We need to find the ‘sweet spot’ where environment, social and health goals meet

April 2018

We are clearly at the crunch time for agriculture policy as we transition away from a European policy framework and develop our own ways of supporting and regulating farming and land use. Conservation and wildlife, animal welfare and environmental organisations and their members are rightly focussed on their specific goals. Sustain supports these goals and will lobby to achieve them, because they are valuable in their own right.

However, it’s also worth considering that some have additional solid public health benefits, such as on reducing farm air pollution, animal health and welfare, access to the countryside, and rural wellbeing. We would do well to help put public health centre stage in farming policy, for the benefit of everyone.

There is often the gap in the narrative; a missing piece of the jigsaw which started to be addressed in the Square Meal initiative from a number of Link organisations in 2014, also involving food and farming groups and Sustain. This made explicit the link between goals connected to land and nature with those of human health, wellbeing and livelihoods. The Square Meals group said, “Our organisations have come together because we want to shift the debate on food and farming. We want a debate that asks the questions that matter to everyone about a healthy countryside and healthy food as these are things in which all of society has a stake. We need leadership and a new sense of direction and purpose in food and farming policy.”

That was a welcome recognition of the need for an integrated approach. We now need to make it happen. We also need to recognise the role of citizen consumers in the mix of levers which influence what happens on the farm. But we also need to recognise that their health matters – in terms of access to nature, yes, but also in terms of what farm policy produces in terms of food and meals, healthy, safe or otherwise. We’ve given them a tool to say this to Defra.

We know other measures are needed, but including the public health of consumers in agriculture policy makes sense. We all, including the millions of NGO supporters, eat food. We notice when things go wrong (BSE, Foot and Mouth, ‘horsegate’) and we often don’t or can’t all access a good diet. This is costly to the public purse in NHS budgets, to the economy and to our quality of life.

Ensuring agriculture policy contributes to solving this is a prime opportunity. Ideally the Department of Health and Social care would be working closely with Defra on their new policy. Public health experts for years have been shouting loudly, sadly with few listening, that the European Common Agriculture Policy (CAP) encourages production of the wrong goods (including too much fats, sugar, tobacco and so on), or in the wrong systems (intensive, medicine-focused treatment, excluding food and lifestyle). This contributes to serious and costly public health problems including coronary heart diseases, strokes, diabetes, obesity and food safety scares.

Public health should be recognised officially – by Defra and HM Treasury – as a public good, and included explicitly in the list of public good that feature in the Health and Harmony consultation. I have argued this in more detail in a separate blog. Inclusion of public health would unlock many benefits. It could mean policy and public investment in favour of public access to the countryside, reduction in air pollution and food contamination from farm chemical use, greater fruit and vegetable production and reduction in farm antibiotic use.

I realise that suggesting public health should be one of the ‘purposes’ of the new Agriculture Bill will worry many environment and wildlife policy advocates. So I will take this opportunity to answer here some of the possible concerns:

Q- Could this inadvertently recouple subsidies to unsustainable production like intensive horticulture, driving intensive production and surpluses?

• If done badly, this could be true. But we can envisage a scheme design that ensures we produce more of what we need (healthy fruit and vegetables grown with agro-ecological methods) without driving unsustainable systems. Where public health encourages transitioning away from production (e.g. reducing sugar) we can help farmers find the right cultivation mix that protects the wildlife currently benefiting from that production (such as pink footed geese).

Q – Couldn’t these outcomes be achieved by other means such as promotional schemes, tackling market failure, culture change and procurement?

• Other tools are needed absolutely (and Sustain and its members have been campaigning for these with some success, such as the sugary drinks tax). Shifting towards a healthy, less processed diet involves many players and actions. Yet these have to compete with the onslaught of cheap, unhelpful ingredients (like sugar, UK and imported) or the lack of affordable, accessible and fresh good stuff like fruit. This needs agriculture policy action. Far greater active promotion and growth in acreage of beneficial farm systems - such as organic, agro-ecological, pasture based and agro-forestry - could deliver some health as well as wildlife, soil and environmental outcomes. Diversification done well – for instance rotations with pulses and reducing cereal monocultures – will provide for a more varied diet and help increase wildlife in farms. There is a sweet spot (excuse the pun) where the environmental and health goals can meet.

Q – We are worried that the already threatened farm budget (currently around £3.2billion) will be squeezed and this is needed for nature, environmental and rural outcomes.

• This is possibly the biggest concern. We don’t yet have all the answers for what budget is needed to achieve public health outcomes. Some measures will be short term such as transition support, grants for local processing and marketing, advice for accessing procurement contracts. Some of the outcomes could require advice and regulation (such as stock management to reduce antibiotic use), not necessarily payments. Others such as supporting diversification into sustainable fruit and vegetables or nuts might have short-term conversion costs and longer term maintenance costs, but could deliver multiple benefits long-term such as wildlife habitats, landscapes and carbon savings. Some, such as feeding fish and livestock in ways to create healthier profiles of fatty acids (like mixed pasture not grain), could involve long-term support if the market continues to fail to pay. That is as true for environmental goods as health. Policy and contractual requirements for fresh, healthy and sustainably produced food for schools, hospitals and armed forces catering, could be delivered via public procurement measures flagged up in the Health and Harmony consultation, but may require support to help diverse and sustainable farmers to access these contracts.

Q. As we’re moving to a public goods approach how could we define public health goods that are affected by so many other factors?

• This is a fair question. Public health often relies on proxy measures of the determinants of health. For example, we could measure consumption of our healthy 5-a-day fruit and vegetables, especially by target groups such as schoolchildren and hospital patients; or we could measure production and consumption of sugar. We could also measure reduction in morbidity or mortality from livestock related diseases and reduction in farm antibiotic use.

This is a complex area and public health outcomes need to be delivered from multiple directions but we believe that, alongside other goals, we need to see reference to public health as one of the defined ‘purposes’ (i.e. public goods) in the final UK Agriculture Bill.

Back in the heady days pre-Brexit in 2014 we all said “Public health, conservation, social, economic and environmental challenges, and their solutions, go hand-in-hand.” Surely there is no time like the present to design an agriculture policy that helps us deliver on these vital and complementary goals.

Guest blog by Vicki Hird

Sustainable Farming Campaign Coordinator, Sustain

Follow @vickihird and @UKSustain on twitter.

The opinions expressed in this blog are the author's and not necessarily those of the wider Link membership.