When the London Health Commission published Better Health for London in October 2014, it did not stop at broad statements of intent. Chaired by Professor Lord Ara Darzi, the report translated its ambition for London to become the world’s healthiest major global city into ten named aspirations, several carrying explicit numeric targets and deadlines. Reading those aspirations together is the clearest way to understand what the Commission was actually trying to achieve, as distinct from how it gathered evidence or who sat on the panel.
This piece sets out the ten aspirations themselves and the specific commitments attached to them, as a reference for anyone trying to understand what "Better Health for London" promised in plain terms.
Why the Report Was Structured Around Aspirations, Not Just Recommendations
Better Health for London contained more than 60 recommendations, but the Commission organised its argument around ten headline aspirations for the city. Framing the report this way served a specific purpose: recommendations are technical and easily lost in implementation, while aspirations are meant to survive changes in government, NHS structure, and mayoral administration. Whether that framing succeeded is a separate question from what the aspirations actually said.
The Ten Aspirations, In Full
The Commission’s ten aspirations for London were:
- Closing the health gap between the richest and poorest Londoners.
- Giving all of London’s children a healthy, happy start to life.
- Getting London fitter, through better food, more exercise, and healthier living.
- Making work a healthy place to be in London.
- Helping Londoners kick unhealthy habits, principally smoking.
- Caring for the most mentally ill Londoners so they live longer, healthier lives.
- Enabling Londoners to do more to look after themselves.
- Ensuring every Londoner can see a GP when they need to, at a time that suits them.
- Creating the best health and care services of any world city, throughout London, every day.
- Fully engaging and involving Londoners in the future health of their city, with London at the centre of the digital health revolution.
Several of these read as system-design goals rather than measurable pledges. What sets the report apart from a purely rhetorical wish list is that a handful of the aspirations were pinned to actual numbers.
Where the Report Attached Real Numbers
Not every aspiration carried a quantified target, but several did, and these are the ones that matter most for judging the report against outcomes:
| Aspiration area | What the report specified |
|---|---|
| Childhood obesity | A 10% reduction in the proportion of children who are obese by Year 6, and reversing the trend in children who are overweight. |
| Smoking | Cutting adult smoking rates to 13% by 2020, intended to match the lowest rates among major global cities, alongside a recommendation to ban smoking in parks and other public spaces owned by London’s local and regional government. |
| Severe mental illness | Reducing the life-expectancy gap between adults with severe and enduring mental illness and the rest of the population by 5% by 2020. |
| Workplace health | Gaining one million working days across London through improved health and reduced sickness absence, via an expanded London Healthy Workplace Charter. |
| Adult obesity and inactivity | Addressing a baseline in which 57% of adult Londoners were overweight and more than 1.8 million were not sufficiently physically active, alongside a proposal for compulsory traffic-light food labelling in London restaurant and cafe chains with more than 15 outlets nationally. |
These figures matter because they turn the aspirations into something that can, in principle, be checked. A goal to "get London fitter" is open to interpretation; a goal to reduce Year 6 childhood obesity by 10% is not.
What the Report Left Unquantified
Not every theme received the same treatment. Life expectancy, arguably the most fundamental measure of population health, was discussed in terms of London’s existing trajectory relative to the rest of England, rather than pinned to a specific future figure. The report acknowledged that life expectancy in London had been rising faster than in other English regions, but framed further improvement as part of the overarching ambition to close the health gap rather than as its own standalone numeric pledge. Similarly, the aspirations on primary care access, digital health, and public engagement were stated as directional commitments rather than measured against a baseline and a deadline.
This distinction matters when reading any commentary on the report today. A claim that the Commission "promised" a specific improvement in life expectancy, or a specific reduction in GP waiting times, is not something the 2014 text itself supports in numeric form; those areas were aspirational in the looser sense, while childhood obesity, smoking, and mental health life expectancy were aspirational in the stricter, measured sense.
Reading the Targets in Context
The ten aspirations, and the handful of targets attached to them, were never intended to stand alone. They sat inside a wider governance structure, with reporting mechanisms meant to track progress against them over time, and they were followed by later London-wide health strategy documents that referenced and built on the original 2014 aspirations. Understanding exactly what was promised, in exactly what terms, is the necessary first step before any fair assessment of what changed in London’s health system in the years that followed. This archive exists to hold that plain-language record: what "Better Health for London" actually said, separated from what has been claimed about it since.