- What is the background to this guidance?
- Who is the guidance for?
- What are the main recommendations?
- What evidence are the recommendations based on?
- Does NICE really have the power to put up parking charges?
- How accurate is the media's reporting of the story
- What happens now?
- How much exercise should I be doing?
“Raise cost of parking to force motorists to walk! Nanny watchdog’s plan to get Britain fit”, is the strident yet inaccurate headline in the Daily Mail.
This was prompted by the publication of guidelines produced by the National Institute for Health and Clinical Excellence (NICE), designed to encourage more people to walk and cycle for the benefit of their health.
In fact, the report does not recommend increasing the cost of parking. It simply states that ‘encouraging people to walk or cycle… could be achieved, for instance, by introducing restricted parking and higher parking charges’. Even then, the suggestion is tempered with the proviso that ‘there is a need to consider how this would impact on car owners living in areas where the environment is not conducive to walking or cycling, or where there is little real alternative to driving.’
The Mail’s blinkered take on these guidelines is unfortunate, as they consist of useful, evidence-based ideas that could encourage more people to walk or cycle regularly and so increase their physical activity levels. These ideas include:
- encouraging more towns and cities to introduce cycle hire schemes
- car-free events or days
- ensuring cycling and walking routes are safe
- personalised travel planning programmes
The report says that walking and cycling, rather than cars, should become the norm for short journeys, as it is in other European countries. This could result in important public health benefits, including lower rates of obesity, diabetes and heart disease.
What is the background to this guidance?
The Department of Health (DH) asked NICE to produce this guidance. NICE highlights that regular physical activity is crucial to achieving and maintaining a healthy lifestyle and can help reduce the risk of coronary heart disease, stroke and type 2 diabetes by up to 50%. It is also now known to be important for good mental health.
Yet at present, around two-thirds (61%) of men and nearly three-quarters (71%) of women aged 16 and over do not achieve nationally recommended levels of physical activity.
A similar problem exists in children, with just over half of boys and a third of girls aged 2 to 10 years old achieving the recommended levels for this age group.
NICE says it has concentrated on walking and cycling as a way of promoting physical activity because walking is the most common recreational and sporting activity undertaken by adults in Britain (cycling the fourth most common). Also, both activities cost very little to engage in.
The majority (85.8%) of adults claim that they can ride a bicycle, yet NICE says the average time spent travelling on foot or by bicycle has decreased from 12.9 minutes per day in 1995/97 to 11 minutes per day in 2007.
It also says that cycle use is lower in Britain than it is in other European Union countries, with bicycles used in around 2% of journeys in Britain, compared with around:
- 26% of journeys in the Netherlands
- 19% in Denmark
- 5% in France
Who is the guidance for?
The guidance is aimed at a wide range of people involved in physical activity promotion or who work in the park and leisure, environment, or transport planning sectors. This includes those working in local authorities, the NHS and other organisations in the public, private, voluntary and community sectors.
NICE report that this is the first time they have published guidance for organisations and institutions, such as schools, workplaces and local authorities that have a responsibility or influence over local communities, to encourage them to promote physical activity through walking and cycling.
What are the main recommendations?
The guidance sets out detailed recommendations on the way people can be encouraged to increase the amount of time they walk or cycle, for both travel and recreational purposes. NICE says this will not only help to meet public health goals, but also reduce traffic congestion, air pollution and greenhouse gas emissions. They say action is needed on many fronts and by many different sectors. The recommendations include:
- High-level support for the promotion of walking and cycling in the health sector. For example, ensuring walking and cycling are considered when working to achieve specific local health outcomes, such as a reduction in the risk of chronic diseases.
- High-level action by local authorities to ensure all relevant policies and plans consider walking and cycling.
- Developing town-wide programmes to promote walking and cycling, for example, publicising available facilities such as walking or cycling routes, developing cycle hire schemes, car-free events or days, providing information such as maps and route signing and fun rides.
- Personalised travel planning – helping those interested in changing their travel behaviour at an individual level. For example, providing people with information and help such as tickets, maps, and timetables for local attractions.
- Ensure walking routes are integrated with accessible public transport links to support longer journeys. Signage should give details of the distance and/or walking time between public transport facilities and key destinations.
- Developing school travel plans that encourage children to walk or cycle all, or part, of the way to school, including children with limited mobility.
What evidence are the recommendations based on?
NICE’s recommendations are based on the best available evidence, including reviews of research, economic modelling and the testimony of expert witnesses. In particular, they used studies looking at which local measures to promote walking and cycling can achieve changes in behaviour, improvements in levels of physical activity, and a reduction in traffic.
Based on this evidence, the recommendations were developed by a multidisciplinary panel called the programme development group, which included public health practitioners, clinicians, local authority officers, teachers, social care professionals, representatives of the public, academics and technical experts.
Does NICE really have the power to put up parking charges?
NICE is an independent body that provides evidence-based guidance on the most effective ways to prevent, diagnose and treat disease and ill health. Its guidance is for the NHS, local authorities, charities, and anyone with responsibility for commissioning or providing healthcare, public health or social care services.
Its guideline recommendations do not have statutory force, although they do carry weight and are taken seriously by government agencies.
However, NICE never made any recommendations regarding parking charges – the idea was only mentioned as a single consideration.
No specific recommendations were made on this issue in the guidance.
How accurate is the media's reporting of the story
Most papers covered the report fairly, stressing its message that people should be encouraged to walk or cycle on short journeys, rather than go by car.
The exception to this was the coverage in the Daily Mail.
The Mail’s implication that this is a “nanny state” initiative to charge drivers more for parking was inaccurate and misleading.
The Mail even carried a photo of a car owner who had clearly just been issued a penalty notice, with the caption that the NHS is advising raising parking fees.
The paper quoted an attack on the NICE guidance by a campaign group called the Taxpayers Alliance, which called the NICE guidance “boneheaded meddling”.
It is not clear who this campaign group represents, although it claims to have thousands of supporters.
The Mail could be accused of ‘cherry picking’ a potentially controversial issue to cause outrage among readers. If this was the case, then it is regrettable that potentially life-saving public health initiatives are ‘spun’ in order to sell more newspapers and attract more visitors to a website.
What happens now?
The report has been welcomed by Norman Baker, minister for local transport, announced that from April, the responsibility for public health will return to local authorities. He said: “We want to see more people walking and cycling and this new guidance will play a valuable role in making sure that the funding we are providing translates into local measures that help more people to get more active.”
It will be up to individual local authorities and other organisations and institutions to determine whether they adopt any of the recommendations in the guidance, and how they do so.
How much exercise should I be doing?
Current Department of Health recommendations state:
- Adults (19-64 years) should be doing at least 150 minutes of moderate-intensity activity each week, in bouts of 10 minutes or more. Activities could include brisk walking or cycling.
- Older adults (65 years +) should aim to be active daily. Over a week, activity should add up to at least 150 minutes of moderate-intensity activity in bouts of 10 minutes or more.
- Children and young people (5-18 years) should engage in moderate to vigorous-intensity physical activity for at least 60 minutes and up to several hours every day. (Department of Health, July 2011).