With increasing awareness of the rise in lifestyle diseases health initiatives are pouring into schools. The World Health Organisation, the United Nations’ education organisation, UNESCO, charities and the European Commission all have them in their sights. But do the schools have the resources and experience to promote health?

Last year, I spent much of my time visiting primary schools and talking to PE co-ordinators and headteachers about the British Heart Foundation’s Active School resource pack for primaries. The pack aims to raise awareness about coronary heart disease and to drive home the message that even modest increases in activity could bring significant reductions in the disease. It is one of a number of projects intended to reverse the decline in time schools devote to PE and games.

How did schools respond? Some had bucked the trend in declining levels of PE. These schools had protected the time devoted to the PE curriculum, with one school devoting four hours a week for all key stage 2 pupils as well as offering after-school sports. In these cases there was an understanding that fielding teams to compete against other schools created cohesion and that recognition of success promoted a collective sense of worth and well-being.

Many of the schools had achieved the Sport England Activemark Award. In most cases the headteachers’ own enjoyment and success at sport drove the value placed on sport in these schools. This value was put into practice via the purposeful appointment of enthusiastic PE co-ordinators with either specialist training in PE or a genuine love of sport. Promoting an active lifestyle was incidental.

Some schools had projects to raise activity levels. Usually, these projects arose as a solution to a problem - bad behaviour in the playground, for example. They were not seen as part of the broader issue of encouraging healthy lifestyles. Primary-aged children proved to be more concerned about the health of the environment.

Most schools showed a trend towards devoting less time to PE during school hours. The increased focus on literacy and numeracy has been, undeniably, to the detriment of PE and games.

The new subject of citizenship attempts to redress the balance, requiring that children acquire “basic rules and skills for keeping themselves healthy”. The national curriculum calls for a similar acquisition of skills. But is this enough to provide a foundation for healthy living over a lifetime? Isn’t a healthy lifestyle more about creating good habits and experiencing the sheer fun and enjoyment of physical activity? In which case can it be delivered through the primary curriculum?

Primary schools certainly do create good habits in children. They are socialised, learn where to be quiet and where to speak, where to hang their coats, how to co-operate, how to ask about going to the toilet and tying shoe laces. These are vital functions, taking up vital time in nursery and key stage 1. If, as public health bodies would like, schools were to extend this habit formation to healthy lifestyles it would require even more time.

Perhaps it is time to ask the National Health Service to dip into its primary care budget and make a contribution to resources for this extra time which, until now, they have had at the expense of teachers and schools. What is needed is a nationwide, all-inclusive approach to children’s health with education, health and social services working together to deliver an integrated child-centred policy through primary schools.

The intention would be to to provide a co-ordinated approach which would allow primary schools in areas of deprivation to flourish and build community links. It would mean health and social services refocusing budgets, providing capital and putting physical resources into schools to give children time, opportunity and encouragement not only to develop essential life skills and good habits, but to be fit and healthy too.

Collette Jones is research officer for the British Heart Foundation Health Promotion Research Group at the University of Oxford