(8 years, 11 months ago)
Commons ChamberRead Hansard Text Read Debate Ministerial Extracts
Dr Sarah Wollaston (Totnes) (Con)
I beg to move,
That this House calls on the Government to bring forward a bold and effective strategy to tackle childhood obesity.
I want to thank the Backbench Business Committee for granting time for this debate. I also want to thank all my colleagues from across the House who are members of the Health Select Committee—and the staff of the Committee, particularly Laura Daniels—for their work on the report on childhood obesity that was published recently. Outside this House, there are also many organisations and individuals who have campaigned tirelessly to improve children’s health.
Perhaps we can start by looking at the example of Team GB and their success in the Olympics. On the morning of their track cycling victory, the architect of the team’s success, Sir David Brailsford, put their success down to the principle of marginal gains and their relentless pursuit of identifying every efficiency in the rider, the bike, the environment around them and their training regime. All those marginal gains were added together to win gold for Team GB in the Olympics. I think we need to adopt the same principle when it comes to tackling childhood obesity.
Too often, I hear people saying that it is all about education, or about getting children to move more in PE at school, but I would say that there is no single measure. We all know that this is an extremely complex problem that requires action at every level. I therefore call on the Minister to look at every single aspect of tackling childhood obesity. If we were running a cycling team hoping to win the Olympics, we would realise that we could not achieve success if we left any of the factors out, so let us apply that principle here.
Let me set the scene by telling the House why this subject matters so much. We know from the child measurement programme in our schools that around one in five of our children who enter reception class are either obese or overweight. However, by the time they leave in year 6, a third of our children are either obese or overweight. Perhaps even more worrying are the stark data on the health inequality of obesity. A quarter of the children from the most disadvantaged groups in our society are leaving school not just overweight but obese, which is now more than twice the rate among children from the most advantaged families. My first question for the Minister is this: will the childhood obesity strategy not only tackle the overall levels of obesity but seek to narrow that yawning and growing gap in our society between the least and most advantaged children? Any strategy that fails to narrow that gap will have failed our children.
Geraint Davies (Swansea West) (Lab/Co-op)
Does the hon. Lady agree that some of the overall problem can be explained by the fact that people do not know how much sugar is in their food? She will know that women are supposed to have no more than six spoonfuls a day, and men no more than nine. Only today, when I was in Portcullis House, I bought three items: a Snickers bar, which has five spoonfuls of sugar; a yoghurt with seven spoonfuls; and a Coke with nine. She will be glad to hear that I did not eat any of them; perhaps I was just removing them from other people. Does she agree that an awareness of how much sugar we are eating is very important if we are to manage our diets?
Dr Wollaston
Indeed. I completely agree with the hon. Gentleman, and I shall come on to that subject later. I am relieved to hear that he is not on a sugar high for the debate.
I want to set out not only the scale of the problem but its consequences. It has consequences for the whole lifetime of our children, in relation to their physical and emotional health. They also suffer the impact of bullying at school, as they are too often stigmatised in the classroom because of their weight. There is increasing evidence that obesity is a factor in causing many preventable cancers, and it also has an impact on conditions such as diabetes and heart disease. This has a cost not only to individuals but to wider society and to the NHS.
The Minister will know how essential it is that, as part of the “Five Year Forward View”, we tackle the issue of prevention. We cannot do that without tackling obesity, particularly among children, given the lifetime impact and consequences of the condition. She will know that 9p in every £1 we spend in the NHS is spent on diabetes. We estimate from the evidence that the Health Committee took during our hearings that the overall cost of obesity to the NHS is now £5.1 billion a year, and the wider costs to society have been estimated to be as high as £27 billion, although the estimates vary. We simply cannot afford to take no action.
Physical activity is of course extraordinarily important and I am confident that it will feature strongly in the Government’s strategy, but it is no good focusing solely on that. Physical activity is good for children, whatever their weight. Indeed, it is good for all of us, whatever our age. However, any strategy that assumes that we can tackle childhood obesity solely through physical activity will simply be ignoring the overwhelming evidence that most of the gain will be in reducing calories. That is not just about sugar, however. It is easy to be accused of demonising sugar. The fact is that children have more than three times the recommended amount of sugar in their diet, but that is perhaps the easiest aspect of the problem to tackle. The Minister will recognise the fact that we are talking about overall calories, which also include fats.
Sir Paul Beresford (Mole Valley) (Con)
I need to declare an interest here; it is a fairly well-known one. My union has been pressing me to remind my hon. Friend that sugar intake has a disastrous effect on the teeth and causes tooth decay. Is she aware that the most common cause of hospital admissions among five to nine-year-olds is tooth decay? Every week, almost 900 children in this country require hospital treatment for tooth decay, and the biggest single factor is sugar.
Dr Wollaston
I thank my hon. Friend for mentioning that. I was going to come on to that point and he has saved me from doing so. I completely agree that we must not forget the impact of sugar on children’s teeth. He will recognise that there are great health inequalities relating to that issue as well.
So how should we tackle this? I have spoken many times about a sugary drinks tax, but I recognise that that is not where the greatest gain lies when it comes to tackling childhood obesity. As the Minister will recognise from the evidence presented by Public Health England, price promotions will need to form an extraordinarily important part of the childhood obesity strategy if it is to be effective. It is a staggering fact that around 40% of what we spend on our consumption of food and drink at home is spent on price promotions. Unfortunately, however, they do not save us as much money as we assume. They encourage us to consume more. In British supermarkets, a huge number of those promotions relate to sugary and other unhealthy products. I call on the Government to tackle that as part of their strategy. We need a level playing field as we seek to rebalance price promotions, but that has to be done in a way that does not simply drive us towards promoting other products such as alcohol. We need to take a careful, evidence-based look at all this.
Norman Lamb (North Norfolk) (LD)
I am delighted that the hon. Lady is pursuing this issue. Has she looked at whether there could be a tax on the ingredient “sugar” in products, so that we create an incentive to reformulate, in order to reduce sugar content not just in fizzy drinks but across foods and drinks generally? Could that be a way to get the industry to start to think about the content of its food?
Dr Wollaston
I thank the right hon. Gentleman for his point, which prompts me to address the issue of a sugary drinks tax. We looked at examples of where taxation can be applied across sugar more broadly, perhaps to incentivise reductions within reformulation, as some countries have done. However, we wanted to address the single biggest component of sugar in children’s diets, which is sugary drinks. The Committee recommended a sugary drinks tax rather than a wider sugar tax, and there are several reasons for doing that. First, we know that it works. Secondly, it addresses that point about health inequality.
Mexico introduced a 1 peso per litre tax on sugary drinks and by the end of the year the greatest reduction in use—17% by the end of the year—was among the highest consumers of sugary drinks. The tax drove a change in behaviour. The whole point of this sugary drinks tax is that nobody should have to pay it at all. To those who say it is regressive, I say no it is not; the regressive situation is the current one, where the greatest harms fall on the least advantaged in society. As we have seen with the plastic bag tax, the tax aims to nudge a change in behaviour among parents, with a simple price differential between a product that is full of sugar, and causes all the harms that we have heard about, including to children’s teeth, and an identical but sugar-free product—or, better still, water.
Keith Vaz (Leicester East) (Lab)
I congratulate the hon. Lady on securing this debate and on her work in this area. We do not really have to wait for a tax; we can take what the Mayor of London has done in City Hall as an example. He has made sugary drinks more expensive, and therefore people have that choice immediately. In the presence of the Chairman of the Administration Committee, the House’s greatest living dentist, who is participating in this debate, may I say that it is possible for this House to put up the price of sugary drinks so that those who go to the Tea Room will then have that choice?
Dr Wollaston
I thank the right hon. Gentleman for that and welcome what he describes. That movement is not just happening in City Hall, because it is being recommended within the NHS by Simon Stevens. I also congratulate Jamie Oliver and the many other outlets that are introducing such an approach. The other point to make is about public acceptability, because all the money raised goes towards good causes. As we have seen with the plastic bag tax, the fact that the levy is going to good causes increases its public support. That levy has been extraordinarily effective, as plastic bag usage has dropped by 78%. That is partly because we all knew we needed to change but we just needed that final nudge. That is what this is about: that final nudge to change people to a different pattern of buying. It has a halo effect, because it adds a health education message and that is part of its effectiveness.
Maggie Throup (Erewash) (Con)
I am a fellow member of the Health Committee, in which we also discussed ring-fencing the sugary drinks tax so that money could be put back into health education about obesity, particularly in schools, to prevent child obesity in the future. Could my hon. Friend speak a little more about that?
Dr Wollaston
I thank my hon. Friend and fellow member of the Health Committee for her intervention. At a time of shrinking public health budgets, there is a huge additional benefit from having this kind of levy, in that many of the other measures that the Minister will want to see in the strategy—on exercise in schools, teaching in cookery lessons and health education—could be funded in part through a sugary drinks tax. I hope she will look carefully at this idea and consider introducing it.
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. It is meant to be a 15-minute opening speech. Mr Davies will want to speak and he will not want me to take any minutes off him, so I am sure this will be a very quick intervention.
Geraint Davies
The debate is often between reformulation and tax. I agree with the tax on fizzy drinks, but if we had a tax on overall sugar input—for the sake of argument, let us suppose that sugar makes up half a Hobnob and the tax is at 10%—that would give an incentive to the manufacturers to reformulate without the price going up and we could get the sugar content down.
Dr Wollaston
I thank the hon. Gentleman for that, which brings me on to reformulation. It should also form a core part of the strategy. Our view was that we should have a centrally led programme of reformulation across foods and drinks, and that what manufacturers want is a level playing field. The trouble with reformulation is that it takes time; there has been an effective programme on salt, but that has happened very gradually, over a 10-year period. There is no reason why these things should be mutually exclusive; I come back to that point about marginal gains and say let us do all of the above. I know that the Minister is looking closely at reformulation and understands how powerful it will be. The evidence we heard was that it could take 6% of the sugar out of children’s diets. Reformulation, alongside other programmes, will play a part, but it will not work on its own and, unfortunately, it will take longer.
We also need to examine the pervasive effect of marketing and promotion. Do I want to have a kilogram of chocolate for almost nothing when I buy my newspaper? Of course I do, but please do not offer it to me. Please do not make me walk past the chicanes of sugar at the checkout or when I am queuing to pay for petrol. We know that 37% of all the confectionary we buy is bought on impulse. It does not matter how much we are intending not to buy it, if it is presented to us on impulse, we buy it, as impulse is an extraordinarily powerful driver. I therefore hope that any strategy will tackle that part of consumption, along with portion sizing. The supersizing of our society is in part down to the supersizing of portions and offers. All of this needs to be included in our approach, as does dealing with advertising. This advertising is pervasive and it is hitting our children everywhere they go, on television, online and through the influence of “advergames”. We know that this is very powerful in driving choices for children, so I hope the Minister will look carefully at that. She will have seen our recommendation of a watershed of 9 pm.
Time is running short, so I shall close my remarks, as I know other Members will want to cover many other aspects, such as exercise, the effect of what local authorities do, how much more powerful they could be in their roles if we gave them greater planning powers, and so on. Early intervention, research, education, teaspoon labelling—please do it all. We need a bold, brave and effective strategy, and we need to learn from British cycling and the law of marginal gains.
Several hon. Members rose—
Mr Deputy Speaker
Order. With an eight-minute limit, I call Sharon Hodgson.
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
I congratulate the hon. Member for Totnes (Dr Wollaston) on proposing and securing this important debate, and she will be pleased to hear that I agreed with almost everything she said. Many here in the Chamber will be aware of my strongly held passion to provide all children with a hot and healthy school meal, especially one that is free. The debate around the Government’s impending childhood obesity strategy, both here in Parliament and in the outside world, has focused on the reformulation of foods that are high in sugar and salt and the introduction of a sugar tax. Although I support those measures, I want quickly to discuss how school food can play a significant role in addressing the obesity crisis facing our children today.
I want to say at the outset—I am sure people are thinking this, if not here then definitely on social media—that I am rather overweight myself and that some may say I should practise what I preach. I do try. But that is why I am so passionate about this agenda: I know how much harder this becomes as you get older. I was allowed to adopt bad habits that are hard to break, and that shows why we need to educate the next generation to do much better.
School food has played a role in public policy for more than 100 years. It was first discussed in this place in 1906 when Fred Jowett, former Member of Parliament for Bradford West, used his maiden speech in the Chamber to launch his campaign to introduce free school meals when compulsory education was being rolled out. That led to the passing of the Education (Provision of Meals) Act 1906, which was originally Jowett’s private Member’s Bill.
Jowett’s campaign was driven by his experience as a member of the Bradford school board, where he witnessed the malnourishment of children who then fell behind their more affluent peers. Here we are, more than 100 years later, and those arguments are still being made today.
Andrew Gwynne (Denton and Reddish) (Lab)
I was just thinking the same as my hon. Friend about how far we have come in some respects but not in others. She will be aware of the private Member’s Bill of my right hon. Friend the Member for Birkenhead (Frank Field). Does she support it?
Mrs Hodgson
Yes, that private Member’s Bill is an excellent initiative, and should be adopted by the Government and local authorities. It is very simple to share the data that we already have on families who are entitled to benefits, to ensure that the entitlement of their children to the pupil premium is not lost when universal free school meals are rolled out. That is a very important point.
Although we do not always think about obesity in this way, it is a form of malnourishment. What we are seeing today is very similar to what we saw more than 100 years ago, with children lacking the right nutrients to see them living a healthy childhood and growing into healthy adults. That is especially concerning given that today more than one third of children are leaving school overweight or obese.
The school setting is one of the most important interventions in a child’s life; it is where we nurture and educate future generations. Why should we not feed these children so that they are fuelled to receive the best education and life chances possible? That notion was strongly supported by the previous Labour Government, who introduced a raft of measures that addressed the food eaten by children in our schools. They included nutrition-based school food standards that provide children with the proper nutrition to learn, fully costed plans to extend our universal free school meal pilots, and the introduction of healthy, practical cooking on the national curriculum.
Although much, or all, of those measures were scrapped when the coalition Government were formed in 2010, it was very welcome when, in 2013, the school food plan was published, calling for the reinstatement of lots of those measures as well as new and improved measures in our schools to address the health of our children. Those included introducing food-based standards for all schools, training head teachers in the benefits of food and nutrition, improving Ofsted inspections on school food, and the roll-out of universal free school meals for primary school children, when funding was found.
As we know, that funding was found, thanks to David Laws and the right hon. Member for Sheffield, Hallam (Mr Clegg). Fortunately, universal infant free school meals were secured by the Chancellor in the comprehensive spending review. All those measures came out of concerns for the health of our children and the growing obesity crisis, especially given that 57% of children were not eating school lunches. Some were opting to take in packed lunches, only 1% of which met the nutritional standards of a hot lunch, while others were opting to go off site to eat junk food at local takeaways.
As research has found, health problems associated with being overweight or obese cost the NHS more than £5 billion a year, and, with obesity rates continuing to rise for 11 to 15-year-olds, especially in deprived areas, it is now clearer than ever that we need seriously to address childhood obesity.
Giving children a healthy and balanced diet during the school day can only be a positive intervention in helping to address obesity. I cannot stress how strongly I believe that one of the most important interventions to help address health issues in childhood is universal free school meals.
Helen Whately (Faversham and Mid Kent) (Con)
The hon. Lady mentioned that children are consuming junk food from outlets near schools. Does she believe that councils should have powers, as part of planning guidance, to take action on junk food outlets being so close to schools?
Mrs Hodgson
Yes, I do. I really welcome that intervention, because it not only makes the point, but stresses it very strongly. Some councils are very good and introduce byelaws to ensure that burger vans cannot pull up outside a school, and that, if there is already a number of takeaway shops nearby, no more can open. Matters such as that need to be addressed by councils.
The pilots introduced by the previous Labour Government in Durham and Newham to look into the benefits of universal free school meals found many benefits to a child’s health, and research continues now that we have universal infant school meals. The pilots in Durham and Newham found a 23% uptake in vegetable consumption at lunchtime and a steep decline in the typical unhealthy packed lunch foods. For example, there was a 16% decline in soft drinks and an 18% decline in crisps. Those are all-important figures that the Government should remember, and both the Department of Health and Department for Education should look further into how best they can use the vehicle of universal free school meals to help improve children’s health.
Although universal free school meals are protected in the Government’s comprehensive spending review—this followed a concerted campaign by school food campaigners, myself and others in the House—there is another area that the Government must consider when looking to improve the health of our children: holiday hunger. Children are in school for just 190 days of the year, and the rest—a total of 170 days—is totally down to their parents. Some may say that that is how it should be and that when we lock the school gates for the holidays it is none of our business what children eat, whether they eat or what they get up to. None the less, with the growing use of food banks in school holidays and the reports that children return from the longer school holidays noticeably thinner and unhealthier, the issue is one that we can no longer ignore.
If there is a push for better food provision in our schools, then we need to be doing much more during the holidays so as not to undo the hard work that goes into improving the life chances of children during term time. That is why the school food all-party group, which I chair, has established a holiday hunger task group, which last year launched its “Filling the Holiday Gap” guidelines to provide organisations and local authorities wishing to provide food during holidays with the resources to offer healthy and nutritious food. Late last year, it published its update report, which called for action to be taken by the Government.
When the Government’s childhood obesity strategy is published, I hope that there will be significant mention of the benefits that school food, especially universal free school meals, can have on a child’s health, and of how it can be used to address the growing childhood obesity crisis. There is evidence out there to support using universal free school meal provision to its fullest, instead of squandering its potential, to improve the health of our children.
This is a moment when the Government can really make a difference to children’s lives and I hope that all options and avenues will be pursued so that children are given the healthy food that they need to fuel their education and to make them as healthy a version of themselves as possible so that they grow into fit and healthy adults.
Will Quince (Colchester) (Con)
It is a pleasure to follow the hon. Member for Washington and Sunderland West (Mrs Hodgson). I thank my hon. Friend the Member for Totnes (Dr Wollaston) for calling this important debate. I am sure that Members can all see that I am a man who likes his food, and that I am not particularly in a position to lecture others on obesity. At the same time, I cannot ignore the fact that too many children in this country are obese, that poor children are more likely to be obese than rich children—boys and girls in the lowest quintile are three times more likely to be obese as those in the highest quintile—and that those living in towns are more likely to be obese than those living in rural areas. Those are unpalatable facts. It is right and proper that we investigate, and, where we have clear evidence, take the appropriate action.
However, the evidence does not suggest that childhood obesity is a problem that is getting significantly worse. The proportion of obese children in year 6 is higher than it was in 2006-07, but for reception children the proportion has fallen over the same period. Moreover, there has been a significant decrease in the proportion of British children, aged two to 10, who are obese.
Dr Wollaston
Will my hon. Friend go back and look at those figures in more detail? What he will see is that, although those figures are falling for the wealthiest children, they are rising for the most disadvantaged children. We are seeing a widening of the gap, which masks the underlying problem.
Will Quince
My hon. Friend makes a very good point, and I will come on to that in a bit more detail. The important element is that any approach we take must be evidence-based. I absolutely agree with her that we need to look at all the evidence.
I stated that the proportion of those aged two to 10 who were obese had gone from 17% in 2005 to 13% in 2013. The evidence suggests that childhood obesity rose quickly in the mid-2000s and has slightly fallen ever since. That is an important fact for two reasons. First, it suggests that our education programmes in our schools and the Government-backed campaigns on obesity within the last decade have had a positive impact in halting the increase in childhood obesity. Secondly, it undermines the scaremongering that suggests that childhood obesity is rocketing year on year. It simply is not; the reality is much more complex.
As my hon. Friend the Member for Totnes has already mentioned, there is a growing clamour for a sugar tax on soft drinks to combat childhood obesity. She has called in a recent article for a 20% tax on sugary drinks as part of that overall solution. Her calls have been echoed by the British Medical Association and other public health campaigners. I have huge respect for my hon. Friend, but I think that a sugar tax is completely the wrong answer. A sugar tax is illiberal and patronising —in my view, nanny statism at its worst.
Given how sugar tax campaigners argue, one might think that consumption of sugar in the UK is at a record high. It is not. Consumption of sugar per head in the UK is falling, from a high of more than 50 kg a year in the 1980s to less than 40 kg a year now. What is more, soft drink consumption in the UK is falling. The latest household food survey from the Department for Environment, Food and Rural Affairs shows that household soft drink consumption purchases have fallen by 5.2% since 2011 and by 19% for high-calorie soft drinks in the same period. Regular soft drink purchases are now at their lowest level since 1992.
Geraint Davies
Does not the hon. Gentleman agree, though, that a sugar tax would be eminently fiscally responsible? It would gather revenue, increase life chances, increase health and reduce health costs. From the point of view of the Exchequer, it would be very sensible. Can he not come up with other sensible ideas like that?
Will Quince
The hon. Gentleman makes an important point and, of course, that would make sense if the evidence suggested that a soft drink tax implemented anywhere else in the world had actually worked and had the effect that he suggests. He is right to suggest that there are a lot of other measures that we as a Government and that businesses and organisations can take to address this issue; I do not believe that the sugar tax is the right one.
Sugar tax advocates have pointed out the introduction of a sugar tax in Mexico and the corresponding 6% decline in soft drink sales since the tax was introduced. However, research in The BMJ does not show evidence of a link between the introduction of the tax and the small decline in soft drinks consumption. Further taxes on non-essential energy dense foods were also introduced at the same time as the sugar tax, and they accounted for a higher proportion of Mexicans’ daily calorific intake. As the authors of the research admitted,
“we cannot determine the independent role of each”
of the taxes. The research even acknowledges that there is a lack of information on nutritional data for packaged drinks in Mexico, which means that researchers cannot see what the fall in soft drink consumption meant for a decline in sugar intake.
As many Members may know, Mexico does not have safe drinking water. As a high-profile advocate of the sugar tax in Mexico, Alejandro Calvillo, stated:
“We know that there are people who drink a lot of sodas and they don’t have access to drinking water.”
How can we possibly compare the results in a developing country that has unclean, unsafe drinking water with how a tax might operate here in the United Kingdom? Instead, let us compare like with like. When sugar taxes have been tried in developed nations such as France, they have had a negligible effect on reducing consumption. Denmark scrapped its sugar tax on soft drinks in 2014 and labelled it an expensive failure. The Danish Ministry of Taxation labelled food and drink taxes as
“misguided at best and may be counter-productive at worst”.
They even described it as an expensive liability for business, and, as we all know, a sugar tax would be a very bitter pill for British businesses to swallow.
Study after study on soft drinks taxes in the USA also shows that they have a negligible impact on sugary drink intake and calorie consumption. What is more, the small decline in sugary drinks is almost entirely offset by consumption of other sugary products.
Dr Wollaston
My hon. Friend is very generous to give way again. I wonder whether he has had an opportunity to look again in detail at the article in The BMJ to which he refers. He is citing the figure of 6%, but the article makes it clear that by the end of the year the decline was 12% overall, and—more importantly, if we are to address the issue of health inequality—17% among the heaviest users. He might wish to update himself. I am happy to share the paper with him.
Will Quince
I thank my hon. Friend and I would be delighted to take another look at that piece of research.
My hon. Friend has made a case for the sugar tax to protect the poorest, and I think that that was the point that she was just making. As I have mentioned, and this is a good point, the poorest children are the most likely to be obese. However, the statistics show that, in low-income households in Britain, soft drink purchases dropped by 14% between 2007 and 2013. Perhaps a 20% sugar tax on soft drinks is not very much to celebrity chefs such as Jamie Oliver and some of those who are pushing the idea of a sugar tax, but for those on the lowest incomes—who we know, proportionally, buy these products—about 12p a can or 37p per 2 litre bottle is a massive amount of money.
Maggie Throup
I think that the point is that we are talking about a tax on sugary drinks and there are alternatives, such as drinks with artificial sweeteners. We are not making it so that these people do not have a choice. There are two different sides of the argument.
Will Quince
I thank my hon. Friend for that intervention. As someone who spent five years working in the soft drinks industry, I think she makes a valuable point. We need to question what we want our children—and adults —to drink. Do we want them drinking sugar or sodium benzoate, acesulfame and aspartame? That is a whole separate debate that we can have. I tend to choose to drink diet variants myself, but those options are there and the industry is driving people towards those lower calorie drinks. Let us take Britvic Soft Drinks as an example. Members will notice that they can buy a 600 ml bottle of diet Pepsi or Tango for the same price as a 500 ml full-sugar variant. The industry is already encouraging behavioural change.
To return to the Mexican experiment, 63% of sugar tax receipts have been collected from low-income households and 37.5% of receipts came from those in poverty. As I mentioned before, particularly with soft drinks but across the board, labelling has never been better, nor has the choice for consumers. The industry is doing a huge amount of work to encourage behavioural change and do the right thing.
I am conscious of the time and that lots of Members would like to speak, so I will conclude. I welcome a debate on childhood obesity and a clear strategy to reduce it. There are a huge number of measures that we as a Government could take ourselves and that we could encourage businesses and organisations to take, but let us ensure that the strategy is based on solid evidence. I strongly believe that a sugar tax is not the answer.
Several hon. Members rose—
Madam Deputy Speaker (Natascha Engel)
Order. Before I call the next, very experienced, Member to speak, let me remind less experienced Members that when there are time limits, the first two interventions are compensated for and the clock stops, but after that the clock continues. I just want to ensure that no one gets a horrible fright.
Keith Vaz (Leicester East) (Lab)
I will stick to my eight minutes, Madam Deputy Speaker, and I will not give way, if that helps—[Interruption.] All right, I will give way.
It is a pleasure to follow the hon. Member for Colchester (Will Quince). He is hard on himself; he is not obese, just very well built. I know that his enthusiasm for curry is known throughout Colchester, so that might be a contributing factor. It is a pleasure to speak in the debate and I congratulate the hon. Member for Totnes (Dr Wollaston) not just on how she chairs the Select Committee on Health but on how she brings issues to the House, especially this critical issue of childhood obesity. I am delighted to see the Minister at the Dispatch Box, as she gets it. She is the Minister responsible for diabetes and whenever we in the all-party group on diabetes ask her to deal with these issues, she has always been very open and transparent. I think that she is on the same page as the rest of us.
That helps me put aside at least half of my speech because I do not need to repeat the statistics that Members who are experienced in these matters know all about—the cost of diabetes to the national health service, the worry that over half a million people have type 2 diabetes and are not aware of it, the need for prevention and awareness, and the importance of protecting our children. The figures given by the hon. Member for Totnes are clear. The problem gets worse as children get older and the figures are so worrying that if we just stand still, the crisis of childhood obesity will continue.
David Rutley (Macclesfield) (Con)
With reference to standing still, the debate today has largely focused on sugar and our intake of it. One of the key things we need to do to tackle the challenge of childhood obesity is to focus on activity—getting people to be physically active, through sport or, as I increasingly believe, outdoor recreation. The Department for Culture, Media and Sport sports strategy, which focuses more on outcomes and includes outdoor recreation, could help to tackle the crisis that we are facing. Does the right hon. Gentleman agree?
Keith Vaz
Absolutely. The hon. Gentleman is looking at someone who constantly tells people to move more, but prefers to go by car rather than walk. It is a wonderful thing to say, but it is a different matter to get us on to those bicycles, on to our feet and involved in physical activities. My physical activity extends to table tennis, which is not the best way of losing weight and ensuring that my type 2 diabetes is under control. The hon. Gentleman is right—those lifestyle changes are necessary and they need to happen at a very young age. Schools, teachers, kids and parents need to be involved in ensuring that there is more activity because that will help in the long run.
We should be pretty dramatic in the way we deal with the problem. As you know, Madam Deputy Speaker—as you have no doubt shown the film to your children at some stage—Mary Poppins thought that a spoonful of sugar helped the medicine go down, but a spoonful of sugar, or nine teaspoons of sugar in a can of Coca-Cola, does not help the medicine go down—it makes matters worse.
In the short time available, I shall concentrate on the need to ensure that retailers do their bit to bring down the sugar content in sugary drinks. I am full of praise for the Mayor of London, the hon. Member for Uxbridge and South Ruislip (Boris Johnson), for going one step further than waiting for a sugar tax, which I understand is still on the agenda. There was a feeling that the Government had rejected that, but there were newspaper reports that the Prime Minister was still considering the matter. Perhaps the Minister can tell us when she winds up.
The retailers, having been invited by the previous Secretary of State for Health to be part of a voluntary arrangement, did not keep their side of the bargain. Despite the great declarations that were made by the previous Secretary of State, which I am sure were well intentioned, it is difficult to control global empires to ensure that they reduce the amount of sugar in drinks. We therefore have to take drastic measures. That is why I support a sugar tax, as enunciated by the Chair and other members of the Health Committee. We need to do that. We also need to do what the Mayor has done. Putting up the price of sugary drinks in City Hall is an extremely important way of sending out a clear message. Simon Stevens has said that he would do the same thing at NHS hospitals. How many of us turn up at local hospitals and see vending machines openly trying to sell us sugary drinks such as Coca-Cola?
I recently returned from a holiday in India. Whenever I asked for water or Diet Pepsi or Diet Coke, I was told it was not available. There is an interesting read-across to other Government Departments. The big retailers may be more conscious of the fact that the British House of Commons is interested in the issue, but in countries outside western Europe and the United States, they may feel that they can dump their sugary products without offering an alternative. Before we get to the issue of the sugar tax, which, as I said, I support, there is much that retailers can do.
I recently visited a branch of Waitrose in West Bromwich. I was interested to see that all the sugar-free products had been put in one kiosk in the middle of the store, so when people walked in they were not overwhelmed by the promotion of two-litre bottles of Coca-Cola for the price of one—they looked at the kiosk, where there were only no-sugar products. That is a way of encouraging those who purchase—I am not saying dads do not do it, but in most cases mums—to go to the kiosk and try to think positively about buying products that are free of sugar.
As I said in an intervention, there are things we can do. If we go to the Tea Room to have our lunch after this great debate, what is on offer? Club biscuits, Jaffa cakes, the most fantastic Victoria sponge—marvellous stuff that the Administration Committee offers us. The fruit is at the side, between the refrigerated drinks and the till. By the time I get there, even I, with my type 2 diabetes, am sometimes tempted to go for the sugary products and the chocolate. Why do we not promote the food and drinks that are healthy?
That is why, like others, I commend what Jamie Oliver has done. We need people like that, who have captured the imagination of the British people, to ensure that the public and the press help in the efforts to reduce sugar. Finally, I lavish praise on my hon. Friend the Member for Swansea West (Geraint Davies), who has introduced a Bill to provide for better labelling. We still do not have effective product labelling. It is important that we see such information because it will enable us to make informed choices.
If we do nothing, the obesity crisis will get much worse. We are not drinking at the last-chance saloon. That is now closed. We are outside and we are ready for firm Government action. That is our request to the Minister. Because of her own commitment to these issues, I know she will react positively.
Several hon. Members rose—
Madam Deputy Speaker (Natascha Engel)
Order. I am afraid I have to lower the time limit on speeches to seven minutes now.
Steve Double (St Austell and Newquay) (Con)
I am delighted to take part in this important debate and congratulate my hon. Friend the Member for Totnes (Dr Wollaston) on securing it.
As we have been hearing all afternoon, we are facing a crisis of obesity among our children. That is storing up trouble for the future for our nation, as it has implications for the personal health of those individuals, and will create wider social problems and economic challenges—loss of productivity because of ill health and the cost to the NHS, as we have heard. It is therefore right that the Government take the issue seriously and develop a comprehensive plan to address it.
We need to be realistic. The issue is complex and there is no silver bullet that will solve the problem of childhood obesity in one hit. There needs to be a comprehensive plan and a combination of measures to encourage greater activity and participation in sport and to address aspects such as diet, labelling and lifestyle. Parents must be at the heart of any strategy. We cannot replace their role and responsibility in raising their children and deciding what is best for their children’s welfare and future. We must never lose sight of that. Many parents feel that they are fighting a losing battle. The greatest influence on many children growing up today is no longer the parents and the household, but the media and the marketing budgets of multinational companies. Even the simple fact that in most shops a bottle of water is more expensive than an equivalent-sized can of fizzy, sugary drink—I think that is the case even in this place, so perhaps we should address that here—is evidence of the losing battle that many parents feel they are fighting in teaching and enabling their children to make the best choices.
In the time remaining I want to address the sugar tax. I am privileged to have one of Jamie Oliver’s Fifteen restaurants in my constituency. Only a few days after my election, the restaurant got in contact and asked me to lead a campaign for the introduction of a sugar tax. I have to say that my first response was to say no, because I am at heart a low-tax, small-state Conservative; my natural inclination is never to raise taxes. In fact, I want to cut taxes and have fewer taxes, so I did not particularly warm to the idea of introducing a new tax. Also, I do not want to see the state interfering in people’s lives, and particularly family life, any more than is absolutely necessary. Members will also be able to tell from my physique that I am not renowned for being a diet fanatic. In fact, I have been on only one diet in my life, and that was when my wife persuaded me to try the Atkins diet, with the bribe that I could eat as much bacon as I liked.
However, having looked at the evidence, I have come around and now believe that the Government should seriously consider introducing a sugar tax, because it would send a clear message about what is right and help people to make the right choices. In this country we have many taxes that are designed not only to raise revenue, but to educate and to influence people in the choices they make. I think that a sugar tax would be another step towards helping people, and particularly helping parents to help their children, to make the right choices. It would send a clear message that sugary drinks are not good for us. The Government would also be seen to be providing leadership on the issue, making a very clear and bold statement.
A tax on sugary drinks is not a silver bullet. It needs to be part of an overall package and a comprehensive strategy that includes better labelling, as we have heard, better education and encouraging physical activity. But I have been convinced that it needs to be seriously considered as part of the strategy to send that clear message and help parents make the right choice. I welcome the fact that, as the right hon. Member for Leicester East (Keith Vaz) suggested, there might have been a little movement in the Government’s position. I encourage the Minister to take back the clear message that the Government should seriously consider introducing a tax on sugary drinks as part of the overall strategy. It is something we need to see move forward, and a clear message needs to be sent.
Jim Shannon (Strangford) (DUP)
I am pleased to be called to speak in this debate. I thank the hon. Member for Totnes (Dr Wollaston) for setting the scene so comprehensively, and for speaking along the lines that I and, I hope, most Members in the Chamber agree with. I declare an interest, because I am a type 2 diabetic, as is my friend and colleague the right hon. Member for Leicester East (Keith Vaz). He and I have many things in common. We are both type 2 diabetics and we both support Leicester City football club—who would have believed that Leicester City would be top of the league? They are equal with Arsenal now, so there we are. I am very pleased to share that as well.
Obesity is at epidemic levels across the nation. Although strategies and responses have been developed, achieving results and driving down levels of obesity appear to be very difficult, which is disappointing. I am not here to argue or fall out with anyone—that is not my form—but I do not agree with some of the things that have been said today. For example, I am in favour of a sugar tax. My colleague, Simon Hamilton, who is the Health Minister in Northern Ireland, is against a sugar tax. I am in favour of it because I think that it would be the best thing. I think that sometimes we have to make decisions for people and that we have to do what is right. We have the power in this House to bring in legislation that hopefully can be used for the benefit of all.
Northern Ireland has the worst levels of obesity in the United Kingdom. Just over 24% of the 1,300 children from Northern Ireland who were surveyed by researchers at the Institute of Education in London were found to be not just overweight, but obese. We all know that the Ulsterman and the Ulsterwoman are fond of an Ulster fry. I used to be, but now I am allowed a fry only once a week because I am a diabetic. Believe it or not, as a diabetic I used to weigh 17 stone, but now I weigh 13 stone, so we can address the issue if we put our minds to it. Had I known what diabetes was about before I became a diabetic, I think I would have taken steps to change. I did not know it then because I was not interested. I did not know it because I did not realise there was anything wrong, but things were wrong. Sometimes we have to educate ourselves and take important steps and move forward by legislative means.
Members have referred to a balanced meal. Some people who carry a bit of weight think that a balanced meal means one hamburger in each hand. We have to think about this seriously. A balanced meal is not two hamburgers and big bottle of Coke; it is much less than that.
Obesity levels for 11-year-olds are higher in Northern Ireland than they are in other parts of the United Kingdom; in Wales the figure is 23%, in England it is 20%, and in Scotland it is 19%. It was reported in the news the week before last that every child in the United Kingdom will eat their body weight in sugar each year. Just think about what that means. That is four or five stones of sugar. Adults probably eat their body weight in sugar as well—not me, though, because I am a diabetic.
Will Quince
I am interested to know why sugary soft drinks, in particular, are being targeted. Why are we not looking at cereals, biscuits and cakes as well? Why is it just sugary drinks?
Jim Shannon
I am happy to look at sugary drinks because we have to start somewhere, but I will happily look at cornflakes and other foods as well, so they should not think that we are going to let them off. The issue is that there are nine teaspoons of sugar in a can of fizzy drink, so we need to address the issue where it starts.
We cannot ignore the statistics, because they are very clear. The fact that by age 11 a quarter of children in Northern Ireland are not just overweight, but obese is an alarming statistic. I think that a comprehensive and robust approach will be required if we are to address that. One way to doing that is through education in schools. I think that we need to bring that education in at an early stage. I think that the Minister will probably respond along those lines.
I fully support having a tax on sugar, which I think would be a step in the right direction. If we do that, we can move things forward and address the issue of obesity and people being overweight very early. Without addressing this serious health issue at the earliest stage possible, it will lead to problems for the health of the person in question, and for public health and society as a whole. I found some statistics on obesity the other day. The obesity epidemic in Northern Ireland has led to a doubling in just three years in the number of callouts for firefighters to help obese people. Those are startling figures. We can sit and ignore those and say, “No, we’re not going to tax sugar,” or we can address the issue early on. I say that we should do it early on. Let us do it now.
Dr Hilary Cass, president of the Royal College of Paediatrics and Child Health, has said that if the problem is not tackled now, it will rapidly get worse. She said:
“We should be worried because if we do not fix this problem now, we will see unhealthy kids turning into unhealthy adults with diabetes, heart disease and kidney problems.”
Why is it that it tends to be those on low incomes who are overweight or obese? It is quite clear to me, but perhaps it is not clear to others. I think that it is because their income dictates what they buy. If they do not have much money, they will buy the cheapest food they can, even if it is not the healthiest food, and more often than not cheap food contains levels of fat and sugar that are far too high. The issue of low incomes is therefore something we have to address as well, for those whose food choices are dictated by what is in their pockets.
We should be tackling these issues now not only because that is the right thing to do morally, but because it makes economic sense. The right hon. Member for Leicester East referred to the supermarket that had all the chocolate and sugary foods in one aisle in the middle of the shop. That is where they should be. They should not be at the checkout, where kids will see them and want their chocolate bar or their bottle of Coke. We have to address that issue as well.
Despite greater education on food and nutrition, there is still an obesity epidemic. Children are getting too many of their calories from sugars—on average, three times the Government’s recommended amount. That only contributes to an overall overconsumption of calories. One in three children are overweight or obese by the time they start secondary school, and that is a very clear problem that needs to be addressed. Childhood obesity is associated with conditions such as insulin resistance, hypertension, asthma, sleep problems, poor mental health—we cannot ignore that in children; we cannot think that they do not have it, because they do—early signs of heart disease, and an increased risk of developing cancer. The hon. Member for Colchester (Will Quince) referred to the need to have more physical activity in schools, and that issue could be addressed. Ministers mentioned it during this morning’s Culture, Media and Sport questions, so they recognise it as well. I have mentioned just a small number of the health costs of not acting to address this epidemic.
It is not just health that suffers because of inaction on this epidemic. Health problems associated with being overweight or obese cost the NHS more than £5 billion annually. Poor dental hygiene costs the NHS £3.4 billion a year, of which £30 million alone is spent on hospital-based extractions of children’s teeth. The total societal cost of obesity in the UK in 2012, including lost productivity, was £47 billion. The evidence is clear.
There can be no one solution to this complex issue. We need to enhance our nutritional education strategy, tackle poor diets through legislation, and encourage greater physical activity among our children. Given the shocking statistics that we have all spoken about, it is clear that despite health being a devolved issue, obesity, and obesity in our children, is truly a national problem. As such, it will require a national solution and a comprehensive approach.
Nigel Huddleston (Mid Worcestershire) (Con)
I, too, pay tribute to the Health Committee for its great work. I pay tribute particularly to the Chairman of that Committee, my hon. Friend the Member for Totnes (Dr Wollaston), and to my hon. Friend the Member for Erewash (Maggie Throup) for her work in the all-party obesity group.
This is a very important topic. It is also a very emotive one, as we have heard, especially for those of us who are generally instinctively against Government interference and taxation, and want small government. I have wrestled with that, like my hon. Friend the Member for St Austell and Newquay (Steve Double), but I have come round to the idea that when it is necessary to interfere, and when we have to balance out these freedoms with doing the right thing by our children, then we do need to consider all options. I have been slowly persuaded, but am now comfortably persuaded, on issues such as the sugar tax. So unfortunately, probably for the first time ever, I disagree with my hon. Friend the Member for Colchester (Will Quince). However, I am sure that it will be the first of many such times over coming years.
The evidence is overwhelming. Like the hon. Member for Strangford (Jim Shannon), in researching this topic I found that the numbers are astounding. The figures are overwhelming, and very alarming. I will not repeat them, but the report contains many such figures, and it is well worth a read.
One of the issues that comes up again and again is food marketing. Research tells us that children as young as 18 months can be influenced and are capable of recognising brands, which is a truly astounding fact. The House will be aware that current regulations on TV advertising mean that foods high in fat, saturated fat, salt and sugar are banned from being advertised during children’s programming, but many organisations, as well as the report, have suggested that that should extend up to the 9 pm watershed, and with considerable reason, given the evidence. The latest Ofcom figures show that two thirds of children watch television during what is considered adult airtime, with peak viewing for children between 7 pm and 8 pm. The British Heart Foundation found last year that during just one episode of “The X Factor”, a programme that is quite popular with children, there were no fewer than 13 junk food adverts. The issue is even more acute with online advertising, where adverts are often attached to videos, including music videos. That is probably worthy of a debate in itself.
Let me turn to food standards in schools, where there has been a tremendous breakthrough over the past few years. Those of us who visit schools look on with envy at the school meals now compared with the ones that many of us had to suffer years ago. Yet in many schools up and down the country, we have the farcical situation where lunches provided by schools are generally very healthy, but the food children themselves bring into schools, or is provided by their parents, is often not healthy. We can only imagine how frustrating it is for teachers, and indeed everybody who works in schools, including my wife, to see children filling themselves up with junk food at school and knowing there is little they can do about it. We need more co-operation between schools, and between parents and teachers. I back the Committee’s proposal that nutritional guidelines should be published for packed lunches and that, where necessary, teachers should be able to have, perhaps robust, conversations with parents so that these guidelines are followed.
Of course, diet is very important, but so is physical activity, as has been mentioned many times. I back up the supportive comments about the DCMS’s sports strategy. In The Times on Monday we saw a snack guide that included information on how long it would take to burn off the calories of various foods. It is easy to laugh at things like this, but it showed that a chocolate bar, bag of crisps and a bottle of Coke would require almost one hour of running or more than two hours of walking to burn off. How many children, or indeed parents, know that? Given that a child could consume all those things on top of, or instead of, a healthy meal, while doing no exercise, it is a really alarming picture. We must do more to encourage and enable exercise.
I am blessed to represent a primarily rural constituency. It is very easy for me and my family to get outdoors, to go on bike rides, and to go on public pathways. I am well aware that not everybody in the country has those privileges. Councils and local government need to do much more to enable access to healthy outdoor living and sports facilities. Planning plays a part in this too. When I see planning proposals for housing developments, I find it remarkable how little provision there is for recreational facilities, or indeed access to countryside. Cities fare far worse than the countryside in this regard.
Helen Whately
My hon. Friend is making an important speech covering a wide range of actions that need to be taken to tackle the obesity problem. Does he agree that this is not just about the sugar tax or product placement? The scale of the problem is such that we need a whole range of steps where the Government take a lead in showing how serious the problem is, and a whole range of actions to make sure that a difference is made quickly.
Nigel Huddleston
I thank my hon. Friend for that intervention; I could not agree more. Indeed, she has stolen my conclusion. It is absolutely the case that this is a very complex matter that covers so many areas that it is difficult to fine tune it. I hope that we can avoid focusing purely on the sugar tax, as important as it is.
We must recognise and praise the fact that up and down the country there are some great experiments going on, with schools practising innovative ways to encourage physical activity. For example, Commando Joe’s goes into schools and encourages team building and physical activity. I give credit to Bengeworth academy in Evesham in my constituency where we have our own Commando Joe—a gentleman called Chris Parry who works alongside staff and children having previously done four tours of Afghanistan with the Marines. He is doing great work, and long may that continue.
As my hon. Friend the Member for Faversham and Mid Kent (Helen Whately) said, this is not just about healthy eating. It is also about planning, education, labelling, and information, and the cost in healthcare if we do not do anything—we need to cover so many areas. If the aim of this debate was to give the Government ideas about what they could do to help in this area, then I am sure that by the end of it that will have been achieved.
Geraint Davies (Swansea West) (Lab/Co-op)
It is a pleasure to follow the hon. Member for Mid Worcestershire (Nigel Huddleston). I agreed with everything he said, including his disagreement with the hon. Member for Colchester (Will Quince). I also agree with the points made by the hon. Member for St Austell and Newquay (Steve Double). We are both members of the SAS—Surfers Against Sewage, that is, before people get the wrong idea.
I congratulate the Chair of the Health Committee, the hon. Member for Totnes (Dr Wollaston), on introducing this debate. As she will know, I have been active in this area, not least in the Sugar in Food and Drinks (Targets, Labelling and Advertising) Bill, which has its Second Reading tomorrow. The Bill basically asks for sugar labelling because people do not realise how much sugar they are eating. As I said earlier, this morning I bought three products from Portcullis House: a can of Coke, which has nine spoonfuls of sugar, the daily limit for a man; a container of yogurt, which has seven spoonfuls, more than a woman is allowed; and a Snickers bar, which has five spoonfuls.
The reason for a focus on fizzy drinks, other than the reasons set by the Chair of the Health Committee, is that they represent a very large proportion of the overall sugar intake of children, and so they represent an easy big hit, early on. There was a trading of statistics about the efficacy of sugar taxes, but we need only look at the elasticity of demand for fizzy drinks. Part of my background is in marketing products in multinational companies—not these products. I was the marketing manager for Colgate, for example. People have talked about the impact on teeth. When I was at Colgate, we thought that with the advent of fluoride we were going to see the end of tooth decay. However, there has been such a big increase in the consumption of fizzy drinks through focused marketing, that we have turned the corner and gone into reverse, and people’s teeth are dropping out. The point about marketing aimed at children highlights some of the demographic differences in the impact of sugar, because high consumers of television tend to be less well-off people who pick up brand awareness from watching it and then follow those brands.
I am in favour of labels noting the number of spoonfuls of sugar. I know that the Minister will say that there are issues with packaging in Europe, but my understanding is that, while there is a European competence, we have a national opportunity to do our own thing, and that is what we should do. Jamie Oliver and the Health Committee are following up on that. Retailers could put pressure on manufacturers to take voluntary action, but, sadly, even though retailers claim they are doing so, they are not taking proper responsibility, certainly not on cola drinks, which is a massive problem.
At one point in my distant past, I promoted the School Meals and Nutrition Bill. Its suggestions that Ofsted should be required to audit nutrition in schools and to get rid of unhealthy vending were agreed. I also still stand by its suggestion to gate children in schools so that they could not run to McDonald’s or elsewhere at lunchtime.
Obesity is costing the economy about £47 billion a year. This is not just about diabetes and the cost to the NHS, which is terribly important; the overall economy is suffering. Members have mentioned bullying in school, but obesity also has an effect on people’s quality of life. It is uncomfortable and those who are obese live shorter lives. If people know that one jar of pasta sauce has six teaspoonfuls of sugar and another has three, they will be able to make a rational choice; otherwise they will pick the one that is sweeter. The mechanisms available are simple. Members have also mentioned the need to encourage exercise, which is clearly very important.
On the main thrust of the debate, I agree with a fizzy drinks tax, but I want us to move towards an ingredient tax, which would mesh into the reformulation. Professor Graham MacGregor, who is now working with Action on Sugar, has been instrumental in getting the salt content down through reformulation. As I have said, if a 10% tax is put on a Hobnob, for example, the producer could reduce the amount of sugar and the price would not go up.
There are concerns about regressive taxation. The sad fact is that poorer people find it more difficult to afford fresh foods. People pooh-pooh that argument, but if various products are mashed up with sugar, salt and fat and then frozen, they will stay on the shelf for months on end. However, if produce has to be sold within a week because it is going to decay, it will be more expensive, which causes problems. There is a case to be made for taking the revenues from the tax and hypothecating it to provide easier access to fresh foods for people with less money. As well as putting up the prices of sugar-rich products, we need to provide information. We have a battery of opportunity to confront this difficult task.
It has been suggested that multinationals have been helping. Such companies are rational, focused and see the lie of the land. They know that people have cottoned on to the fact that sugar consumption is costing the country an arm and a leg, sometimes literally. Productivity is down and costs are up, and they know that the Government will ultimately take action, so they are following a rational trajectory. We need to encourage them to do so.
We have heard stories about elasticity of demand before. As every economist knows, when the price is put up, demand goes down. That is not a point of argument. Certain manufacturers used to say that there was nothing wrong with smoking. We know there is a problem with sugar. The emerging science suggests that if, for example, I and the hon. Member for Colchester both consumed 2,000 calories a day but I took in more sugar than him, over time I would develop a predisposition that meant that more of the calories I consumed would settle as fat. I would then feel hungry and listless and become obese. There are, therefore, other issues associated with sugar consumption.
The World Health Organisation has said that the sugar calorie intake should be 5%. Those of us here know that that means six spoonfuls for women and nine spoonfuls for men, but people out there do not realise how much sugar they are supposed to have, and even if they did they are not able to calculate it. Public Health England has produced an app that enables people to scan products with their phone to find out how many cubes of sugar they are consuming. It is difficult to calculate how much sugar is in one chunk of chocolate and in the bar as a whole. It would be better if it was all clearly labelled, without having to go through that process. The app is helpful and I welcome it, but it is not a serious solution.
Dr Tania Mathias (Twickenham) (Con)
I concur with the hon. Gentleman on labelling. Does he agree that, whether we label a chocolate bar or fruit, we need information on sucrose, glucose and fructose? We need to know how many of those chemicals are in everything we consume, including fruit.
Geraint Davies
I agree that people should be aware of that. My big beef, as it were, is that people do not know how much added sugar they are consuming. For instance, they do not know if there is twice as much sugar in one jar of pasta sauce than another. People need to know how much sugar they are taking in. To a certain extent, people prefer naturally occurring sugar in bananas and similar products, but I agree with the hon. Lady that people should know what they are eating.
The manufacturers argue that they have done everything they can. The back of a packet of Frosties has all the information, so long as people have a PhD and a lens through which to read the data. Products are packaged in such a way as to give the impression that they are healthy. The Bill that I am promoting tomorrow argues that products should not be allowed to be promoted as low fat when they are in fact high in sugar, because people infer from that that they are healthy. It also proposes an overall, aggregate sugar target—similar to a carbon target—so that the Government can see how much sugar we are consuming overall and gradually manage strategies to get it down.
Dr Tania Mathias (Twickenham) (Con)
May I join other Members in applauding my hon. Friend the Member for Totnes (Dr Wollaston) for securing this important debate? I did not come across paediatric type 2 diabetes when I was a medical student. Perhaps her experience was similar to mine. Like many people, I was shocked to find at the turn of the century that there were instances in this country of childhood type 2 diabetes. There are now more than 100 cases a year in this country of that incredibly serious condition. Just a few months ago, a three-year-old in America was diagnosed with type 2 diabetes. The treatment involved decreasing the weight of the child, who was obese.
I believe that the Minister’s strategy should be cultural. The papers show that more evidence is emerging and it is prescient. It involves not just genetics, but nurture. Studies of children who have been adopted by obese parents show that there is a risk that they will have childhood obesity.
On culture, I, like others, have seen many households with a TV room but no dining room. Families do not eat at a dining table in the same way as previous generations did. Members have talked in depth about the cultural change relating to exercise. I applaud the head of St Ninians in Stirling, who introduced a 1-mile-a-day idea for the primary schoolchildren. Interestingly, obesity levels on entry to the school are not as high as those in other schools; the figure a few years ago was one in 10. There is now an association—we are not talking about causation—between the 1 mile a day and pupils leaving St Ninians without being obese. That lady has rightly been given Pride of Britain awards. I want that culture change to continue and for the House to applaud it.
At the moment, I am not in favour of new taxation. In our culture, we can access such information. I absolutely agree with what everybody has said about better labelling, and we need more of it. However, as I said to the hon. Member for Swansea West (Geraint Davies), we need information about all the foods we eat—about fruit and vegetables, as well as about fast food. There is a debate about using sucrose as opposed to fructose, but we need to be aware of all such chemicals. In our culture today, we can give people that information. I would like to have such information myself.
As we get more evidence, the treatment and management of, as well as education about, childhood obesity will rise to the levels available for adult obesity. For many people, the concern is not about the obesity itself, but about its medical consequences. An obese adult who goes to their GP can look at the algorithm or the chart, and discuss the five or 10-year risk of their developing cardiovascular problems. If we give parents such information about their child, they will, in time, change their family habits. They do not want their child to have an increased five or 10-year risk of cardiovascular complications.
Geraint Davies
On that basis, does the hon. Lady advocate removing the tax on cigarettes?
Dr Mathias
The hon. Gentleman is testing me. I would say yes if I followed the argument all the way through, but I would not now go back on the tax on cigarettes. In my experience, education and information are the most powerful factors. Sadly, all GPs have treated people who later died from lung cancer. In my limited experience, it is information, not the effect on their pocket, that will change such people’s behaviour. I want an obesity strategy that will provide such information, because I trust the patient to make an informed choice. For me, the facts and the evidence are key.
We need to hold up a mirror to our culture at the moment. We have a culture of fast food and little exercise. I want that to flip to become a culture of slow food and more exercise. I encourage the Minister to look at such a culture, rather than at taxation.
Patricia Gibson (North Ayrshire and Arran) (SNP)
Before I begin, I want to add my voice to those of other Members in thanking the hon. Member for Totnes (Dr Wollaston) for securing this debate.
Childhood obesity is a problem across the UK, and the devolved legislatures as well as the UK Government must do all they can to tackle the problem, both in the short and the long term, for the benefit of our children and tomorrow’s citizens, to relieve the health problems obesity all too often creates, and for our long-term economic sustainability, as has been outlined this afternoon. All corners of the UK can learn from each other, and I hope they will. The Scottish Government have been working hard on this concern by taking forward a number of initiatives to enable people more easily to become active, to eat more healthily and generally to find ways of feeling better through an improved lifestyle.
There is no silver bullet, as we all know. We all agree that there is a significant problem. We must take into account the clear socioeconomic considerations that have a direct effect on the health of our children in general and on obesity in particular. The SNP Scottish Government are implementing several measures both to combat and to prevent childhood, and indeed adult, obesity. However, there are far too many to mention in the limited time available.
It is worth remembering that fruit and vegetable consumption among the poorest 20% has fallen by 20% since the recession began, with children’s diets being hit hard. On a number of national indicators of obesity and childhood obesity in Scotland, performance is improving or being maintained. In particular, physical activity performance has improved. The SNP Scottish Government are working well with schools and local authorities to ensure that children are more physically active. My local authority, North Ayrshire Council, has developed its own outdoor access strategy.
Much has been made today about imposing a sugar tax. The food we consume all too often contains significant quantities of sugar, of which many of us are seldom aware. I know that both the UK and the Scottish Government are considering a sugar tax. It is certainly an option that we are quite right to consider, but we must be careful about a tax that may, disproportionately, hit the poorest hardest. We all know that eating healthily is not always affordable for families on a tight budget, and a sugar tax must not be held up as a panacea for a very complex problem. If it is introduced, we must be certain that it has a positive impact on our health, without the unintended consequence of increasing inequalities.
We pay the price for our poor choices. We pay the price with our health and with our life expectancy, due to the development of serious health problems such as heart disease, type 2 diabetes and cancer. This puts more demands on our health services, and those demands will become greater unless we tackle this problem. The Health Committee has recently heard that the cost to society of this problem is £27 billion.
Beyond the cost in pounds, shillings and pence, overweight children face other problems, such as bullying, social exclusion, lack of self-confidence, unfulfilled potential and underachievement in school, which plague them long into adulthood and feed into their job prospects for many years afterwards. In Scotland, about 31% of children were at risk of becoming overweight in 2014, and 17% were at risk of obesity. Although those figures have stabilised in recent years, they are still worryingly high.
Research in Scotland shows that factors associated with children being overweight or obese include snacking on crisps or sweets between meals, skipping breakfast, not eating in a dining room at home and a lack of parental supervision, not enough physical activity and greater social deprivation. A higher proportion of children are at risk of obesity in Scotland’s most deprived areas—22% in 2014, compared with 13% for the least deprived. Any action to tackle this problem must be sensitive to that fact. Any debate about how to make our children healthier must avoid wagging fingers at parents, who, often in very difficult circumstances, are doing the very best they can. It is important to support people to make healthy choices where possible, not to shake our heads at them in righteous condemnation.
I end by making an important point for us all. Food labelling must be part of the solution. Although labels telling us what is in our food have improved over the years, in my view they are still too complex. One should not need to be a pseudo-scientist to understand what is in the food one buys. Labels must be clearer for shoppers so that parents are fully informed about what is in the food they eat and in the food they feed to their children.
There is no doubt that there are challenges ahead, but we must take people with us in this debate. How and what people feed their children can be a sensitive matter. Parents of course want the best for their children, and we must support and enable all parents to make the best choices for their children. Otherwise, regardless of what we say in this place, they just will not swallow it.
Maggie Throup (Erewash) (Con)
I am pleased to contribute to this debate as chair of the newly reformed all-party group on adult and childhood obesity. The group has been set up to bring together Members of both Houses and parliamentarians of all parties who want to explore the best ways to lower the obesity rate. There is no doubt that such a group is needed. It barely needs repeating, but two thirds of adults are obese or overweight, as are more than a third of children. Such a pressing public policy issue demands the constructive involvement of parliamentarians, and I welcome today’s debate as a means of highlighting the need for action. My vision is for the all-party group to become a forum for lively discussion of practical ways in which we can support people both to live healthier lives themselves and to help their children grow up healthy.
I understand why the role of the Government is a tricky one when it comes to tackling obesity. Some Government involvement is vital, but a Government cannot simply pass a law to make people eat healthier food and give healthier food to their children or legislate for a certain amount of exercise each day. What the Government can do is produce strategies, ideally for both children and adults, that lay out a longer-term solution for what is a long-term problem.
The worst thing that a Government could do would be to publish such proposals and then forget about them. Fortunately, the APPG will be there to keep an eye on the progress that is made, or not, and to work with the Government to promote what works and point out what does not work. I hope that Members on both sides of the House this afternoon, including my hon. Friend the Member for Colchester (Will Quince), with whom I usually agree, are interested in getting involved in the group, because all are welcome.
Let us focus specifically on childhood obesity, not forgetting that adults are role models. Our children are our future and it would be irresponsible as legislators not to take the future health of our nation extremely seriously. We must take whatever action is needed to address this issue. We can see the impact of obesity on the lives of adults in an increased risk of heart disease, diabetes and the life-changing complications that go with it, and cancer. All those medical conditions are life-limiting. Why would obesity have a different effect on children from the one it has on adults? It does not.
As my hon. Friend the Member for Totnes (Dr Wollaston) said, the Health Committee report on childhood obesity called for “brave and bold action”. That brave and bold action is needed from Government, the food and drinks industry, food outlets, educators and healthcare professionals. But let us not forget that all that will be wasted unless people take personal responsibility. This is a huge issue and fiddling at the edges will not work.
Today, there has been a lot of focus on the proposal for a sugary drinks tax. I was originally against it, but when I saw the compelling evidence, I changed my opinion, like my hon. Friend the Member for St Austell and Newquay (Steve Double). A sugary drinks tax should be just one of a range of measures. I believe that the food and drink industry can and should implement many of the measures that are needed without the need for legislation. The industry can make changes without legislation, given the will, and that is already happening.
In the run-up to this debate, I received many emails from organisations on both sides of the argument. I had one email from a leading supermarket, outlining the measures that it is taking. Those include reducing sugar in its range of breakfast cereals, chilled juices, fizzy drinks and yoghurts. I know that reformulations do not happen overnight, but I would like to think that the extra focus on obesity over recent months, including in Jamie Oliver’s campaign, has embarrassed manufacturers into making changes to their formulations in their own way, rather than as a result of legislation.
There is still more to be done. I am sure that we have all bought a newspaper from a well-known high street newsagents and been offered a mega-sized bar of chocolate at a special price. I do not know about my fellow Members, but if I want a bar of chocolate to eat while reading my newspaper, I will buy one without being asked—not that I do that, of course! What I am saying is that some manufacturers and retailers are taking the current and future health of our nation seriously and acting responsibly, but sadly others are not.
The causes of obesity are extremely complex and numerous, so it would be wrong of me just to focus on sugar. Fats, saturated fats and salt all have an impact on our weight, as does exercise. For adults—not for children, I hasten to add—alcohol also has an effect. It is because of this complexity that we cannot rely on just one measure. The Health Committee has made a range of recommendations, as has been outlined.
Regular exercise has a role to play. One of my local primary schools, Ladywood in Kirk Hallam, makes exercise fun. It is a member of the Erewash school sports partnership, it has active dinner playtimes and it links up with the secondary school, Kirk Hallam Community Academy, to take part in “This Girl Can”. We need to inspire young people at an early stage to make exercise a part of their way of life.
We must not forget that we need to consider cure as well as prevention. I have spoken to a number of healthcare professionals about this matter. Although it is important to recognise that people need to take personal responsibility for their own lifestyle, it is important not to stigmatise people who are obese. We must ensure that people recognise it as a condition, as they would with any other medical condition.
Obesity is a ticking time bomb. As politicians, we have a responsibility for the current and future health of our nation. I am ready to address it straight on.
Alison Thewliss (Glasgow Central) (SNP)
I am glad to be able to speak in this debate and hope that what I say will provide a different kind of insight into the debate on childhood obesity.
I am a great enthusiast for breastfeeding. Breast milk has many exceptional qualities, the most obvious being that it is exactly the right thing for infants to be eating. In the beginning, there is the double cream of breast milk, colostrum, which appears before a baby is even born in preparation for those first feeds. The milk that comes thereafter changes and adapts over time as the baby’s needs change. Breast milk has everything that a baby needs and, taken directly from source, it has the advantage of being at the correct temperature. It is easily absorbed by the infant gut. It is a miracle of nature.
What breastfeeding contributes to this debate is the impact that it can have on reducing childhood obesity. An excellent study was pulled together by UNICEF a few years ago called, “Preventing disease and saving resources: the potential contribution of increasing breastfeeding rates in the UK”. The report analysed data from many studies to ensure that there was a sound scientific basis for the claims that it made. Although I accept that giving precise figures and modelling on this is difficult, the UNICEF report estimates that:
“A modest increase in breastfeeding rates could result in a reduction in childhood obesity by circa 5%. If this was the case, the number of obese young children would fall by approximately 16,300, and annual health-care expenditures would reduce by circa £1.63 million.”
That would be no mean contribution. Breastfeeding starts babies off on the right track and, with the accompanying health benefits, such an increase could result in a generation of healthier babies and young people.
The Government should bear that in mind and ensure that services to promote, protect and support breastfeeding are well maintained. This is too important to be left to the good will of the wonderful network of voluntary organisations across the country. It needs to be an identified priority of this Government. The newly formed all-party parliamentary group on infant feeding and inequalities, which I established this week with colleagues from across the House, aims to examine the matter further. We will consider the issues of inequality, because there are multiple deprivation issues, with lower rates of breastfeeding in deprived communities.
What is less well known about infant formula is the specific contents of that product. It takes a complex chemical process to produce formula that involves either dry blending or wet mixing and spray drying, in which cow’s milk is treated with added lactose or other carbohydrates, vegetable and other oils, vitamins and minerals. According to the First Steps Nutrition Trust, the current regulations require infant formula and follow-on formula to have an energy content of between 60 kcal and 70 kcal per 100 ml. Those figures are based on the energy content of breast milk, but, as I mentioned earlier, breast milk composition changes in response to the baby as it grows. Breast milk also has more unsaturated fats than cow’s milk and the fats in infant formula tend to come from the vegetable oil. If anyone has an interest in finding out more about this, I recommend that they seek out the “Infant milks in the UK” report that is produced by the First Steps Nutrition Trust. The level of detail is fascinating.
There are differences between the growth curves of breastfed and formula-fed babies, with the formula-fed babies gaining more weight in the first year. Some studies suggest that that may, in part, contribute to childhood obesity. Pressure is also put on mothers to ensure that their baby is gaining the correct amount of weight. We should consider how formula milk is delivered. I have heard many people describe how many millilitres of formula their baby has drunk at any given time, comparing and contrasting this with others. There is an expectation of how much is normal.
There is a risk in the making up of formula milk, because one must ensure that the correct dosage of powder is dissolved in the water. If this is not done accurately, there is a risk of babies being overfed or, indeed, underfed. The risk of that is far lower for breastfed babies, although I admit that I could only really tell how much breast milk my babies had by the amount that they both threw up all over me. There is not really any other way of telling.
Mrs Hodgson
I agree with everything the hon. Lady has said so far. As she knows, I took part in the debate that she led in Westminster Hall on this issue. The point that she is making is very important. I was an evangelical breastfeeder myself and still encourage everyone to do it in every which way they can. She makes the point that breastfed babies feed on demand, so they take as much or as little as they need, whereas when babies are bottle fed, there is an obsession with whether they have taken half a bottle, 8 ml or whatever. Parents inadvertently force-feed their baby the amount they think they should have, rather than what the baby needs, so babies get used to being full. As we all know, that is not necessarily good and can lead to the bad habits in adulthood that I spoke about earlier.
Alison Thewliss
I absolutely agree with what my good friend says. Bottle feeding tends to be at a set time—“Is it time for the baby’s feed yet?”—rather than when the baby actually needs to be fed, whereas breastfed babies are fed little and often on demand, which is a slightly better habit to get into.
There is also a beneficial effect on breastfeeding mothers. As well as reducing the risk of cancer and diabetes, breastfeeding burns calories and helps to get mothers back to their pre-maternity weight—for me the prospect of burning an extra 400 to 500 calories just by breastfeeding my baby was very attractive, and it certainly helped me to fit back into the clothes that I wore before I had my children, both of whom were breastfed for two years.
I was interested in the findings of the Select Committee report, and I particularly note the points about marketing and sugar content in foods. I was a wee bit disappointed that it does not contain much discussion on baby foods and toddler milks, as there are significant issues in that area regarding the advertising and the content of the products. In evidence to the Committee, Dr Colin Michie of the Royal College of Paediatrics and Child Health stated:
“Follow-on formulas are not necessary for human beings, but it would not seem so if you watch television. The problem is we are all very convinced by the stories. There are other issues that have parallels for what was said earlier in that the milk companies sponsor education, training, events and an awful lot of professional activities, which again does exactly, to our minds, what we heard it does to infants’ minds: when we see brand names, we equate certain things with them. It is an insidious business that we know enough of to be very wary of.”
The artificial creation of a market for follow-on or toddler milks is of some concern, because those products are not subject to the same level of scrutiny as formulas for very young babies. Research gathered by the First Steps Nutrition Trust suggests that
“Growing-up milks and toddler milks contain almost twice as much sugar per 100 ml as cow’s milk, and some Aptamil and Cow & Gate growing-up milks and all SMA growing-up milks contain vanilla flavouring. It is unclear whether repeated exposure to sweet drinks in infancy and toddlerhood might contribute to the development of a preference for sweet drinks in later life.”
It is important to take cognisance of that and consider the issue as part of the obesity strategy.
Dr Wollaston
I thank the hon. Lady for her powerful contribution, and I completely agree with what she says. I also agree that the advertising of follow-on milks is a covert form of advertising infant formula. Does she feel that that should be completely banned?
Alison Thewliss
Absolutely, and a lot of the advertising is very—I supposed we could say cunning. Products are made to look the same on the shelves and to match the adverts for follow-on milks, rather than those for the younger infant formulas, and more needs to be done about that.
The sugars in follow-on milks are not always made clear on the packaging, and that should certainly be of concern to us in this House. Establishing a sugar habit at such an early age should be discouraged, and as was said earlier, that also has an impact on the teeth of a growing child. Baby Milk Action has campaigned tirelessly on the marketing of formula, and it has been involved in challenging those issues in the European Parliament. There are related issues concerning the marketing and composition of baby food, and about the jars and packets found in supermarkets, which are often marketed at babies under six months, contrary to World Health Organisation advice.
Pressure from groups such as Baby Milk Action, and actions by MEPs such as the Green MEP Keith Taylor, led yesterday to the European Parliament rejecting draft EU rules on baby food. If they had been approved, they would have allowed baby foods to contain high levels of sugar, and products to be labelled for use from four months of age, rather than from six months, which is the advice. As a result, the Commission has been forced back to the drawing board to bring the regulations in line with recommendations of the WHO and the World Health Assembly, and to fit better with the international code on such issues. I would like further debate on the composition of baby foods, how they are marketed, where they are placed in supermarkets, and what advice is given to parents. Again, the sugar content and the rationale behind waiting until six months before bringing babies on to solid foods is not always made clear to parents.
Advice on such matters has changed over the years and has sometimes been conflicting, and well-meaning advice from family members can cause doubt in the minds of new parents. People need to have the best advice on feeding. All agencies should be clear about the advice that they give out, and we must guard the most vulnerable babies in our society against the vested interests of wealthy baby food and formula companies that seek to exert influence on professionals and groups giving out that advice. I hope that these issues will be given due consideration in the debate on obesity, and that thought will be given to the contribution that breastfeeding can make to improving infant and maternal health.
Mrs Flick Drummond (Portsmouth South) (Con)
I am delighted to follow the hon. Member for Glasgow Central (Alison Thewliss), who has established the fantastic all-party group on infant feeding and inequalities. I am looking forward to being part of that as it progresses, and I thank her for setting it up.
The chief executive of NHS England describes obesity as “the new smoking”, and in many ways he is right. Obesity leads to a multitude of health complications, ranging from lack of mobility to cancer. There are also many hidden health risks for people who are obese or severely overweight. Obesity can lead to a lack of self-worth or depression, and it can affect relationships and careers. Because of the growing obesity problem, and the very serious threat to our children’s futures, I am happy that this debate is taking place, and I congratulate my hon. Friend the Member for Totnes (Dr Wollaston) on securing it.
In my constituency of Portsmouth South, 20% of children and 25% of adults are obese, which is above the average for England. In other ways, obesity is unlike smoking—there is no “vaping” technology for people who struggle to maintain a healthy diet. We know that fast food is an immediate satisfaction, whereas healthy food can take longer to prepare. I am concerned, however, that some studies suggest that healthy food is more expensive than the fast and unhealthy food that we see on offer every day, or positioned conveniently at supermarket checkouts.
I am particularly concerned by a fairly recent report by the University of Cambridge, which found that healthy food was three times more expensive than unhealthy food. I would dispute that. It is perfectly possible to eat healthily on a low budget. As Baroness Jenkin from the other place has shown, someone can live healthily on £1 a day, and I know from my own busy household that it is possible to live healthily on a very small budget. At the local food bank where I volunteered before the election we handed out healthy recipes for the food that was provided, which should have lasted people for three days. I am sure that I do not need to repeat what that issue means for those living in deprived areas, except to say that in my constituency of Portsmouth South, where deprivation is higher than the English average, the challenge to encourage people to eat healthy food is even greater.
The whole House will agree that today our nation’s children are more susceptible and at risk of becoming obese. Children do not control their diets—it is the parents who do the weekly shop—and we would never blame a child for their poor dietary choices. Children who develop obesity at a young age are at risk of developing lifelong conditions, some of which are also life-limiting; as we have heard, cases of diabetes are increasing. During childhood, people develop habits that can last the rest of their lives. A lot of facts have been flying around in this debate, and although I understand the financial burden that a growing obesity problem poses for our NHS, the human cost cannot be quantified.
The solution to this problem is not simply more money. As other Members have said, it requires the energy and commitment of central and local government, health organisations, and our local charities, to educate the population on how to live on a low wage. I am really pleased that the Roberts Centre in my constituency is a family-focused charity. It offers a range of services offering support and assistance, including making healthier lifestyle choices, to some of the most disadvantaged families in the city.
Mrs Hodgson
On the hon. Lady’s point about living healthily on a low wage, I take on board that it is very possible to make healthy food very cheaply, but people need the skills and knowledge to be able do that. I wonder whether she will say a bit more about that. The School Food Plan says that education should start with children learning the skills they need to be able to look after themselves as adults.
Mrs Drummond
That is exactly what I was going to come on to, so I thank the hon. Lady very much indeed.
Last week, I met Home Start, a national family charity with a strong presence in Portsmouth. It has an army of volunteers who offer unconditional help and support to all families who need help in getting it right, and show them how to cook healthily. There is, however, a major role for our schools in tackling obesity. The school where I am a governor, Milton Park primary, is taking the lead locally in educating children about healthier choices. The cooks at the school have won awards and I can recommend their so-called “chocolate muffins,” which in fact are made of beetroot.
I would like to see cooking classes become mandatory in schools. I know it would be difficult to re-establish kitchens, but the rewards would be worth it. I see that as the only way to prevent future generations from continuing poor eating habits. The only way to do that is by teaching them how to cook healthily and how to budget. Like some of my colleagues, I was against a sugar tax to start with. If we can use the sugar tax to fund cooking classes in schools, however, then I am all for it.
In Portsmouth, there are a number of charitable organisations actively engaging with the community to help to tackle obesity through a more active lifestyle. Affiliated with Portsmouth football club, Pompey in the Community provides education and opportunities for children in the city.
Geraint Davies
The hon. Lady makes some interesting points about the relationship between nutrition and poverty. Does she agree that it is a good idea to provide free school breakfasts in school? They help poorer children in particular to achieve and to know what good food tastes like.
Mrs Drummond
I totally agree. I also back the attempt by the right hon. Member for Birkenhead (Frank Field) to get free school meals for everybody receiving the pupil premium. That is a very good point; I am thinking particularly of a healthy breakfast with porridge, not necessarily sugar-laden cereals.
Not only does Pompey in the Community provide a lot of the physical education curriculum in local schools, but it runs a number of out-of-school and holiday clubs. There are plenty of sports clubs in Portsmouth. I would like to see a lot more outreach from sports clubs to children from low-income families. The Portsmouth Sail Training Trust does this with sailing, focusing solely on children from low-income backgrounds. More sports clubs need to get out and do this, too. Perhaps we could use the sugar tax to help to fund some of those sports activities. I would also like to see more sport in the curriculum, with the possibility of at least one hour of activity every day. We heard about a school doing one mile a day. Every school should be doing that. I would like the Department for Education and the Department of Health to lead on more sport in school, perhaps with extended days to fit it in.
Often the simplest changes are the most effective. By encouraging our children to walk to school, and by continuing to develop nutritional education, I am sure we will see more positive results. Members on both sides of the House talk a lot about tackling deprivation in our communities. It is crystal clear that the House must now turn its energy towards fighting the terrible problem of obesity, through education and providing more opportunities for an active lifestyle.
Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)
I thank the hon. Member for Totnes (Dr Wollaston) for securing this extremely important debate. It is not listed in my entry in the Register of Members’ Financial Interests, but I must declare a terrible sweet tooth, which gives me great experience from which to speak in this debate.
Over preceding decades, there have been profound changes in the UK in the relationship we have with food. Historically, the public health challenges we faced tended to relate to under-nutrition and unsafe food and water. However, in modern society, those issues have largely been replaced by the risks of poor diet. Food is now more readily available and there have been significant changes in how we eat, the type of foods we consume, and how they are produced and marketed. Busy lifestyles and easy access to convenience and processed foods have helped them to become a staple part of many families’ diets.
In general, we over-consume foods high in fat, sugar and salt, and we do not eat enough fruit, vegetables, fibre and oily fish. Our type of diet underlies many of the chronic diseases that cause considerable suffering, ill health and premature death. It is also a major factor in the issue of childhood obesity, heart disease and type 2 diabetes. The recently published findings from the Health Committee’s investigation into childhood obesity highlighted that one in five children is overweight or obese when they begin school. That figure was found to rise to one in three by the end of primary school. There was also evidence of inequality between different sectors of society, with those from deprived backgrounds found to fare significantly worse and to be twice as likely as their more affluent counterparts to be overweight or obese.
These figures are extremely concerning. Obesity is a serious problem that has significant implications, both on the long-term wellbeing of the individual child and on society as a whole. Many of the most serious and potentially life-shortening physical health risks that accompany obesity are well publicised and have been raised already in the Chamber today. I will not, therefore, go into them again.
Instead, I will highlight the detrimental social effects that can impact on individuals’ overall wellbeing and life chances. Research indicates that childhood obesity is associated with mental health issues in both children and adults, such as depression, low self-esteem, social isolation, self-harm and behavioural problems. It is also associated with stigma and bullying. In addition to obesity, a poor diet that includes too much sugar and acidic food substances can lead to oral health issues, which can impact on an individual’s ability to eat and socialise, and this again can adversely affect their mental health and contribute to their social isolation.
Addressing these issues will require a concerted effort to alter health choices, to address cultural and lifestyle issues and to improve our relationship with exercise and sport. It will require a multifaceted response; no single measure will do the trick. We need a response from private enterprise to improve choices and healthy options that are appealing and, importantly, cheap, as was highlighted by my hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson). We need to address the effect that marketing can have on children and parents and make sure it is done responsibly, as was mentioned by my hon. Friend the Member for Glasgow Central (Alison Thewliss). We need to enhance skills gained at school and home in cooking healthy meals, and this must be role-modelled at school, with fruit bars, water and other healthy choices that are low in fat, salt and sugar, as was discussed in detail by the hon. Member for Washington and Sunderland West (Mrs Hodgson).
Childhood obesity must also be addressed by local commissioning in areas where fast-food outlets are placed near to schools. In one of my local areas, refuse staff are in place at school lunch times to clear up fast-food packages left by school children in shopping squares. This must be addressed and must not be encouraged. Wider Government initiatives are also required to improve food labelling. We need labelling that is understandable to families and ordinary people and which does not look like gobbledegook.
As debated today, taxation should be considered as part of an evidence-based approach. We also require an increased focus on sports, exercise and healthy pursuits as being integral to our lifestyle; increased funding; and an emphasis on engaging children and young adults in these activities and making them affordable to people from all walks of life. We know from psychological research that education, in itself, does little to change behaviour. We therefore require a Government strategy to reinforce healthy choices. This would be cost-effective in the long term for our health service and quality of life.
Geraint Davies
The hon. Lady is making a powerful and excellent speech. She might know that in Mexico the average consumption of Coca-Cola is 0.5 litres a day per person and that children are being fed Coke in baby bottles. Does she agree that the Government need to take action not just on pricing but on marketing? We cannot have this situation where people can buy two litres for 5% more, so that we have these huge stocks of Coke that people feel they have to get rid of before it loses its fizz, and everybody’s teeth fall out.
Dr Cameron
The hon. Gentleman makes a good point. I have pinpointed the need to address the effect of marketing on children and parents’ healthy choices.
A clear strategy would benefit our children, society as a whole and future generations. That is surely Parliament’s job. We should not shy away from a bold and effective obesity strategy.
Andrew Gwynne (Denton and Reddish) (Lab)
I pay tribute to the Backbench Business Committee for allocating time for such an important debate and to the hon. Member for Totnes (Dr Wollaston) for her eloquent opening speech. I also extend my thanks to the entire Health Select Committee for producing such a comprehensive report on childhood obesity. She was dead right to entitle it, “Childhood obesity—brave and bold action”, because that is precisely what is needed. I would also like to thank for their contributions my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), my right hon. Friend the Member for Leicester East (Keith Vaz), my hon. Friend the Member for Swansea West (Geraint Davies) and the hon. Members for Colchester (Will Quince), for St Austell and Newquay (Steve Double), for Strangford (Jim Shannon), for Mid Worcestershire (Nigel Huddleston), for Twickenham (Dr Mathias), for North Ayrshire and Arran (Patricia Gibson), for Erewash (Maggie Throup), for Glasgow Central (Alison Thewliss), for Portsmouth South (Mrs Drummond) and for East Kilbride, Strathaven and Lesmahagow (Dr Cameron)—I am sure I pronounced that kind of right.
Returning to the Select Committee report, the starting point has to be the scale and the consequences of the problem, and this requires looking at doing things differently. Failure to act will make the problem worse—not just for the individuals concerned, but for the public purse, which will, frankly, struggle to cope with the health inequalities that we are exacerbating.
The statistics are clear. Childhood obesity is strongly linked to deprivation, almost reversing the trend of the entire history of the human race whereby malnourishment, not obesity, was the key indicator of poverty. As we know from the statistics of Public Health England, the most deprived children are twice as likely to be obese at reception and at year 6 than the least deprived children—and that gap is widening, as the hon. Member for Totnes set out.
We often get into the habit of praising the fact that a debate is even taking place here, but in this instance, the timeliness of the debate really cannot be overstated. It is no understatement to say that the Government’s strategy has been a long time coming. Although we are debating obesity today, I hope that this is not a sign that the document is being slimmed down. Today’s debate has suffered from the slight disadvantage of addressing the contents of a document that does not yet exist. Perhaps the Minister will give some certainty—perhaps even a date—on when we can expect publication of the strategy. This also presents a rare opportunity, hopefully, to influence what will eventually be published in that strategy. It is important to remember that Government can do immense good when it comes to public health.
If we think about some of the great strides in public health that we have taken in recent years—from the banning of smoking in public places to reducing the rates of teenage pregnancy—we realise that these moves came about, in part, as a result of Members putting difficult issues on to the political agenda. With that in mind, I shall focus my remarks today around the key issue of obesity and diet.
I believe that we need action to tackle the problem at the supply side on the part of food and drink companies, and also action to tackle it on the demand side, with a need for far better education on how we could be looking after ourselves, as well as give people the means to eat healthier food. We believe a comprehensive and broad approach is necessary to help families, schools and children to make the right decisions. I commend the work of my hon. Friend the Member for Washington and Sunderland West, who has long been a champion of better standards of food in our schools.
In November, the Health and Social Care Information Centre released data showing that one in every five children leaving primary school are classified as obese, and one in every three children are either obese or overweight. Frankly, those figures should shame each and every one of us. Although there has been a shift in providing healthier, more nutritious meals at schools, so many of the problems start before school or at least outside of school hours.
Between April and September 2015, Trussell Trust food banks in Greater Manchester, which includes my constituency, gave 22,739 three-day emergency food supplies to people in crisis. Some 8,666 of those three-day emergency food supplies were given to children. When so many families are having to rely on food banks to feed their children, they may be limited in their ability to provide fresh and healthy meals. In these upsetting circumstances, feeding their child something is better than seeing them go hungry. Wider problems of poverty must be addressed to ensure that people have access to good diets. How does the Minister plan to help families who are having to rely on food banks to improve their diets?
Funding is a crucial side issue. Following the removal of protected status from all Department of Health budgets that are not controlled by NHS England, the pot of money that pays for public health will be subjected to huge cuts in the coming years. That will have a significant impact on Public Health England, and could put at risk our ability to tackle obesity to the necessary extent. It could also put at risk the future of public awareness campaigns, many of which have been a great success. The cuts in the public health grant to local authorities could drastically reduce the amount of support that is available locally to those who want to lose weight or have a healthier lifestyle. I should be interested to hear from the Minister how the public health cuts in the coming years are consistent with the emphasis on prevention in the “Five Year Forward View”, and, in particular, whether the crucial issue of funding will be addressed in the forthcoming strategy.
Geraint Davies
Obviously funds are tight, but does my hon. Friend agree that if we introduce a sugar tax, it will ease the burden and enable us to focus our fire on reducing obesity in other ways?
Andrew Gwynne
That may well be the case, but we must of course ensure that any income raised by such a tax is reinvested in public health.
It is also important to increase levels of physical activity among adults and children throughout the United Kingdom. Inactivity is a key factor in ill health, and it is important that we encourage children to maintain active lifestyles from an early age. I believe that increasing the opportunities for young people to get involved in physical activity is just as important as improving diets. Treating obesity and its consequences alone currently costs the NHS £5.1 billion every year. Given that nearly 25% of adults, 10% of four to five-year-olds and 19% of 10 to 11-year-olds in England are classified as obese, the human and financial cost of inaction is significant. We must do much more to ingrain physical activity in our daily lives, whether that means walking instead of driving or taking the stairs instead of the lift. Every little helps.
A number of Members have touched on a point that is crucial to the debate. Many people have argued that the Government should introduce some form of tax on sugary products, particularly soft drinks, and the debate on that issue goes far beyond the Chamber. Public figures such as Jamie Oliver have come out in support of a sugar tax, and he has made a compelling case. However, the issue is complex, and I do not think that the answer is necessarily straightforward. Labour Members have always feared that a sugar tax, in itself, could be regressive, and that it would focus attention on consumers, many of whom are addicted to sugar, rather than manufacturers, who should be reducing the amount of sugar in their products. That said, however, I suggest to the Minister that it is right for us to look at the emerging evidence from other countries, which has shown that where similar taxes have been introduced they have had a positive effect, not least in changing behaviour.
Andrew Gwynne
I am afraid not. I do not have time.
It has not escaped my attention that the Prime Minister has effectively gone from ruling out a sugar tax to not ruling out a sugar tax. I hope that the Minister will clarify the Government's position, but, in any event, it seems that the forthcoming strategy will mark a departure from the ineffective voluntary approach that they have favoured in recent years. The public health responsibility deal has seen firms making all sorts of promises and then hijacking the agenda to promote their own products, ultimately failing to fulfil their pledges. At the time of its introduction, organisations such as the Royal College of Physicians and Alcohol Concern complained that the pledges were not specific or measurable, and that the food and drink industry had simply dictated the Government’s policy.
I hope that the Government will take a much stronger line with industry than it has taken previously, because it must be incumbent on industry to reduce the amount of sugar in products, including comparable products in the European Union that are boxed in exactly the same way, but contain significantly different amounts of sugar and other ingredients. I also hope that if the Government are forthcoming with a fiscal solution, that is part of a much larger and comprehensive strategy of measures. I do not think anyone would try to argue that a sugar tax on its own is a silver bullet. I want food and drinks manufacturers to reduce sugar in their products, and we need to ensure that that happens.
I thank everyone who has spoken in the debate, and I hope the Minister will consider the many excellent contributions when the Government put the final touches to the childhood obesity strategy.
The Parliamentary Under-Secretary of State for Health (Jane Ellison)
I am delighted to respond to the debate on behalf of the Government, and, following on from what the shadow Minister just said, I welcome the opportunity to take forward all the points made in the many excellent and well-informed—although occasionally a little confessional—contributions. It is a timely debate that will make a valuable contribution as we finalise our strategy.
The House is at a slight advantage as it has the chance to influence, but I am at a disadvantage as we have yet to publish the strategy and therefore I have to talk in slightly more general terms.
I welcome the Health Committee’s recent report, which we have debated once already, and its previous report, “Impact of physical activity and diet on health”. We will be formally responding to the Health Committee’s most recent report soon.
There is no denying that in England, and indeed globally, we have an obesity problem. Many shocking statistics have been given in this debate and I will not repeat them, but many Members on both sides of the House dwelled on the health inequalities issue—the gap that is emerging—and I will come back to that. My hon. Friend the Member for Colchester (Will Quince) drew our attention to what is, in effect, a stabilising of childhood obesity statistics, although it is at far too high a level. As he acknowledged, there is a pronounced gap between different income groups.
Once weight is gained, it can be difficult to lose and obese children are much more likely to become obese adults. In adulthood, obesity is a leading cause of serious diseases such as type 2 diabetes—as the right hon. Member for Leicester East (Keith Vaz) and others mentioned—heart disease and cancer. It is also a major risk factor for non-alcoholic fatty liver disease.
We also know that eating too much sugar is linked to tooth decay; it was good to hear my hon. Friend the Member for Mole Valley (Sir Paul Beresford) make that point. In 2013-14 over 62,000 children were admitted to hospital for the extraction of teeth. This is a serious procedure that frequently requires a general anaesthetic. Children should not have to go through this.
Many Members highlighted—I think there is consensus on this—that there is no silver bullet to tackle obesity. That means that in order to reduce rates we need a range of measures and all of us, and all the parts of our society mentioned in the debate, have a part to play, as our forthcoming strategy will make clear.
Sometimes in the national debate around obesity people question the role of the state and how it should intervene to drive change. In the face of such high obesity rates, with such significant implications for the life chances of a generation, it is right that tackling obesity, particularly in children, is one of this Government’s major priorities, and we showed the priority we place on the issue by making it a manifesto commitment.
As my hon. Friend the Member for Portsmouth South (Mrs Drummond) said, the human cost is enormous. Young children in particular have limited influence over their choices and Government have a history of intervening to protect them: we do not question the requirement that younger children use car seats on the grounds of safety, for example. Children deserve protecting from the effects of obesity, for their current and future health and wellbeing and to ensure they have the same life chances as other children, especially those in better-off parts of our society.
As I have said, I was struck by how many Members alluded to the health inequalities issue. There is strong evidence of a link between obesity and lower income groups. The obesity prevalence among reception year children living in the most deprived areas was 12% compared with 5.7%, and that gap rose to 25% as against 11.5% respectively by the time they leave primary school. That is not acceptable, and we must take action to tackle it.
Any Government with a state-funded health service also have a responsibility to take an interest in the nation’s health to ensure the sustainability of the NHS. The huge cost of treating lifestyle-related type 2 diabetes has been mentioned by a number of Members. Our election manifesto supported the programme for prevention set out in the NHS England’s “Five Year Forward View”, which states that
“the future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health.”
Tackling obesity is a key component of this work. I accept the challenge from the shadow Minister on budgets, but I can give him the assurance that over the spending review period we are still going to be spending £16 billion on public health. We can complement local action with national initiatives, and we will talk more about that when we publish our strategy.
We are continuing to invest in the Change4Life campaign, which has been going on for many years. We have learned a lot from it, and we now have valuable evidence about what works and what provides motivation and support for families to make small but significant improvements. On 4 January, we launched the new Sugar Smart app to encourage parents to take control of how much sugar their children eat and drink. Members have described how people can scan the barcode on any of the thousands of everyday products that are catered for by the algorithm. This allows people to visualise the number of 4 gram sugar cubes the product contains. In the first 10 days of the campaign, about 800,000 people downloaded the sugar app. That is a great success, and an example of how we can empower families with information so that they can make decisions about their diet. A number of Members made that point, including my hon. Friend the Member for St Austell and Newquay (Steve Double), who talked about the role of families.
Jane Ellison
I do not think I have time. I think I know what the hon. Gentleman is about to say, and we have had the teaspoon discussion before. I recommend the sugar app to him; he acknowledged its introduction in his speech, for which I am grateful.
The Sugar Smart app builds on the Change4Life Sugar Swaps campaign, from which we learned a lot. More than 410,000 families registered with the campaign. However, we know that public health messaging and support are not enough. That is why our childhood obesity strategy will be wide ranging and involve Government action across a range of areas.
The food and drink industry also has a role to play, as many Members have said, and I am pleased that it has made progress in recent years. My hon. Friend the Member for Erewash (Maggie Throup) alluded to that fact earlier. Under the voluntary partnership arrangements and the responsibility deal, there has been a focus on calorie reduction, of which sugar has been a big part. We have made progress. Some retailers have also played their part by removing sweets from checkouts, which we welcome. We urge others to follow suit. Importantly, parents and customers have strongly welcomed that change and supported the measures being taken by the industry. But the challenge to the industry to make further substantial progress remains.
Providing clear information to consumers is vital if we are going to help them to make healthier choices. That has been a theme of the debate. The voluntary front-of-pack nutrition labelling scheme, introduced in 2013, plays a vital part in our work to encourage healthier eating and to reduce levels of obesity and other conditions. The scheme enables consumers to make healthier and more balanced choices by helping them to better understand the nutrient content of food and drinks. It is popular with consumers and provides information on the calories and nutrients in various foodstuffs. Businesses that have decided to adopt the scheme account for two thirds of the market for pre-packed foods and drinks.
As a Conservative and a former retailer I believe in customer choice, but if consumers are to make an informed choice they need information. Informed consumers can of course shape markets and drive change, as my hon. Friend the Member for Twickenham (Dr Mathias) pointed out in her thoughtful speech. That point came out strongly in the debate, and I shall reflect on it a great deal.
I want to say a little about physical activity, which is also a key theme. We are very clear that for those who are overweight and obese, eating and drinking less is key to weight loss, but we know that physical activity has a role to play in maintaining a healthy weight. It is also hugely beneficial in many other ways. For children it is a vital part of growing into a healthy, happy adult, so it has been great to hear about the work being done in schools up and down the country. We heard examples of that from my hon. Friends the Members for Mid Worcestershire (Nigel Huddleston) and for Erewash. That is why raising levels of participation in sport and exercise among children and young people is an area the Government are keen to make further progress on.
The Department worked closely with the Department for Culture, Media and Sport on the new sports strategy, published just before Christmas. We will be working with DCMS, Sport England and Public Health England in the coming months to implement the strategy. The Minister for sport and I have worked closely together on both the obesity agenda and her agenda on physical activity. We are also working to raise awareness of the UK chief medical officer’s physical activity guidelines. We have already developed an infographic for health professionals to use when they discuss physical activity with adults, but we want to go further and work on further infographics to raise awareness of the daily activity levels required for children and young people, including the under-fives. We hope that that will be a useful resource, not only for families, but for the leisure sector and for many more who have a key role in encouraging people to be more active.
A slightly different point was made by the hon. Member for Glasgow Central (Alison Thewliss), but it was an important one and she spoke knowledgeably about nutrition in the very early years and during pregnancy. I commend to her the recent chief medical officer’s report on women’s health, as it contained a number of chapters that I think she would find of huge interest if she has not already had the chance to look at them.
There has been a consensus on a number of facts, although a key one stood out: obesity is a complex issue, which the Government cannot tackle alone. Businesses, health professionals, schools, local authorities, families and individuals all have a role to play, as does Parliament. We were all struck by the contribution made by the hon. Member for Washington and Sunderland West (Mrs Hodgson), who spoke so passionately about the need to tackle health inequalities. She spoke about the influence of a good start in life and how that works all the way through one’s life. Parliament does have a role to play, so I welcome the engagement of so many Members from all parts of the House. I would be happy to provide more information if it is ever of help to Members about key public health indicators in their own local areas and how they can help to take this agenda forward. Local leadership will be important as we seek to make the critical leap forward on preventive health action described in the NHS “Five Year Forward View”.
This has been a great debate and I thank Members for their contributions. I look forward to discussing this issue further when we publish our comprehensive childhood obesity strategy.
Dr Wollaston
I thank all Members who have contributed to today’s debate, including the Minister, who rightly said that the action the Government take now will affect the life chances of a whole generation. I am grateful for her recognition of the importance of not only obesity in itself, but the pressing concern that everyone has about how health inequality affects this issue. I am also grateful that she is going to include that at the heart of the Government’s obesity strategy.
In conclusion, we are looking for bold, brave and, most importantly, effective action. I would like to finish as I started by saying that we should take a leaf out of the book of British Cycling, because there is no silver bullet and we need to follow the principle of marginal gains—let’s do everything.
Question put and agreed to.
Resolved,
That this House calls on the Government to bring forward a bold and effective strategy to tackle childhood obesity.