Halting the childhood obesity epidemic within the next five years is one of the Government's most ambitious targets to improve children's wellbeing.
A sixth of children aged between two and 15 are obese and obesity in school-aged children has tripled in the last decade, according to the Health Survey for England 2002.
Local authorities and health authorities were jointly charged with spearheading the attack on obesity in the Treasury's Spending Review last summer through a public services agreement target to halt the year-on-year rise in childhood obesity by 2010.
So news that health authorities will not be expected to measure the extent of the problem until 2007 - just three years before the 2010 target - has come as a blow to professionals (Children Now, 29 June-5 July).
A base line to measure progress
"How can you have a target for tackling child obesity unless you have a mechanism for monitoring it in place?" asks Professor Chris Drinkwater, president of the NHS Alliance, which represents primary care trusts.
"You've got to have a base line, without it you can't tell if you're making a difference."
Drinkwater, a GP and professor of primary care development at the University of Northumbria, is about to publish research on obesity and weight management initiatives in primary care trusts. He says there is ample evidence of good practice on managing children's weight, from initiatives on advising pregnant mothers on diet and breastfeeding to collaborative work with the Healthy Schools initiative.
However, despite a lot of money spent on good work, the majority of trusts are not measuring the impact and don't know if children are getting healthier, says Drinkwater.
Darlington Primary Care Trust plans to get evidence showing the extent of local child obesity ready by the original target date of March 2006, explains Lucy Wheatley, the trust's children's services project lead.
"Evidence from measuring children is crucial in getting partners who might not initially see childhood obesity as being 'their business' to get on board with initiatives," she says. "When we speak to them, we need to know what we are talking about in terms of the number of children needing services - then we can go to them and say, 'this is the problem, what are we going to do about it?'"
Joint targets on obesity have already led to a closer working relationship between Darlington PCT and the local authority, which runs key preventative services such as school meals, explains Wheatley.
Yet despite the good work, she anticipates the checks will uncover the real extent to which services are needed. "We think there are a lot of children that don't have the right exercise facilities, or access to them.
If they had these things already, we wouldn't need a strategy."
However, some people argue it may be prudent for the Government to delay incentives for primary care trusts to take action.
The national shortage of services may leave large numbers of children without services, leaving them to struggle with the issue on their own, says Penny Gibson, obesity advisor for the Royal College of Paediatrics and Child Health.
Although information from Darlington's pupils has yet to be analysed the issue is of local concern. For example, under the current system children self-refer to dieticians, an expensive and scarce resource, says Linda Oliver, clinical lead for health visitors and school nurses at the trust.
Oliver believes there is no reason why children's nursing professionals cannot take up the bulk of the expected extra work in giving healthy eating advice.
Anticipating this, the trust has stepped up training in weight management for health visitors, which it plans to make available to school nurses as well.
No time to delay
Another problem is that the National Institute for Clinical Evidence will not publish obesity guidelines until 2007.
"There's no point in getting measurements done if the gold standard comes out two years later, changes things, and trusts have to alter systems, which could be expensive," says Drinkwater.
The issue was hotly debated between local trusts, with some wanting to hold off for the guidelines, says Oliver. But she argues there is too much at stake to delay.
"Until an assessment is done we can't make a formal plan. For children's wellbeing, we really need to know the extent of the problem now."
KEY POINTS
- Obesity in children aged six to 15 tripled from five per cent to 15 per cent between 1990 and 2001 (the Health Survey for England 2002)
- Overweight children have a 50 per cent chance of going on to become overweight adults.
