps because Directors of Public Health aren’t trained in road safety.”

He continued: “Government can lead on 20 mph. In a time of less money it makes even more sense,” adding, “If British people care about children and have a soul, they’d want 20 mph residential speed limits.”