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The Parliamentary Under-Secretary of State for Health and Social Care (Steve Brine)
What an interesting debate. I echo the view of the shadow Minister, the hon. Member for Washington and Sunderland West (Mrs Hodgson), that it is a privilege to be in this position at this time in the NHS’s history. I feel like I know her Aunty Ella personally—what a lovely family anecdote that was. That real example was a good reminder of what the NHS has brought to families.
I congratulate the hon. Member for Blaenau Gwent (Nick Smith) on securing the debate. Those who know me know that I certainly share his passion for this topic. Winchester cannot claim ownership of Mr Bevan, but Florence Nightingale established a hospital in my city on the hill—the Royal Hampshire County Hospital, which is much loved and is still there doing great things. It has very committed and caring staff. The hon. Member for Bristol South (Karin Smyth) said that the NHS was a great achievement but that there were also a number of compromises. If I may say so, she was very astute to put it that way. As many Members have said, we live with that achievement but there are many compromises.
The NHS is of course 70 years old this year. Much has changed in our society and our health since 1948. Our health needs are very different, and we have better drugs and diagnostic tools. When the NHS was born, life expectancy was 66 for men and 71 for women; today it is 79 and 83 respectively. That is incredible. In 1948 there were more than 34 deaths for every 1,000 live births; today there are just five, although that is still too many.
I will start where every Health Minister should, by thanking our NHS staff for all they do, day in, day out, to make our NHS something that we are incredibly proud of. There was a great awards event this week in London, at which the Duke of Cambridge spoke, which showcased so many wonderful examples. Indeed, Mr Bevan would be amazed at the work that goes on today across the NHS.
We want to use the NHS70 moment to reflect on the last 70 years of patient care, to celebrate the innovations in the NHS, to raise awareness of the many ways we can support the system and, probably most importantly, to promote the public’s role in the future of the NHS and the importance of taking care of our own health and using the NHS wisely—and, yes, accountability, which the hon. Member for Bristol South wisely raised. I am giving her a lot of credit. [Interruption.] “Keep going,” she says.
So much of this debate is about our changing society, but the NHS has consistently been a universal service that is free at the point of need. That will continue. However, as several Members said, we are facing many different challenges from those we faced back in the ’40s, such as the prevalence of type 2 diabetes, which my hon. Friend the Member for Henley (John Howell) mentioned. He sits on the all-party parliamentary group on diabetes. I was bitterly disappointed that he did not give us any of his medical updates, but I know that those will come another time. In fact, we heard a couple of medical examples from the SNP spokesman, the hon. Member for Airdrie and Shotts (Neil Gray). The rising prevalence of type 2 diabetes is a great challenge for us, as is cancer. Both can be reduced if we tackle obesity and encourage more people to lead healthier lifestyles, so that is where I will focus.
The Government take the public health challenge we face incredibly seriously. We have responded by putting prevention at the heart of public policy making. We have taken quite stringent steps. As the shadow Minister said, we are a global leader on tobacco control. We were the first country in Europe to introduce legislation to bring in plain packaging for cigarettes, off the back of the smoking ban in public places. She rightly mentioned Fresh North East, which is a very good example—it is in many ways the apple of my eye in this policy area. I hope at some point, if the arithmetic in this place ever allows, to go and see it for myself. I will let her know if I do—perhaps we can do that together. In April we introduced the soft drinks industry levy, which is a big public health measure. In recent years we have vaccinated more than 1 million infants against meningitis and an additional 2 million children against flu.
We have run award-winning public health campaigns, including Be Clear on Cancer, which I am very invested in, and Act FAST, the public health stroke campaign. They all sit with the inheritance of the landmark Don’t Die of Ignorance campaign about the AIDS challenge we faced in the late 1980s—I am surprised that was not mentioned. That campaign still makes the hair on the back of the neck stand up, does it not? It was an incredibly impactful and powerful piece of work that came out of the public health movement.
I want to cover a lot of things, but let me return to diabetes, which is a major challenge. Preventing diabetes is a huge priority for the Government. According to Diabetes UK, which I saw just last week, about 5 million people in our country are currently at high risk of developing type 2 diabetes. If the current trend persists, one in three people will be obese by 2034 and one in 10 will develop type 2 diabetes. Some of the risk factors for type 2 diabetes, such as poor diet and a sedentary lifestyle, which can lead to obesity, can be changed. We know that 61.4% of adults are either overweight or obese; and 26% of adults and 20% of children aged 10 to 11 are obese. The obesity crisis has been decades in the making, and tackling it is a real challenge. It will not be turned around overnight, and no one pretends that it can be. That is why tackling obesity is absolutely a Government priority. I will come back to that point in a moment.
I mentioned the NHS diabetes prevention programme, which is aimed at providing people aged 40 to 60 who are at risk of diabetes with personalised help with healthy eating and lifestyle, and bespoke physical activity. So far, as I said at Health questions last week, more than 170,000 people have been referred to that programme. Those who are referred get tailored, personalised help, and that is really making an impact.
Steve Brine
I thank the hon. Gentleman for that point. I touched on child obesity, which is one of the top public health challenges, if not the top challenge, for this generation. Overweight and obesity-related ill health is estimated to cost the NHS in England about £5.1 billion each year. The estimated total cost to society is between £27 billion and £46 billion per year. Our child obesity plan, which was published back in 2016, is informed by the latest evidence and research in the area. At its heart is a desire to change the nature of the food that children eat and make it easier for families to make healthier choices. Since we published the plan, real progress has been made on sugar production. Since the introduction of the soft drinks industry levy, which I mentioned, sugar has been drastically reduced in around half of all soft drinks products that fall under the levy. I recognise the daily mile, which was rightly raised by the hon. Gentleman, which he said started in Scotland. It is in England as well, though not as much as I would like to see it—we have an ambition for it to do much better.
Many Members mentioned child obesity, and we have always been clear that the child obesity strategy is the start of a conversation and not the final word—we call it chapter 1 for a reason. We continue to monitor the progress we have made since the publication of the strategy a couple of years ago, and if further measures are needed we will take them.
Let me touch on physical activity, which the hon. Member for Blaenau Gwent rightly spoke about. People know that being active is good for their health and they want to do more, but the truth is that many of us are simply not active enough to benefit our health. Only 66% of men and 58% of women in England meet the chief medical officer’s recommendation to be active for at least 150 minutes a week. Children are no better, with only 23% of boys and 20% of girls being active for at least 60 minutes a day. As we get older, we become less active. It is recommended that we do muscle strengthening and balance exercises on at least two days a week, but the most recent health survey shows that only 1% of the adult population in England meet that guideline.
Why is that important? We are facing an ageing population and there is good evidence that being active reduces the chance of falls, depression and dementia by up to 30%. That will help people stay healthy and independent for longer, and we need that to happen if the NHS is to be sustainable for its next 70 years. People need to understand why being active is important and have a clear understanding of how much activity they should do and the impact that can have on their health. I was pleased to hear parkruns mentioned by a number of Members, including the hon. Member for Blaenau Gwent, because they are incredibly important. I have them in my constituency at the River Park leisure centre.
It is vital that we acknowledge the importance of good mental health, which was mentioned a couple of times in the debate. Everybody’s mental health is on a point on the spectrum and, as my hon. Friend the Member for Ayr, Carrick and Cumnock (Bill Grant) said, mental health is just the other side of the coin of physical health. Good mental health is so important to leading positive and productive lives and to the NHS. This is Mental Health Awareness Week, but really every day should be a mental health awareness day. Mental health is a key priority for the Secretary of State and the Prime Minister, which is why last December we published the Green Paper on children and young people’s mental health, backed by more than £300 million of funding to improve access to services and, crucially, mental health support in schools.
Just yesterday I was at the Maudsley Hospital in London, looking at the incredible work it has done in bringing us to a smoke-free NHS. We identified mental health in-patients as a key target in the tobacco control plan. I saw the important work being done, which I would recommend to any Members who think they could inspire their local areas to follow that lead.
My hon. Friend the Member for Ayr, Carrick and Cumnock was dead right to mention delayed transfers of care—delayed discharges—which are a key component and in many ways the magic key to the NHS. It is also always nice to hear Robert Burns quoted in the Chamber, but I am sorry that he did not sing it—maybe next time.
I understand why the hon. Member for Coatbridge, Chryston and Bellshill (Hugh Gaffney) made the speech he did. He certainly put down a marker for the Scottish Government, who govern his constituents.
I thank my hon. Friend the Member for Henley for mentioning the long-term economic plan—I have not said that for a while—and the multi-year funding plan that the Prime Minister talked about at the Liaison Committee. He is dead right. That is exactly what we should be doing, and it is exactly what we will do.
As always, the hon. Member for York Central (Rachael Maskell) spoke from the heart about health matters. She mentioned the integrated public health plan for her city, which sounds great. Local application of what is good for local areas is right, and I look forward to hearing more about her local area when we meet.
The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) raised questions about the devolution settlement. Of course, we talk across England and the devolved nations, but the settled will of this Parliament and of the people in this country is that we have a devolution settlement. Devolution can bring difference, and that can be good or bad. Yes, we do talk and share best practice, and I know that NHS England and Public Health England talk to their counterparts in the devolved nations all the time.
On good and bad difference—this is not political knockabout; it is just some facts—it would be remiss of me, as a Conservative Health Minister, not to put on the record that since 2010 we have increased NHS spending each and every year, even as we have had to take some very difficult financial decisions, given the state of the public finances we inherited. The NHS now has £14 billion more to spend on caring for people than it did in 2010. To give that some context, over the past five years funding for the NHS increased in Wales by 7.2%, in Scotland by 11.5%, and in England by 17.3%. I say that not to make a political point; it is a simple fact that should be put on the record.
Let me take this opportunity once again to congratulate the hon. Member for Blaenau Gwent on introducing this timely and important debate. As we have seen, the challenges that the NHS faces are radically different from those it faced in 1948. The debate has shown us why we, the Government, the NHS and the people we all represent, wherever they live in this United Kingdom, are all part of the solution to the deep and significant public health challenges we face as a nation. They are also all part of the inheritance of that health service that we are all so proud of.
In the short time available I have tried to show how seriously the Government and the NHS take those challenges. We must use all the opportunities we have at our disposal and that long-term health economic plan—I like saying that—to address the big public health challenges facing our nation. Only through the combined efforts of the Government, the NHS and the people in our country who are taking responsibility for their own healthcare, as technology increasingly allows them to do, which was another good point made in the debate, can we truly tackle the public health challenges we face and make sure that the NHS does not just survive for another 70 years—we are not interested in that—but thrives and goes from strength to strength, being a preventive health service as much as a treatment health service. That will truly honour Nye Bevan and everyone else involved in its establishment back in the ’40s.