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The sugar tax: Not about sugar. Not about tax.

By Judith Husband

The announcement by the Chancellor of a new sugar levy on producers of certain soft drinks came as a surprise to campaigners, the producers themselves and the public. In the immediate hours and days after the March 2016 Budget, it sparked significant debate and has polarised opinions.

This could be perceived as a partial u-turn by a government that just a few months ago stated in response to a hugely successful e-petition, that there were 'no plans to introduce a tax on sugar-sweetened beverages'.

The levy has been greeted with a diverse range of opinions, ranging from it being in the right direction, to outright cynicism, that it is too little too late, and the 'nanny state' impinging on free choice.

My view falls squarely within the first of these responses. This is recognition of public and professional lobbying, scientific evidence, and is most importantly an opportunity to build and expand the conversation. It is the beginning of a much needed health and social care revolution in the UK, one reflected globally in both developed and developing nations.

The UK is not alone in the challenges it faces due to the increasing burden placed upon healthcare resources by preventable diseases. These are all being fuelled by poor choices and cheap and easily accessible processed foods.

The proposed levy falls short of the calls for a 15p to 20p per litre tax on all sugar-sweetened drinks. Health campaigners and the medical/dental professions would argue it's not just drinks but hidden sugars in all processed foods that adversely affect health. In spending the expected £0.5 billion raised on exercise in schools, misses an opportunity to invest in health promotion - and, of course, the fact that exercise can't make up for a bad diet!

Tooth decay caused by sugar is the most common reason that children aged between 5-9 years, are admitted to hospital, with the trend rising 10% in the past four years. Sugar consumption is also coupled to significant increases, described by some as 'an epidemic', in obesity and type-2 diabetes that is also costing the NHS an estimated £9 billion each year. The additional challenges this brings to already overstretched social care providers, the wider economic impact of decreased work productivity and, most importantly, the human cost of lives cut short, is nothing short of scandalous in the 21st century.

The estimated revenue generated by the levy is almost an irrelevance when compared to the figures referenced for the NHS funding gap of approximately £22 billion and the social care funding gap of another couple of billion pounds.

There is global recognition that universal health coverage provides a fairer, more efficient funding model, sharing cost equitably across large populations. We are now at risk, in the UK, of eating our way into an uncertain, expensive new healthcare future. The poorest in society already face the largest disease burden, and this inequality will only be reinforced if we don't take action.

The debate that's been ignited is valuable, and although I consider we are still in the awareness-raising phase, in my view the levy is already acting as a further catalyst to that debate.

We all recognise though, that there are multiple strands and competing issues at play.

Information is key. Labelling of all foods needs to be simple and honest. Great as the 'sugar swap' app from Public Health England is, it shouldn't be necessary to have a smart phone with internet access to scan barcodes in order to know what is in a particular food or drink.

Advertising and product marketing, in all their various guises, exist because they work. Companies invest vast sums of money both in direct advertising and in much more subtle, sophisticated sponsorship and product placement. In the UK we have regulations to protect children from such promotions on TV and online, but loopholes exist and these are being capitalised upon.

In dentistry, we have great examples of targeted preventative programmes that have a huge impact for relatively little cost. The ChildSmile programme in Scotland, and similar ones across the world, have the evidence base that simple initiatives can have a huge health and well-being impact. This programme is a school-based tooth brushing initiative with twice yearly fluoride application.

There is an estimated £5 million of savings in Scotland using the ChildSmile programme and most importantly, longer term, an increase in healthy, caries free children. These significant health gains have been achieved in some of the most deprived communities. Addressing health inequalities needs bespoke solutions to different groups, owned by the community and supported with targeted investment.

And so to the Sugar Tax...

You have undoubtedly guessed that, for me, it's not really about sugar or taxation. It's about taking every opportunity to encourage, inform and enable communities to make healthy choices; to leverage change on commercial organisations, often by using their own profit-based drive and motive.

It's about us all ensuring business doesn't undermine society, that governments and communities are investing to ensure good outcomes for all, while ensuring reasonable healthcare costs enable us to maintain sustainable systems.Health and well being is a human right. Let's make it happen.

Judith HusbandJudith Husband has practiced in all spheres of dentistry-primary and secondary, private and NHS. In 1996 she became President of the British Association of Dental Students. In addition to involvement at a national level, she has continually worked with respective Local Dental Committees currently Chairing Oxfordshire LDC.

In 2006 Judith was elected to the Executive Board of the British Dental Association leading initially on Equality and Diversity and later Education and Standards. She was Deputy Chair of the Executive Board for four years.

Her current responsibilities on the BDA Principal Executive Committee include Chairing Education, Ethics and The Dental Team a wide ranging portfolio encompassing some of the most significant areas of dentistry. Judith is also Chair of the BDA Audit Committee.

The views expressed in this article are the personal opinions of the author.

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