This is the speech that Andy was trailing in the film, from national archives, made 14th August 2009. He was focusing on 'building a more active Britain'.
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''Speech by Andy Burnham MP, Secretary of State for Health, 13 August 2009: Fit for the future - can we build a more active Britain?
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14 August 2009
The next 10 years will be the most exciting decade in our sporting history. Opportunities are about to arise that we’ll never get again. That’s why I wanted to give this speech today. I wanted to talk about how we might use this moment in our history to build a more active, and healthier, society.
But, first, we must look at ourselves in the mirror and face an uncomfortable truth. For such a sport-loving nation, we are not as active as we should be. About 27 million of us don’t do the recommended 30 minutes of moderate exercise five times a week. 14 million, about one in three, don’t even manage one session.
There has been real progress – sport in schools has revived, free swimming is helping – but this is not a self-congratulatory speech.
Standing on the cusp of this decade of world-class sport, can we truly say we’re world-class in the way we encourage active lifestyles?
We publish today for the first time an international physical activity league table to help us all focus on the scale of the challenge. It places the UK in 21st place in Europe. Out of the premier league, firmly in the second tier, trailing way behind the pace-setters in Holland and Germany. We have to ask ourselves why. Part of the problem is that physical activity has for too long been an orphan policy in Government. Many Departments have a stake, but no one Department has taken overall responsibility.
So there are two things I want to make clear from the outset.
The first is that we can’t afford physical activity to be a floating issue in Whitehall any longer.
This orphan policy needs a loving home, and under my leadership, this will be in Richmond House, with the Department of Health becoming the lead Department for physical activity. It will be core business for us, core business for the NHS.
This completes work I started in my old job working with Alan Johnson. It comes from the recognition that sport and physical activity are complementary, but require different policy interventions. So Ben Bradshaw and I will pick it up and work together to bring clarity to the policy function.
The second is that we need a new ambition for physical activity commensurate with the ambition we’ve already shown in bidding to host the decade of sport, and in bringing more sporting success.
Five years ago, we set ourselves the target of coming fourth in the 2012 Olympic medal tables. People said it couldn’t be done. But it was achieved, four year ahead of schedule, in Beijing.
Let’s now set ourselves a comparable challenge for physical activity - to climb up to fourth place in the physical activity league table and become one of the best places in the world for promoting more active lifestyles by the end of the decade of sport. It’s a big ambition and no doubt some will say it’s impossible. But they said the same about Everton breaking back into the top four.
If we can’t aim high in this next decade, then we never will. And, it is one area where huge social change doesn’t require huge public spending. It will be achieved not by Government edict but by people working together, grassroots action.
But we can help. Working with councils, working with the NHS, working with sport and physical activity bodies, to make it as easy as possible for people to get active. That has to be our goal.
Just think of the legacy for the country if we got there. Nearly two billion pounds a year – more than £3,000 a minute – is spent treating conditions that could be prevented by regular exercise within the NHS.
But the potential benefits go far wider. If we get to fourth in the league table, and have physical activity rates up there with the best, the savings could be significantly larger.
Think of the impact on social care spending if we help more older people stay to active and independent for longer.
Think of the value to business if we can cut sickness rates and boost productivity.
And think of impact on the welfare bill if we helped more people off incapacity benefits or job seekers allowance or not go on in the first place. Over a third of the people on incapacity benefits have mental health problems or muscular or skeletal disorders – both of which are known to respond well to tailored physical activity programmes. So, in England, even if we can get just one per cent of them back into the workplace through active lifestyles, this would save the Exchequer £36 million and industry £31 million – that’s a combined saving to the economy of £67 million a year.
But, more than that, how many lives would be lifted and hopes raised?
Regular physical activity lifts self-esteem, raises ambition and aspirations, helps people contribute in all aspects of their life. It can bring people who feel low, lonely or isolated back in touch with their communities. Put simply, it makes us feel better about ourselves, more positive and better able to cope with what life throws at us.
It is a simple answer to life’s problems. But they same can be said at the other end of the scale - the macro challenges we face as a society.
Increasing active lifestyles is a simple answer, staring us in the face, to many of the big challenges facing our country today – rising obesity, the ageing society and sustainable public spending.
This isn’t just rhetoric. Other countries have already done it. Thirty years ago, Finland had some of the highest rates of heart disease in the world. As a result, the Government made a conscious decision to promote active lifestyles. And, through careful targeting of programmes, good use of natural assets, and strong engagement with business, it achieved a 50% increase in activity levels within a generation. Today, around half the population is active.
Of course, the other thing that’s distinctive about Finland’s success is the level of investment put into physical activity – some four per cent of total public spending. In this country, the figure is less than one per cent. Now this isn’t my spending bid for the next CSR. It’s an argument for spending differently, both across Government and particularly within the NHS.
Time and time again, you’ll find the cost of up-front investment is dwarfed by the price of failure. There are studies that show exercise was at least as successful as anti-depressant drugs in fighting depression – and prescribing pills is often our first answer.
So the central question is one of belief.
Do we really believe the business case stacks up? And if we do, as the savings can take time to materialise, do we have the courage to see it through?
We are in uncharted territory as we attempt to stimulate social change on the back of the global sporting events. The IOC president acknowledged this when he described our plans to get people active as part of the “distinctive magic” we will breathe into the Games. But the evidence from past sporting events suggests the Games are likely to have two distinct effects on the general public.
The first is the “demonstration effect,” which encourages people to rekindle their enthusiasm for a particular sport, or try out a new activity based on what they see on their TV screens.
This tends to spark a temporary surge in grassroots participation. The classic example is the Wimbledon effect that we see every year, in parks up and down the country, when tennis courts suddenly become heaving for a couple of weeks in June. The drawback is that the demonstration effect is normally temporary. Those same tennis courts tend to empty out soon after the last serve is struck on Centre Court. So the first trick we have to master is to ensure the demonstration effect is sustained and that it actually stimulates long-term participation.
The other drawback is that this effect tends to be focused on those who are already fairly sporty or inclined to ‘give things a go’. It doesn’t cut through to those who could benefit most from physical activity.
So this is where the second effect – the festival effect – becomes crucial. The festival effect works by building a sense of community involvement where everyone gets involved in activities, simply because they want to feel part of the occasion. In other words, it captures people’s imagination, catches the mood, as a way of boosting participation. This, for me, is the effect we need to maximise. And it’s where Change4Life, already delivering initiatives in the community, for the community and by the community, can make all the difference.
So how will we fulfil this ambition? How do we move ourselves from relegation contenders to playoff candidates in the international standings?
Today I want to set out a new four-point plan.
One, a new accord across Government – that matches the scale of our ambition and enables politicians and policy makers to lead from the front.
Two, a new awakening across the NHS – from the board to the ward – that active lifestyles are now an intrinsic part of 21st century health.
Three, a quantum shift in social attitudes, so that physical activity starts to resonate as a clinical need, not just a lifestyle choice.
And four, a sea change in local provision – to make active lifestyles universal: etched in people’s minds; woven into the very fabric of community life.
Let me add some detail to these points.
We need a new focus in Government to help set the right lead. Working with Tessa Jowell and Ben Bradshaw, I will bring together regular Ministerial summits on Physical Activity, involving all Ministers with a stake in physical activity. These summits will evaluate progress to date, and provide top tier forum to challenge ourselves, and constantly re-examine what more we can achieve across each Departmental area to meet these ambitions.
I’m also delighted to say that Mike Farrar, Chief Executive of the North West Strategic Health Authority, has agreed to take on the job of championing physical activity across the health service. As many of you know, Mike is steeped in these issues, from his early career as an aspiring sportsman, right through to his current role in the North West and as board member of Sport England, where he also served with distinction as interim chair. I’m confident he will be a terrific ambassador for change within the NHS.
We will get real progress when national focus in government is matched at local level. It’s heartening that more than half of all local areas have signed up to the sport and active recreation target. But when that is 100 per cent we are really in business.
This brings me to my second point of change - the need for culture change in the NHS, so that promoting physical activity moves from the periphery to the mainstream, integral to 21st century health care.
I want to see the NHS bodies leading from the front, striking up new partnerships to deliver better opportunities for people to get active. The NHS Operating Framework already makes promoting wellbeing a priority but it’s time to translate it into hard action. What we’ve learnt from the Let’s Get Moving trials in London surgeries is that where you have clear mechanisms in place to help GPs start a dialogue with people about physical fitness, the impact can be massive.
The pathways use the same ‘screen, intervene and follow-up’ process used to identify and support those who want to give up smoking or who need to reduce their alcohol intake. In effect, they position primary care as a gateway to local opportunities. And they allow health professionals to join forces with health trainers and fitness experts, to guide people who may not have thought about physical activity, or may be intimidated by the prospect of joining a sport or fitness club, towards things that work for them.
So the national roll-out of Let’s Get Moving this autumn can marry up primary care with local physical activity programmes. This is a potentially big change that makes some of the welcome experiments in the area of prescribing exercise become in time mainstream prescribing practice.
Of course, the flipside is that there has to be the right opportunities available. The message from me to PCTs and practice-based commissioners is not to wait for central Government schemes. You’ve got the green light. Be creative and ambitious. Do local deals – for instance with councils, local gyms and fitness centres – that open up those opportunities.Because we need to build programmes that capture public mood, and offer the would-be heart disease and cancer patients of tomorrow an easier route to healthier lifestyles today.
It’s vital we make full use of major sporting events as a catalyst. With Ben Bradshaw, I want to work to develop physical activity legacy plans alongside the sports legacy plans they have to promote physical activity – to maximise the ‘festival effect’ of this golden decade.
And this is also where Change4Life and the various activity sub-brands also come into their own. We’ve now got three activity-based sub-brands – Bike4Life, Swim4Life, Walk4Life – and will be introducing others such as Dance4Life and Play4life in the months ahead. It’s important we now start to use these brands as the basis of a coherent, meaningful and resonant grassroots offer.
What we’re looking for is a domino effect. A nudge from the centre to topple the first tile and then local community-based action carrying things forward.
Take dance4life. The way that John Sergeant and friends captured the public imagination over the last 18 months is a classic example of the ‘festival effect’ I spoke about earlier. If we move quickly and cleverly, we can turn this huge public interest into regular participation.
Next month, therefore, we’ll establish a new Dance Champions Group under the chairmanship of Rod Aldridge, and I’m pleased to say we’ve already got Arlene Phillips from Strictly Come Dancing on board, and Darren Bennett, Angela Rippon and Capital Radio’s Lisa Snowdon. They will bring the dance sector behind a major project to boost participation in the run up to 2012 – more details to follow shortly. And they will also help to build the profile of the Dance4Life brand and lay the groundwork for a nation-wide, community-based dance offer.
The beauty of dance is its simplicity. It doesn’t take a huge amount of investment. You can start with regular dance sessions in any decent local venue – a school, a church hall, a working men’s club – and you go from there.
The same is true of organised walks. Again, the nudge comes from the centre – and we’ve just launched a campaign with Natural England to deliver 200,000 more people active by 2012 through Walking for Health. Under the Walk4Life brand, this programme already provides a service for an astonishing 30,000 people every week.
In effect, we’ve already got the kernel of a national offer. And in the future, if we can connect this up with Let’s Get Moving, we can start to make structured walks available in every part of the country and reaching out to those who can most benefit. Not least, there are the social benefits of meeting new people.
Similarly for cycling, there are already strong partnerships in place with Active Travel partners, commercial sponsors and expert groups like Cycling England and British Cycling. And Sky, who’ve put great support behind the sport, have worked with British Cycling on a scheme to encourage people of all ages to back on their bikes. This summer, Sky and British cycling have created a series of Skyride events, with mass participation rides, on traffic-free roads, staged in five major cities, plus hundreds of smaller local rides led by trained British Cycling ride-leaders. The Department of Health will work with both of these partners over the next six months to develop model for a national programme of additional cycling opportunities in line with the local Skyride initiative.
So in effect, we want to achieve for cycling what the cross-Government Free Swimming programme has done for swimming – to create simple, consistent and easy-to-access opportunities for as many parts of the country as possible.
And then, of course, there’s swimming and the Free Swimming scheme that is a real passion of mine. The tremendous public response since it launched – driven the excellent work of the 200-plus councils who signed up – answers the sceptics who say this focus on physical activity will leave people cold. Over 20 million young people and senior citizens are now eligible for the programme. 4.4 million free swims made since the scheme began in April, and there are reports of queues round the blocks of leisure centres that are taking part.
Free Swimming is symbolic. It’s game-changing. A real statement of intent. And it works because it delivers a clear, simple, resonant message that cuts through to people at large. I see this in my constituency where I’d proud to say people of all ages can swim for free.
I believe we need these big ideas to break through the rumble of smaller, local initiatives. And that’s why I now want to give councils the chance to go further.
So on top of the £1 million we’re now making available for councils who didn’t sign up first time round, we’ll also be looking at how we can support existing free swimming councils to innovate and extend their offer.
I’ll be setting out more detail on this in the coming weeks. But I’m particularly keen to see more councils take the plunge – literally and figuratively – by making swimming free to everyone, not just certain age groups.
And that’s really my long term aspiration for Change4Life. Each of these activities – dance, swimming, walking and cycling – are universal in scope. They can appeal to everyone. They can benefit everyone.
So can we now foresee a future where every community aspires to a free and comprehensive offer across these four brands? For me, this is the logical way forward. Of correcting the anomaly, that you get free treatment on the NHS, but you have to pay to prevent the illness in the first place.
That’s the sea change we need, both in policy and practice. That’s where we need to show belief, conviction, vision. And what better time than now, in the glow of this carnival of elite sport now upon us, to push ahead and make it happen?
So August 2019, we come back to this room. Successful events staged. A rack of medals and even a couple of big trophies won. Great memories. But the biggest prize – everybody more active than they were.
No pressure. Let’s go and do it.
Thank you very much.''
