Can free leisure services get people fit?
When it comes to council responsibilities, most people would think of collecting the bins, running libraries and looking after elderly people. But they now have a new responsibility - encouraging people to live healthily.
Birmingham Council has already been busy. For the last few years it has been providing free leisure services to get its local population fit.
Two years ago Katherine Coughlan was diagnosed with diabetes. She was in her late 40s and, by her own admission, carrying too much weight.
Today she has her condition under control, has lost five stone and is exercising more days than not.
"I swim, use the gym, cycle and do dance mats. It has changed my life," the 51-year-old says.
She is just one of the many beneficiaries of Be Active, Birmingham Council's scheme to provide free leisure services to its residents.
More than 360,000 have signed up to the scheme, a third of the local population, since it was launched in 2008.
Participants register and are given a card which allows them to use a range of facilities from swimming pools and gyms to exercise classes and badminton courts for free during certain times.
There are 29 leisure facilities involved in the scheme, although Be Active sessions are also provided in other settings, such as community centres and schools, while guided bike rides are also provided.
Each leisure centre has to provide at least an hour of swimming and an hour of gym time free, although in some of the most deprived areas as much as 70% of the opening hours are for Be Active members.
Meera Rawji, 32, has been exercising regularly at the Handsworth Leisure Centre in the north of the city since October.
"I was really lazy and my daughter used to say I was too big so I decided to do something about it. When I heard about the Be Active scheme that was it. I now use the gym, go swimming, play badminton and do spin classes."
Ms Rawji and Ms Coughlan are, in fact, typical Be Active users in that the programme has been effective at targeting the so-called hard-to-reach groups.
Some 60% of people taking part are from black and minority ethnic communities, while the average age is 49 as opposed to 29 for private gyms.
Councillor Steve Bedser, the cabinet member for health and wellbeing, says: "We have been really pleased with the range of people who have taken part. When we started, some said it will just be subsidising those who were paying to use the facilities. But that has not been the case."
In fact research by Birmingham University shows that three quarters of users were not previously members of a leisure centre, gym or swimming pool.
What is more, half were overweight or obese and a fifth reported poor or very poor health.
The evaluation of the scheme has also shown other benefits, including a rise in demand for other lifestyle information, such as stopping smoking and alcohol advice.
Overall, for every £1 spent on the scheme £23 is estimated to have been recouped in health benefits.
With such impressive results it is unsurprising that other areas are showing an interest.
Officials from Birmingham have been holding workshops with other local authorities about what can be achieved.
Nonetheless, Be Active has not been immune from the squeeze on finances in local government. It has seen its budget cut in half to £2m a year in the past few years, which has forced it to reduce the hours it is able to offer free access at some centres.
But now with extra money from the NHS to accompany its new public health responsibilities, Birmingham is looking to increase what it makes available under Be Active.
A pilot is starting to see if there is interest in providing Be Active sessions in open spaces. This will include team sports, such as rounders, as well as exercise classes, such as buggy push for new mothers.
"I would like to see our investment increase," says Mr Bedser. "I have told the team to explore what else we can do. Obviously it has to be effective - money is tight - but I think we have proved so far that this really works."