While public health generally is improving, obesity and alcohol misuse is getting worse. The Audit Commission and the Healthcare Commission have called for a renewed drive to reverse this trend. The steep rise in the number of people who are overweight and obese or suffering from alcohol related illness could reduce the impact on mortality rates of recent improvements in heart disease and cancer.

In England, which has the fastest rising rate of childhood obesity in Western Europe, a third of school age children are overweight or obese.

There was no national strategy to tackle obesity across the whole population until 2008. There continues to be a lack of policy coherence in approaches to tackling obesity and no clear direction from the Government on how to address the complexity of issues relating to obesity. Although there are a range of national strategies that indirectly contribute to tackling obesity, including the School Sports Strategy, they have not been developed with the intention of reducing obesity, but have been claimed to be part of a programme in retrospect.

Deaths associated with alcohol consumption have risen. In men, the death rate doubled from 9.1 deaths per 100,000 in 1991 to 18.3 in 2006. For women, the rate increased from 5.0 to 8.8 deaths per 100,000 over the same period, a rise of around 80 percent.

The lack of targets and national indicators for alcohol misuse led to the belief that it is not a priority for the Government. This lack of clear measurable objectives or a systematic programme to drive change through the system, has resulted in inconsistent improvement at the local level. A further difficulty is the absence of a clear picture of the current situation because of inconsistency in data collection between the NHS, local government and police.

The two watchdogs call for the Government to apply lessons learned from its most effective programmes to ensure that the problems of obesity and alcohol misuse do not derail health improvement in the future.