Health: Active Lifestyles
(11 years, 11 months ago)
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Baroness Heyhoe Flint
To ask Her Majesty’s Government what action they are taking to highlight the impact on health and well-being of an active lifestyle.
Baroness Heyhoe Flint
My Lords, I feel a little like a night watchman in the middle of a timeless test. However, as a former PE teacher, sports journalist, ancient retired sportswoman and with both my parents being PE teachers, I know what a positive impact physical activity can have on our well-being.
The UK faces serious health challenges. Rising levels of sedentary behaviour put huge pressure on the NHS; obesity alone is estimated to cost the economy £8 billion a year. This is as much a problem of society, but with a co-ordinated effort by all government departments we can help to inspire a generation. Where have I heard that before?
Worryingly, the NHS 2011 national child measurement programme showed that one-fifth of children have obesity problems when they enter primary school and one-third are overweight or obese by the time they leave primary school. Levels of physical activity are steadily falling. Only one in 20 adults currently meets the Government’s recommendations of 150 minutes a week for adults and 60 minutes a day for children, according to the Chief Medical Officer’s report in 2011, Start Active, Stay Active. Sixty minutes a day for children is the health professional’s recommendation. Yet the Department for Education last year removed the statutory requirement of a minimum two hours a week of PE in schools, to be replaced by a voluntary statement; it expects schools to want to maintain two hours per week, which sounds a bit like a backward step to me.
The Sport and Recreation Alliance’s Game of Life report calculated that in just 10 seconds, the NHS in England spends more than £10,000 tackling life-threatening conditions—cardiovascular disease, obesity and diabetes—all of which, through regular physical activity, are largely preventable. An active lifestyle can also improve mental health. An individual who is regularly active is much less likely to develop dementia in old age, and dementia is estimated to cost the economy £23 billion every year.
The same SRA report shows that exercise can be as effective as anti-depressants for mild clinical depression and anxiety. There is a connection between depression and isolation, but taking up a recreational activity offers considerable social interactive benefits for the lonely. The Ramblers’ Association’s “Get Walking Keep Walking” scheme encourages non-active people to get together and take regular walks. After 12 weeks, 75% of participants reported that they felt far more active and wanted to continue being active.
The National Institute for Health and Clinical Excellence wants councils, schools and businesses to encourage more walking and cycling to improve the nation’s health. The average Briton is walking 80 miles less a year than a decade ago, states Nanette Mutrie, professor of sports psychology at Edinburgh University. Britain is facing a glut of inactivity.
From next April, local councils will be responsible for public health initiatives to ensure that they give walking and cycling a high priority. Physical activity for work forces can do wonders for productivity. The Cornish food company, Ginsters, may not be the first brand name we associate with a healthy lifestyle—and I promise not to mention the word “pasty” more than once—but it installed a fitness suite in its factory and employed a full-time co-ordinator to organise weekly activity sessions for staff with sports clubs and local authorities. The project led to a reduction in sickness, stress-related illness and accidents at work, and to a fall in staff turnover.
The Department of Health’s Start Active, Stay Active scheme, aimed at the NHS, local authorities, and voluntary organisations, is designed to promote physical activity. Can the Minister indicate whether the Start Active, Stay Active programme has been embraced and implemented by the targeted professionals?
I welcome Sport England’s recent announcement of £10.2 million funding for 44 new projects to help disabled people take up sport, as part of the inclusive sport fund. Of this grant, £731,000 will assist Age UK to create a programme of sports for older disabled adults. The 2012 Paralympics showcased wonderfully that sport is a must for people with disabilities, therefore all national governing bodies must strive to integrate able-bodied athletes with those with disabilities. The “Active Kids for All” scheme, funded by Sainsbury’s Paralympics legacy project, will invest £1 million to enable schoolteachers to integrate disabled children into mainstream PE and sport. Can the Minister assure us that the Government’s support for the inclusive sport provision is secure for the long term, and not just a one-off?
In announcing its youth sport strategy in January 2012, the DCMS laid down plans to help young people establish a sporting habit for life. Within this strategy, we urge the Government that primary schools as well as secondary schools must be included in the promotion of sport and physical activity. Logically, therefore, I suggest that the Department for Education should engage with the DCMS to implement the youth sport strategy. Primary school physical activity is not just team games. At my state junior school—last century—we played netball, rounders and football but also did badminton, swimming, tennis, and dancing, all from the age of six. I was also the self-styled captain of the conkers team.
Given the important role that schools play in introducing young people to sport, I welcome the Government’s commitment to maintaining physical education in the national curriculum yet, concerningly, PE is not included as one of the five core subjects in the new baccalaureate. The Amateur Swimming Association states that one in three children are leaving primary schools unable to swim and that four in 10 children get no swimming lessons at all, despite it being a compulsory part of the curriculum at key stage 2. Swimming provides good physical activity, helps to control weight and provides a gateway to other activities such as canoeing and sailing. Can the Minister therefore tell me what plans are in place to ensure that every primary schoolteacher receives adequate training in PE and aquatics? Will the Government urge Ofsted to include swimming and sports provision as part of school inspections?
The Government, recognising that there is a dramatic drop-off from sporting activities by school-leavers, have urged establishing closer links between secondary schools and sports clubs. This linkage is to be planned by DCMS and Sport England, with each national governing body signing up to deliver a school-to-club link. In an exemplary case study, the Cricket Foundation’s “Chance to Shine” project has, since 2005, linked 6,000-plus primary and secondary schools to more than 1,000 cricket clubs. Importantly, 52,500 schoolchildren have moved on to local cricket clubs. Is the Minister able to give an assurance that government plans for all 4,000 England secondary schools to link with a local sports club are making good progress?
Active ageing was vividly highlighted by last Friday’s excellent debate in this Chamber. Evidence tells us that elderly people with low activity levels have more than twice the risk of developing Alzheimer’s. The sport and recreation sector is working hard to engage with those of senior years. To give some examples, the British Masters Athletic Federation delivers opportunities for older people to compete in disciplines such as cross-country running, race walking and sprinting. The oldest participant to date in the seniors master games is 92 years of age, so there is hope for us all yet. The movement and dance organisation Extend specialises in providing recreational exercise to music for the over-60s; participants benefit from increased mobility, strength and co-ordination. It is a sort of “Strictly Come Dancing” for seniors, by the sound of it.
In other examples, Sport England funds the Bowls Development Alliance to drive participation for the over-65s and Age UK created the “Fit as a Fiddle” programme, which is backed by the Big Lottery Fund and highlights healthy eating, physical activity and mental well-being for the elderly.The Lawn Tennis Association’s foundation encourages adults to play tennis. It offers affordable fun, including cardio tennis, based on a fitness workout to music. Cardio tennis can burn more than 700 calories an hour, which sounds quite exhausting to me.
A structured, active lifestyle plan demands a national sports strategy, backed by the Government. The DCMS and the Department of Health already take the lead, then count in the Treasury to fund the strategy; the Department for Education to drive up the active hours of school PE and to ensure that teacher training includes a strong emphasis on physical education; the Department for Communities and Local Government to free up sports facilities under the local authority jurisdiction; and Defra to make available more recreational spaces. I could go on but the timeless test is running out.
Recently my noble friend Lord Moynihan, told members of the All-Party Parliamentary Group for Sport that we need to work hard to get better access, better teaching and better links so that every government department realises the importance of sport in offering lifestyle opportunities. I was disturbed to hear that the Cabinet sub-committee on public health has been disbanded. This disappointment is shared by the Faculty of Public Health and the British Medical Association. Can the Minister tell me what will replace it so that all government departments accept a responsibility to get the nation moving towards an active lifestyle?
With my noble friend Lord Coe named as the Government’s legacy ambassador, and on a day when Sport England announced the funding of £493 million over four years to boost participation for all, I feel the Cabinet Office is taking sport seriously. I am incredibly confident that, with my noble friend Lord Coe at the helm, something is bound to happen. I hope it is another of his made-in-Britain triumphs. However, we need the political will of all government departments to inspire a generation.
I wish noble Lords a very healthy Christmas and an extra-active new year.
Baroness Massey of Darwen
My Lords, I thank the noble Baroness, Lady Heyhoe-Flint, for securing this debate and for supporting it with such eloquence and commitment. I would much rather face her across the civilised Chamber of the House of Lords than across a cricket pitch. She is a splendid supporter of active lifestyles and was an outstanding president of the Lady Taverners, of whom I am also one. The Lady Taverners raises funds to provide equipment to encourage young disabled people to play cricket, basketball and many other sports—very much part of an active lifestyle.
Active lifestyles should begin at a young age and carry on into old age. I had the pleasure last week of hearing much of the debate in your Lordships’ House on older people. They were magnificent and inspirational speeches. I want to mention wise words from just two of the speakers. The most reverend Primate the Archbishop of Canterbury spoke of the importance of older people being participants in society, not passengers. My noble friend Lord Griffiths of Burry Port, in a very moving speech, spoke of maintaining a sense of selfhood in old age. There is good evidence that an active lifestyle can help to maintain dignity, a sense of self and participation in society. Active means active in all senses—physical and mental. It is a preventive measure; a protective factor in health.
There is popular book called 100 Simple Things You Can Do To Prevent Alzheimer’s by Jean Carper, an American. In chapter 15 the author advises us to “Be a busy body”. The more you move, the better you think. It is also true that the more you move, the better you move. I am not sure how conkers features here.
Thinking is part of an active, healthy lifestyle. Brains must be active too. I am very impressed by the University of the Third Age. It is wonderfully and proudly local and easy to get to in many communities. It offers a tremendous variety of activity including languages, history, flower arranging, craft and literature, as well as sport. I was somewhat surprised when my husband embarked on a study of Ulysses in a group. For older people to tackle one of the most difficult novels in the English language is surely designed to develop brain power to the extreme. I found it challenging at the age of 20.
The U3A provides an example of how to engage people in activity. It is promoted well, with enormous variety on offer, and is easily accessible by local communities. A three-year study reported recently in the Journal of Neurology, Neurosurgery & Psychiatry states that an active social life is important in maintaining physical and mental health. Exercise, good nutrition and not smoking are cited as having a beneficial impact on health in older people. These examples emphasise that not just physical health but mental and emotional health can be improved. Keeping the mind active, as well as the body, is important. Maintaining health and well-being is primarily of benefit to individuals but would also save millions, possibly even billions, when we consider the costs of care and drugs, particularly for older people. Sport England estimates that increasing physical activity could save about £3 billion a year in healthcare costs.
We are not, I think, surprised by such evidence. Reports from the four home countries’ Chief Medical Officers, the BMA and the Royal College of Physicians all point to the importance of the benefits of physical activity. Activity not only increases mobility, but can have an impact on a range of medical problems such as osteoporosis and diabetes.
I have some figures from the Sport England Active People survey. This indicates that there has been a growth in people doing sport at least once a week: 15.5 million; 750,000 more than a year ago. There has, not surprisingly, been an increase since the London 2012 Olympic Games. Participation by disabled people has also risen steadily since 2005, but still lags behind that for people who are not disabled. Sport England has announced a £10.2 million National Lottery initiative to encourage disabled people to take part in sport.
Sport England also wants to increase the number of young people between the ages of 16 and 25 taking part in physical activity. Progress has been made, but not enough. Surely getting children and young people to participate is the key to encouraging active lifestyles for life. Like the noble Baroness, Lady Heyhoe Flint, I worry about government policy for schools, not just for sport but for leisure activities such as music and drama. All this is relevant to being active. We all know many people who have, at school, discovered talents and interests in all kinds of creative arts and sport. I wonder, together with many others outside this Chamber, whether changes to the school curriculum, such as the EBacc, will remove opportunities for young people to develop their potential in being creative and engaging in physical activity, something that could influence and enhance their lifestyles for ever. That would be short-sighted. I look for reassurance from the Minister.
The Women’s Sports Network has concerns about the place of women in sport. I have just received an e-mail asking me to help encourage more coverage of women’s sport on TV. There is a terrible deficit here. At a recent meeting of the All-Party Parliamentary Group on Women’s Sport and Fitness, Clare Balding and Kathy Grainger issued a rallying call for more coverage of women’s sport in the media. Our sporting heroines, who will inspire more girls and young women to take part in sport than possibly anything else, are, in contrast to some of the men, poorly paid, and lacking sponsorship.
There is good news. National governing bodies of sport seem to be aware of the problem and are encouraging greater coverage for women. Apparently, 53.6% of adults say they would like to take part in more sport. So why do they not? I repeat my point that beginning to take part in sport and exercise at an early age is a good predictor of maintaining an interest in exercise. In particular, exercise such as Pilates, yoga and dance may encourage girls, women and older people to participate.
On the example of the University of the Third Age, the offering of activity must be local, cheap or free, and attractive. We need two things. First, there must be a national strategy—mentioned by the noble Baroness, Lady Heyhoe Flint—to encourage people from a very young age to a very old age to participate in physical and mental activity. The benefits are proven, the research is there. Secondly, people also need local policies and strategies which target their populations from an early age with campaigns, joining up opportunities for sporting activity in clubs and schools with the chance to participate in social and mental activities in groups. A readily accessible visible continuum of possibilities is needed. This would encourage active lifestyles, which would result in physical, mental, emotional and social benefits to society.
Lord Addington
My Lords, this is one of those subjects where, whichever department answered for the Government, it would be the wrong one in regard to half of the points made. The Department of Health probably stands the best chance. Indeed, I would be in favour of the Department of Health covering sport. I say that because it is one of those subjects that touches every aspect of our lives. Whenever we talk about it, we always go round a little circuit. We talk about the DCMS because it is in charge of sport and the Department for Education because sport education should start early in schools. However, in my opinion schools are not that great at it. To be perfectly honest, I could have a nice 20-minute rant about how dreadful many of the examples of school sport are, but I will not do so tonight.
Let us take, for example, the football match from “Kes”. I am afraid this House is one of the few places that will understand the predicament of pupils who are frozen to death and disinterested, watching four or five players kicking each other and the ball in a small circle with the goalkeeper doing tricks as the ball sails past him. This is what most people experience at school. My sport, Rugby Union, has a worse reputation with those who are not interested. “Let’s cower and freeze to death on the wing while the big boys roll around in the mud”, is how someone described the experience to me.
What do we do about this? No one department can deal with it. If the Department of Health takes a lead, it must decide whether it is encouraging a lifestyle or using sport as a treatment. Which is the driver? Encouraging it as a lifestyle would probably have far greater results. If we look at what has improved health quality in our society, medical treatments come nowhere near clean water, clean air and a decent diet. Doctors and medicines cannot touch those things when it comes to life expectancy and the quality of life. That is the way it is. Everyone must be encouraged from an early age. We must ensure that those who are enthusiastic and creative have better access.
When it comes to policy on sport for young people, all Governments try hard and all get it half-right and then stop until something else is tried. The current idea of bringing clubs into school sport is a good one. It builds on some of the better ideas of the previous Government. There is a continuation of policy there that I do not think either side wants to admit to, but it is late at night and nobody is paying any attention, so let us admit that now.
Schools do not have the breadth of talent or forward thinking in their sports to encourage people to adopt a sport so that it becomes a creative process. It should not be about status. Competitive sport is not about saying, “We have played eight games and won so many”. Competitiveness in sport makes it enjoyable and fun. It comes, for example, from learning how to move a ball into a space to allow someone else to carry on and run with it. The competitive nature comes when someone tries to stop you. That is the essence of it. Whether you record it as a competitive match for the school or say, “They had a kick about and learnt new skills”, it is still a competitive experience.
One of the problems with our coaching and youth in sport has often been that we put far more emphasis on whether results have been recorded than on how well the pupils played and how their skills can be developed in later life. All the major sports develop short games that are more accessible to people in their clubs and schools. What I call prep-school culture has a lot to answer for. Are we going to encourage people to make pitches available? Then, for instance, there are places such as parks where these skills can be used casually. An informal kick-about every week is infinitely better than one organised game once a month. Is the Department of Health going to encourage all the tiers throughout government to make sure that that kind of thing is available? This is a big ask and it will not happen overnight. It will not happen within one Parliament; it will take many Parliaments, and there will have to be a process of building it up to get it into the culture. The will is there but whether we have the drive and the focus to make sure that it continues is a question that all of us involved in politics and public life have to deal with.
I turn to the idea of using sport and activity as a treatment. It would appear that exercise is the wonder drug. I have recently heard it described as aspirin and cannabis, but there is always a wonder drug and activity seems to be it. As has been said before, if you are active, it is better for you, even if you suffer from things such as arthritis. Nobody ever thought of that. We all know about cardiovascular problems and the need to control one’s weight at a healthy level. I am glad to see in the briefing that people are now referring to a “healthy weight”, as opposed to body mass index based on an inactive person in the 1950s. I declare my interest as an old rugby player. Using physical activity would seem to be a very useful, cheap and self-regulating treatment, but can it be done without education, or access to a version of it, possibly being taken up in later life? It will be difficult, as you do not willingly do something that is boring and unpleasant. This has to be tackled in a creative way. Indeed, the Royal College of Physicians says, “Well, doctors aren’t used to this, especially those who were trained a long time ago, or even a few years ago. They don’t know who to refer to, what pathways to use or who they should trust to do it”. That is the culture.
I have bored noble Lords with the idea of somebody who is physically active dealing with a lack of trust or the serious need for physiotherapy to be given at an early stage. I think that at some time all sportsmen of my generation and those who are a bit younger have said, “I’ve hurt myself, doctor”, and have been told to rest. When they say, “Won’t that mean that the muscles get weaker and the tendons shorter?”, the answer is, “Well, rest a bit more then”, which means that the doctors do not know what they are talking about. Getting doctors to admit that and to refer patients to somebody who does know what they are talking about would be a huge step forward. It is happening more often and it is very important to make sure that that culture is maintained.
I could go on for much longer but there are only so many minutes available. Effectively, unless we promote activity wisely and well, we will waste a huge opportunity to save everything from money to a little bit of personal misery for people. Social interaction can be encouraged through activities, and mostly group activities. Unless we do this and unless the Government give us an idea of how they intend to drive this forward across government, we will miss our targets. Indeed, if all political parties can come up with a coherent answer and if we can achieve something that the Olympics taught us—that sport does not have to be very political—we can probably go forward. However, it will not happen quickly and we will not do it if we have three different camps shouting at each other.
Baroness Byford
My Lords, I am delighted to be able to speak in this debate, and I thank my noble friend Lady Heyhoe Flint for bringing the subject to our attention. I have to start by making an admission. Last night, I was very inactive. I was glued to the television, first, because of “Strictly Come Dancing” and, secondly, because of “BBC Sports Personality of the Year”. The interesting thing was that one of the people lost from “Strictly Come Dancing” was a jolly competitor. I think that she proved to everybody that you do not need to be slim and slight to be a good dancer and to have fun. Knowing that we were going to have this debate today, I said to myself what a good message it sent out. Sadly, that person did not make the final but it really was quite amazing.
The second thing that really struck home last night was the recognition of the wonderful contributions made at the Olympics this summer not only by the Olympians but particularly by the Paralympians, too. They said to the world, “Look, we might have disadvantages but we are here, we can do the best we can, and achieve”. I thought that some of the presentations and reflections on this summer were very moving. The winner was Bradley Wiggins, followed by Jessica Ennis and Andy Murray. They come from three very different sports and three different regimes.
I want to pick up on two things from the awards. The first is Martine Wright, who won the Helen Rollason Award for achieving the gold medal in the sitting volleyball competition, having lost her legs tragically in the bombing of 7/7. The second comes much closer to home: the award for unsung heroes. The winners came from Desford, not exactly my home village but it is close to me in Leicestershire. Sue and Jim Houghton were given the award for their commitment to community activity. They formed a sports centre aimed at young people, but which takes on both the young and the young at heart. I thought that this was very moving.
I move on to a recent report by the House of Lords Science and Technology Select Committee. The report, published earlier this year, questioned how robust the research and evidence base is for improving the performance of elite and non-elite athletes, and how this knowledge can be translated into treatments and preventive interventions to improve the nation’s health. The Government responded in many ways; I have picked up on two things in particular on which the Minister might like to comment. First, the Government have said that they wish to target investment to support the translation of biomedical research. Secondly, they have provided some £30 million of funding to develop the country’s first National Centre of Excellence for Sport and Exercise Medicine. These are indeed welcome commitments. However, I wish in my time to enlarge upon two other areas identified by the committee. The first was to increase grass-roots participation in sport, particularly by young people; the second was to increase community engagement to bring people together over a national event.
I am also grateful to the BMA and Bupa for the briefs which they sent, I suspect, to everybody taking part in the debate. They picked up particularly on walking, which was briefly mentioned earlier. It is a key thing that any of us can do very easily. It costs virtually no money—sole leather, maybe—and it gets people out and about in the air, giving them the chance to keep physically fit. When driving the other day, I came up behind a car in the window of which was written, “Dogs are for life, not just for Christmas”. I thought below that should have been added, “Walking is for life, not just for now”. Clearly, walking is one of the very good ways in which one can keep fit. The BMA’s study paper this year considered healthy transport, healthy living and active travel. It particularly looked at walking and cycling. Several local authorities have become aware of the need to create more cycle routes for people, and we have done so in Leicestershire too.
In 2012, Bupa produced a report titled Get Walking and Keep Walking which stated that,
“just 15 minutes a day of brisk walking can have significant health benefits, adding up to three years to life expectancy”.
Walking need not be boring; it can be fun. I suspect many of us in this Chamber have taken part in walks or runs—I do not run these days, but I do walk—to raise money for charity. The amount of money raised for charities reflects on people’s ability to get fit—one need only think of the London marathon. When I came across a walking group just this weekend when I was out walking the dog, I stopped and said hello to one man I had not met before. He said that he had just moved to the village from another area, and that it was a wonderful way to get to know people. As I found to my great interest, it is a double bonus.
I turn to the particular area of expertise of the Minister to take a few minutes to talk about the NHS. In many ways it gets a very rough passage, but many of us—including me and, recently, my husband—have reason to be very grateful for the wonderful service it provides. I will concentrate on one aspect. After a major operation, one comes out with uncertainty and a lack of confidence about what one should do and how one should do it. I give great credit to the recent work of the physiotherapists who were an enormous help to my husband after his stay in hospital. When one is very weak, the first thing they want to do is to get one up. That is quite right; up one should be. Then one starts to move around, leaning on a walking frame. For somebody who is very tall, this is not easy because their core balance is going in the wrong direction. Very quickly, they prescribed for my husband some elbow crutches. They made a huge difference. Instead of leaning forward with his weight going in the wrong direction, he was balanced on his core and able to recover much more quickly. He went from zimmer frame to elbow crutches. When he came home he was more confident; he went out and about, starting with short walks and then taking longer ones.
Often when one mentions exercise, people think of pounding away in a gym. For a lot of people, exercise is just that. They enjoy going to the gym, and I go occasionally. However, there are much simpler ways of keeping fit. When a cat or dog sits up after relaxing, it stretches. I was sorry not to be able to speak in the debate on Friday. Often as one gets older, one loses the ability to move around physically in the same way as one did when one was young. However, moving neck muscles and using very basic movements can be a help to people who are not able to get out and walk as much as they were able to in the past.
Unfortunately, we are becoming a country of very sedentary people. The young sit fascinated and do not get out and about. I totally agree with other noble Lords that the more we can do in our schools—and by linking schools to clubs, because that is where it all happens—the better. My introduction to cricket was when I attended a school in Scotland where playing cricket was the norm. I was lucky enough to be introduced to it. I never went very far with it and never became very good, but it was interesting to play another sport.
Perhaps I should have declared that for 10 years I taught tennis in schools and clubs. I am not a professional—I was what they called an associate—and I totally agree with my noble friend Lord Addington that one of the joys of sport is when a child connects. Somebody asked me if my best result was when somebody reached something. I said no, it was when they could physically connect with a ball and track its bounce and rise. There are many ways of engaging young people in activity but the most important thing for the young—or young at heart—is that it must be fun and that people must be able to enjoy it. I am very grateful to my noble friend for securing this debate and look forward to what the Minister has to say.
Baroness Billingham
My Lords, as we look ahead to the consequences of an inactive lifestyle, it is to the medical profession that we should look first. Before I do that, I thank the noble Baroness, Lady Heyhoe Flint, for introducing this debate and for her contribution, so much of which I completely agreed with. I was delighted to hear another participant in our regular sporting debates—and such an excellent one, too. All the other speakers brought different facets to the debate, and all spoke from personal expertise and experience. I only wish that there were more people here to hear it tonight. I hope very much that we will encourage our colleagues to read these debates in Hansard; they have been truly excellent.
Having said that we will look at the medical profession in order to examine the impact on health and well-being, I will study the excellent briefing from the BMA, which others have alluded to, and reflect on its findings. Secondly, I will comment on the existing health regime and reflect on the comparison with previous provision. Thirdly, I will give my views on what must be done if future generations are to avoid catastrophic illness in old age.
I will begin with the advice of the doctors. I woke up a few days ago to the “Today” programme. One of the first items, which I am sure many of your Lordships heard, was the dreadful news that one in three of our primary school children are obese. When the BMA briefing came, therefore, I studied it very carefully. It made devastating reading, listing a wide range of damaging medical conditions, all of which could be traced back to obesity and an inactive lifestyle. The prognosis on individual health is a matter of great concern, and the financial implication for the National Health Service is equally worrying.
The Government tell us that by 2050 the cost of overweight-related illnesses will be £49.9 billion, with a direct cost to the NHS of £9.7 billion. This is a staggering sum and cost to society. Let us not forget that we are in the middle of one of the most dreadful recessions, which will blight national expenditure for many years to come. We have to change our lifestyles if the costs to the nation are not to be catastrophic.
Various critical conditions are linked to an inactive lifestyle. The BMA lists them very clearly. Type 2 diabetes, such a threatening condition, is clearly attributable to obesity. Cardiovascular diseases have a similar cause, and the BMA claims that dementia could be reduced by 12.9% if a more active lifestyle were adopted. Depression also manifests itself with a lack of physical activity.
I have not done the cost-cutting analysis from the BMA figures, but it is clearly horrific and undeniably capable of significant reduction by changing our form of lifestyle. The report provides us with sensible suggestions: more walking and cycling and more active travel patterns. All those suggestions should be heeded. The suggestion of combined responsibility, which has already been mentioned by other speakers, does not rely solely on the medical profession; it combines major government departments, such as health, education and local government. It is not a new notion; I remember arguing for such a collaborative approach more than 30 years ago. Sadly, it has never happened.
That, then, is the medical diagnosis. I will now turn to other practical solutions. My second media shock came not on the “Today” programme but in the national press some days later. Many in this Chamber tonight will know of my constant criticism, which may be described as my rant, of the Lawn Tennis Association, an association that is stunningly wealthy and ineffective. We have tried for years to find proper answers to a number of vital questions, all with scant responses. One question that I and, for that matter, every sports journalist in the country has wanted to know is: how much is Roger Draper, the chief executive, paid? Rumours flowed for years but now, as a result of government legislation, we know: his take-home pay is £640,000, which is four times that of the Prime Minister. As a national paper said last year, the LTA spends £250 million and has absolutely nothing to show for it. Just in case noble Lords think that British tennis is on the up, think again—Andy Murray, Laura Robson and Heather Watson all came as products of their families and had nothing to do with LTA training. They all had to do it for themselves.
I am concerned by these facts because for years the LTA has ignored the best and most successful way of getting people involved in tennis. It has totally ignored the fact that grass-roots sports of any kind, as has already been said by many noble Lords, are an essential basis for lifelong involvement. It is also worth reflecting that 94% of our primary school children—that is all the children in state schools—are where the money must be spent, but the LTA has almost totally ignored them.
Sport England has already been mentioned tonight. I bring noble Lords a stop press: Sport England announced this afternoon that, for the second year in succession, it is cutting funding to the Lawn Tennis Association because of its belief that the LTA’s business plans and projects are not proving successful. Last year there was the same cut in funding, which many noble Lords know, because the figures that the LTA suggested were going to be involved in the game were nothing like that.
What a wonderful inspirational evening last night was. I was delighted to see Seb Coe—the noble Lord, Lord Coe—saying so rightly in print that the failure to have sport in primary schools is his gravest and greatest concern. I have identified the LTA for its failures in one important way, and the Government fund the LTA with a £28 million grant of taxpayers’ money. We have a right and a duty to dictate how that money is spent. I ask the Minister to take this message back to the Government and ensure that the role of the LTA and its funding is well known.
Talking about being known, Michael Gove is now known as the anti-sports personality following his decision to rip sport out of state primary schools and wreck all the good work that was done by previous Administrations, such as school sport partnerships and the ring-fencing of PE funding. The decision to completely remove PE from the Gove curriculum in primary schools was only partially changed following an outcry from the general public, professionals and education and medical experts who lobbied relentlessly. As a result, part of the old funding—a very small part—has been restored, but I remind noble Lords that that is only until the end of the academic year.
All this destructive negativity is from the Government, who have funded and overseen the most successful 2012 Olympic Games, which inspired a whole nation to warm to the role of sport in society. We will never be the same again—the Olympics, Paralympics, volunteers and families. This is the time, and we cannot miss this unique opportunity. We have wonderful role models including the Duchess of Cambridge and our athletes.
The Government must also address the lack of women and girls in sport. I look back 30 years when I was working with people such as Billie Jean King on Title IX, which I know that many noble Lords will be aware of. It transformed female participation. We need to look at this as a specific gender problem. It is worth reminding ourselves that children born to women who are involved in sport are 80% more likely to be sporting too.
We all share responsibility. The medical profession gives warnings and the governing bodies of sport receive government funding. Most importantly, those responsible for PE opportunities in primary schools must be called to action. Money spent on encouraging and promoting active lifestyles will be more than rewarded in the years to come. Let the coalition put this issue at the head of its objectives. A good, happy and healthy life is surely worth working for, and we owe it to all our citizens. I very much hope that the Minister will take some of these messages back to his colleagues
The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)
My Lords, I congratulate my noble friend on securing this debate, which though brief has been of a very high quality. I found myself agreeing with noble Lords from all sides of the House in many of the things that they were saying so powerfully. We are all aware of the distinguished contribution that my noble friend has made to English sport and helping to raise the profile of women’s participation. That wisdom and experience were amply demonstrated in her opening speech. The timing of the debate, as a number of noble Lords have said, is very appropriate following our extraordinary summer of sport.
Many of us would agree with the noble Baroness, Lady Massey, that we should be moving more as part of a healthy lifestyle—indeed, many noble Lords have spoken eloquently about the benefits of regular exercise—and commentators have started to argue that as a nation we are suffering from a physical activity deficit. Regular physical activity helps to prevent and manage over 20 chronic conditions. The noble Baroness, Lady Massey, was right to remind us of that as did the noble Baroness, Lady Billingham. Conditions include coronary heart disease, stroke, type 2 diabetes, cancer, obesity, mental health problems and muscular-skeletal conditions. The strength of the relationship between physical activity and health outcomes persists across the life course and highlights the potential health gains that could be achieved if individuals can be supported to become more active. Inactivity, on the other hand, is associated with coronary heart disease, breast and colon cancer, and diabetes. It is been estimated to lead to 9% of early deaths globally. It is a silent killer. Less well understood are the risks of sedentary behaviour—sitting for long periods and excessive screen time—which would appear to be independent of how much exercise we do.
My noble friend Lord Addington asked whether the Government were intent on making exercise and sport part of a lifestyle. In July of last year the chief medical officers of the four home countries published Start Active, Stay Active, setting out new guidelines for physical activity. For adults, the new recommendation for at least 150 minutes of physical activity spread across the week replaces the old “five times thirty minutes” message. Importantly, the guidelines address the whole life course from early years to older people and include advice on avoiding sedentary behaviour. Providing expert-led advice to individuals in this way to inform their own lifestyle choices lies at the heart of this Government’s approach to health promotion, one that provides information and enables choice without nannying or hectoring.
As I will set out in a moment, much is being done to encourage people to play sport and exercise more. However, the sad fact is that most of us are insufficiently active. In England, six out of 10 men and seven out of 10 women do less than the CMO guidelines. For children, the guidelines recommend at least 60 minutes of activity daily, but again participation levels are low, with less than a third of youngsters getting enough exercise. In the face of these statistics, we have established a national ambition for physical activity for a year on year increase in the number of adults doing 150 minutes of exercise per week and a similar reduction in those who are “inactive”. This represents what could be achieved if all sectors work together, supported by the new delivery system for public health. The ambition is reflected in the public health outcomes framework indicator for physical activity.
The London Olympic and Paralympics Games this summer have provided us with a once in a lifetime opportunity to address the “activity deficit”. Much has been put in place in the run up to the games to deliver a sport and physical activity legacy. For example, Sport England is investing £150 million into grassroots sport through the “Places, People, Play” programme. Following on from the Games we are determined to raise the proportion of young people playing sport at least once a week through the youth and community sport strategy. Indeed, increasing access to and participation in sport is one of the key themes of the Government’s ongoing legacy plans.
The focus of this debate is about raising awareness of the importance of an active lifestyle. During the summer, the Department of Health ran a highly successful Games4Life campaign, which built on the success of the 2011 really big summer adventure campaign and targeted children, their families and adults. The central theme of Games4Life was for families to get up off the couch and join in the summer of sport. A quarter of a million people received personalised activity plans as a result of the campaign and 88,000 signed up to receive Games4Life follow up e-mails. Alongside Change4Life, NHS Choices offers a great deal of extra information for those who want to learn more about activity. A cornerstone of Change4Life is partnership. The public health responsibility deal physical activity network also takes a partnership approach to engage a range of organisations in the promotion of physical activity to employees, consumers and communities.
My noble friend Lord Addington spoke powerfully about the need to encourage the young into sport. Change4Life recognises that healthy behaviours are forged in the young and we make no apologies for placing children and young people at the centre of our plans for driving up sports participation. The School Games represent a major legacy commitment, creating the opportunity for every school and every child to play competitive sport all year round. Over 15,000 schools have registered to be part of the games, with a reach of around 4 million pupils. We are also working with the Youth Sport Trust to deliver Change4Life sports clubs in schools. These are targeted towards children and young people who are at risk of dropping out of sport and have already seen a 166% increase in participation by those youngsters. All this should of course be seen in the context of our support for PE and school sport and the wider youth sport strategy.
My noble friend prompts me to mention that central to our ambition and commitment to have a lasting legacy from the Olympics is our determination to put competitive sport firmly on the agenda in all schools. Competitive team and individual sports will be at the heart of the programme of study. In addition, through the School Games, we will make sure that a range of competitive sporting opportunities are in place for all schools that sign up to be a part of the Olympic aspiration to “inspire a generation”. My own department remains committed to this agenda for all youngsters, irrespective of ability.
The noble Baroness, Lady Massey, indicated that changes to the school curriculum might remove opportunities for young people. We are aware that some pupils would prefer to take part in non-competitive activities such as dance. We are supportive of that wish. However, our aim is that all pupils, regardless of ability, should have the opportunity to experience both individual and team-based competitive sports. The Change4Life sports clubs in schools are targeted at the least active children, and the independent evaluation has shown that they are particularly effective at engaging girls, which is very positive.
Incidentally, the noble Baroness, Lady Billingham, mentioned my right honourable friend Mr Gove’s policies, in particular what she described as his decision to scrap two hours of compulsory PE. This issue has been subject to frequent misunderstanding. The previous Government’s targets for physical education were wholly aspirational and could not be enforced. The law specifically prevents the Secretary of State for Education dictating to schools how much time they should devote to PE or, indeed, to any other national curriculum subject. That is for schools to decide. PE will remain a compulsory subject at all four key stages following the review of the national curriculum. I believe that is positive.
The Government’s youth sport strategy is intended to encourage everyone, but particularly young people, to take up sport and develop a sporting habit for life. This will deliver at least 6,000 partnerships between schools and local sports clubs, an additional £160 million on new and upgraded sports facilities and £250 million for communities, including our work with county sports partnerships and local authorities.
I have spoken a great deal about sport, but my noble friend Lady Byford has reminded me to mention that the Department for Transport and my own department are working across government to give a strong boost to walking and cycling for travel purposes. Most recently, the Chancellor’s Autumn Statement included an additional £42 million investment in the sustainable transport fund for cycling infrastructure, including cycling safety.
Healthcare professionals are in a unique position to encourage their patients to exercise as part of a healthy lifestyle. As early as 2006, NICE advised that brief advice in primary care was a cost-effective way of promoting physical activity. “Let’s Get Moving” is one way for GPs to build on this guidance.
My noble friend Lady Byford invited me to say a little about the Government’s investment of £30 million to develop the new National Centre of Excellence for Sport and Exercise Medicine. The national centre will build on research into sport science and current expertise to translate this knowledge into benefits for patients and to enable more people to be more active. The primary role of the centre is to provide the best possible evidence base for sport and exercise health for our elite athletes, but also for the general population, particularly those with chronic, long-term conditions, which can be improved by exercise, safely supervised. The £30 million funding that we have made available will allow researchers to work alongside clinicians to quickly translate research into clinical practice. I hope that that will be music to the ears of my noble friend Lord Addington as well.
I am receiving strong messages that my time is nearly up. I have, however, one minute left and I would like to turn to some of the excellent questions posed by my noble friend Lady Heyhoe Flint. In response to her comments on Start Active, Stay Active, I think it is fair to say that there remains a disappointing lack of awareness of the UK physical activity guidelines among health professionals. We are committed to the dissemination of the messages contained in Start Active, Stay Active, both to the public and to doctors. For example, this summer’s Games4Life campaign included summaries of the guidelines in personal activity plans provided to families. My noble friends referred to specific funding streams to help disabled people take up sport. These are only part of the bigger, long-term approach being taken by Sport England in its youth and community sports strategy. Forty national governing bodies of sport have presented plans to make sport a practical choice for disabled people as part of the wider whole-sport plan investment programme, which is funded and overseen by Sport England.
I turn to the teaching of PE and swimming in primary schools. Initial teacher training should prepare newly qualified primary teachers to teach the full range of curriculum subjects to the required standard. This would include the national curriculum for PE, which currently requires all pupils to be capable of swimming 25 metres unaided by the end of key stage 2. Ofsted will inspect swimming, as well as PE and sport, if it is one of the lessons encountered during the inspection.
With the leave of the House, I will continue for another minute or so, as there is theoretically time in hand. With regard to the Government’s plans for 4,000 secondary schools to host a link with a community sports club, which I have already mentioned, I can confirm that progress in this huge undertaking has been very promising. There are currently 380 satellite clubs already up and running, and this will increase to 700 by March 2013. We are monitoring delivery very closely to ensure that we maintain progress throughout the lifetime of the strategy.
My noble friend asked what would replace the Cabinet sub-committee on public health. Public health issues will now be brought into the broader domestic policy committees rather than sitting with a separate sub-committee. This will allow public health issues to be discussed and decisions to be taken by a wider group of senior Ministers across government.
The noble Baroness, Lady Massey, asked me about women in sport. Sport England continues to fund the Women’s Sport and Fitness Foundation, which campaigns to make physical activity an everyday part of life for every woman and girl.
The noble Baroness, Lady Billingham, rightly drew attention to the public health problem of obesity. She will, I am sure, recall that our call to action on obesity in England, published in October last year, sets out how obesity will be tackled in the new public health and NHS system. Clear ambitions are set out in that strategy, which bear on much of the debate this evening.
I have tried to demonstrate how we are using the London Games as a springboard to raise everyone’s awareness of the importance of exercise for health—in short, how we can turn a winning summer into an active future.