(13 years ago)
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Mr Gregory Campbell (East Londonderry) (DUP)
It is a privilege to speak under your chairmanship, Mrs Riordan. I am delighted to have secured the debate. I have come to notice, particularly with health-related issues, that an hon. Member may think they are well informed on a topic when they succeed in securing a debate, but once they have succeeded in securing it, the administrative back-up kicks in and all the groups involved start supplying them with significant amounts of promotional material, and they are even more well informed by the time the debate arrives. I thank all the groups involved with this issue for providing me with information.
Sometimes it is wise to start a very serious debate with a slightly humorous anecdote. I am reminded of the overweight gentleman who was sent along to his local well man clinic by his wife, as men are wont to be. She instructed him to go to the well man clinic and to come back with precise instructions on what he was to do to lose weight. When he came back with a smile on his face, his wife said, “There’s something wrong here. What exactly were you told?” He said, “Well, I’m exactly the right weight—for someone who is 7 foot 8.” Unfortunately, that encapsulates part of the problem.
A sedentary lifestyle is not only costing those members of society who are overweight very dearly; it is costing all of us exceptionally dearly. From the correspondence that I have had and my own research, it appears that obesity currently costs us—depending on whom we believe—between £4 billion and £7 billion a year directly and indirectly. Whichever figure is right, the reality in 2011 is that we are talking about an exceptionally expensive but preventable series of conditions. The situation is bad at the moment, but unless we take radical steps and measures, unless we do something fundamental—I will come to that later—the rates of obesity are likely to double in the next 30 years.
Currently, almost one third of children are overweight, so obesity is not a condition that is the preserve of either the elderly or the middle-aged. All of us in society, right across the age spectrum, are being affected. Only 20 years ago, people who visited America—perhaps somewhere such as Florida—would come back here and say, “The United States has a terrible obesity problem. Thankfully we will never be like that.” But we are, and things are likely to get worse.
For example, 25 years ago, about three quarters of schoolchildren walked or cycled to school; now, less than 10% do so. When giving that figure, I take into account the fact that there have been lifestyle changes, school closures and so on, but the fact remains that there has been a significant increase in sedentary lifestyles. There has been a change in attitudes. The unfortunate reality is that more and more of us are spending more and more time at desks, in front of computers. Many people become couch potatoes—unfortunately, that analogy is all too accurate.
I will give another statistic to show how things have got considerably worse. In the early 1980s, roughly 7% of the population were classed as overweight. That ratio has trebled in the past 30 years. We can see the trend. It is likely to double again in the next 30 years. We must get to grips with a problem that, as I said, is proving exceptionally expensive for us all.
Obesity is linked to socio-economic deprivation. The figures that I have been able to establish indicate that the ratio of children in lower-income households suffering from obesity is twice that of those in higher-income households. Again, we see the repetitive nature of the problem, the cyclical response that is indicative, because many obese children are, unfortunately, the children of either one obese parent or two.
Of course, we all know of the additional and subsequent health risks associated with this condition. We are all aware that heart attacks and strokes, coronary artery disease and type 2 diabetes are much more likely among the overweight. There is an additional cost further down the line, in years to come, as people who begin to be overweight today begin to show the symptoms of those other conditions only in years to come and then of course have to be treated by the NHS.
Jim Shannon (Strangford) (DUP)
Type 2 diabetes is one of those hidden diseases that some people do not know they have. The indications are that there will be a 50% increase in the number of diabetics in the next couple of years. Does my hon. Friend believe that diabetes itself needs a direct Government plan in order for that issue to be addressed, because it is a hidden disease that can kill?
Mr Campbell
I thank my hon. Friend for that intervention. I hope that the Minister will respond to it. I want to come on to some of the things that Health Ministers throughout the United Kingdom—in the devolved regions as well as here—can do to deal with the issue, but my hon. Friend’s point is certainly well made.
Having diagnosed the problem, as it were, I want to consider what is being done. It is not all negative. A considerable series of measures is being taken, not just nationally but locally. Various councils, various health trusts in Northern Ireland and other bodies are actively engaging in trying to come to terms with the problem. Many programmes that promote healthier food choices are being actively promoted. I am aware of the healthy eating awards, and of course we are all aware of the food labelling issues that have come to the fore in recent years. There have been other programmes aimed at reducing the salt, sugar and fat in some foods. All those things are creating greater awareness among the wider community, but we are fooling ourselves if we think that the measures currently in place will arrest the problem.
I will turn at this point to what needs to be done now and for the foreseeable future. Obviously, the fast food industry is a key player in relation to the problem. Some people in that industry are quite responsible. Some have responded to the campaigns driven locally and introduced more healthy eating options—they are to be commended for doing so—but some have not. We need to see best practice not just nationally but internationally being analysed and then promoted, so that we can see significant progress.
At the moment, there is—certainly in Northern Ireland, and I assume across the UK—a better educational approach in schools. Our young children, particularly primary school children, are now getting information that simply would not have been proper protocol 25 years ago. Many people then would not have even seen the need for primary school children to receive that type of education. That is changing, but again, more needs to be done to increase awareness. We have all seen issues where, for example, healthy eating has gone wrong. Sometimes we see photographs in newspapers that show parents queuing up to give other types of food to children because healthy eating standards have gone awry. We need to ensure that the whole educational process about healthy eating for children is properly assessed and rationally implemented.
When we ally the fast food sector—I do not want to name any of the organisations—with a sedentary lifestyle, I think we can account for 80% to 90% of the obesity problem.
Nick Smith (Blaenau Gwent) (Lab)
The hon. Gentleman’s point about a sedentary lifestyle is important. The Welsh health survey 2008 showed that 21% of the population in Wales were obese. Does he agree that encouraging people to exercise and to avoid the sedentary lifestyle that he is talking about is important to reduce the alarming obesity rates, in addition to eating more healthily?
Mr Campbell
I agree with that; I was just about to come to the issue of exercising. I love walking, and when I get the time to walk, as I try to weekly, I despair at the rarity of seeing other people walking and exercising.
Jim Shannon
Surely, my hon. Friend does not just walk; he marches. When someone marches, they lose more calories, and I understand that he marches often.
Mr Campbell
I thank my hon. Friend for bringing us back to basics with a Northern Ireland and Scotland perspective on that. That is true.
I do despair when, for example, I see very few people exercising between October and March or April, and even fewer children.
Simon Hart (Carmarthen West and South Pembrokeshire) (Con)
The hon. Gentleman will be aware, as I am, that part of the problem lies in the Department for Education, not the Department of Health. One of the obstacles to kids exercising is that teachers do not want to take them out of the classroom because of the raft of health and safety obstacles in the way. We need to address that in this Chamber as much as we do the health aspects.
Mr Campbell
I knew that the dreaded health and safety would come in at some point, and I am glad that the hon. Gentleman managed to get it in. I agree with him totally. Many teachers, administrators and principals would dearly love to get their children to exercise more, but they know that all the dreaded health and safety boxes have to be ticked.
David Simpson (Upper Bann) (DUP)
I congratulate my hon. Friend on securing this important debate. I shall encourage him by telling him that I have started to walk; it has not made a lot of difference, but I have started to do it.
Surely fast food outlets have a responsibility in their marketing tactics, which offer “buy one, get one free”. That needs to be addressed.
Mr Campbell
My hon. Friend is absolutely right, and I hope the Minister will respond to that. I know that a small number of fast food outlets in Northern Ireland have acted responsibly, but unfortunately they are a small number. It appears that the behemoth of consumerism will simply market and promote the message of “stack them high and sell them cheap.” We have to come to terms with that reality, because it is driving many people to an early grave—it is as serious as that. In 2011, many in the younger generation are not only overweight, but will be diagnosed in 20 years’ time with health conditions that could shorten their lifespan by up to 10 or 12 years, unless we get to grips with the problem.
There is, as the hon. Member for Carmarthen West and South Pembrokeshire (Simon Hart) indicated, an educational and health problem. It is for all of us in society to promote a healthier lifestyle. That is where I think we can do more to get role models to do what they can to promote healthy eating and a healthy lifestyle. Some role models, unfortunately, do anything but promote a healthy lifestyle, but we need to ensure that more suitable role models are approached and asked to try to promote such a lifestyle, so that we can address this horrendous and difficult problem.
Mr Nigel Dodds (Belfast North) (DUP)
I, too, congratulate my hon. Friend on securing this important debate.
Does my hon. Friend agree that although good progress on the issue has been made on a voluntary and self-regulatory basis, the time has come for more legislation? We have seen that approach with the compulsory wearing of seat belts and the banning of smoking in public places, which was resisted on all sorts of grounds. That approach has had a beneficial effect on health and public safety. Is it not time for the Government to go further in forcing food and drink companies to act more responsibly?
Mr Campbell
I agree with my right hon. Friend. We also need to look at the cost of products on supermarket shelves. Again I refer to some of the correspondence that has come my way. Fizzy drinks are quite attractive to younger people, and to some who are not so young. Is it fair that their low-calorie equivalents, some of which contain one calorie, and the fully fizzed-up versions, which can contain 139 calories, cost virtually the same?
A range of approaches needs to be co-ordinated and best practice needs to be introduced. I hope that the Minister will be able to speak about the devolved Health Ministers, with whom I hope he will have discussions about the best way to promote best practice and to ensure that, wherever practical and possible, close co-ordination can take place, so that across Scotland, Wales, England and Northern Ireland we can begin to address and—I hope—reverse this horrendous and difficult problem.
Dr Sarah Wollaston (Totnes) (Con)
I thank the hon. Member for East Londonderry (Mr Campbell) for securing this important debate. I do not want to repeat his message about the economic cost of the problem, but I would say, having been a general practitioner for 18 years, that once someone becomes obese, it is extraordinarily difficult to regain their normal weight in the long term.
I would like the Minister to consider the following points. We need to focus on better identification of those who are most at risk, particularly children, and to target action on those high-risk children. A nudge will just not go far enough, and it is time for more of a bit of a shove. We need particularly to look at the role of liquid calories in obesity among children. I ask the National Institute for Health and Clinical Excellence to update its guidance and review the evidence.
Nearly two thirds of adults are overweight or obese, but they do not start out that way. Around one in five four to five-year-olds are overweight or obese, but by the time they reach 11, that figure will have risen to one in three.
The Minister of State, Department of Health (Mr Simon Burns)
On the point about NICE, may I give my hon. Friend a reassurance that might be helpful at this stage in her contribution? As she may know, NICE has recently consulted on whether now is the right time to review its original guidance. As a result of that consultation, it will be making a decision later this month.
Dr Wollaston
I thank the Minister for that helpful response and look forward to hearing the outcome of that.
Children at primary school and in the early years before they have reached school are among the really high-risk groups. Some 85% of obese children go on to become obese adults, whereas only 12% of normal weight children become obese adults, so it makes sense to focus on that group of children, but that can happen only if we have better early identification. We should introduce annual measurements of weight and height, so that we can see when children are starting to slip towards obesity. We should target our resources much better on that group.
Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)
Years ago, parents with chubby children would be told, “It’s puppy fat and they will grow out of it.” There is still that idea around among otherwise bright and responsible parents. We need to press the point that chubby children grow into chubby adults.
Dr Wollaston
I absolutely agree with the hon. Lady. We need to be much clearer with parents that their children are at risk and that being overweight is not something that they will grow out of.
We should be much more creative about how we target help to high-risk children. Why not allow all those children to have free healthy school lunches? As poverty and deprivation have such strong links with obesity, considering that high-risk group is particularly appropriate if we are to address the Marmot agenda. Unfortunately, families on tight budgets are much more likely to be pushed towards unhealthy and cheaper choices. If we want to nudge them in the right direction, we must recognise the role that price plays in the choices that they make. We should look at the role of loss leaders. We urgently need a change in what supermarkets offer so that loss leaders are redirected towards healthy rather than unhealthy products.
Why not incentivise exercise in those high-risk families with vouchers for success and free access to good-quality sports facilities? We should incentivise a whole-family approach to cooking skills because cooking is a fun activity. An effective way forward would be to make such a service free and readily available to whole families.
On liquid calories, a survey conducted by the British Dental Association and Ipsos-MORI showed that 47% of children’s fluid intake is in the form of sugary and carbonated drinks. That means that one in five children is consuming 500 calories or more a day just in the form of sugary drinks and 73%—nearly three-quarters of children—are consuming more than 200 calories a day. It is a staggering number of calories that children are consuming.
If we look at adults, we will see that there is a particular issue with alcohol. The chief medical officer has already highlighted that around 10% of an adult’s calorie intake can be through alcohol. What we should understand from that is the role that discounting plays. I have mentioned that before. It really does not matter how disciplined the rational part of our brain tries to be—the irrational and impulsive side will continue to be irrational and impulsive. It is not helpful to see heavily discounted products in super-sized multi-buy packs piled high at the check-outs in supermarkets. If we want to move “nudge” towards “shove”, we should regulate how supermarkets market their products. I do not suggest that the whole answer to obesity lies in regulating supermarkets. I realise that there is a complex interplay between over-supply, pricing, culture, marketing, poor consumer choices and human nature. There is also the interplay between genetic predisposition and a lack of exercise. However, it is unlikely that our current strategy will go far enough in this regard. If we are going to do something about the £5 billion a year that this problem is costing us—the figure is predicted to rise to £10 billion a year by 2050—I suggest and hope that the Minister takes a strong line and abandons the idea of giving the problem a little nudge, in favour of giving it an almighty shove.
Justin Tomlinson (North Swindon) (Con)
I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing this very important debate. I echo many of the points that have been raised this afternoon, but I want to concentrate mainly on the childhood obesity angle. It was mentioned that a third of children are overweight, and that 85% of those will then go on to be obese in adulthood. I want to cover four topics: planning, food, sport and youth provision.
Gardens are a third of the size they were in the 1960s. Front gardens are often more of an aspiration than a reality in new build areas. I am keen that we make greater use of accessible and usable open space. Before becoming MP for North Swindon, I was for 10 years a councillor for a new build estate. I used to complain time and again that there was not sufficient usable and accessible open space, and I was told, “You are wrong. You have more open space than anywhere else in Swindon.” It transpired that that is because the definition of open space includes hedges and heritage sites, neither of which is suitable for a child to play football on, and that is something that needs to be considered.
I am not asking for premier league, standard turf right across all housing estates. When I was growing up, our open space was an almost vertical hill. The twins, Matthew and Paul Gilbert, who were technically gifted at football, got to kick the ball uphill all day long and myself and my friends got the advantage of kicking it downhill. Such is the creativity of young people.
Open and accessible spaces are very important. As a child, I was very sporty. I grew up in the 1980s when children were fuelled with artificial colourings and flavourings—the sort of things that we are now worried about. None the less, I had the balance because I spent all day running around. We copied the television, so mostly we played football. If the Ashes were on, out came the cricket bats. When it was the Tour de France, the bikes came out. When it was Wimbledon, we brought out the tennis rackets. Normally, we brought them out for only two weeks or for one or two days if we were following our British hopes.
I was also the lead council member for leisure. People always said to me, “The emphasis is on creating lots of really good leisure centres.” The reality is that youngsters go to leisure centres only once or twice a year—normally for somebody’s birthday party. It is the jumpers-for-goalposts mentality that matters. It is really important that we build in to developments usable and accessible open space.
It became fashionable to build new public buildings under the private finance initiative scheme. Ignoring the advantages or disadvantages of the scheme, there was a particular problem for local communities in that they could not afford to access those community facilities. Again I know, from my time as a councillor, that we had some wonderful open spaces behind very big fences and the local community could not afford to hire the sports clubs, so that is another issue that requires consideration.
Local authorities are always under pressure on funding. One of the areas that I would like to see prioritised is investment in local country parks. Families would use them and we would see jumpers for goalposts, family walks, people walking their dogs and all sorts of different free activities to get people going.
Councils can be innovative in this area. Let me give three examples from my own local authority. First, £1 million has been invested in Mouldon hill through section 106 money—nothing new there. We had £5 million invested in Lydiard park, of which £4 million came from the Heritage Lottery Fund and £1 million from local private businesses and organisations. The best one of all was the £2 million investment in Shaw forest, which was a tip. We charged neighbouring authorities to put their rubble on top of the tip and then we planted trees and now it is a very enjoyable country park in which to walk the dog.
There have already been some very good contributions on food, so I will just mention my particular bugbears. First, basic cookery in schools should be compulsory. Nowadays, too many people’s idea of cooking is a three-minute wait and then the ping of the microwave. As an MP I have visited a number of schools to see how they provide cookery lessons. I am a big supporter of the £20 million national lottery-funded “Let’s get cooking” campaign, which is coming to the end of its five-year scheme. I hope that it will carry on. The main function of the campaign is to encourage cooking in schools. Last Friday, I visited a cookery session at Warneford secondary school in Highworth. Boys and girls from different backgrounds joined in enthusiastically. Cooking is not a bind for young people; they want to do it and they enjoy doing it. With “Junior Masterchef” and all the other cookery programmes on TV, they are inspired to cook.
The children themselves made another point to me. A lot of professional sportspeople are the role models for young people. Because professional footballers, for example, only train for a couple of hours a day, they have to do something with the rest of their time and a lot of them now are very good chefs, which has filtered through to a lot of young people, particularly younger boys.
I have also visited Haydonleigh primary school, which had what to my mind is the perfect example of cookery in schools. In Haydonleigh’s cookery sessions, the parents or grandparents of children were invited to come in, so that they were cooking with the children, who would then take their skills back home. However, there was also an allotment at the school, so the children got to see the full cycle: they planted the seeds; they grew the vegetables; they cooked in school with their parents or grandparents; and they went home and carried on cooking.
In my role as the vice-chair of the all-party group on heart disease, I fully echo all the points that have been made about the need for clear and uniform labelling of food, which allows people to make informed decisions.
Dr William McCrea (South Antrim) (DUP)
Does the hon. Gentleman believe that GPs have a greater responsibility and need to be more proactive in informing people about, and leading people in, healthy eating?
Justin Tomlinson
Yes, I absolutely do, but this is an area where the schools can lead, in terms of teaching the basic cookery and giving students the information they need, and I am covering that.
Then there is food labelling. I want to refer to labelling here in Parliament, because people often say, “Does labelling really make much of a difference?” Well, we have the “traffic light” system in our canteens in Parliament. As a general rule, anything that has a red sticker next to it is normally the most attractive thing, but we are able—even we MPs, with our limited intelligence—to say, “I can’t have too many of those,” although I confess that, as I was writing this speech earlier, I was eating a pork pie. So I failed by that rule myself.
I turn to organised sports now. I have already said that the most important element is the open, accessible and usable space on which kids will be creative. But organised sport also plays a very important role and there are a lot of opportunities that we can examine, in order to be more proactive.
I set up a sports forum when I was a councillor and that forum brought together about 60 different sports groups, who shared best practice. For example, there would be one group saying, “We’ve got a facility, but it’s underused,” and there would be another group saying, “We haven’t got the facility, and we need one.” We put those two groups together and between them they became experts at applying for external funding. There are lots of examples of external funding and I will talk about one in a moment.
I was quite an outspoken critic of the plan to scrap the school sports partnerships scheme and I was delighted when the Government changed their mind and delayed the scrapping of the scheme by nine months, to allow the good and successful examples of school sports partnerships to dig in and secure their existence. The principle of the school sports partnerships in schools was not to deal with those children who are already technically gifted, because by and large if a child is naturally good at sport—probably because their parents encouraged them—they are usually already involved in competitive sports clubs. Instead, it was to deal with the three out of five kids who were not naturally inspired to participate in sport and to provide them with a menu of alternative sports, because there is something for everyone.
It is not only a question of getting people to be active. One of the biggest challenges that sports groups tell me about is that they would like to provide lots of facilities but are struggling to do so because they are struggling for volunteers, for example to join the administrative staff and coaching staff who do all sorts of things, such as filling in forms to make all the bookings, to provide the organisation so that the kids can take part in activities.
I will touch on the point that my hon. Friend the Member for Carmarthen West and South Pembrokeshire (Simon Hart) has made today, and in previous speeches, which is the need to address the cost of insurance. One of the barriers for a lot of schools is that many teachers are very young and it costs a fortune to insure a teacher to use a minibus. I have pleaded with several Ministers to consider providing some national insurance scheme for all different schools, so that they can achieve economies of scale and make the cost of insurance cheaper. In addition, health and safety issues prevent a number of schools from taking up more opportunities.
Councils should also do more to open up facilities. It is a crying shame that many of our facilities are closed on Friday and Saturday evenings. We are talking about tackling antisocial behaviour and childhood obesity. Where there are leisure centres that are shut, surely we should open their doors and provide facilities.
A good example of how that process works is that we have just had an academy built in the last few years in Swindon; an old school was closed down to build it. However, just before the decision was made to do that, £4 million was invested in a fantastic new sports hall in the old school. Initially and regrettably, the council was going to bulldoze the new sports hall along with the old school, because there was no point in having a random, stand-alone sports hall. Through the sports forum, however, we managed to identify a sports group that could take over that sports hall. It was Esprit Gymnastics and Mark Hows, who runs it, is fantastic at identifying funding opportunities. He had about 250 kids a week in his old facility, but that was at full capacity. However, he had an income, so he could pay a rental income to the council, which is revenue-stretched, and he said, “Just don’t bulldoze it. I will rent it.” Now his group has more than 500 kids a week participating, including potential Olympic athletes, and they are a real jewel in the crown for Swindon. That is a good example of the council being proactive and working through the sports forum to identify other facilities that can be used.
One of the external bodies that provide funding is the Football Foundation, which provides funding through its “Grow the Game” scheme. That scheme aims not only to increase participation but the sustainability of it. I have seen a lot of funding come in and people will put on a one-off session. That is great, but it does not really make that much difference. The “Grow the Game” scheme slants its funding to ensure that it is not just used for one-off things. It targets things such as coaching qualifications to provide additional coaches so that more junior clubs can take part, and paying for facility hire if there is a group of volunteers, particularly in challenging areas where there may not necessarily be a huge amount of funding. Also, first aid provision is funded, as part of the process of ticking off the many items on the very long health and safety list that exists. Already the sports forum has increased participation by 12,000 new players and, crucially, by an extra 2,000 new coaches. That is just one of many, many schemes, but councils and the Government can do more to help sporting groups and volunteer groups to identify the different streams of funding that are available.
My final point is about youth provision. My suggestion is a little bit contentious, but I have road-tested it on a number of schools, youth clubs and colleges. In the past, there was a traditional divide, whereby children were either very sporty and they went to a sports club, or they might choose to go to a youth club, and the divide would never be crossed. But times have changed and when I talk to young kids they are all very keen, either on whatever sport is popular on TV or even on things such as cheerleading or street dance, which are not strictly “sports” but which get the heart rate going.
I think that the youth service and the leisure service in local authorities should be merged to become one service. The chief officer within those areas should be one person and they should not employ armies of youth officers with very expensive youth clubs attended by only a handful of children, where they do things that we may have liked doing when we were younger but which, I can assure hon. Members, these days kids are not particularly switched on by. Instead, we should open up schools, community centres and leisure centres. We would pay for football coaches, street dance instructors and so on, and say, “Right, it is 50p. You come along and for the next two hours you’re in a constructive environment, and you’re doing something that is active.”
That is not just some pie-in-the-sky thing. In Swindon, we have the ice-skating disco on a Friday night for teenagers and 600 kids chase around the ice after whoever they think is particularly good-looking. They are being very active for a couple of hours; they are off the streets; and the youth service could and should be parking its mobile facility outside. Those young children who need the traditional youth service, from which they can get advice and seek help, will find that that is available. For all of the others who might have been put off going to the youth club, because that was the only thing that was available, there is the enjoyable activity of ice-skating. I am very keen to push such projects and we could judge their success by the number of children who are engaged by them.
To conclude, it is for us—whether we are the local authority or the Government—to provide as many opportunities as we can: through the planning system, through making changes in teaching cookery and in food labelling, and also through the power of sport.
Dr Daniel Poulter (Central Suffolk and North Ipswich) (Con)
I am grateful for the opportunity to contribute to this debate. I will not speak for very long, but it is worth highlighting some of the issues that have been raised in a comprehensive way. I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing this debate.
Obesity in the UK is a growing problem. In 1993, only 13% of men and 16% of women were obese, but in 2009, 22% of men—and 24% of women—were obese, which represents almost a doubling of the number of men with obesity. I am not talking about people with a body mass index of between 25 and 30, which means that they are overweight; I am talking about obesity. Almost a quarter of the UK population is obese and I am sure that we all find that unacceptable.
How can we deal with obesity effectively, because whatever previous Governments have done, obesity has not been addressed in a way that has worked or has been effective? First, I will briefly outline how Government policy is moving towards more community-based interventions on obesity, and I will explain how that approach, through the health and wellbeing boards that will be set up under the health care reforms, will be effective and work well. Secondly, I will talk a little about nudge theory, because I am more hopeful and optimistic about it than my medical colleague, my hon. Friend the Member for Totnes (Dr Wollaston). There is good evidence elsewhere, particularly in Iceland, that it has worked, and I hope it will also work effectively in relation to obesity.
Jim Shannon
While the hon. Gentleman is giving us his thoughts, and given his experience in his previous job, will he comment on gastric band operations? Just two weeks ago, I had occasion to visit the Northern Ireland Health Minister, Edwin Poots, with some of my constituents. These people had tried everything to lose weight; they had tried dieting and exercise—some of them were not able to exercise, which was the other problem—but they had clear medical and health problems. As a last resort—this really is the last chance saloon, or the last chance restaurant, perhaps—should regions and Health Ministers set aside money specifically for gastric band operations?
Dr Poulter
We certainly have to look at how the Government can help people to take more responsibility for their own health care. That is fundamental to obesity issues, and it is a particular challenge in more deprived areas. People often require gastric bands at the point where the medical problems associated with obesity—diabetes, the risk of heart attack or stroke, or high blood pressure—pose a potentially life-threatening risk. Such people may not have that long to live if a gastric band is not put in place, so it is the only feasible mechanism for dealing with obesity in such cases. Gastric bands have been shown to be an effective mechanism for looking after that part of the population, and there is good medical evidence to support their use. There is also good evidence in terms of the health care economics, as helping people to become slimmer will lessen the burden on the NHS.
The gastric band is good for the patient, because their health improves dramatically when it is used effectively, but the challenge with obesity is to bring about long-term lifestyle change, and the question with gastric bands is whether they necessarily deal with long-term lifestyle changes. In a medical sense, there needs to be greater emphasis on the education that goes with the bigger issues around obesity and lifestyle at the same time as the gastric band is fitted. I hope that that helps to answer the hon. Gentleman’s question.
Andrew Bingham (High Peak) (Con)
Does my hon. Friend share my concern that celebrities regularly have gastric bands fitted, with the result that the bands are now seen as a shortcut to losing weight? People think that celebrities have them, so we must all have them.
Dr Poulter
That is a good point. There is good evidence that the celebrity culture around dieting causes anorexia in young girls. It would be much better for us and for many of our constituents if celebrities sometimes showed greater responsibility in the way in which they behaved. Gastric bands are an effective way of dealing with severe obesity, but they should not be used as a general method of bringing about weight loss. Weight loss is about education and people taking responsibility for their own weight and lifestyle. It is also about putting support in place in communities to let people do that, particularly in more deprived areas.
Mr Dodds
I have heard constituents talk about the use of statins and polypills. These medications have enormously beneficial effects for many people, and many people need them, but people almost seem to think, “Well, we have this magic pill available. We can eat and drink as much as we like, and then we can go on this pill.” Does the hon. Gentleman share my concern that we need more education about the use of such medications? At the moment, people are under the impression that there is something out there that can solve all these problems without their having to do anything to change their lifestyle.
Dr Poulter
Yes, certainly. There is an issue about how physicians prescribe effectively. Statins are an effective way of controlling cholesterol, and there is good evidence that they benefit people with heart disease and high cholesterol and that they increase life expectancy. There has been a lot of research, and I believe that it has been shown that statins may have beneficial effects in reducing the risk of breast cancer, although the Minister will correct me if I am wrong.
The right hon. Gentleman touches on the wider point that the emphasis in this debate needs to be on effective community-led interventions that tackle obesity and health care, and my hon. Friend the Member for North Swindon (Justin Tomlinson) discussed that very effectively. However, we need to ask how we will make those community health care measures effective.
The Government are setting up health and wellbeing boards, which are a very useful part of their health care reforms, because they will, for the first time, bring together different organisations in a meaningful way. Local councils in certain towns may run good community initiatives that connect GPs with leisure centres, exercise and sport, and some schools may encourage sport and physical activity in an effective way or have good links with local sports clubs. However, that does not often happen in a co-ordinated way across whole counties or, indeed, across the country. Health and wellbeing boards will help to bring together different organisations to address key public health problems, and obesity is a key public health challenge in all our constituencies.
As part of the health care reforms, the health and wellbeing boards will be able to address issues such as obesity. For example, if we know that there is an issue with teenage pregnancy or obesity in certain schools or among certain schoolchildren in my constituency, targeted interventions can be put in place in a much more community-focused way by getting the local authority together with health care representatives at a much more strategic level. That must be a good thing, because it allows much more targeted interventions.
The second thing I want briefly to discuss—I do not want to speak for much longer—is nudge theory. My hon. Friend the Member for Totnes has a slightly different view of it. I have more faith in nudge theory than she does, and I say that because we have had debates about agriculture—some of the Opposition Members here today were present—in which we discussed the need for corporate firms and supermarkets to show greater corporate responsibility on issues such as food labelling. We have now seen active movement from some supermarkets on honest food labelling. For example, we talk about food in a store being labelled British only if it is actually farmed in Britain, and not if it is merely processed or sliced here. We are beginning to see such initiatives come through, with supermarkets supporting British farmers. Morrisons is a good example of a supermarket where the British food stamp actually means something, and that allows consumers to make an informed choice. Supermarkets are therefore able to show corporate responsibility when they are asked to do so, although things are not entirely perfect, as we all know.
In a similar vein, the Government have introduced a public health responsibility deal, and it is a good initiative. Almost 200 different companies have signed up to the deal, including supermarkets such as Asda, the Co-op, Morrisons, Marks and Spencer, Sainsbury’s, Tesco, Waitrose and many others. Fast-food outlets such as McDonald’s, Pizza Hut and KFC have pledged to remove trans fats and introduce calorie labelling as a result of this initiative. Those are all pleasing and beneficial steps in the right direction.
Dr Wollaston
Does my hon. Friend share my concern, however, that organisations such as Asda, which have signed up to the new responsibility deal, are in some ways undermining it by offering hugely discounted alcohol products?
Dr Poulter
There are areas of obvious concern, where supermarkets can go further. As I said earlier, when we were talking about the agricultural sector, even though several supermarkets are backing honest food labelling, and showing responsibility in food labelling and calorie counting to tackle obesity, it is right to highlight the areas in which they need to show greater corporate responsibility. Cut-price alcohol is one of those, and we will continue to monitor it carefully in our work on the Select Committee on Health, and as physicians. My hon. Friend makes a good point.
In preparing for the debate, although I do not normally take an active interest in children’s TV, I found out about an Icelandic TV show called “LazyTown”—the Minister may want to expand on the subject a little later. The show is watched by children all over the world, and we have it in Great Britain as well. There is a healthy sports superhero character, called Sportacus, who motivates children to eat healthily and be active. In Iceland several “LazyTown” initiatives have been run in partnership with the Government and the private sector. For example, children between four and seven years old were sent an energy contract, which they and their parents signed, in which they were rewarded for eating healthily, going to bed early and being active. In one supermarket chain, all the fruit and vegetables were branded “sports candy”, which is the “LazyTown” name for fruit and vegetables. That led to a 22% increase in sales at that supermarket, and improved health and reduced obesity levels in Iceland.
The fact that Iceland’s child obesity levels have started to fall as a result of initiatives of that kind is good evidence in support of such corporate responsibility. Those initiatives are designed to support supermarkets coming together with Government, to make effective use of the nudge theory of improving behaviour, and they can work—and have worked. For that reason, we must support what the Government are doing, because there is evidence that it can work. It is a good thing and the evidence from Iceland is that we need to do what works, with children and communities.
I understand, and I am sure that the Minister will confirm, that the Department of Health has set up a partnership with “LazyTown” and is interested in expanding that initiative in the United Kingdom. We need more such approaches. The reason supermarkets sign up to such deals and initiatives is that it is good not just for the children, who become healthier and less obese, but for the supermarket and its brand image. Supermarkets see that working with corporate responsibility—we see it in our constituencies with Tesco schools vouchers—can enhance their image and custom, and do real good, for example, by reducing obesity levels.
I have greater faith in the nudge theory than my hon. Friend the Member for Totnes, and we need to allow similar initiatives to take root in the future. What has been done in the past has not worked very well; obesity levels have been going up. We have good evidence, from examples of corporate responsibility, that things can be tackled, so let us give nudge theory a chance. Let us also look to those health and wellbeing boards to provide community-based interventions that will work. If we do not do something, things will get worse, and the boards are a good way to address the problem.
Andrew Bingham (High Peak) (Con)
Thank you for giving me the chance to speak in the debate, Mrs Riordan. I had not applied to speak until I arrived today. I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing the debate. Obesity is a problem that we underestimate at our peril. We have heard from Members who are medical people—I am not one of them—and have heard figures about the increase in obesity and the problems being stored up for the country. Those problems are to do with both physical well-being and the economy. Late onset diabetes, which can be related to obesity, will have an impact on health spending in the future, for example.
The problem has crept up on our society in the past 10 or 15 years. We have talked about diet, and I am at a slight advantage because I spent two years training to be a chef many years ago. To this day I always try to cook myself a balanced meal, although since being elected—other hon. Members’ experience will no doubt chime with mine—there is a tendency on getting back to the flat to get a little lazy and reach for the frozen ready meal. That behaviour—the sort of thing we are probably guilty of—is what pervades the country. As people cook less, they tend to eat less healthily. We have already heard discussions about school cookery classes. I tend to agree with my hon. Friend the Member for North Swindon (Justin Tomlinson) that those classes should be a staple part of children’s education.
As to the cost of ready meals, we have all been to the big-name supermarkets, where there are buy-one-get-one-free offers, ready meals for £1 and so on. I often have an argument with people outside this place about the fact that I still think it is cheaper to cook a balanced meal than to buy a ready meal, whatever its price. Fruit and vegetables are not expensive; they can be bought and prepared quite cheaply. The difficulty is that people are so busy—or the perception is that they are so busy—that they say, “I haven’t got time.” They prefer, as my hon. Friend the Member for North Swindon said, to do microwave cooking—three minutes, and ping. It is a question of education. We need to educate people to understand that it is quite simple to cook a balanced meal and live on a balanced diet.
I was visited some time ago by a constituent who came up with an idea called the Diet Plate. It is a fantastic idea—a plate that is portioned. If someone puts the relevant food group on the right portion of the plate it will be a balanced meal. Kay Illingworth was named in the British female inventor of the year awards in 2002 for that invention. I was given one, which I have in my office, and I am sure that hon. Members will realise, from looking at me, that I use it every day. It is a really good product, which looks nice and is made in this country. It demonstrates how to balance a meal and is a great way of educating people.
We have talked about sedentary lifestyle. I, like my hon. Friend the Member for North Swindon, remember the days of jumpers-for-goalposts football—kicking the ball around in the street, playing cricket in the summer, and so on. I still think that a lot of young people like physical activity. I spent 12 years as a councillor on High Peak borough council. We have a new all-weather football pitch in Hadfield. Hon. Members who know the area will know that someone coming down the road can see the floodlights, and every night there are dozens of people playing there. We used to do summer sports in the school holidays, to use the school facilities that were lying idle. Young people like to get out and play physical sport, and we need to encourage that as much as we can. There are two strings to this: it is not only what people eat, but how they burn it off. If the energy is not burned off, what is eaten becomes more important.
Simon Hart
My hon. Friend is making a strong case for children being inspired to take part in sport. Does he have a sense, as I do, that sometimes sponsorship of major sporting events by chocolate or crisp manufacturers creates a slightly false image, by relating unhealthy food to healthy activity? Does he have a view or some advice on that?
Andrew Bingham
I was going to come on to other activities shortly. I will watch or take part in sport, but who sponsors it does not chime with me much. However, ideally it would be better for an active product to support a sport. Interestingly, leisure centres all have vending machines full of chocolate. I know from experience that when the chocolate bars are replaced with cereal bars and healthy alternatives, the spend drops, because people like chocolate.
I am fortunate to live in the High Peak, which is a fantastic area with a huge amount of outdoor activity to do, including walking and hiking—the woods to play in. I am lucky, but inner cities do not have a huge playground such as the one I and my constituents have to play in. It is vital that people use leisure centres, and that they are encouraged into them. We can talk about what the Government should or should not do to get people to do that. I agree that the nudge theory will work. We have been subconsciously nudged into the present situation, because people have gone to the quick, easy meal and have taken up a more sedentary lifestyle. We have heard about the PlayStation generation, and we all walk around with BlackBerrys. If texting was good exercise and made people fit, the present generation would be the fittest ever. With young people in particular it is text, text, text. However, that is not active.
Mr Simon Burns
I am very interested in what my hon. Friend says and have listened carefully to the interventions. A number of Members have talked about what the Government, the Department of Health, the Department for Education or local government should do, but it strikes me as slightly odd that there has been little recognition of the responsibility of parents.
Andrew Bingham
I think that the Minister has been reading my notes. The point I was coming to was that we have talked a lot about what the Government can or cannot do, but this is one of many issues on which responsibility lies with us and with the parents of young people. My generation’s parents taught us how to poach eggs, for example; it is all about education in the home. I know that I sound like a grumpy old man, talking about how it was in my day, with rose-coloured glasses—[Hon. Members: “No, Never”] I will concede on grumpy; old I will argue with, at the moment. We can discuss different demographics, but if people are brought up on balanced, home-cooked food they will carry that on through their lives. It worries me that the more ready meal-type culture we have, the more it will go on and the bigger the problem will get.
We can expect, or ask, the Government to do this, that and the other, but as with many things, responsibility lies with individuals and with the parents of young children. That is where we need to start, with people being responsible for their own actions.
We have a fantastic opportunity with the 2012 Olympics, when we will see athletes from across the world. I will wager that in a year’s time, when Jessica Ennis wins a gold medal—I hope she does—we will see children out doing long jump and triple jump, using their own resources to copy their sporting heroes. We must capitalise on that. I played football in the winter as a kid because that was what was on TV, I played cricket in the summer and we all played tennis for two weeks when Wimbledon was on. We can use the Olympics. We talk about the legacy Olympics, and I would like the legacy to be the starting point for people getting active again.
Justin Tomlinson
We all have a role in encouraging our local schools to get 100% behind the school Olympics principle, so that when we have our successful athletes, in javelin or whatever we prove successful in, children can be inspired to take up the sport on a regular basis.
Andrew Bingham
Absolutely. There are dozens of sports in the Olympics, and everyone will watch and take an interest in one, so let us foster that and make the legacy of the games a healthier and more active society. We need to take that together with using the supermarkets, to get healthier eating.
We have a surfeit of cookery programmes on television. Every time we put it on there is someone gardening, doing DIY or cooking. Those three hobbies, or whatever we want to call them, can help to produce healthier people and a healthier country. Let us not necessarily rely on the Government. I agree with my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) that the health and wellbeing boards and the reforms in the Health Bill will help, but let us take on our responsibilities and get the message across to our constituents, getting the whole of society involved in this to make for a healthier and less obese Britain.
Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)
It is a pleasure to serve under your chairmanship, Mrs Riordan. I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing this important debate, to which we have all been glad to contribute. He reminds us of how many issues we have in common in these British Isles.
I want to focus on the important subject of child obesity, and to talk about the responses so far to the Government’s obesity strategy entitled “Healthy lives, healthy people: a call to action on obesity in England”, which was presented to both Houses on 13 October. First, however, I want to say that some people might feel that Members of Parliament have a certain temerity talking about healthy lifestyles when their own lifestyle is relatively unhealthy, and I speak as someone who has been in this House for 20 years. Perhaps we should give credit to the few colleagues we sometimes see going through the Division Lobby dressed in their running gear after a bracing run. I am sure that Members will unite with me in congratulating those rare Members on that.
We are facing a crisis in childhood obesity. As I said earlier, gone are the days when we could look at a chubby child and say that they would grow out of it: chubby children grow into obese adults. I have to say, more in sorrow than in anger, that a wide range of people both inside and outside this House have expressed doubt about the effectiveness of the Government’s obesity strategy. Before moving on to what I think the Government should be doing, let me focus on the picture in London.
London has higher levels of childhood obesity than any other British region. The capital’s childhood obesity rate is 22%, compared with an average for England as a whole of just 19%. Across the capital, one in five youngsters are obese, with rates varying widely from 12% in leafy Richmond to 28% in Westminster. Childhood obesity costs the capital £7.1 million a year to treat, and the annual bill could reach £111 million if today’s young people remain obese into adulthood.
Research commissioned by the Greater London assembly found that adult obesity costs London £883.6 million a year, and in my own constituency—Members will forgive me for mentioning it—a quarter of all year 6 pupils are obese. That is one of the highest rates in the country as recorded by the national child measurement programme. In 2010 in City and Hackney, 13% of children in reception year were overweight and 14% were obese. The number of overweight children was similar to the national average, but the proportion of obese children was slightly higher. Greater efforts are needed to prevent overweight and obesity at the pre-school stage, because a high proportion of children are already obese and overweight by the time they start school. The escalation of the trend through to year 6 suggests that we also need to implement robust interventions in primary schools.
A number of Members have talked about parental responsibilities. I put it to colleagues that some of the parents who are doing what we might understand as the wrong thing are, in their own minds, trying to be good and vigilant parents. One of the problems that young children in Hackney and the rest of London have is their sedentary lifestyle, and part of what motivates parents to keep their children indoors is this idea of stranger danger. We all know that attacks on children have not gone up in 20 years, but childhood obesity has spiralled. Many parents—not bad or careless ones—think that they are doing their children a service by keeping them indoors, safely watching television or playing on the PlayStation, rather than playing outside.
I was not the most sporty of children, unlike some of the Government Members who have contributed to the debate, but in the summer holidays my mother thought nothing of us having breakfast and then going out to play all day. We might have come in for lunch, or have gone to a friend’s and come back for tea. Nowadays, no London parent would allow their child to play out all day without knowing where they were, and it is that sort of vigilance and possibly unwarranted fear of stranger danger that leads to many thoughtful parents deciding, perhaps because they have not had the education or do not have the understanding, that they will feel better if their children are indoors rather than outside playing.
Let us also remember that in a big city such as London a greater proportion than ever of our children live in flats, maisonettes and other accommodation without a back garden. As a child, if I was not out, I spent most of the day in the back garden, on the swing, climbing trees and shouting at my brother, but many children in my constituency are trapped in flats and it is not obvious to their parents where they can be allowed to play safely.
Andrew Bingham
That is a good point. We talked briefly about video games. Does the hon. Lady think that the advent of Wii Fit-type games is beneficial? I have seen young people playing them, and they involve a lot of jumping around and so on, which I suppose is a form of exercise, at least.
Mr Simon Burns
I have been listening carefully to the hon. Lady, who is making some valid points. The danger has to do with not simply the age of computer games but the age of television before that. For some parents—this is a generalisation—the easy option is to let their children spend hours watching television or playing games, because it involves less effort on the parents’ part. One must try to educate people that that is not only an easy option but an unfair one.
Ms Abbott
I am loth to agree with the Minister, but I think that he is right on that point. A particular interest of mine is the education of urban children and the challenges of getting them to achieve their educational potential. As part of working with parents, especially in urban communities, we must teach them that just putting their children in front of a television set is not necessarily the best thing for their health or their education.
I agree entirely with what has been said about exercise and sport, but we also need a particular focus on girls and exercise. Statistics show that girls give up exercise younger; after they leave school, they do not continue to exercise, as boys do. I was interested to hear about, was it ice hockey—
Justin Tomlinson
It was an ice-skating disco on Friday nights.
On the point about getting more girls involved, that is why I proposed merging youth and leisure services to identify opportunities. Girls, in particular, follow what is on television. If street dance, cheerleading or football is popular, let us provide those services and facilities, and they will come flocking.
Ms Abbott
I agree. That is the point that I was going to make. We need to be more innovative in the sorts of game that we encourage and make available to children. Girls do not want to play ping-pong, because they are quite self-conscious physically, but they will do things such as breakdancing and ice skating.
As other Members have said, we have a generation of parents, especially in inner cities, who do not know about food, have only the dimmest idea of where some foodstuffs come from and do not know how to cook. Because they are bombarded by advertising for processed food, when they whip out a ready meal from Marks and Spencer, it is not just idleness; they think that they are being good parents: “Look, I’m getting you something from Marks and Spencer which is advertised on the television.” We should work with communities and parents to educate them.
In my view, the Government obesity policy’s reliance on responsibility deals is a little problematic. Common sense suggests that companies that make billions of pounds every year peddling fizzy drinks and foods larded with trans fats will not seriously undermine their profits by genuinely trying to change the public’s eating habits. Although we must applaud the Government for whatever progress they think they have made with responsibility deals, we must go beyond them as they are currently fashioned if we are to stop the epidemic of obesity among our young people.
To return to the Government’s obesity strategy, the message from health professionals, key health groups and experts is clear. We need tough action now and a proper long-term strategy to stem the rising tide of lifestyle-related diseases. Jamie Oliver, probably the single most famous person in public health, has said in the past few weeks that this Government’s obesity strategy is
“worthless, regurgitated, patronising rubbish”.
As usual, he was not pulling his punches. Terence Stephenson, president of the Royal College of Paediatrics and Child Health, said that the Government’s plan
“has no clear measures on how the food and drink industry will be made to be more ‘responsible’ in their aggressive marketing of unhealthy food…Suggesting that children in particular can be ‘nudged’ into making healthy choices, especially when faced with a food landscape which is persuading them to do the precise opposite, suggests this would be best described as a call to inaction.”
Which? executive director Richard Lloyd said that the Government’s approach to tackling obesity was
“woefully inadequate…The Government calls on people to cut down the calories they eat, but isn’t giving them the tools to do so.”
Charlie Powell, campaigns director of the Children’s Food Campaign, said:
“This is a deeply disappointing and utterly inadequate response which represents a squandered opportunity to address the UK’s obesity crisis.”
There is broad agreement in the House about the issues that we must address. It is a mix of issues; there is no silver bullet. Better labelling of food, including in restaurants and cafés, is part of the answer. Fashioning a sport offer for young boys and girls is crucial, as is better education and working with parents and communities.
I would like to say a word about gastric bands. We read an enormous amount about them, particularly in relation to celebrities. As a Conservative Member said, there are cases, if people have tried everything else, where a gastric band might be the answer, but I deprecate the promotion of gastric bands without some of the measures that we have discussed if that suggests to people that they can eat whatever rubbish they like because, at the end of the day, the NHS will pick up the tab for a gastric band. That is not the way forward, either for costs in the NHS or for people’s quality of life. I have read about people who, having got gastric bands, proceeded to liquidise fish and chips so they could continue to enjoy their favourite junk food. That suggests that a gastric band, in itself, is not the answer to the underlying issues.
I hope that, in his winding-up speech, the Minister will address the serious concerns raised about the Government’s obesity strategy by a wide range of stakeholders and specialists. I look forward to hearing what the Government plan to do further to address the growing epidemic of obesity among our young people.
The Minister of State, Department of Health (Mr Simon Burns)
It is a pleasure to serve under your chairmanship, Mrs Riordan, during this extremely interesting and thoughtful debate, to which there have been a number of erudite and imaginative contributions across the range.
I congratulate the hon. Member for East Londonderry (Mr Campbell) on securing the debate and giving us the opportunity to discuss one of the major public health issues of modern times. He has spoken repeatedly on the subject in the House and should be congratulated on doing so. He knows, of course, the scale of the problem. Most adults in England, 61%, are overweight. Sadly, one third of those are clinically obese, giving us one of the highest obesity rates in the world. As for children, almost a quarter of four to five-year-olds are overweight or obese, rising to one third in 10 to 11-year-olds. I am sure that we all agree that those figures are genuinely shocking. The hon. Gentleman will be aware that the scale of the problem in Northern Ireland, to which he alluded during the course of his remarks, is similarly daunting, with 59% of adults and 22% of children overweight or obese.
As recently as the 1980s, obesity rates among adults were a third of what they are now. Although figures for the last few years show that levels of obesity may be stabilising, that is simply not good enough, because excess weight has serious consequences for individuals, the NHS and the wider community. Not only does it cause day-to-day suffering such as back pain, breathing problems and sleep disruption, but it is a major risk factor for diseases that can kill. An obese man is five times more likely to develop type 2 diabetes, three times more likely to develop colon cancer and two and a half times more likely to develop high blood pressure than a man with a healthy weight, and women face equally serious risks. That is not to mention liver disease, heart disease, some cancers and miscarriages, all of which are linked to excess weight.
Although the real and present danger of obesity in terms of immediate health risks is seen largely in adults, obesity also has significant effects on children and young people, as many hon. Members have mentioned. Obese children are likely to suffer stigmatisation, and there are growing reports of obese children developing type 2 diabetes. We also know that if a child is obese in their early teens, there is a high chance that they will become an obese adult, with related problems later in life.
As waistlines expand, so does the amount of money that we spend on the issue. As a number of Members have said, excess weight is a burden of approximately £5 billion each year, and costs billions more through days of work and incapacity. Neither can we ignore the link between obesity and health inequalities. Data from the national child measurement programme show a marked relationship between deprivation and obesity. The Marmot review in 2010 showed the impact that income, ethnicity and social deprivation have on someone’s chances of becoming obese. As things stand, the less well-off a person is, the more likely they are to be carrying excess weight, so we are talking about an issue of social justice, as well as a narrow health issue involving exercise and healthy living.
The hon. Members for East Londonderry and for Hackney North and Stoke Newington (Ms Abbott) both asked, in effect, whether the Department of Health should work with companies that produce and sell products that contribute to the nation’s obesity and alcohol problems. Up to a point, it is the responsibility of the individual how much they consume and what they consume. How do we make sure that people know what they are eating—the calorie, salt and fat content and so on? To my mind, that means clear, easily understandable labelling, and education about what is healthy and what is the best approach.
On the narrow point of the issue mentioned by both hon. Members, improving the health of the public is clearly a priority for the Government, but we need a whole-society approach to tackle the health problems caused by poor diet, alcohol misuse and lack of exercise. To change people’s behaviours, we need to make the healthier choices the easier choices for everyone.
Commercial organisations have an influence on and can reach consumers in certain ways that Governments cannot. They have a key role in creating an environment that supports people to make informed, balanced choices that will enable them to lead healthier lives. Through their position of influence, they can address some of the wider factors that affect people’s health, such as how healthy our food is and how easy it is to access opportunities to be more physically active. Through the work on the public health responsibility deal, despite what the hon. Member for Hackney North and Stoke Newington has said, we are tapping into that unrealised potential to help improve the public’s health.
Mr Burns
I will give way in a moment. It is also important to say that, if we can get an agreement with commercial companies to change the way they behave and some of their practices, it will be far quicker to achieve that and put it in place than to wait for the heavy hand of Government legislation, which can take a minimum of a year and sometimes years. Why wait for the heavy hand of legislation that might take a long time, if we can get a voluntary agreement that will work quicker and more effectively to start dealing with the problem?
Ms Abbott
On changing commercial practices, when will the Government do something about the practice of so many supermarkets whereby they place rows of sweets next to the checkout? If a parent has fought off their children and not bought sweets on their way around the supermarket, the children then have 10 minutes to whine while the parent waits to pay for their shopping.
Mr Burns
I understand the hon. Lady’s point, because the charge has been made on a number of occasions and I have considerable sympathy with it. The supermarket at which I shop each week—I shall not name it, because I do not want to advertise for it—does not do that any more. I think that the hon. Lady will find that, throughout the country, the responsible supermarkets have stopped that practice, for the very reasons that she has mentioned.
Dr Poulter
Does my right hon. Friend agree that we need to be careful about introducing regulation for alcohol and other relevant products? It could be a very crude measure and have unforeseen consequences. For example, on alcohol, we may be concerned about the cheap sale of white cider, but the bigger issue is that introducing legislation may impact on brands that market themselves responsibly to responsible drinkers. We have to be careful about that sort of thing.
Mr Burns
My hon. Friend makes a valid point.
I will address a number of issues that some of my hon. Friends have raised. My hon. Friend the Member for Totnes (Dr Wollaston) talked about the important issue of weighing and measuring children. I hope that she will be reassured by the national child measurement programme. It measures children in reception class—four to five-year-olds—and in year 6. Those measurements and weights are fed back to parents, so that they can not only know the information, but make informed choices about the lifestyles of their children.
My hon. Friend the Member for North Swindon (Justin Tomlinson) made some valid and good points about the planning regime and open spaces that enable parents and children to exercise. His points were well made and sensible. It would be worthwhile for local government, which has responsibility for the issue, to read what he has had to say, particularly, as the hon. Member for Hackney North and Stoke Newington has said, because certain inner-city areas do not have the advantages of some of the more rural and smaller town constituencies, which have far more access to open spaces.
As a Government, our general approach to tackling the problem is based on the latest scientific evidence on the underlying issues and causes of obesity, as well as what has worked best previously. Ultimately, there is a simple equation: people put on weight because they consume more calories than they need.
Mr Burns
No, I will not, because I have only three minutes. People need to be honest with themselves. We need to recognise that we are responsible for controlling our weight. That means eating less, drinking less and exercising more.
We are also calling on the food and drink industry to play a much bigger role in reducing the population’s calorie intake by 5 billion calories a day, to help close the crucial imbalance between energy in and energy out. That will build on commitments that businesses have already made, through the public health responsibility deal, on things such as eliminating trans fats, reducing the amount of salt in food, and proper calorie labelling.
Of course, it is for each of us to make our own decisions about how we live our lives. The best and most sustainable changes come not when people are ordered about, but when they are given the tools to change, given the justification and then take responsibility to do it themselves. That is why we need to work together to make sure that the healthier choices become the easier choices. Everyone has a role to play—the food industry, the drinks industry, the many organisations that encourage physical activity and sport, employers who can support the health of their employees, and the local NHS staff in talking to people more about obesity and its consequences.
Under the new public health system, local leadership will be critical. We want to move away from the days when legislation and demands came down from Whitehall like thunderbolts from Mount Olympus. Local authorities will be supported by a ring-fenced budget and will bring together local partners, including the NHS, to provide the most effective services for their communities. We will support local people and local authorities by making sure that they have access to the best possible data and evidence.
We will not shirk our duty to provide national leadership where it is necessary—by working, for example, with business and non-governmental organisations, and making sure that Government Departments work together in supporting better health. That is already happening. The Department for Transport is providing more than half a billion pounds of funding for local authorities to increase sustainable travel such as walking and cycling. The new teaching schools programme, led by the Department for Education, will explore how schools can support and encourage children’s health and well-being. We will also continue to try to inspire people, young and old, to embrace a healthy, active lifestyle, via, for example, Change4Life. Moreover, the London Olympics, as many of my hon. Friends have mentioned, give us the golden opportunity to perpetuate that legacy after they have finished.
The new national ambitions provide a clear goal that we can all aim for. We should all play our part in raising awareness. Once again, I congratulate the hon. Member for East Londonderry on securing this debate, and I hope that he sees the benefits in our strategy. I hope that he supports it and that he will continue to be an advocate for his constituents on the matter.
Mrs Linda Riordan (in the Chair)
Order. Mr Bryant has withdrawn his debate, so the sitting is suspended until 4.30 pm.