Our response to the Public Service Reform Committee - August 2026

In our letter to the Public Service Reform Committee, we highlight obesity prevention as a key example of preventative public service reform, and one that sits at the intersection of health, poverty and inequality. With obesity rates significantly higher in Scotland’s most deprived communities, prevention cannot be treated as a standalone or siloed issue. We set out the need for a joined-up, cross-government approach that addresses the wider social, economic and environmental factors that shape health and drive inequalities.

We also highlight the importance of taking a long-term approach to prevention, with investment focused on improving population health, reducing inequalities and creating more sustainable public services. Prevention should be viewed holistically, recognising the interconnected factors that influence health and wellbeing, rather than focusing solely on individual risk factors or clinical outcomes.

We recognise the significant pressures facing public services and the need to identify efficiencies. However, we caution against framing prevention primarily as a cost-saving measure. Prevention should first and foremost be about improving health, wellbeing and life chances, while reducing future demand on services over the longer term.

Key points in our letter:

• We call for a greater shift towards primary prevention, noting that current preventative spending remains weighted towards managing existing illness and risk rather than preventing poor health from occurring in the first place.
• We emphasise that obesity prevention should not become increasingly medicalised. Weight management services and new treatments have an important role, but they cannot replace action to address the wider environmental and commercial drivers of obesity.
• We highlight the importance of population-level prevention, including stronger restrictions on the promotion and advertising of HFSS foods, healthier school food environments, action on food insecurity, and planning and transport policies that support physical activity.
• Children and families should be prioritised, with longer-term and more secure funding for successful preventative programmes so that they can be embedded and scaled.
• We call for longer-term funding and evaluation of preventative programmes, recognising that the costs of prevention are often immediate while the benefits emerge over many years.
• We highlight the need for better monitoring of obesity across childhood and adolescence, to strengthen the evidence base and help assess whether preventative interventions are succeeding.
• We argue that prevention should not be viewed primarily as a cost-cutting exercise. It should be seen as a strategic investment that can improve population health, reduce inequalities and create more sustainable public services over the long term.
• We call for public service reform to take a whole-person and whole-system approach, recognising the links between physical health, mental health, social wellbeing and the wider determinants of health.

We encourage the Committee to place a preventative approach at the centre of Scotland’s public service reform agenda. Investing in prevention today can help reduce future demand on public services, support a more productive workforce and enable healthier, longer lives for Scotland’s people.

The consultation closed on 14 August 2026.