Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
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The Minister for Care (Stephen Kinnock)
It is a great pleasure to serve under your chairship, Mr Mundell. I am indeed starting with an apology. I am very embarrassed by the fact that the debate was put by my officials in my diary as starting at 3.30 pm, and it is completely unacceptable that I arrived late. I apologise to you, Mr Mundell, and to the hon. Member for Strangford (Jim Shannon). It is a very embarrassing situation, and I am not happy about it at all.
I thank the hon. Member for Strangford for securing this debate on such an important issue and for the vital work he does as the chair of the APPG on vascular and venous disease. For their excellent contributions, I also thank my hon. Friend the Member for Dudley (Sonia Kumar), who spoke powerfully on the basis of her extensive real-world experience and expertise, my hon. Friend the Member for Ilford South (Jas Athwal), who spoke so movingly about his family and personal experiences, and the hon. Member for Mid Sussex (Alison Bennett), who spoke passionately about the shocking health disparities that blight our country, caused by 14 years of Tory neglect and incompetence.
Before I begin my remarks, I want to pay tribute to people working in local government, our NHS staff and GPs up and down the country for their efforts to find, treat, and manage people at risk of cardiovascular disease—also known as CVD. As hon. Members will know, health is a devolved issue, so my remarks will be limited to matters in England; however, I am happy to pick up on many of the broader points that the hon. Gentleman for Strangford has made.
The last Labour Government made significant progress on reducing premature deaths from CVD through the introduction of big-hitting interventions such as the ban on smoking in public places and increases in statin prescribing. However, as the hon. Member for Strangford said, among the many appalling findings of Lord Darzi’s report, there is clear evidence that progress on CVD stalled, and even went into reverse in some areas, between 2010 and 2024. That is why it is this Government’s mission to invest in the health service, alongside fundamental reform to the way that healthcare is delivered. We will build a health and care system fit for the future by moving from sickness to prevention, hospital to home, and analogue to digital. Tackling preventable ill health is a key part of these shifts.
As part of our 10-year health plan, we are committed to helping everyone to live a healthy life for longer, and as the hon. Gentleman also outlined in his remarks, too many lives are cut short by heart disease and strokes. In 2022, one quarter of all CVD deaths in the UK occurred among people under the age of 75. Tackling CVD is not just the right thing to do for patients; CVD is also having an impact on growth. People with CVD are more likely to leave the labour market than people with poor mental health, and we must dispel the fiction that people with CVD are always old and infirm. Around one in three people who have a heart attack, one in four people who have a stroke, and two in five people with coronary heart disease are of working age.
The hon. Gentleman referred to premature deaths, and we know from the most recent figures that I have, from 2023, that in England alone over 130,000 people died from CVD and over 30,000 people died before they turned 75. The best estimates show that the annual cost of CVD to the NHS is a staggering £8.3 billion, with knock-on effects of £21 billion to the wider economy. This is a huge challenge, which is why we are meeting it with great ambition: to reduce premature deaths from heart disease and stroke in people under 75 by one quarter within a decade. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for West Lancashire (Ashley Dalton), will be spearheading our work in this area, and will also be picking up on many of the issues that the hon. Gentleman raised in his speech.
We know that around 70% of the CVD burden is preventable and due to risk factors such as living with obesity, high blood pressure, high cholesterol and smoking—all of which can be reduced by behaviour changes, early identification and treatment. In England, the NHS health check is a free check-up for people between 40 and 74. The NHS health check is a wide-reaching programme delivered by local authorities in England. This CVD prevention programme aims to prevent heart disease, stroke, diabetes, and kidney disease—and also dementia for older patients.
In the very short period of time that I have left, I just wanted to say that the hon. Member for Strangford called for the introduction of Lp(a) tests. As I understand it, lipoprotein(a) measurement is not currently recommended by NICE guidance, and there are no treatments available that specifically target Lp(a). Instead, our focus is to improve the uptake of lipid-lowering therapies for prevention of CVD and to treat people with established CVD to NICE treatment targets. We will look closely at new tech and innovation and the essential role they will play in reducing health inequalities.
Jim Shannon
I apologise, but at the end of my speech I asked for three things. I asked whether there would be a willingness to meet me and representatives from the Lp(a) taskforce to discuss the essential steps that are needed, and that—
David Mundell (in the Chair)
That is not technically a point of order, but I am sure the Minister has heard what you have had to say. I am sure he and, indeed, the hon. Member for Glasgow South West (Dr Ahmed)—who was here from the start—will have noted all the points that Mr Shannon raised. If the points that Mr Shannon raised at the end—and indeed earlier, in his contribution before the Minister spoke—were unaddressed, I am sure that the Minister will write to him.
Stephen Kinnock
I absolutely will. I would be happy to complete my remarks, but I do not know that would work, given that Mr Shannon has made his second contribution.
David Mundell (in the Chair)
I will make the determination that Mr Shannon’s contribution was an intervention—although an excessively lengthy one, which he will not repeat at the conclusion of the debate.
Stephen Kinnock
This has been an interesting debate on so many levels. I thank you for that clarification, Mr Mundell.
I was just talking about the fact that around 70% of the CVD burden is preventable, and that the causes include obesity, high blood pressure, high cholesterol and smoking. All those factors can be reduced by behaviour changes, early identification and treatment. In England, the NHS health check is a free check-up for people between 40 and 74. It is a wide-reaching programme delivered by local authorities in England. This CVD prevention programme aims to prevent heart disease, stroke, diabetes and kidney disease, as well as dementia for older patients. It engages over 1.4 million people a year and, through behavioural and clinical interventions, prevents around 500 heart attacks or strokes annually.
I agree with the hon. Member for Strangford that the National Audit Office report shows that there is still so much more to be done. That is why we have asked officials to be more ambitious, developing policy proposals for how that programme can go even further. In the meantime, we are focused on delivering a new digital NHS health check, available through the NHS app, so that people can assess, understand and act on their CVD risk at home. We want to make it easier for people to access that programme, especially our constituents who have caring or childcare responsibilities, or cannot easily get to their GP surgery during opening hours. The creation of a state-of-the-art national digital NHS check service will improve access to this lifesaving check.
The hon. Member was right to mention diabetes as a key risk for CVD. Each year, the NHS health check identifies 22,000 people with high blood sugar who are referred on to primary care for further assessment and management. GPs can refer people at risk of developing type 2 diabetes into the Healthier You NHS diabetes prevention programme. The programme has been highly effective: some 35,000 people have been referred to it by their GP, and over 20,000 have started the programme since September 2020. For people who complete that programme, it can cut the risk of developing type 2 diabetes by 37%. For those who already have diabetes and are overweight or obese, the NHS type 2 path to remission programme is available. This joint initiative between NHS England and Diabetes UK aims to support eligible people with type 2 diabetes to achieve clinically significant weight loss, improve blood glucose levels and reduce the need for diabetes-related medication. A recent study found that almost a third of patients with type 2 diabetes who completed the programme went into remission.
Around half of heart attacks and strokes are a result of high blood pressure. A third of adults have high blood pressure and, worryingly, almost a third of these conditions are currently untreated, meaning that over 4 million people do not know that they have high blood pressure. It is often referred to as the silent killer, as high blood pressure is largely symptomless. The tragedy is that the treatment is so cheap and effective. We could prevent around 17,000 heart attacks and save more than £20 million in healthcare costs alone over three years just by treating 80% of patients on target.
The hon. Member for Strangford also mentioned high levels of cholesterol as a key risk factor in CVD. For every three NHS health checks delivered, one person is found to have high cholesterol, and there are well-known health inequalities in CVD affecting underserved communities in England. Addressing undetected and poorly managed high blood pressure and raised cholesterol is key to preventing CVD and reducing health inequalities.
There are effective drug treatments. Statins are readily available and very cheap. They can reduce an individual’s risk of CVD in four to six weeks. If we improve treatment rates for people with CVD to 95%, more than 18,000 CVD events, such as heart attacks and strokes, may be prevented over three years. We will look closely at how we can get that done. The hon. Member for Strangford called for the introduction of Lp(a) tests. As I mentioned, that is not currently recommended by NICE guidelines. I have taken account of his other remarks, including his request for a meeting and engagement with system partners. The Minister for Public Health and Prevention will take all those requests on board. She is the right person for him to meet, given that she leads in this policy area.
Smoking costs health and care services £3 billion a year—resources that could be freed up to deliver millions more appointments, scans and operations. The cost of smoking to our economy is even greater, with around £18 billion lost in productivity every year. Smokers are a third more likely to be off work sick, which is why we introduced the Tobacco and Vapes Bill: the biggest public health intervention in a generation. It will break the cycle of addiction and disadvantage, and put us on track towards a smoke-free UK. That will make a real difference in constituencies where smoking contributes to the cycle of poverty and ill health. We are also supporting local stop smoking services with an additional £70 million this financial year.
Today’s debate has shown what a challenging and complex area this is. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), raised a range of issues. I will ask the Minister for Public Health and Prevention to write to him on all his points, many of which I think would be best dealt with in correspondence.
Jas Athwal
The Minister makes powerful points. Does he agree that we should consider a wider, holistic approach, taking into account planning and advertising—for instance, children going to school and having access to the proliferation of chicken shops and fast-food shops, and being exposed to, on average, 13 to 15 junk food adverts? That would help to limit the number of heart diseases later down the line.
Stephen Kinnock
My hon. Friend is right that prevention should focus on as early as possible in the life of our young people. Bad habits form at early ages. That is not helped by the behaviour of some aspects of our economy, and the way in which products are advertised. It is essential that we move to a model of prevention that is a partnership between the Government, our communities and business. We are taking action against the advertisement of certain products before the 9 o’clock watershed. We are also cracking down on energy drinks, which are really pernicious in terms of the amount of sugar, caffeine and other deeply unhealthy components they contain.
My hon. Friend is right that we are genuinely all in this together. We need that partnership with the private sector, and a change in mindset around healthy and nutritious food. That needs to be put into schools through community health, and through working with parents and communities to change the habits of our country. We have a gargantuan challenge ahead of us, but our Government are absolutely committed to facing it, and that prevention strategy will be at the heart of our 10-year plan. It is one of the key shifts from sickness to prevention.
That leads me to my closing remarks. We have seen today what a challenging and complex area this is. It is a challenge that requires sustained action on a number of risk factors, but I assure colleagues that this Government will leave no stone unturned in getting premature deaths from heart disease and stroke down by a quarter for people under the age of 75 within the next year.
In my contribution, I have sought to demonstrate our commitment to getting on with the shift from sickness to prevention with our cast-iron commitment to expanding NHS health checks, the shift from hospital and community by making it easier for people to get checks at their convenience and at home, and the shift from analogue to digital through an innovative and expanded digital service. I once again thank the hon. Member for Strangford for securing this important debate, and thank all hon. Members across all parties for their excellent contributions. Watch this space: we will continue to work on this issue with focus and at pace.