Therefore, we move to item 4, which is a statement by the Minister for Health and Social Services on 'Healthy Weight: Healthy Wales'. I call on the Minister to make the statement—Vaughan Gething.

Diolch, Llywydd. Last week I was delighted to launch 'Healthy Weight: Healthy Wales', our 10-year strategy to help prevent and reduce obesity. This sets a clear path for a long-term approach that makes use of the five ways of working set out in the future generations Act as key components to deliver an approach that will have far-reaching impacts for the future health of the population.

Obesity is a complex issue, with many contributing factors acting at an individual, community and global level. We are at a point in time where the UK already has one of the highest levels of obesity in western Europe. We start from a position where over 60 per cent of our adult population are either overweight or obese, and that has become a normalised state, with around 27 per cent of our four- and five-year-old children starting school each year who are already overweight or obese.

The burden of obesity is felt hardest in our least affluent communities, and there are significant impacts upon life expectancy as we see worrying trends around links to type 2 diabetes, cancers, heart conditions and many other conditions associated with diet and an inactive lifestyle. We know that obesity can also have a significant impact on our mental health. In many cases that tracks from a young age to having lifelong consequences.

The final strategy is a culmination of the views of our stakeholders, international evidence and research. When I stood before you to launch the consultation, I was grateful for the large measure of cross-party support and the understanding of the significance of this as an issue. Since then, we've held far-reaching consultation, which included conversations with over 1,000 people across Wales. There is strong support for the proposals that we have set out in the strategy, together with energy and backing within our communities to support positive lifestyle change. I want to ensure that our strategy unlocks that potential.

Our strategy sets out a 10-year vision to help us all to make the healthy choice the easy choice. Our aim is to achieve these changes by 2030. We want future generations to live in environments where the healthy choice is the norm, where physical activity is part of everyday life, encouraged and supported by working in partnership with local government, education and transport, where Wales’s natural beauty is taken advantage of and our food choices are nutritious and affordable. I want to close the health inequalities gap and, in particular, I want to focus and target support for children and families.

Suzy Davies took the Chair.

Taking the approach of 'A Healthier Wales', this is the first time that the Welsh Government has adopted a co-ordinated approach to tackling obesity. The range of cross-Government action highlights how existing programmes and approaches can work in tandem to promote and enable positive change. This includes how interventions in areas like transport, planning, early years, education, communities and health services can be brought together to enable even greater opportunities for people to change behaviours. 

The four themes of the strategy are: healthy environments, healthy settings, healthy people, and leadership and enabling change. They illustrate the system-wide approach that will be required to tackle obesity, recognising that the environment influences our everyday choices. Over generations, we have evolved the environment into one that places a focus on convenience over health. We'll develop and scale approaches to reverse the current imbalance placed towards unhealthy food choices, and ensure that our active environment can help to make good physical activity choices.

Our focus upon the environment will be coupled with approaches through behavioural change. This will develop a range of actions to enable prevention and early intervention support for people, which will focus upon providing the right information, advice or provision at the right time. We'll also develop an equitable and accessible clinical obesity pathway across Wales, which will put in place a range of specialist services for those who require the most specialist support.

But obesity cannot be solved by the Government or NHS working in isolation. Our systems-based approach should help to develop leadership across all levels. This is on the basis of collective responsibility and drawing upon the strengths and assets of a particular community. We'll underpin this approach through the development of dynamic data, evaluation and strong communication.

Now, I have previously stated that we will not set superficial targets and that the strategy is focused on delivering outcomes. To supplement the strategy, we'll publish an outcomes framework in the new year, which will help us to monitor and track change. We've begun to explore new data sources to develop this work. This will provide us with a range of indicators that are linked to behavioural change.

Accompanying the strategy will be a series of two-yearly delivery plans, which will span its lifetime. The first delivery plan will be from 2020 to 2022, and it will provide detail of the initial priority areas that we will take forward. I will chair a newly-established implementation board later this year to agree these priorities and establish how to utilise and maximise existing resources, policies and programmes to achieve an integrated approach. Over the next two years, we will begin to develop policy and legislation, and I will make funding available to help achieve our aims. This will allow us to put a greater focus, together with partners, on prevention and early intervention through all systems as part of our approach to building a healthier Wales. The strategy will help to ensure that we can leverage and maximise additional funding and opportunities to drive changes across partners, to see a shift in how we use spend towards prevention. 

Of course, we have to take into consideration the impact of Brexit. Whilst I intend to announce funding approaches to influence positive health impacts across our population, the uncertainty over funding is unavoidable in the current climate. If we leave the European Union, especially a crash-out 'no deal' Brexit, then we will have many hard and unpleasant choices to make. There is no evidence to suggest there will be an overall shortage of food. However, a 'no deal' Brexit is likely to lead to a reduction in the choices and availability of some foods, especially fresh fruit and vegetables that we regularly import from the European Union. As a consequence, it is likely that costs for these foods will rise, and that will impact disproportionately upon families on the lowest incomes. We will need to consider and reflect the impact that Brexit would have on the delivery of this strategy.

I continue to welcome cross-party support and challenge to ensure that we can achieve shared ambitions and forward-thinking aims. I welcome continued support and engagement with other parties and the wider public to ensure that we can deliver an approach that will make a significant difference for the health of our population.

Thank you, Minister. Angela Burns. 

Thank you very much, acting Deputy Presiding Officer. Thank you very much for the statement today, Minister. There's much in it to agree with, although I will have to just say that I thought your end paragraph about Brexit was utterly ridiculous in this particular context. Yes, we will have challenges no matter what happens, in or out, but the situation we have today is a current situation that has been evolving over the last decades, decades when your Government have been responsible for trying to help to solve this issue. To suddenly land the end of your statement with an 'Oh, woe is me; this is all down to Brexit', I think, is ridiculous.

There are some very good points that you make in this, but I would like to make a couple of my own. The first is that at no point in this document do you actually follow a line that says that people have a personal responsibility. And I can say this as someone who's had more than her fair share of ill health over the last few years, and I am no sylph, regrettably, but I am fully aware that in order to get truly well, I have to take myself in hand. We all know that. We don't smoke, we need to have more exercise, and we need to control what we eat. And in your statement, there's very little reference to that; it's all about what you can do, communities can do, GPs can do. But I do think that somewhere along here there needs to be a slight call to action on the public, that we also try to do our bit to control what we weigh and understand what impact not controlling what we eat is going to have on our long-term health outcomes. It's an honesty agenda, and we are very, very scared at times, I think, of being quite straightforward with people.

You talk a lot about prevention, and I think there is an awful lot of very good prevention work going on, and particularly in schools through the healthy eating initiatives. But of course, being a healthy weight isn't just about what you put in your mouth; it is about the exercise that you take and your attitudes to the way you go out and live your life. And I wondered if you can clarify for us what discussions you have had with the Minister for Education about increasing the amount of time that children have within their school day to spend on sports, because over the last decade, the amount of time that children have had in the playground—and I've done the FOIs, I've had all the answers back—has slowly been reducing. There may have been a step change in the last year, because I haven't checked in the last year, but it needs more than just an extra five minutes a day or five minutes a week. So, what discussions have you had, particularly at primary age, on ensuring that young people have that opportunity to really have inculcated into them the desire to go out and be fitter and just to enjoy it? They don't even know it's exercise, they're just playing, they're having fun. Education is absolutely key.

The food environment comments, I think, are extremely important. I think there is a real argument for widening the advertising exclusion zone around schools and to work closely with Sport Wales.

Your whole statement is called 'Healthy Weight: Healthy Wales'. I understand it's driving on the obesity agenda, but I couldn't stand here and not mention the fact that, particularly for our young teenagers, underweight is also a massive issue. So, I would like to ask you what steps you're taking as a Government to ensure that when promoting this agenda, what we're actually saying is, 'Let's get the right weight.' Because we have, especially our young girls, an awful lot of them who just do not eat appropriately because they are terrified of being too fat or they feel they should be following some norm that's been pushed by some celebrity. And on Instagram, I couldn't agree with you more, Minister for Education; I think Instagram is one of the great ills of the world.

On the active environment, I'm so glad to see that the Minister for housing is also here because, actually, again, in the planning, I'd like to ask you to go through what discussions you've had about how we can use the planning system to increase our recreational and sports ability and play ability in our new housing developments. Because, again, we've been through this in the past where developers have said, 'Oh, well, we've got x metres of green space', but actually it turns out to be the green grass along the sides of the pavement. That is not a sports facility where kids can play. And the other thing that developers do not do is they don't recognise the fact that parents actually quite like to have the play area where parents can see it, so that they know that their kids are safe. So, they put the play area on the other side of the village lane, away from all the houses. We want them in the middle of the houses. It's very old-fashioned, but you can look out of your window, you can see your child, your child's outside having fun and having that play. All of those small things help to contribute towards having a healthier life.

I do just want to very quickly, though, mention a couple of very good programmes that have been running. There's a fabulous one—and I'm going to get this wrong; no, it is right, it's been written down about three times—Man versus Fat. This is for men, middle aged, a bit too wide, and they go out and they play football. There is a big programme, it's running in the National Assembly, and people are losing weight by the droves. That's the kind of thing we need to be encouraging people. Middle-aged women like me, I don't want to go to a gym and face off with a gym bunny in Lycra. No, thank you. I'd much rather we come up with programmes and it's about getting the adults out there—they'll get fitter, the kids will get fitter, but it's about targeting it.

There's a fabulous programme running in London. It's called 'Mind, Exercise, Nutrition...Do it!', MEND. It's a programme that's aimed specifically at seven to 13-year-olds who are very obese, and again, it's had great successes. Minister, can you tell us what you've done to look at other initiatives that have already been proven? I saw in your programme, which I've read today, that, again, you're talking about finding best practice and making it happen throughout the whole of Wales. If you can just give us some of that information, that would be very helpful.

And, before I'm booted off the floor, may I just add about the funding? It comes back to my point about Brexit. Actually, this is a really serious issue about making us all slimmer, fitter and healthier. The saving to the NHS in the long term would be immense, and even more important, the saving to the individual. And it is within your power; you get over £16 billion a year as a Government. We're not talking big bucks, but you can spend a little bit of that money in helping local authorities to keep their gym facilities open, open their swimming pools, keep their bowling greens going, keep all their green spaces and allow them to have play equipment that can be looked after and maintained so that people actually have a great environment to go out there and to try and be fit.

Thank you for the range of comments and questions. I'll deal, to start off, with your point about Brexit. I've never said, either in launching the consultation or in the statement that I made today, that the challenge that we face in terms of combating and reducing obesity as a society is only the result of Brexit—far from it. The point that I make is an unavoidable one, that the scale of our challenge is made harder because of the reality of what Brexit would do. And don't take my word for it; there are many representatives of your own party who recognise the economic impact of leaving on the currently proposed deal. That would have an impact. We know that's true. If we have less fresh fruit and veg available and what we have costs more, we know that will have an impact too. And that's part of being honest. That's part of the honesty that is required, but I certainly don't deny that even if Brexit were not happening, we would still need to look again at what we are doing in this area, because our population figures and the reality of the impact of this issue is not something that we could or should avoid. And that's why we have the strategy.

We start by looking at how we empower and enable people, the assets that exist within people and in their communities. Because, at the outset of this consultation, I did try to point out that I recognise that sometimes, this can be a difficult debate to have. If you wag your finger at people and say, 'You must do better', that doesn't always work, it often puts people off. So, there's something about how you empower and encourage people, because most people actually do want to make a change, and the challenge is how we can support them into a place where they can make that change an effective one. And that is partly about the message of some responsibility for self, but how that is provided is really important and not straightforward, because that can easily turn into a very harsh and unkind debate. And, at the times that we're in, we live at a point in time when, often, that is the default position, and it's very difficult, sometimes, to find the room for reasons through the middle. And this strategy tries to take that approach saying, 'This is what we can do, but we have to work with people', because it's always the case that the biggest influencer on your own healthcare and your own health outcomes is you, the individual person. And that includes me when I look at my health.

On your point about physical activity, you talked about sport in schools, and yes, we do talk about this and officials across the Government have talked about this, but I remember that there was someone who looked quite a lot like you when the consultation was launched in this Chamber, who said that they didn't just want to talk about sport, because not everyone enjoys sport. But there's something about physical activity and opportunities to make the activity range that people undertake, not just in schools, but in communities as well, and that is definitely part of what we're looking at. So, it's not just the daily mile in schools, but very clearly set out within the strategy we do talk about having more physical activity within school settings as part of what we want to achieve.

In terms of your point about what is a healthy weight, and the challenge for people who are underweight and have eating disorders, this is again one of the difficult parts of the consultation because not everyone liked the title 'Healthy Weight: Healthy Wales', as if there was an impression it was deliberately avoiding issues of people who have eating disorders, or people who are underweight. As ever, there is never a perfect title for anything we choose to do, but we do take that seriously, and so there's a whole different stream of work ongoing, but this is the point about what is 'healthy'. It isn't just the weight you are necessarily, it's about 'Healthy Weight: Healthy Wales', the way you live your life, the choices that you make, and understanding what you do to your own body with the choices that you make about eating, drinking and exercise in particular. You'll definitely see those themes, of course, in the areas of learning within the school curriculum, and you'll see consistency between that and the approach we're taking in the strategy.

When it comes to the point about planning healthier environments both at home and at work, again, I take on board the point you're making and again I strive to make clear that we do want to look at that. There are things that we'll want to try and test and do with future legislation. For example, I'm quite keen to test the limits of what we can do in terms of public health and planning, where fast-food outlets are and aren't allowed to take place, the number of them that might be allowed to take place, and how close they are to leisure centres and schools. Those are the things we want to test and see how far we can go with that, because we know that otherwise we'll end up having more of those in areas where we recognise they'll have an adverse impact on the health of the population.

In terms of what is appropriate in terms of activity, yes, we have looked already at what exists in the UK and in other parts of Europe and the US in particular, because I do recognise that there isn't a one-size-fits-all approach—no pun intended. For different people, different opportunities will make the difference for them, that will be accessible and things they'll want to do. Some people may really enjoy going out and joining a walking football club, and there are lots of people, men and women, who are enjoying doing things like that. For other people, that would be the last thing that they would want to do. So it's the variety of activity that we can provide and understanding the evidence base for what is the most effective intervention to help support people. It's a difference that, as I say, most people do want to make, and it's about how we help them to do so.

Can I thank the Minister for his statement on 'Healthy Weight: Healthy Wales'? Obviously it's quite comprehensive. I just wanted to drill down on what we can actually do as a matter of urgency because this is an emergency. We've been talking about an obesity epidemic for some time now and really we need to see a step change, because as you say here, over 60 per cent of our adult population are overweight or obese, which has become a normalised state. Yes, correct; it has. With around 20 per cent of our children starting school each year who are already obese or overweight.

Now, obviously, it's a balance of what Government can do and what the individual can do. Government, as you've alluded to, can do things like restrict price promotions on food and drink high in fat, salt and sugar, like two-for-one promotions and stuff. We'd like to see that pretty aggressively enforced. And as you also alluded to, planning restrictions on hot takeaways near schools and leisure centres and stuff. We also really do need to get to grips with tackling the advertising of junk foods targeted at children. Now, I know some of that is not devolved, but frankly we've been talking about that for years and the power of advertising is such that it's still a very pervasive influence on what our children eat, and also portion sizes. That is also a combination of what can be legislated for or individual choice; I'll leave that one up to the Minister. But the important thing is, after smoking, obesity is the biggest preventable cause of cancer. Lots of people don't realise that actually obesity is an independent cause of cancer, just like smoking. Being overweight causes cancers. It causes around 13 different types of cancers. Even in the absence of smoking, being overweight gives you cancer as an independent carcinogen.

But obviously, as you've alluded to, and as Angela Burns has already also alluded to, it's not just about diet, it's not just about eating less, eating fewer carbohydrates, fewer sugars, more protein and also extending the period of the day that you're actually fasting, trying to restrict the time of day that we take calories to about an eight or a 10-hour slot out of the 24—that's the latest medical advice. So, it's not just about diet: it’s about physical fitness and physical activity as well. And walking doesn't require fancy Lycra—well, you could obviously be in Lycra if you wanted to, but on the coastal path, you don’t actually need Lycra. Going up a mountainside—you don’t actually need Lycra there either. But you could do with 10,000 steps a day or any other additional number of thousands of steps per day, walking briskly, getting physically fit. As I’ve said here before, of being physically fit, your blood sugar is 30 per cent lower than if you’re not physically fit. Your blood cholesterol level is 30 per cent lower than if you’re not physical fit. And if you are physically fit, your blood pressure is 30 per cent lower than if you’re not physically fit. Now, as I’ve said before, if you invented a tablet that did all that, we’d be shouting to the rooftops about a miracle cure, but physical fitness is that miracle cure. And, obviously, there’s an overall weight reduction as well.

So, a lot of that is down to the individual, but, as I said, Government has a role here as well, with the planning restrictions, and for restricting price promotions and stuff. But also, as we found, we can educate people until we’re blue in the face, but it’s actually anti-smoking legislation that brought about the greatest reduction in smoking rates in this country in recent years. That smoking ban—. When we had devolution, 32 per cent of the adult population in Wales smoked, and it has been about 32 to 35 per cent for the previous 20 years, despite all the education programmes and stuff. Now, after the smoking ban, it’s down to 16 per cent and getting lower. It was the legislation that did a marked change, along with the education and the help to quit and stuff. And now we’re finding with minimum alcohol legislation in Scotland, people in Scotland are drinking less alcohol. Who would have thought? People in Scotland drinking less alcohol, and that is down to the minimum alcohol legislation about pricing.

So, I think the Government needs to get real and tough about food and drink legislation as well, and start to view food and drink companies—like big food, big drink—a bit like we view big tobacco. Let’s not have any more volunteering or voluntary agreements. Let’s legislate. Sugar tax raised in this country—I know there’s a sugar tax, but we have very little control over it. We need to have control over it here so that we can spend what comes from the sugar tax here in Wales on what we want to do in the obesity agenda.

And finally, in the preventative analogy: education. I’m looking at the education Minister there. As Angela Burns knows well, as the Minister knows well, in the health committee we’ve done a review on physical fitness and obesity—this very agenda. One of those recommendations we came up with was, ‘How about making 120 minutes of physical activity mandatory per week in our schools?’ It was a very strong recommendation. That’s what all the evidence said. How about making Estyn inspections of that physical activity also mandatory? That is something that could happen now. How about moving radically with the active travel legislation? We’ve been talking about active travel legislation—it’s wonderful, it is, but how about making it easy and safe to walk and cycle everywhere? We need to actually do something rather than talk about it all of the time.

So, yes, I welcome a lot of what’s happening here, but we haven’t got 10 more years and stuff. There needs to be a step change in activity, so that we can get the people of Wales into a healthy weight, and for a healthier Wales indeed. Diolch yn fawr.

I'd like to thank Dr Lloyd for the interesting sermon and lecture. I agree with most of what he says. There is agreement on where we are and what we want to try and do. Rather than trading some facts and figures about what we’re doing and investing in active travel and that in the strategy as well, I think it’s just important to reflect and to recognise that the points that you make about smoking are of real interest, because the legislative change helped to move things on with a broader change taking place at different levels within different parts of the country. But it led to wider-spread cultural change, in particular people’s attitudes around smoking around children, and smoking around food as well. You still see that carrying on. You are suddenly seeing a wider shift in attitudes, and, as you know, I agree with you on minimum unit pricing—that’s why I took through the minimum unit pricing legislation in this place. I think we'll see a similar impact here, not just a reduction in the amount of alcohol but the amount of high strength and very cheap alcohol that is consumed as well.

So, in the strategy, we do set out that we do, as I said to Angela, want to test the limits of our powers—the powers we currently have, for example the powers available to us in the Public Health (Wales) Act 2017 we passed in the last Assembly term, as well as looking in that delivery plan to have future options for legislation, to set out how we might use powers that are available to us in terms of our competence to set up the legislation to allow us to do so as well. Because there are things to think about in terms of advertising and promotion. And then some of that is difficult, because we have some people who raise income in different ways at present. If you think about healthy vending, it's part of what we see within the health service, but also in leisure centres too as well. We don't run those directly, and yet I can tell you, when I take my son swimming, as I do regularly, and he's got far too much energy, as most five-year-old children do, but it's great—except, we finish swimming and we sit down to put our shoes on and we're sat in front of a vending machine that is full of chocolate. My son's five, and he sees a bag full of chocolate and he says, 'Daddy, can I have some chocolate?' So, I have to tell him 'no', so I end up being a bit like bad dad, but I'm doing the right thing. So, there's something about how we change the environment so you're not having those different and mixed messages. Because if I tell him, 'This is a treat', then every time he goes around to try and do the right thing, that is there in front of him. That's part of what we need to see a shift and change in as well.

Just finally, on your point about walking, for those of us who have jobs here, this job is not great for physical activity. I regularly walk from the basement up to the fifth floor, because often it is the only exercise I'll get in the day. Otherwise, I'm sat on my backside talking or stood on my feet talking—not a great deal of exercise. So, there is a challenge about our working environment, and not just us in this place, but people who work in office jobs. There are a range of jobs we now undertake in more modern economies that are not physically active in the way that lots of people would have gone to work and had to earn a living in the past. There is a challenge about what we choose to do in a workplace to make it more physically active, but also, then, about what we choose to do in our time outside of work as well. So, big system shift behaviour change is part of what we want to see, and as you say, and I'm glad you recognise, it isn't all about the Government, it is about all the choices that we make together.

I agree with the earlier two speakers: we are the most obese nation in Europe and our food system is absolutely broken. So, no change is not an option. It isn't just a sugar tax we need, we need a salt tax and a fat tax in order to control the actions of the food manufacturing companies who target people with this stuff that passes off as food. And in addition to that, there's been an exponential rise in type 2 diabetes, which already consumes 10 per cent of the NHS budget. So, we cannot wait for a decade to sort this out.

I agree with the Minister that you're absolutely right to point out that the cost of vegetables and fruit will go up as a result of Brexit. So, I'd like to know what the Government's doing now to get more people growing vegetables and fruit here in Wales. That isn't even mentioned in the document. We were at our most healthiest during the second world war when we were digging for victory. We now need to dig to save our nation, really, and save our NHS. And that needs doing now. Even if we manage to avoid the catastrophe of no deal with Brexit, there's lots of evidence that if you get kids to grow food, they will then be tempted to eat it as well.

We are what we eat, and the most terrifying statistic that I've learnt recently is that two thirds of people never eat a meal prepared with fresh ingredients—never. Because even when they go out, they'll go and eat junk food. So, that is the scale of the challenge that we face.

So, I am struggling to understand the difference between milestones and outcomes and targets. I want to see some really clear targets so that we know that we are making progress on this. It's something we've talked about ever since I've been here, and we just need action now. I want to know—the baby born next week: how are they going to be protected from the marketing of unhealthy products masquerading as food? We know that less than three quarters of children starting school have a healthy weight. What is that figure going to be in 2022? We absolutely have to have a whole-system approach; this is not just the Minister for health's department. I want to see what we're going to do with public procurement. What are we doing? We have all the levers here to do something. We've got the 'Appetite for Life' guidelines, regulations, but they're not being adhered to in all our schools, because nobody is monitoring them.

So, we know that up to a third of our children rely on the free breakfasts and the lunches that they get in school, otherwise they are not getting any other thing that I would classify as food. And we know from the statistics and the research done by other organisations that half the children going hungry to bed are not even eligible for free school meals because of the poverty wages their parents are suffering. So, we've got lots of aspiration but not enough action. And one of the things I want to see is the traffic light system, to ensure that people are clear about whether this is something healthy or whether it's something just pretending to be healthy. 

We need action to ensure that all processed food, including baby foods, are not laced with sugar, fat and salt in order to make them more profitable. How does the Minister plan to normalise good eating in primary schools? That's what I find is absent from your document. Will you consider banning the sale of drinks in secondary schools, which, at the moment, encourages pupils to use money that's supposed to be spent on food instead on drinks of limited nutritional value? 

There are lots of opportunities to make Wales into a good food nation, and it's something that we need to work at collectively, not just in the health service. But I'm unclear exactly what differences we expect to see in two years' time so that we can measure whether or not the Government's programme has been successful. 

I thank the Member for the comments. It's fair to point out that with salt reformulation, a range of food businesses reduced the salt content and it had no impact on the taste that customers reported when actually having that food. The challenge is whether a voluntary approach is enough. And, as I've set out, I think we ought to test the limits of what is available to us to make a bigger difference. That's part of what I've set out, and that goes into school and food and the way that children understand the way their food is produced. And in virtually every primary school that I visit, including ones in the less well-off parts of my constituency, I see a very consistent approach to encouraging children to grow food and to understand where and how that's produced on a local level.

And I just want to deal with your points about targets, and then how we use outcomes and then some of the proposals that we have. We had a conversation about whether to have targets in this strategy, and I decided not to have targets. I looked at what is happening in Scotland and England, where they've got targets to reduce childhood obesity, to halve it by 2030, and I just don't think there's any evidence that that is an aspiration that is in any way achievable, because part of our challenge is that we don't understand yet how much of an impact the measures that we're going to try to introduce will have, and I don't particularly want an aspirational finger-in-the-wind target. I just don't think that's smart or sensible for anyone. The outcome framework that we're going to produce will allow people to measure what impact is being had upon the population of Wales. So, if there is no change, then the outcome measures will track that. If there is real change, we'll see that and we'll then need to try and understand which ones of our interventions are having the most significant impacts. We can't always tell which intervention we introduce affects people's lives and what the direct correlation is in terms of how healthy a weight the country has.

In terms of some of the proposals, it may be helpful to set out that we are looking at a ban on the sale of energy drinks to children; restricting the promotion and marketing of unhealthy food and drink in the retail environment; to ban the sale of refillable sugary drinks in out-of-home settings—and we regularly see those, the endless refills; to restrict the size of a sugary soft drink; and mandatory calorie labelling in out-of-home settings; and to explore options to restrict access to the promotion of unhealthy food and drink accessible to schoolchildren. So, there is a range of specific measures we are looking at and I'll come forward with more specific proposals in the future.

Finally, Lynne Neagle. 

Thank you, acting Deputy Presiding Officer. As you've acknowledged today, Minister, and as other Members have referred to, we have got a situation where one in four of our children starts school either overweight or obese. And, as you know, the Children, Young People and Education Committee was very keen to influence Welsh Government's thinking in this area and to make sure that children and young people are at the centre of this all-age strategy. And to inform our contribution to the consultation, we conducted a round-table with key stakeholders and took evidence from the chief medical officer, and I would like to take this opportunity to place on record our thanks to them.

As you'll have seen, in April, we published our detailed response to the consultation and highlighted the issues that we thought needed to be addressed, and I do welcome the steps taken to address some of those issues. However, we also identified accountability as a key area that would need to be addressed if we are to guard against a situation where the strategy becomes everybody's role but nobody's responsibility. And we also called for an ambitious target for reducing obesity, and clarity on who will lead on this complex and cross-cutting issue within Government.

Now, I hear what you said in response to Jenny Rathbone, and I note that the strategy states that, instead of specific targets, we will have built-in milestones for each of the four themes of the strategy to test what progress is being made. Can you provide more information on how that measurement of the milestones will work, and also tell us what leadership and accountability is going to be in place across Government to ensure that this strategy is delivered? Because, clearly, it's not just an issue for yourself as health Minister. So, what assurances can you give that, across the whole of the Government, there is going to be appropriate leadership to drive this forward?

Okay. I think they're fair questions. I've tried to deal with the point about targets, and I reckon there are different views on this, so I won't try to pretend that there isn't a difference of view about whether we should or shouldn't have targets. In terms of the outcomes and the milestones, one of the first tasks of the implementation board will be to set out those milestones and targets. They'll be visible, they'll be published—they won't be secret and kept within my desk. And then you'll be able to see how we're looking to measure the progress that we make. And I fully expect that I'll have the opportunity, should I stay in this post, to come to committee to explain what progress is or isn't being made.

And, in terms of the leadership within the Government, I'm the lead Minister, but this is a whole-Government enterprise. If you look at all the different areas that we cover in this strategy, it certainly isn't just one Minister and one department. And that will again come back to the implementation board looking honestly at where we are and setting out who needs to do what, because the honest truth is that, if we don't get all parts of Government pointing in the same direction, we won't get our partners on board, and we won't get the biggest partner in all of this on board, and that's the public themselves. So, I think some of this will have to be about this is about the Government genuinely trying to work together with others. I'm the lead Minister, but we'll need to able to demonstrate the progress we're making in reality, and then, I think, that will be the best answer to your challenge about whether there's real accountability in implementing what is a shared vision. And I think there is widespread support for the areas of activity we recognise need to be undertaken. 

Thank you, Minister.