Fishburn Hedges

07.07.2010

I think it’s probably fair to say that Health Secretary Andrew Lansley hasn’t made a friend out of Jamie Oliver. 

He used the British Medical Association conference in Brighton last week to criticise the chef’s school dinners campaign, claiming that his method of attempting to change behaviours is flawed. But was he right?

According to Lansley, the campaign, which has been running for around eight years now, hasn’t had the desired impact of getting kids to eat healthier school dinners – in fact, it’s made things worse.

Although children may have better access to healthy food in schools, the number opting to eat school meals has dropped. 

I suppose it’s not too surprising when you think back to the defining image of a mother passing packets of chips to her children through a hole in the school fence…

But perhaps Lansley’s being a bit unfair. Undoubtedly Oliver’s intentions were good. He raised awareness of an important issue that wasn’t previously being acknowledged or tackled. So if his work hasn’t had the desired impact, why not?

Don’t tell me what to do

The Health Secretary suggests that it’s the ‘lecturing’ approach that’s at fault. People feel done to, not engaged with – pushed rather than nudged. 

As an advocate of nudge theory, Lansley might regard himself as a ‘libertarian paternalist’, the approach at the heart of nudge: that government can help us make better choices for our health and wellbeing without infringing on our freedom of choice. Arguably, removing chips and sausage rolls from the lunchtime menu removes children’s right to choose. 

But I can’t help but wonder if this overestimates the appetite for change among the target audience.  If kids just don’t want to eat healthier foods, how do you get them to make healthier choices?

Changing the ‘norm’

Is the problem that we’ve been looking at school dinners in isolation, instead of at the wider environment and the other pulls and influences on the decisions kids and their parents make? 

There’s a whole range of behavioural theories and models we could draw on to map why people make the decisions they do. 

Popular social learning theories, for example, suggest that we learn behaviours and what’s ‘normal’ or acceptable by watching what others do.  After all, aren’t chips part of the institution that is school dinners?  So we’re not going to be able to make a change until we normalise healthy eating. 

And that, ultimately, is at the heart of what both men are trying to achieve.

Fundamentally we need to change our relationship with food. There are a number of ways to go about this:

- changing pricing on the fattiest foods, as with alcohol

- using fear tactics as with road safety campaigns

- reminding people of the cosmetic impact of unhealthy eating, as with smoking

- getting celebrities to extol the virtues of broccoli, as with many charity campaigns…

Take your pick.  

Creating informed choice

All are potentially valid. But what really struck me about Andrew Lansley’s comments last week was the point that we need to take a more evidence-based approach.

Especially now, we can’t afford to feel our way through. We need to have a real, three-dimensional view of the lives of the audiences we’re trying to reach. 

We need to understand their individual barriers to changing.  What is more, we need to recognise that different groups of people will have different reasons, all equally valid, whether:

- financial, because unhealthy food still often costs less

- emotional, grounded in habit or resistance to being told what to do

- practical, struggling to balance competing pressures day to day, or

- educational, simply not having the information needed to make healthier food choices.

We need to look at the methods that have worked - and how they’ve worked – in order to design a form of engagement that we know can make an impact. 

What’s for sure – and what I think both Lansley and Oliver would agree on this – is that it doesn’t start at the centre. It needs a real conversation with people in their own environment, so we’re not just offering choice, but informed choice.

For me, that’s the goal.

By Ayesha Bharmal