Children’s Health: Ultra-processed Foods

Baroness Bennett of Manor Castle Excerpts

Wednesday 25th October 2023 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, I thank the noble Baroness, Lady Jenkin, for securing this short debate and for her excellent introduction. Since very soon after I came into your Lordships’ House, I have been working on a project: to get a Minister to say “ultra-processed foods”. I have hope that we may see that project delivered today, as that is the subject of the whole debate.

I have thrown out a large amount of what I was going to say, because I want to directly respond to the noble Lord, Lord Krebs, for whom I have the greatest respect. However, I entirely disagree with a large part of what the noble Lord said. We know that there are significant problems with the peer-reviewed research process. We know this from what happened with big tobacco and pesticide companies. We have a huge problem with commercial interests in the research process. If you look behind where most of the attempts to challenge and question the NOVA classification system comes from, you do not have to look very far to find commercial interests.

As one of example of that, just last month in London the Science Media Centre hosted an event questioning whether there was any problem with ultra-processed foods and if they are all absolutely fine. The Guardian looked into this and discovered that three of the five participants on the panel had either received financial support from UPF manufacturers or hold key positions in organisations funded by them. They include companies such as Nestlé, Coca-Cola, Pepsi and Unilever.

I point the noble Lord, Lord Krebs, to a specific recent study. The noble Lord suggested that we were talking about either the nutritional content or whether food was ultra-processed. This is a study that covers both areas. The study is by Julia et al in the European Journal of Nutrition. It is based on the French NutriNet-Santé cohort study, so it is an observational study. The conclusions say that

“nutritional quality and ultra-processing should be considered as two correlated but distinct and complementary dimensions of the diet”.

So, yes, the amount of fat, lack of micronutrients and nutritional quality is a problem, but ultra-processing is a problem too. This is a very solid 2023 study demonstrating that.

Very briefly, I want to focus on young children, as the noble Baroness, Lady Jenkin, has pointed us to. We have a huge problem with the diet of young children in the UK. That is now demonstrably obvious in all the health dimensions, whether obesity or height. We are not giving children the chance to develop in the way they should.

I will pick out one deeply shocking figure. Think about the size of child between a year and a half and three years old—quite small. Some 65% of one and a half to three year-olds in the UK drink, on average, one adult-sized can of soft drink a day. One of the things that has not been focused on enough is that, as has been said, this is nutritionally attractive and, arguably, addictive—the paper is strong on that. But you are filling a child up with empty calories or, if the drink is low calorie, with no calories at all, and there is no space for the child to eat the vegetables and fruit that they should.

As others have said—I was going to major on this more—look at all the products in supermarkets directed at children, with cartoon characters all over them, and with messages about health directed at the adults. We are profoundly misleading parents about what their children should be eating—by “we” I mean the multi- national food companies, which are making massive profits from making our children ill.

[Lord Evans of Rainow (Con)]

My Lords, I ask noble Lords to keep note of the four-minute speaking time, please. We still have to hear from the Front Benches and the Minister.

Domestic Violence and Brain Injury

Baroness Bennett of Manor Castle Excerpts

Monday 23rd October 2023 Lords Chamber

[Lord Markham (Con)]

The noble Baroness makes a very good point; it is often the hidden side of domestic violence. The problem is that there is not much information on this, but a US study shows that as many as between 30% and 74% of women who suffered domestic violence had suffered from traumatic brain injury. It is about making people aware that this is not an edge case; this is something that unfortunately is all too familiar. As the noble Baroness mentions, every strand of society needs to be aware of this and to act on it.

[Baroness Bennett of Manor Castle (GP)]

My Lords, the Minister reflected that many victims of intimate partner abuse sometimes do not report until weeks, months or years later. Will the Minister ensure that there are services available that recognise this medical issue when they may not present primarily as a medical case, making sure that all the support that is available to victims of domestic violence is aware of this issue? In responding to the noble Lord, Lord Hunt, the Minister said that we will wait for the research. I think there is already clearly enough evidence in what we have heard today, and the fact that 3% of dementia in the community is attributed to traumatic brain injury. We need to act now, not wait for research.

[Lord Markham (Con)]

It is a good point, and there are already some very good examples, such as in Cambridge, where the ICB has a single front door to make sure that all facilities, whether it is neurologists, psychologists, physios or speech therapists, are there and available. The noble Baroness is correct: there are lessons we can learn and roll out straight away, and we are looking to do that.

Adult Social Care (Adult Social Care Committee Report)

Baroness Bennett of Manor Castle Excerpts

Monday 16th October 2023 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, it is a great pleasure to follow the noble Baroness, Lady Finlay. Her phrase about services that empower is an excellent one which I may well adopt.

Like everyone else, I wish to thank the noble Baroness, Lady Andrews, and her committee for this brilliant report and for her compassionate, caring instruction. The focus on co-production with experts by experience is a crucial phrase. Given the lack of representativeness of your Lordships’ House, that should really be adopted by all your Lordships’ committees—particularly given that, the way politics is heading, it seems that the nature of this House is unlikely to change anytime soon. Our society is increasingly coming to recognise the importance of those experts by experience.

I would like to pick up the point made by the noble Baroness, Lady Andrews, by reflecting on the disappointment that the Government have essentially rejected all the recommendations of this report. If not now, when? The noble Baroness, Lady Fraser, said that we do not seem to be turning the dial, which was a similar reflection; she also noted that neither of the two largest parties’ leaders spoke about social care at their party conferences.

I am going to put a challenge to all the Front-Benchers who will be speaking shortly. I am well aware that they are not able to make up a social care policy on the Floor of the House, but I am going to challenge them to make a commitment that they will take into the election a social care policy that they plan to take forward—because surely this is so clearly desperately needed. As the noble Baroness, Lady Andrews, said, the delay in debating this report has not made it one iota less relevant because we have not made any meaningful progress.

In the interests of living up to what I am asking others to do, I am very happy to set out the framework of the Green Party’s social care policy that we will be taking into the next general election. It is free social care for all adults who need it in England. That policy was decided democratically at our conference in 2021, led by members who were affected by the need for social care—more experts by experience. This calls for all social care support and independent living services to be free at the point of use and fully publicly funded.

The guideline for this comes from—I ask any Front-Bench spokespeople who might like to respond if they acknowledge these standards—the UN Convention on the Rights of Persons with Disabilities. That should set the standards of what is available. The Green Party says that this should be

“accountable to local democratic bodies with a secure national framework of laws, guidance and funding … the services should be designed and delivered locally and co-productively, involving disabled adults, councils, the NHS, carers and unions”.

With that, I will raise a point that is implicitly referred to in the report, but developments have happened since it came out. Skills for Care, the workforce planning body for the sector, has noted that an estimated 70,000 people took up care jobs in England after arriving in the year to March 2023. That was after visa changes, and there were a further 30,000 to 40,000 people arriving between April and August. Despite that fact, the vacancy rate in the adult social care sector is still nearly 10%.

The noble Baroness, Lady Fraser, referred to difficulties in Scotland. I would point to the fact that Scotland, despite having about 8% of the UK population, took up only about 2.5% of those care visas. That reflects the fact that both Scotland and Northern Ireland have slightly raised the rate of pay already. Scotland is planning next April to raise the rate of pay to £12 per hour. In Scotland, carers are also employed by the local authority, unlike in England where authorities are forced to take legal responsibility for a market in care. Would the Minister acknowledge that the market as a model of providing care is one of our underlying structural problems?

National Health Service: Major Conditions Strategy

Baroness Bennett of Manor Castle Excerpts

Monday 18th September 2023 Lords Chamber

[Lord Markham (Con)]

My noble friend is absolutely correct, in that we are setting out the whole emphasis of what we are trying to do here. It is really ingrained in those pathways. It is about culture and behaviour as a whole, rather than a silo-based scheme, looking at the whole patient. Once we have got those pathways set up properly, it is Ministers’ job—I have mentioned before that we each look after six or seven ICBs—to hold them to account and make sure they are following those pathways.

[Baroness Bennett of Manor Castle (GP)]

My Lords, on that whole- patient approach, in 2021 when the Office for Health Improvement and Disparities was launched, the then Secretary of State said that the Department of Health would be co-ordinating activity across government, looking at the wider drivers of good health—employment, housing, education and environment—lack of which often drives many major conditions. Can the Minister tell me how that co-ordination is going?

MMR Vaccine

Baroness Bennett of Manor Castle Excerpts

Thursday 20th July 2023 Lords Chamber

[Lord Markham (Con)]

As mentioned, there are outreach programmes, particularly for home-schooled children or children who are not there. There are also programmes in community centres, with the idea of trying to pick them up in as many places as possible. Obviously, there is concern about certain communities that are harder to reach than others. That is particularly the case in London, as I mentioned earlier. That is where we are trying to specifically target those community centres with outreach work.

[Baroness Bennett of Manor Castle (GP)]

My Lords, in April the UK Health Security Agency’s director of public health told the Health and Social Care Committee in the other place that the workload for delivering vaccines now falls disproportionately on general practices—particularly after the 2012 NHS reforms—and that this is one of the weaknesses we are trying to put back together.

In that context, the Minister may be aware of the issue around the quality and outcomes framework payment to GPs. GP practices in deprived areas are missing out on payments for delivering vaccines that could help them deliver more vaccines because it is extremely difficult for them to register the patients whom they have tried to contact multiple times when those patients do not respond. So, the GPs are missing out on payments they need to be able to reach those difficult-to-reach patients.

[Lord Markham (Con)]

I am sorry, I am not quite sure what the question was there. Clearly, we need to make sure that the system is working in terms of making sure that the payments are there so the doctors can follow up. If the noble Baroness would like to follow up with me, so that I can fully understand it, I will get her a response.

Emergency Healthcare (Public Services Committee Report)

Baroness Bennett of Manor Castle Excerpts

Thursday 20th July 2023 Grand Committee

[Baroness Bennett of Manor Castle (GP)]

My Lords, it is a pleasure to follow the noble Baroness, Lady Morris of Yardley, and to join others in thanking the noble Baroness, Lady Armstrong of Hill Top, for this report. I share the reflection that it is a great pity that there is no capacity for people to participate remotely, particularly given that there is a speakers’ list here, so it would be very easy, logistically, to facilitate. This debate does not have the potential difficulties of when there is no speakers’ list. I also join in with the comments about how long it has taken us to get a debate on this.

As others have said, the report came at a point of absolute crisis in emergency services, but there is no real evidence that the crisis has in any way abated. I did not originally plan to, but I will speak from a different perspective that might at first be surprising: the environmental impact of emergency care. The context is that yesterday, my office launched a policy briefing entitled, Eco-directed and Sustainable Prescribing of Pharmaceuticals in the United Kingdom. It was written by my interns, Julze Alejandre and Emily Stevenson, working with Paul-Enguerrand Fady. I acknowledge the financial support of the British Society for Antimicrobial Chemotherapy for that work.

I must admit that, in thinking about the report and the environmental impact of pharmaceuticals and medical devices, I have mostly thought about chronic conditions and treatment in the community and the great deal of discussion about the alternatives of using social and green prescribing—issues that do not apply to emergency care. However, I was absolutely inspired at the launch event yesterday by one of the attendees, a critical care consultant from a foundation trust in the north of England. They said, “Each day, I consider the environmental impact of the treatments that I give my patients in the ICU”. The doctor set out that that meant three steps, or principles: first, choosing the most environmentally friendly route for medical care, which means acknowledging that intravenously administering drugs requires more plastic packaging; secondly, minimising the amount of PPE used by opening only the PPE that is needed; and thirdly, demedicalising by trying to shorten the length of hospital stays where possible, which means less PPE and generally lower consumption of resources in hospital. The consultant told us that these environmental considerations are included in the doctors’ notes and discussed by the healthcare team during the patient handover.

That approach addresses something that we are starting to get some attention and focus on: the fact that, in England, 4% of our total greenhouse gas emissions come from the healthcare sector. There is the impact of plastics, which is increasingly acknowledged, and the pharmaceuticals going into the water supply.

Another of yesterday’s inspiring speakers was Sharon Pfleger from the One Health Breakthrough Partnership in Scotland, a partnership of the NHS Highland, the University of Highlands and Islands, the Environmental Research Institute and the University of Nottingham, which has a £100,000 UKRI Medical Research Council grant. This picks up the point that the noble Baroness, Lady Morris, made about joining up all the issues and all the healthcare bodies, as well as those not immediately related to healthcare, that collectively make up part of our healthcare system. We cannot afford to think, “Here’s the NHS that does healthcare, and everybody else does other things”. This applies in the case of the environment as well as in other things. Looking at the overall aims of the One Health Breakthrough Partnership, I see that it

“seeks to facilitate new knowledge sharing across organisational boundaries, raise awareness of the environmental impact of medicines, and develop novel and robust solutions to complex sustainability issues”.

That joined-up, complexity-systems thinking is an example of what we need to do.

I was reminded of an interview I did recently on LBC. We had been talking for some time about what might be described as the social determinants of health, and how environment helps determine people’s health and whether they will need the emergency care that is now so stretched—meaning everything from mouldy, cold homes to air pollution and all those other issues—when the presenter said to me, “I realised that I invited you on to talk about environmental problems, but you are talking about social problems too. They are all interrelated”. I thought, “Bingo! We have just had a moment of understanding”.

The point I really wanted to make is that, when we talk about healthcare and environment, emergency medicine probably looks like the most distant part—the part where it is hardest to think about the environmental impact. You have an emergency situation in front of you and you have to care for this patient. I think, however, that I have just shared with the Committee a really inspiring example of where individual leadership is really showing a way of operating differently. This is what we need to encourage and evolve. Consultants are, perhaps, seen to have the power to do something like that on their own ward; we need to empower people right across the healthcare system and more broadly to take the steps needed.

To pick up the point made by the noble Baroness, Lady Morris, there are so many good pilots. One of the great institutional problems in the UK is that we have funding for pilots, systems for funding new ideas and people who really clearly see the problem, and who can maybe make a difference in their local trust in their local area, but it does not get rolled out further.

We are the most centralised polity in Europe. Power and resources are concentrated in Westminster and Whitehall. We need to move to a system where the power and resources are held vastly more locally to create circumstances that work for local conditions.

Mental Health In-patient Services: Improving Safety

Baroness Bennett of Manor Castle Excerpts

Monday 3rd July 2023 Lords Chamber

[Lord Markham (Con)]

I thank the noble Lord for his commitment in this area over the years. With regard to the first question about past evidence, clearly the HSSIB will be looking at what evidence exists. As the noble Lord said, some investigations go back 30 years, so there will not always be circumstances where it can pick out that evidence, unfortunately. However, where there is that information, we are trying to make sure that we pull it out and learn from it. That is very much the direction of travel. Clearly, if part of the HSSIB’s findings is that we need to make sure that every death in such circumstances is investigated under a certain pathway, then I am sure that will come into its recommendations. In terms of the other questions, I think it is best that I write to the noble Lord, if I may.

[Baroness Bennett of Manor Castle (GP)]

My Lords, the Statement includes a number of themes which it is expected the new Health Services Safety Investigations Body will consider. Not included in that list, however, is the growing role of private provision in NHS mental health care services. This is something that patient groups and others are expressing considerable concerns about. Take, for example, the Priory, where the Care Quality Commission reported that the number of deaths at its sites rose nearly 50% from 2017 to 2020. One of those was the tragic death of 23 year-old Matthew Caseby. An inquest jury concluded that his death was contributed to by neglect, and the coroner issued a prevention of future death report because of continuing risks.

The Priory Group earns more than £400 million from the NHS, and much more from social services. It is now owned by a Dutch private equity firm after it was sold by its former owner at a loss and is financed by a sale and leaseback deal of 35 properties with rents subjected to annual inflation-based escalators. Through the mechanisms in this Statement or others, are the Government going to consider the risks presented by private ownership—particularly private equity ownership—of mental health care services?

[Lord Markham (Con)]

As noble Lords are aware from some of my previous answers, I think the key thing is the quality of output rather than the ownership of an institution. Around the House, we have very good examples of where we believe the Government need the help of the independent sector to increase supply and capacity. That always needs to be done with the right quality of regulatory regime, and that is what we have put in place. From my point of view, I am always going to be looking at the quality of the output and not the ownership of a company.

Lung Cancer: Screening

Baroness Bennett of Manor Castle Excerpts

Monday 26th June 2023 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, I have two questions. My first question is about the timeframe and the role of GPs. The Statement says that, using GP records, current and ex-smokers aged 55 to 74 will be assessed by telephone interviews. Will that require resources from GPs? We all know that there are many different computer systems so where are the resources going to come from? Specifically on GPs, I can well imagine at many GP surgeries tomorrow morning at that terrible time of 8.30 am as everyone frantically tries to hit the dial button that a lot of people will be asking for a scan. Have GPs been equipped to handle that? Do they know what to say and how to manage that kind of scenario?

My other question follows on from the questions about the Khan review. That said that we are grossly underfunding things. Mass media campaigns in particular are funded at 90% under what is needed, while other services are about 50% underfunded. Surely we have to stop these cases happening. Can we see a commitment from the Government within some sort of timeframe to say that we are going to put more money into this?

[Lord Markham (Con)]

I thank the noble Baroness. In terms of identifying the smokers, the telephone is just one way of doing it. The hope is that using the digital data and the app means that more of these things will be on people’s records and identified with them. As ever with these things, electronic means will be the best way to do that, albeit those telephone resources in terms of supporting the GPs are very much part of the plan. It is understood that GPs have a large burden at the moment.

There is not a lot more to add about the Khan review. The ambition is still there to be smoke-free by 2035 and investment has gone behind that. The best example of that, as has been mentioned, is people swapping cigarettes for vapes as one means to do it. Undoubtedly, a lot more needs to be done in that direction as well.

NHS: Performance and Innovation

Baroness Bennett of Manor Castle Excerpts

Thursday 15th June 2023 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, it is a pleasure to take part in this select but very interesting debate, which is small in number but rich in content. I thank the noble Lord, Lord Scriven, for securing it. I will take a different approach from that of other noble Lords so far—perhaps a slightly stereotypical green approach. While we are talking about the current performance of the NHS and innovation, I will focus on the NHS’s environmental impacts.

The noble Lord, Lord Scriven, said that we have a 1940s health service in its structures and systems. We are in the 21st century and in a climate emergency and nature crisis, consideration of which has not been built into the system. I will major on aspects related to the comments made by the noble Lord, Lord Addington, about the centralisation of the system. Indeed, the noble Lord, Lord Crisp, was just talking about that and about how it prevents innovation and people taking action.

Let me do a little frame-setting. The NHS is responsible for 5% of the UK’s climate emissions and 40% of public service emissions. NHS England has a large focus on carbon emissions. Interestingly, NHS Scotland is leading on antimicrobial resistance and dealing with that area of environmental impact, and NHS Wales is focused on the environmental determinants of health and taking that approach. Each NHS can learn from the others, and a more joined-up approach is desperately needed. As I will come to, in Europe there is a lead on the impact of general pharmaceuticals on the environment, and we are not joined up with that at all.

The noble Lord, Lord Scriven, approached this in a positive way. I will do the same, in some places by highlighting success stories. The NHS has a net-zero carbon target by 2040. All NHS England estates now use 100% renewable electricity and 99% of waste is diverted from landfill. There are issues around incineration, but obviously there will always have to be some of that. It is worth stressing how much money this has saved the NHS, with a cost saving of £36 million and a £10 million investment in one year in energy-efficient technologies having positive impacts.

Slightly less obvious is an exciting development on which Scotland is leading the way and NHS England is following. Scotland has banned the use of desflurane, an anaesthetic with a global warming potential 2,500 times that of carbon dioxide. NHS England will be banning it in 2024. This is one of the leading ways in which thinking about the negative environmental impacts of medicines is happening. There is also an exciting new plan being developed for reducing the carbon impact from the use of inhalers. Much is happening, but everyone agrees that much more must happen.

I want to focus on an area that I have been majoring on since 2020, when we began debating the Medicines and Medical Devices Bill: the impact of pharmaceuticals on the environment. I saw the noble Baroness, Lady Cumberlege, in her place earlier, who wrote the very important report, First Do No Harm, which still needs to be implemented. When we think about the use of pharmaceuticals in the NHS, we have not thought sufficiently about the harm that they are doing.

What I am about to say draws heavily on a meeting I had recently with the pharmaceutical industry and my British Society for Antimicrobial Chemotherapy senior interns. I also worked with Paul-Enguerrand Fady, who is working with the Foundation to Prevent Antibiotic Resistance, which is based in Stockholm. Paul-Enguerrand is working here in Parliament, and I would urge anyone who is interested in antimicrobial resistance to get in contact. A whole series of events is being held to inform parliamentarians about this, and there is a chance to learn cutting-edge science with that.

From this meeting, I learned about the PREMIER project, a multi-disciplinary consortium of 25 public and private sector groups across Europe, proactively working to manage the environmental impact of general medicines, especially those with limited data availability. It is exploring ways to incorporate environmental considerations early in the drug development process to steer the development of new drugs. It aims to establish a new European standard of environmental protection and reassurance, for patients and society at large, that medicines are increasingly safe for the environment. If the Minister is not aware of this project, can he make himself aware? This is a Europe-wide project. I very much hope that NHS England will be following on and adopting this, not seeking to go it alone in an area where clear leadership is already happening. I do not expect an answer today but can the Minister look into that and get back to me on how the Government are looking at the outcome of that project?

I point out that the PREMIER project is working only on general pharmaceuticals; it is not working on antimicrobials or endocrine active molecules. Potentially, the UK Government could take a lead in ensuring that this project is broadened to include these crucial pharmaceuticals which we know are having a big impact on our environment and our environmental health. It was suggested at this meeting that there is a role for the Government Office for Science in promoting such connectedness in its position as an apolitical, evidence-based organisation. Being cross-departmental, it helps in focusing on systems thinking. The Government potentially have a convening role here to work with a variety of stakeholders. Can the Minister consider how they might take a role in that area?

I said that I would focus on some positives, and I noted that NHS Scotland is very much leading on the impact of pharmaceuticals on the environment. I draw the attention of the Minister to a project in the highlands. NHS Highland got a £100,000 grant from the Medical Research Council to develop a framework to reduce environmental pollution from healthcare practices. This is the first time that this has been done in the UK. Its leader is Sharon Pfleger, a consultant in pharmaceutical public health working with the University of Nottingham and the University of Highlands and Islands. This builds on the work of the cross-sector One Health Breakthrough Partnership, which has a data visualisation tool that helps to understand the link between medicine use and the presence of pharmaceuticals in the environment. I draw the attention of the Minister’s department to that.

Having looked around these islands I see that Wales, as I mentioned, is leading on environmental determinants of health. The Welsh NHS Confederation produced an interesting response to a Climate Change, Environment and Infrastructure Committee consultation on the Environment (Air Quality and Soundscapes) (Wales) Bill. I urge NHS England to contribute to cross-governmental working in this way. It is a very interesting model and we need to see this happening.

I have praised Wales and Scotland, so I should find a project in England to praise and focus on. Some work is happening in Cornwall. I draw here on the work of Roberta Fuller, who is head of hospital reconfiguration at the Women’s and Children’s Hospital at the Royal Cornwall Hospitals NHS Trust. Ms Fuller is working on how to ensure that a new hospital meets the best possible environmental standards. Drawing on the comments of the noble Lords, Lord Addington and Lord Crisp, I quote a paragraph from Ms Fuller’s reflections:

“What will it take to move away from traditional top-down funding allocation towards the kind of cross-industry partnering and thought leadership needed to meet these extremely challenging climate goals?”


Empowering people must be at the heart of tackling the issues that I am talking about, but of course there are so many other issues.

Finally, I will reflect a little on innovation. We have heard the word a great deal from the Government in recent weeks. I am afraid that, very often, when we hear members of the Government talking about it, they are talking about inventing new products that people will make profits from, usually involving shiny new things and, indeed, new pills. Of course, we know that the kind of innovation that I and pretty much all speakers in this debate have been talking about is about doing things differently and more smartly, and operating in ways that acknowledge the One Health paradigm: that our health is entirely dependent on the health of our environment. I would love to see more analysis and understanding from the Government that this is innovation. Innovation may, dare I say it, less directly involve GDP: you are not selling things but improving the public health of the population. We all know about the productivity crisis, the labour shortage and all the problems arising from the absolutely parlous state of public health in the UK at the moment.

In that light, I want to take a step away from the environment side to focus on an issue raised by the noble Lord, Lord Parekh, about the problems of obesity and the threats that it presents to our health. We have been talking about obesity, and it has been almost impossible recently to open a newspaper without seeing talk of the new Wegovy and these other weight-loss drugs. Newspapers have been quoting NHS sources suggesting that, eventually, 12 million people might be treated with Wegovy and similar weight-loss drugs in the NHS. I find that statistic truly horrifying. These are very new drugs, and we have very little idea of how long people might have to take them and what the long-term effects are: they simply have not been around for very long.

Yet, at the same time, we have Dr David Unwin in Southport. He has been an absolutely huge pioneer, starting from the grass roots up, in working to reverse type 2 diabetes. This was thought impossible until recently. What is interesting is that, reading accounts from him, he credits the initial impetus as coming from one patient who said to him, “Why have you been prescribing this drug for me for 10 years when I went off, researched for myself and found that I could change my diet?” Through diet reversal, this patient no longer had type 2 diabetes. We had one patient talking to one doctor, who started to innovate. This is starting to be rolled out around the NHS, but why are the Government not trumpeting it from the rooftops? When we hear the Prime Minister talking about innovation, would it not be great if he were talking about innovation in terms like this? This is a home-built, British innovation done in the grass roots—not based in a university, nor based in Oxbridge, and perhaps that is why we are not hearing about it. But we need to hear far more about this kind of innovation and empower much more of it.

On which line, I will finish with a reflection. I have talked about this ever since I came into your Lordships’ House, virtually. This is a request for innovation in government rather than directly in the NHS, and the Minister has heard it from me before. I am sure that he and all other Members of your Lordships’ House have noticed the strong media focus in recent weeks on the health impacts of ultra-processed foods, which are very clearly causing massive costs to our NHS. The Government have continually declined to acknowledge ultra-processed foods as a category, despite the fact that the Welsh Government, the WHO and many other groups around the world do. My request to the Minister is not to give me a total government turnaround today, but I will ask him whether he will commit to going back to the department and talking about where the latest science is on ultra-processed foods. This media focus has come from the publication of one book, but there are new peer-reviewed research articles coming out every week about the issue.

Sodium Valproate

Baroness Bennett of Manor Castle Excerpts

Monday 5th June 2023 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend. Yes, the number of cases of people of childbearing age—this is a key criterion—taking sodium valproate has reduced by 33% over the past five years. The number of pregnancies has reduced by 73% but clearly that is not zero so more work needs to be done. I was speaking to Minister Caulfield this morning about the Patient Safety Commissioner. We are expecting her report shortly and from there we hope and believe that there will be a lot more we can do on regulation.

[Baroness Bennett of Manor Castle (GP)]

My Lords, I refer to the work of Dr Hughes, the Patient Safety Commissioner, and the initial Question from the noble Baroness, Lady Cumberlege, which referred to where sodium valproate is prescribed in different numbers of pills from the number that come in a packet, so the excess pills are taken by the pharmacist and put into plain paper packaging. The Patient Safety Commissioner has identified this as a real issue because sodium valproate must not be dispensed without the appropriate safety labels, but that is clearly happening. What are the Government doing to stop it?

[Lord Markham (Con)]

The noble Baroness is correct. First, the MHRA is working on guidelines which say that you must always dispense in the original packaging, come what may. In the meantime, secondly, all pharmacists should absolutely be putting leaflets in, whatever the packaging. Thirdly, everyone should have to sign an acceptance form so that they are going into this with their eyes open and understand the risks. Every year they are supposed to renew that acceptance form to make sure that, while it may be necessary in some cases, everyone goes into it with their eyes open to the risks.