Item 4 on the agenda this afternoon is a statement by the Minister for Health and Social Services, 'Healthy Weight: Healthy Wales—Our national ambitions to prevent and reduce obesity in Wales'. I call on the Minister for Health and Social Services to deliver the statement—Vaughan Gething.

Thank you, Deputy Presiding Officer. I'm happy to update Members today on the launch of 'Healthy Weight: Healthy Wales'. I had the pleasure of launching a consultation with stakeholders on 17 January. This set out our national ambitions to prevent and reduce obesity across Wales. The consultation begins a period of engagement, challenge and reflection as we develop our priorities for action.

Obesity is one of the greatest public health challenges of our generation, and the Assembly, of course, agreed to make the production of this strategy a statutory requirement through the passage of our Public Health Act 2017. We know that the UK has one of the highest levels of obesity in Western Europe. The challenge of tackling obesity is one that faces countries across the world. So, we are no exception here in Wales. Twenty seven per cent of our four to five-year-olds and 60 per cent of our adults are either overweight or obese.

High rates of overweight or obese four and five-year-olds are a matter of national concern. This Government is not prepared to stand by and do nothing. That could let a poor diet or physical inactivity be defining features in the lives of our children and young people. We know that being overweight increases our risk of developing major health conditions such as coronary heart disease, type 2 diabetes and some cancers. We also know that this is a risk to our mental health that can lead to low self esteem, depression and anxiety.

The long-term sustainability of our NHS will require us to improve public and population health, encouraging people to manage their own health and wellbeing, to lose weight and to be active. Last year, I launched ‘A Healthier Wales’, the Welsh Government’s long-term plan for health and social care in Wales. The plan sets the scene for how all healthcare issues will be approached in Wales from now on. In that plan, I outlined a vision for the people of Wales to live longer, healthier and happier lives.  Being a healthy weight is a key component to achieving that vision. To develop the consultation, Public Health Wales has undertaken extensive research to develop a strong case for change, and that has been published in parallel. This has led to the development of four key themes.

Leadership and enabling is our first theme. We recognise that a coherent systems approach at both a national and a local level will be essential. Too often in the past, great plans have failed to deliver their intended outcomes because of a lack of understanding of how the policy will be implemented. I look forward to hearing from partners about how we can ensure that we deliver measures that are co-produced with communities and that are scalable, evidenced based and evaluated on an ongoing basis to drive the continuous improvement we know we need to see.

The healthy environment theme considers how we can provide greater opportunities in a person's everyday life to enable them to make healthier choices. We want to ensure that our lived environments, from our daily shop, eating choices, daily commutes or leisure time can be geared to support us to move more and to eat healthier. Our proposals here include bringing forward legislation for the first time to help tackle obesity—this includes on price promotions, calorie labelling on foods eaten out of the home, and banning the sale of energy drinks to children. I also want us to work proactively with industry to drive change through reformulation and to limit the advertising of unhealthy foods. Developing healthy weight environments through our planning and infrastructure could help us to create real opportunities to encourage healthier options on our high streets and to increase opportunities for daily physical activity.

Where we spend our time can often dictate the food and activity choices we make, and politicians will know that themselves. In the healthy settings theme, we consider how changes in our education, work and leisure could help us to maintain a healthy weight. We spend a large amount of our time in education, work or in public settings, all of which can play a key role to nudge us towards making unhealthy choices. In particular, we are proposing strengthened support for early years and schools settings to enable healthy eating and daily physical activity opportunities.

However, I am also clear that schools in particular cannot pick up the sole burden of tackling childhood obesity. They are an important part of the solution, however, through our third, healthy people theme of the consultation, we want to consider how we can motivate and support communities and individuals to attain and maintain a healthy body weight. That includes considering key points in our lives where we know additional support could be best placed. Crucially, we want to embed healthy eating and activity habits from the beginning, for example, helping women to manage their weight in pregnancy, through the first 1,000 days of their child's life, and providing the support that people need. We will work with health boards to ensure that we have a consistent clinical pathway in place as well.

There are strong links to levels of obesity within areas of higher deprivation and we want to consider how we close the health inequalities gap. Our proposals set out how we want to work with communities to increase support. In particular, we want to think about how interventions with children and families can be targeted and facilitated in a way that helps to achieve positive and sustainable lifestyle choices.

During the consultation, we will hold a number of consultation events across Wales, including discussions with members of the public in town centres, colleges and places of work. We're committed to publishing a final strategy in October of this year. I welcome your views today across the Chamber and I look forward to working proactively across the Chamber to ensure that we develop a set of proposals and actions that should put Wales at the forefront of efforts to prevent and then to reduce obesity.

Can I thank the Minister for his statement today and for giving us an advance copy of it? Obesity, as we know, is a major public health challenge in Wales, and you've referred to a number of important statistics today and the impact that obesity can have on people's health, including, very importantly, their mental health and well-being.

We know that, back in 2017, Minister, the Welsh obesity alliance made 18 recommendations on their views of how to tackle obesity and to address the assumption that, and I quote, 'being overweight has become normal in Wales'. That, of course, is something that you repeat in your consultation document. A number of issues have been incorporated into your strategy from the recommendations that the Welsh obesity alliance made, and I'm very pleased to see those referred to and I'm very pleased to see that the Government is consulting on taking action to address them.

One of the points that they have quite rightly raised is the need for increased regulation in the media around advertising of unhealthy food products, and I know that that is something that we as a National Assembly do not yet have devolved responsibility for. But I wonder whether you can tell us what discussions you've had with the health Secretary over the border in the UK Government regarding the opportunities that there may be to be able to work with them, so that we can actually get some UK-wide approach to resolving this issue of media advertising, because I know it's a matter of great concern to many people.

We, of course, all want people to eat healthier meals. We want people to reduce their reliance on ready meals, with very often high salt content and a high proportion of processed foods, and the obesity alliance have suggested that providing cooking lessons, not only in schools, but also to adults, to teach them how to maximise the benefits of self-prepared food, is one way to help shift people's behaviour. Obviously, this is quite a complicated problem, but I would be grateful if you could advise as to what sort of strategy the Government might have to reach those people who are already adults, but we haven't got them as a captive audience in our schools, so that we can equip them to make those lifestyle choices to prepare more food themselves in an affordable way, particularly in those areas where poverty can sometimes be a problem, and the affordability of food in shops and supermarkets is higher than some people can afford.

The 'State of Maternity Services Report' back in 2018, which was launched in November by the Royal College of Midwives, also highlighted the problems associated with obesity rates and pregnancy, and, again, I was pleased to hear reference to that in your statement today. I wonder what you can tell Members today is in place, as it were, or what proposals you're putting forward, to help to address the high rate of obesity. We know that there are many more caesareans in some parts of Wales in our hospitals than might be necessary, and some of that is linked to obesity. So, what action are you taking to address that problem, particularly in those areas where we've got a cluster of obesity problems in relation to pregnancy?

Another issue that was raised by the obesity alliance was that we need to publish data on obesity rates to ensure that there's transparency so that we can measure some progress and inform future policy decisions. I wonder whether you can tell us what the key performance indicators might be in order that we in this Chamber can hold the Government to account for making some progress on what is an extremely important issue.

Can I also ask that you'll look at the whole issue of social prescribing and whether it's proving to be effective? I know that many GPs these days are using social prescribing in terms of prescribing exercise or participation in local gyms. But I don’t think, frankly, that it's promoted as widely as it could be. We know that social prescribing can have a huge impact on people's mental health as well as helping them with their weight, and I'd be grateful to know what the prevalence of the use of social prescribing actually is in Wales, and whether you can give us any information on how we as Assembly Members can hold our own local health boards and GP services in our own areas to account for the delivery against that.

A couple of years ago, as well, there were two health boards in Wales that were flouting some of the Government advice that had been given to them in relation to banning sugary and fatty foods from being sold in vending machines, particularly on the hospital estate. There was data at that time that showed that Abertawe Bro Morgannwg's Morriston Hospital had 18 vending machines that were selling soft drinks, sweets, et cetera, and Singleton and the Princess of Wales hospitals, also operating in that health board area, had 16 soft drinks machines between them. Cwm Taf said that six of its hospitals also offered canned drinks, chocolates and sweets via 37 vending machines. You made reference in your statement to the need for leadership to be shown, and I'm not sure that that represents the sort of leadership that either you or I want to see the NHS actually having. So, can you confirm that sugary drinks, chocolate, other unhealthy snacks in vending machines and hospitals, will be obliterated by your Government in the future?

But I just want to—

And finally.

I just want to put on record we do welcome the publication of this statement. We want to engage positively with you to address what is a problem in Wales, and you have our full support with the consultation that is under way.

Thank you for the series of questions. You are right that advertising regulation is not devolved, although there is regular contact between officials and the UK Department of Health and Social Care. They're due to be consulting on extra measures around advertising and the potential to have, in particular, high-fat and high-salt-content foods—essentially, to have a watershed in advertising. We're in favour, broadly, of having restrictions on what can be advertised at what time, and, in particular, how that's targeted. Then, we're also considering whether there are things that we might be able to do in the way in which different products are advertised at events we ourselves sponsor and promote.

On your point about cooking for adults, if you look through the consultation document, we do recognise that, actually, helping people to prepare healthier food is a key factor. Actually, almost all of our anti-poverty programmes have looked at helping people to prepare healthier food as well. It's a standard part of the conversation—it's also part of what we look to do in promoting a healthy eating message through schools. It isn't just about educating children—it's actually about the whole school community. Part of what we'll be doing in the consultation is, in addition to the groups that I outlined, we're going to make sure that we talk to parents engaged in Flying Start. We're also going to have some conversations around school communities as well to talk to pupils and to parents, rather than just being one end or the other of the conversation.

On obesity and pregnancy, this comes back to the general challenge that we have on having a healthy weight through life. If you just want to have that conversation immediately before pregnancy or when someone is already pregnant, then there are still things you can do to help people to manage their weight. But, actually, we want to get ahead of that to try and make sure we're having a broader conversation rather than loading this into antenatal education.

But, of course, the reality is that we've increased our midwifery numbers to make sure we're Birthrate Plus compliant, and that is largely driven by the additional complexity in delivery of birth. That's partly because women tend to be older now when they give birth, but also because of the challenges of obesity too. So, there is a challenge about making sure that babies are safely delivered, and we have responded to that by increasing substantially and then sustaining the investment in midwifery training numbers.

But, like I said, in this, I think we're more interested in how we make every contact count, when people have contact with health professionals, and the more general cultural change that we want to see develop. That is about working with people, and it's why we're not referring to this as an obesity strategy, because, actually, the language and the framing in the conversation really matter. If people feel they're being judged, they're unlikely to engage, including those people who do want help to make a difference.

In terms of the measures that we want to adopt, that's part of the point of having the consultation—to see what works, and then, when we have that and when we deliver a strategy, we're clear about how we will have milestones and benchmarks to understand if we are genuinely making progress and what it is apt that the Government should be measured on and what it is apt that we want to set ambitions for the country on. That's a broader question here, because the Government on its own can't resolve this issue—if we could, then we certainly would have done by now.

On your point about social prescribing, I've made a number of statements in the Chamber about social prescribing, about its use not just in, for example, the national exercise referral scheme, but the additional investments we've made, together with the third sector, primarily targeted at mental health. I will update the Chamber again, when we have evaluation on the projects that I've already announced.

On your broader point about obliterating vending machines, there is always a challenge about the balance in what we do. I expect to come from the consultation some measures that will be challenging about how we take that forward. There will be very strong views on either side. If we simply say, 'Hospitals may not sell chocolate', for example, we know that people will simply buy it in other places as well.

So, it's part of the cultural change, but if you look at the way that health boards have moved over the last few years, actually, the food that you will see being made available within our hospital sites has markedly improved, and there's a much greater awareness of the offer and that it is a healthier offer as well. I expect that movement to continue, but I look forward, genuinely, to what Members here and outside have to say during the consultation. 

I'm very pleased to welcome the Minister's statement today and the progress that is being made on this very important piece of work, which, of course, arises out of a Plaid Cymru amendment to the original legislation. I'd associate myself with everything that the Minister has said himself and that Darren Millar has said about the importance of this issue to the health and well-being of our community.

This is such a wide-ranging potential agenda, and I can only touch on a small number of issues today, but, as Darren Millar has said, I would like to assure the Minister that Plaid Cymru will be keen to support him in the progress of this work and to co-operate in any way that is appropriate.

The first question I want to raise with the Minister is the issue of pace on this work. Now, I think it's very important to take time to do it right, but I'm sure that the Minister will agree with me that every day that we are not taking the actions we need to take is a day too long. So, I'd seek the Minister's assurance today that the October timetable will not be allowed to slip and that he will take personal responsibility for ensuring that it doesn't, given the importance of the issues.

Again, in terms of evaluating the progress on the strategy once it's in place, I would put it to the Minister that we will need specific targets. We will need a national target about how we're going to reduce the percentages the Minister's rightly highlighted of our fellow citizens who are either obese or overweight, but we'll also need specific targets for specific organisations to act on, because as the Minister has rightly said himself, we don't need any more warm words on these issues and we do know that what gets measured gets done. 

With regard to the Minister's healthy environment heading and the suggestions for legislation, I wonder if the Minister would give further consideration to how the planning system might be used to ensure, for example, that we no longer have so many fast food outlets really, really close to schools. As I understand it at the moment, there is no capacity for local authorities to limit these on health grounds and I really think that many of us would very strongly support a limit. The Minister will be aware that this is actually particularly an issue in poorer communities where young people may choose to buy chips rather than pay for a healthier school dinner, so that they have a little bit more money in their pockets. 

With regard to healthier settings, I seek the Minister's reassurance that while there's a lot of emphasis here on physical activity in schools, he'll be aware of the Health, Social Services and Sport Committee's report with regard to physical activity. Will he ensure—working with the Minister for Education, who's here—that this will be built into the new curriculum? I'm particularly keen to see that we take steps to ensure that teachers, especially in primary schools, have the skills and the confidence to build physical confidence and physical activity into what they do with children at that very early age. 

Also, with regard to healthier settings, I seek the Minister's assurance that we will ensure that further education colleges are included in this. We know that there's a big drop-off of physical activity, particularly amongst women and girls, between the ages of 16 and 25, and it seems to me that ensuring that further education settings are providing opportunities for young people at that age range can be really, really important in helping to develop and maintain healthy habits, particularly for women and girls.

The Minister's statement rightly highlights that levels of obesity are linked to areas of higher deprivation, and I hope that the Minister will take on board that the strategy should look at access to healthy foods. I would submit, Deputy Presiding Officer, that there are not very many mothers and fathers in Wales who do not know that an apple is better for their child than chips, but the truth is that potatoes are cheaper than apples. So, will he consider exploring, as the strategy's developed, access to healthier foods? I'm thinking particularly of food co-operatives. Some innovative work I saw in the Llanelli area where you've got local farmers coming together with local communities—picking up on Darren Millar's point about needing cooking skills, of course—but using the surplus produce that would otherwise be thrown away to provide at very low cost to local communities. 

Just two very brief further points. With regard to healthier people, I'm very pleased to see the Minister's reference to the First 1000 Days. The Minister will, I'm sure, be very well aware of the importance of breastfeeding in ensuring early child health and reducing the risks of obesity. I believe it's very important that we promote that positively to women, but also that we don't put pressure on them. I think it would be a crucial part of this strategy to ensure that there is support for women, going forward—not pressure, because we know that's unhelpful—but support for women, going forward. 

Finally, I'd like to pick up on the Minister's own point about the tone of the way in which we discuss these issues with our fellow citizens. The Minister is very right to say that if people feel judged, they will not co-operate, they won't participate—in fact, those at high risk turn to comfort eating. But I'd also add to what the Minister has said—that it's very important that there's nothing in the tone of these discussions that can contribute to the kind of anxiety about weight and body image that we know has such a terrible effect, particularly on young women, but increasingly also on young men, and that, if it's not properly managed, can lead to eating disorders. The Minister's referred himself to the impact of obesity and weight issues on mental health. That is, of course, true for people who carry too much weight, but it can also go the other way. So, I'm seeking the Minister's assurance today that when we look at the language we use, we don't put ourselves in a position where we risk worsening that agenda. 

I'm happy to confirm the commitment I've already given to an October date for the strategy to be published, and I expect it to have milestones and measures, but for there to be smart milestones, measures and targets, not aspirational ones. I'm really keen to actually have something that is achievable, as well as measures where we can track our progress, so people can see the progress that we are making not just as a Government and public services, but actually how we're influencing and helping to change behaviours, because much of what we're talking about, really, is how we help to change people's behaviour, as well as one of the point you made about how we make healthier choices easier choices. That's really important for us as well. 

And on one of those points, of course, unfortunately, it is not at all clear—in fact, the majority view is that we don't have the powers to have public health considerations as a legitimate planning construct, so we can't restrict the number of fast food outlets around schools, leisure centres or other areas. I think that is a problem. It is an area that the Welsh Government argued with the UK Government over with the passage of the last Wales Act, about powers deliberately retained by the UK Government. I think we would be able to make much more progress if we could take that into account as a legitimate planning consideration, and I think that we would all be much the better off for. But that still does not mean that when we consider planning healthy environments taking advantage of what we have, that there isn't more that we can do already in the way that we deliver services and the way we plan new developments.

On your broader point about healthy settings and the activity in schools, there's a point here about health literacy as part of the new curriculum. We've just had a statement lasting over an hour with questions about the development of the new curriculum. We're very clear about the role of health and health literacy within that new curriculum. To be clear about activity in schools, we're not just talking about the daily mile and we're not just talking about sport in schools as well, because people like me who loved and enjoyed sport are one group of people, but, actually, there are others who never liked it at all. But we still need to understand that activity is an important part of getting around and getting on, and that doesn't mean to say we're going to say that everyone has to get up and be brutalised by wearing far too little clothing on a cold day and having someone shout at you; that is not a great way to make people fall in love with a sport or any other form of particular activity. It's how to normalise activity that I think matters.

And on your point about cultural change—of course, that is exactly what I said we're looking to achieve, and I'm sure that the Member for Llanelli will be taking forward his continuing interest in active travel, for example. I mentioned that in the statement about how we get around and move around. That will really matter too. But also, I'm sure you'll recall, of course, the healthy and active fund, with £5 million, that I was very happy to launch with my colleague the Deputy Minister for culture—. It's a slightly updated title now—Deputy Minister for Welsh language and international Affairs. No? That's the Minister. Lord Elis-Thomas anyway—[Laughter.]—and I launched the £5 million healthy and active fund. That's about making use of all the assets that we have and, again, it's looking to promote cultural change, as well as to make the best use of all the opportunities for greater physical activity. 

Finally, on your point about breastfeeding, it's a regular topic we return to in the Chamber, and so we should do. There's a challenge with the move from breast is best to breast is normal, and to normalise breastfeeding and to make sure that it is accepted and supported, and, equally, that women who make different choices about feeding their children are not judged either. And that's your final point about not judging people, about wanting to support people to make healthier choices, and not wanting to tip people into a place where they have eating disorders either by overeating or undereating, but actually about how we say, 'What is a healthy weight and a healthy mind to be able to maintain and sustain a healthy weight?', and that is the focus of our attention. That is the way I want the conversation to carry on. 

I disagree with you one thing, where I think you were saying that poor diet shouldn't be a defining feature. Unfortunately, it is a defining feature of Wales. We are the most obese nation in Europe, and that is a pretty shocking statistic. So, we have to stop talking about it and we actually have to do things about it.

I absolutely agree with the focus on the first 1,000 days; I agree that's a very good place to start. But, as you do acknowledge, we can't leave it to schools to pick up the burden of tackling childhood obesity on their own; we have to work with them. But we absolutely have to tackle food in schools. My predecessor as the Member for Cardiff Central, Jenny Randerson, fought long and hard to introduce the Healthy Eating in Schools (Wales) Measure 2009 and she had this vision of instituting freshly made, fresh food in schools. It simply hasn't happened. We still have the large multiple catering companies bringing in food from goodness knows where and, frankly, there is next to no monitoring going on. I was devastated to learn that Flintshire had abandoned the Food for Life programme they had instituted with the Soil Association because that included elements of monitoring as to where the food was coming from. In none of the catering organisations now serving our local authorities is there any monitoring going on. Since 2013, Estyn has an obligation to report on food and drink, but does not inspect it. And there isn't anybody else doing it unless you've got particularly vigilant governors or school councils. So, we need legislation.

We cannot have catering companies flogging bottles of water in school because they simply don't provide it in a jug. This is outrageous. And we have to remember that people like Gareth Wyn Jones struggled to make meals from fresh food when he tried to do that in Canton in west Cardiff, simply because there isn't enough fresh vegetables available within a 50-mile radius. We already have the hallmarks of what needs to be done in Kevin Morgan's report, 'Good Food For All', published by Institute of Welsh Affairs in 2015, and that is public procurement in schools, hospitals, care homes, prisons and government buildings. That is something that the Government already has powers over, and we need to start instituting healthy food being served up in all of those intuitions as one of the ways in which we need to start changing the conversation. 

Lastly, I do hope that the Minister will support Veg Power's latest approach to making vegetables fun for children, because it's no use simply telling children they've got to eat five a day—that isn't going to work, particularly if their parents are simply unaware of the five-a-day message. So, 'eating veg is fun' is the way forward in my view. I think there's an excellent little advert that went out on ITV last week, and I hope that the Minister will associate himself with that sort of creative way of getting children engaged in what they're eating is what they are going to turn into. 

Thank you for the comments and points. I do want to make clear that the Government does not accept that we should allow poor diet to continue to be a defining feature of the way people live their lives and that must be the ambition of the Government to set out. And I recognise what you've had to say about healthy eating within schools and the challenges of procurement, about having healthy meals and adherence to the current regulations we have when considering further legislative change. It's not just about the curriculum, but whether there is legislative change needed as well. And of course, we're having a conversation to flesh out what the most appropriate steps are to make the biggest difference. That will require us to work together with local authorities in thinking about what is guidance, what is required to actually achieve the right outcome.

But I should say that, when you go into primary schools in particular, I'm regularly struck by how consistent the message is about healthy eating. Messages about high sugar, high fat, high salt, and the way that your final point is about the normalisation of making healthy food, and that it's fun to eat healthy food as opposed to something that is an act of penance, rather than something that you should actually enjoy. And I know this from my own child in the school system and the term's current project is 'scrumptious', so they're looking to try out new and different tastes and flavours and to make them interesting and to normalise it at an early age. And I'm delighted to say he is in particular enjoying this theme of his learning journey, and I wish that other children have the same opportunity. So, again, we look at what we do, how we do it, and how we make it more consistent to make the real cultural change we're all looking to achieve.

Thanks, Minister, for your statement today. Obesity is an important issue, as all of the speakers have made clear, and it's going to become more and more of a problem, financially, unless we can get to grips with it. I think I don't disagree with anything that anyone else has said in the Chamber today, but different people are coming from different angles, and it's going to be a difficult job to bring all of these approaches together in a coherent programme. So, there are difficulties ahead. Jenny Rathbone was just talking about the importance of the school diet, and she also mentioned public procurement, which is something that has cropped up recently on the environment committee, which is chaired by Mike Hedges, who's also a very keen proponent of using the lever of public procurement. So, this is something that we could do, and it could also link in to food producers in a post-Brexit environment finding a market for their produce. So, I hope that there is some way in which that idea of public procurement can feed into your programme of tackling obesity. Of course, that's only one angle. Physical activity is certainly another major issue and the need to increase physical activity among the young, and I think it needs to be brought into schools as much as it can be done. But you've actually yourself raised some of the issues that other people have also touched on, in that we can't just limit physical activity to people who are good at it, because the problem, actually, is getting people who are not that great at physical activity, who may not think that they've got a physically very attractive body or a sporty body, into meaningful physical activity. Angela Burns has raised this issue before when she's spoken about it from the Conservative benches. So, this is one of the problems.

Darren Millar was talking about social prescribing, which of course is another thing that we can meaningfully use. But again the problem of social prescribing is that, if you're going to get people to go to gyms, if people think that they're fat, they're probably, a lot of them—it's going to be difficult to get them to go to the gym because they will probably have certain anxieties about their body shape. So, these are massive difficulties, and how we are going to overcome them, I don't know. We do need a joined-up approach.

Active travel is also certainly part of it, and I'm slightly concerned about the way that active travel has kind of been bounced around the Government in the past. It's gone between different portfolios and different departments and different Ministers. So, I hope it's something that is going to be taken seriously. Seemingly, Lee Waters, I think you suggested, or someone suggested, may now be responsible for it. Now, we don't have any real evidence that, since the active travel Act was introduced, levels of participation have improved much. So, I think we do need to use that Act, get a grip of it, implement it properly and use it as part of your programme. So, it's a wide-ranging issue and I'd be glad to hear your thoughts on it today.

Thank you for the range of areas you've covered. On body image, active travel and procurement, for example, I think I've covered those in the statement and been clear that they're areas that we need to cover. They're part of the consultation and I'm looking forward to hearing what people have to say about the proposals that we are consulting upon. I'm genuinely interested in what people have to say and about evidence of what has the best prospect of working, because we're not alone in having this challenge. Every other western nation has a similar challenge, and doing nothing isn't really an option. That will mean that we'll need to learn as we do as well, because there isn't a western European country you can point to where they've got it right on a national level. There is some evidence about parts of Holland on a city basis where leadership has made a real difference, though.

I just politely disagree with you on your point about physical activity in the young. Of course it's important that we try to encourage patterns for life in young people, but, actually, physical activity matters for all of us, whether you're young, whether you see yourself as middle-aged or older, and I won't ask people in this Chamber to put themselves into categories like that, but we know that there are benefits for all of us in remaining physically active through all points in our lives, and it's about what form of activity and how we then make that an easier thing to do and, again, a normal thing to do and, again, not a form of penance or punishment.

Thank you, Minister. I've got a couple of questions today around the issue of childhood obesity, which is an issue that I am very concerned about. Of course, we know that there can be specific geographical problems in terms of tackling that issue, and a statistic that has always shocked me is the fact that a quarter of children in the Cwm Taf health board area are obese—not just overweight, but clinically obese. I know your statement talks about tackling health inequalities, but would you be able to provide any further information on this, or, indeed, examples of best practice that you would look to promote?

Childhood obesity can also be made worse by not giving our young people the confidence to get out and about in the natural world, which, again, is a cause that I have championed since I've come to this place. In the south Wales Valleys, there's a natural world that is quite often on their very doorsteps. With just 13 per cent of Welsh children considering themselves to have a strong connection to the outdoors, how are you working with colleagues across Government to see how that perception can be tackled? I’ve spoken previously about the role more formal outdoors education can play within that. So, I'd be interested in hearing what discussions you may have had about how that could fit into the strategy to tackle childhood obesity.

Thank you for the comments. You're right to point out the differential scale of the challenge that we face. And it's part of the re-normalisation of activity and thinking about the choices that we make as parents, because we make choices for our children, and, in doing so, we're actually helping to set their patterns for life, and that is part of our challenge. Again, it goes back to not judging people. If you say to parents, 'You're bad parents because your child is overweight', that is never going to—well, for the great majority of people, that will send them further away and it won't engage the level of trust and the conversation we need to have about how we make those healthier choices much easier for people. And there are micro-community examples of things that have worked. The challenge is to do this at scale, and that's our big challenge: to have significant cultural change and community changes in behaviour.

There is always a greater opportunity to be had when children are younger and parents are, frankly, more likely to share stories with each other. You're more likely to have interaction with parents when the children are younger, with the different activities they undertake pre primary school and after as well. So, there is a real point of opportunity within those early years in life. We're actually seeing some helpful changes with, for example, the First 1000 Days programme, but we're looking to have a greater scale in consistency and activity.

On the broader point about how we're working across Government, on the healthy and active theme, we initially actually had two different strategies: one on activity and one on healthy weight. We've deliberately brought them together because there are clear links and we want to make them deliberate. In fact, last week, I and the Deputy Minister were attending the cross-Government group looking at how we take forward greater activity, to look at the different levers of Government from active travel to a healthier environment to people in Lesley Griffiths's team, and to look at how we deal with this across Government and not just say, 'This is about health and education'. And that's also part of the reason why we had the healthy and active fund working with not just Sport Wales but also, for example, with Natural Resources Wales as well to make use of the assets we already have, and, again, to normalise the use of those assets that exist within easy reach of every community to make sure people know that they're there and actually take up the opportunity to use them.

And, finally, Caroline Jones.

Diolch, Dirprwy Lywydd. Thank you for your statement, Minister. Obesity is one of the greatest challenges facing our nation, and I welcome the fact that the Welsh Government has unveiled this strategy, because we are the most obese nation in Europe. So, a strategy is very welcome. Minister, there is much about your plan that I support and I welcome the focus on prevention, particularly in the early years. But, whatever age, if change is needed, it is to be welcomed and encouraged.

Minister, in addition to the strategy, will you be working with the Minister for Education to ensure the new curriculum makes provision to teach children and young people about healthy eating? In our communities and towns, we must also ensure that mums, young mums, feel confident about the facilities available for breastfeeding. I welcome the ban on energy drinks for the under 16s. Thankfully, the number of young people consuming sugary drinks has fallen by a quarter over the past decade, and those who consume them drink far less than 10 years ago. School playing fields, or lack of them due to these areas being built on, are also a major concern to me because physical activity is extremely important and it's becoming less and less.

Employers offering assistance to purchase bicycles to cycle to work is also to be welcomed and needs to be highlighted more. However, according to the national diet and nutrition survey, fibre intake is down, as is vitamin and mineral consumption, and many people still consume much less than five a day. Minister, over the past year or so, we have seen the increasing popularity of veganism, and, while a vegan diet can be really healthy, care has to be taken to ensure the right balance of vitamins and minerals. Minister, will you be considering improvements to food labelling to help people ensure that, in addition to reducing fat, salt and sugar, they consume sufficient vitamins and minerals to maintain a healthy body?

On the subject of food labelling, I have concerns about mandating calorie labelling for food purchased and eaten outside the home. While this is relatively easy for large outlets, such as McDonalds or Greggs, the little local cafe may not be able to cope with the additional demands and costs. So, Minister, what consideration have you given to incentivising moves such as this by offering, for example, a reduction of business rates to help those small businesses take this further step?

Finally, Minister, while I welcome the focus on prevention, more must be done to help those who are already overweight or obese. What discussions have you had with the Royal College of General Practitioners about ensuring that GPs have the difficult conversations with their patients regarding weight? And how do you plan to address the concerns of the Royal College of Physicians that little or no progress has been made in improving specialist services for people who are already obese? Tackling health inequalities is also extremely important, as Vikki Howells has already mentioned.

So, thank you once again, Minister. I look forward to seeing your final strategy and I also look forward to working with you to achieve a healthier Wales.

Thank you for your comments and questions and the broad welcome for the consultation. To try and take them in reverse order, we're clear that we'll be looking at the clinical pathway for dealing with obesity; we recognise that there's more that we need to do, and, again, greater consistency and learning from where that's most successful in the country. 

I think your point about GPs having difficult conversations is actually about how contact is regular with different parts of our health and care system. So, it's not just an issue for general practitioners, but, again, how sensitively the conversation takes place and whether the offer of help and support is available. Most people actually want to be a broadly more healthy weight and shape, and they're aware of that, and the challenge is how we help people to do so in a way that is empowering and not judgmental, as I've said many times before.

On your broader point about food labelling, that's the point behind the consultation—to understand that there are different views, but many food businesses already provide the average calories in a serving, whether you're in a large multiple or even in smaller outlets as well. So, we're looking to consult to try and understand what that might look like. On your broader point about changing diet, that is exactly one of the reasons why we're here—not just about more fat, more sugar and more salt, but actually a lack other points within our diets as well. 

And the points about energy drinks, breastfeeding, and, indeed, the curriculum, I think have been made in previous contributions so I won't test the patience of the Deputy Presiding Officer by repeating answers I've already given.

Thank you very much.