NHS: Long-term Sustainability

Baroness Boycott Excerpts

Thursday 18th April 2024 Lords Chamber

[Baroness Boycott (CB)]

My Lords, it is a pleasure to take part in this debate and, like everyone else, I thank the noble Lord, Lord Patel, for introducing it so brilliantly. I also congratulate the noble Baroness, Lady Ramsey, on a really good maiden speech.

This is an interesting week, in that we have decided to ban kids smoking. What we have not banned, and are in fact encouraging, is kids eating an appalling diet. We are flooded with unhealthy food, which is incredibly heavily advertised in all media. You only have to look at sport, and this year’s Olympics. The healthiest thing, everywhere, will be McDonald’s and Coca-Cola, yet we are worrying about our NHS. We must start having conversations with the food industry because if we do not, the NHS, which we all treasure and love, will creak under the strain.

I have lots of alarming statistics. I am not sure which ones to choose in the next four minutes, but here is one. Before the year 2000, there were no known cases of children in the UK with type 2 diabetes. There are now almost 10,000. All those children will be on the NHS books for the rest of their lives. They are also going to be ill. Let us look at it purely economically, rather than compassionately at what kind of life they will lead. They will not be working, not paying tax, not being good parents, not contributing to society. We can change this. I have been doing food politics for nearly two decades, and it amazes me that we have very little involvement with the NHS. We have very little involvement with doctors when talking about what people can do.

Do you know the main reason why most children under 10 go into hospital and have a general anaesthetic? It is to have all their teeth out because of the food they eat. We are also the lowest ranked country in the world for breastfeeding. My daughter, who has twins, managed to feed them for over a year. She had no help or support. I was astonished by the advertising she received from companies calling themselves “hungry baby” and stuff like that, absolutely trying to get under a mother’s skin and say, “Get off breastfeeding and get them on to formula foods”—foods which have higher sugar levels and set your sweet spot higher for the rest of your life. It is outrageous. There is almost no regulation. As for support with breastfeeding, for this young woman with twins, there was nothing. We paid for consultations to help her get through it and achieve that.

Is it any surprise that our kids are therefore growing up to be the most obese in Europe? As a country we are now the third most obese. No medical professional doubts what obesity does to our society, but they fail to connect it back to the food companies. Sticking with the baby food companies, all these little pouches they sell not only cost a lot of money but are extremely addictive to the kids because they are nice, they are handy and they convince mothers that they are doing the best for them, when in fact they are the root cause of them eating too much sugar.

The staggering profits made by the food companies every day are being paid for by the NHS. We are paying for it with our money and in the lack of care that nurses and doctors can give people. I am not saying that these people are not genuinely ill; they are, but from a preventable cause. The Government have had the balls to stand up to the tobacco companies this week. I know that this issue is more complicated than that—I can see the Minister looking at me—and of course we have to eat. However, there is a big difference between what we eat and how we eat it. We are just machines, like everything else. We need to put good stuff into the machine.

Unlike the noble Baroness, Lady Murphy, I had an extraordinary experience with the NHS. I managed to scald my foot and had a blister the size of a tennis ball. I ended up getting sepsis and was in the burns unit in Bristol. It was impeccable. However, in the lobby there was Costa Coffee and the Friends Shop. In the Friends Shop there was not one piece of fruit. It was cakes and biscuits all the way.

I got transferred to the Chelsea and Westminster Hospital for outpatient care. Again, the treatment was impeccable. Down in the lobby was bloody Costa Coffee—doughnuts and a long queue—and, in the Friends Shop, there was not even a grape. We have to start looking at this. As I say, no one would buy a Rolls-Royce, put Coca-Cola in the engine, and expect to go 100 miles down the motorway. We are not dissimilar, but we are even better than a Rolls-Royce. We deserve to put better stuff in. It is time the whole NHS and the country got this one straight.

Premature Deaths: Heart and Circulatory Conditions

Baroness Boycott Excerpts

Tuesday 6th February 2024 Lords Chamber

[Lord Markham (Con)]

I will need to come back in writing to my noble friend on this. I take this opportunity to thank him for his work on the Times Health Commission and for generally pushing forward the whole prevention agenda.

[Baroness Boycott (CB)]

My Lords, following on from the Times Health Commission today, the Food Foundation has also produced a report on childhood obesity. The single biggest factor for preventing childhood obesity and thus adult obesity is breastfeeding. It reduces it by a figure of 25%, as the WHO has found from a worldwide study. To put that into context, all the reformulation of soft drinks has achieved only an 8.3% reduction in obesity in 11 year-olds. This is massive, yet as a country we have the lowest breastfeeding rate because we give the lowest amount of support to women when they have given birth. Not only do we get not that much time off work but there is very little support. My daughter has recently had twins, and the comparison between now and when I had her 40 years ago is really shocking.

[Lord Markham (Con)]

I agree with the noble Baroness. I am sure we all agree that breastfeeding is a really healthy start to life. I think the family hubs are trying to address these sorts of matters. Clearly, this is a point for education as well.

Ultra-processed Food

Baroness Boycott Excerpts

Thursday 26th October 2023 Lords Chamber

[Lord Markham (Con)]

Absolutely—we have to be understanding of the latest research in cause and effect. The evidence I have been shown so far is that it is about the features within those ultra-processed foods—are they high in fat, sugar or salt? Those are the things that are causing the harm. If we find links to the processing itself, we will act on that.

[Baroness Boycott (CB)]

My Lords, a few years ago the Government introduced very good obesity policies on stopping the sale of “two for the price of one” on junk food and limiting junk food advertising during children’s television. These have been delayed until 2025. What was the Government’s reasoning? Can the Minister assure the House that it was not based on any lobbying from the food industry?

[Lord Markham (Con)]

The rationale was very clear. The measures that we introduced by the modelling showed that in what we were trying to do we were attacking the things that cause 95% of the reduction in calories—namely, the product positioning, which has the support of 78% of people to reduce the so-called pester power. Early evidence shows that it is working, because foods that are not high in the bad stuff have gone up by 16% and those with high sugar, salt and fat content have gone down by 6%, all through the product positioning. It is working, but the most important thing is that we have gone after the big numbers, those that effect 95% reductions in calorific intake.

Food: Two-For-One Offers

Baroness Boycott Excerpts

Wednesday 19th July 2023 Lords Chamber

[Lord Markham (Con)]

As I mentioned, the key is giving industry time to adjust so that it can reformulate. We would all agree that, if you can get the same taste but it is a lot healthier, with less fat, salt and sugar, that must be a good outcome. The examples that I just gave show that, and it is working.

[Baroness Boycott (CB)]

The NHS Food Scanner is promoting to children a number of ultra-processed food items. Do the Government not think that this is quite perverse given the new knowledge about what exactly ultra-processed food means? It is not just about the sugars, salts and fat but about the chemical destruction and reformulation of foodstuffs into something else.

[Lord Markham (Con)]

As I mentioned in answer to a Question on ultra-processed food yesterday, as a definition that is not particularly helpful because wholemeal bread, baked beans and cereals are all examples of ultra-processed food. The real point is the content of the food, and that is what our regulations should look to.

Ultra-processed Food

Baroness Boycott Excerpts

Tuesday 18th July 2023 Lords Chamber

Asked by

[Baroness Boycott]

To ask His Majesty’s Government what assessment they have made of the latest research into the effects of ultra-processed food on the mental and physical health of children and adults; and whether they plan to introduce any further restrictions on these foodstuffs.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

The Scientific Advisory Committee on Nutrition did not find evidence for a causal link between ultra-processed food and mental and physical health. It is unclear whether ultra-processed foods are inherently unhealthy, or whether it is more that those foods are typically high in calories, saturated fat, salt, and sugar. Therefore, the Government’s priority is continued action to reduce the consumption of foods high in calories, salt, sugar and saturated fat.

[Baroness Boycott (CB)]

I thank the noble Lord for his Answer, but I beg to disagree. The latest scientific evidence indeed shows that ultra-processed food, which is, in essence, not really food given that ordinary foodstuffs have been put through industrial processes that render them chemically different from what they were when they began, has had a massive impact on the nation’s health, especially in the past 30 years. Some 66% of our diet is ultra-processed food, and 16% of everything we eat every day goes to our brain. It seems to be no coincidence that instances of heart disease, cancer, obesity and many other illnesses, as well as mental illnesses, might have something to do with the food that we are eating, the fuel that we are putting in our cars. No noble Lord in this House would put Coca-Cola in his Rolls-Royce and expect it to do its best. I beg the Government to come back and have another look. I would be very happy to set up a meeting for the Minister with the newest experts in neuroscientific research to see whether we can take this forward.

[Lord Markham (Con)]

First, I thank the noble Baroness for the work she does and has done in this space for a number of years. The problem is the definition of “ultra-processed food”. It includes things such as wholemeal bread, baked beans and cereal. It is not a helpful definition. There are certain ultra-processed foods which are high in fat, salt and sugar. We completely agree that those things are bad for us and that we should do everything we can to discourage people from eating them. The label “ultra-processed food” is not helpful.

NHS Procurement: Palantir Contract

Baroness Boycott Excerpts

Thursday 22nd June 2023 Lords Chamber

[Lord Markham (Con)]

Actually, it is the opposite. It absolutely lets bidders know that, when we are assessing who the best bidder is, we are looking only at who is the best provider. We do not need to have any concerns at all about continuity or risks because we are giving them plenty of time to get their new contract and systems in place. We do not need to worry about any services being lost in the meantime.

[Baroness Boycott (CB)]

My Lords, Palantir is a data analytical company. It wants our data. In cases where it has been in business with other people, it has used that data and sold it under the surveillance capital model. Is the Minister absolutely confident that we are safe in entrusting all of the NHS’s data to an American company? It seems to me that that is not in the best interests of a not-for-profit organisation such as the NHS.

[Lord Markham (Con)]

Yes. I really appreciate having this opportunity to state categorically that the NHS will remain the data user here. The data controller will remain in place for each individual institution; sometimes it is the GP and sometimes it is the hospital. Fundamentally, everyone’s data will be allowed to be used only by the NHS in these circumstances. There are no circumstances in which Palantir—or any other supplier should it win—will have access to see individuals’ data.

NHS Staff: Food Banks

Baroness Boycott Excerpts

Tuesday 7th February 2023 Lords Chamber

[Lord Markham (Con)]

Again, April is very close; the pay review body will be looking at the facts then. The noble Lord is quite correct that the real change is inflation, and that is why the priority for all of us has to be to reduce inflation. It is pernicious in its impact on every single one of our pockets, and most of all on those people with the least money. That has to be the priority, but we will continue to support these people.

[Baroness Boycott (CB)]

My Lords, back in 2008, there were only 26,000 people visiting food banks—they were brought in, really, as a response to the crash—but that figure is now 2.56 million people. Back in those days, Ministers were somewhat ashamed that we had them; now they seem to be handy photo opportunities for Prime Ministers. Where do food banks figure in how the Government look at the economics of this country? It seems to me that they count on them a great deal more than they should.

[Lord Markham (Con)]

Clearly, food banks should be a last resort for people; that is definitely my hope. I am glad to say that there are some good examples of where hospitals have thought that this is the appropriate thing to do and have set them up to help people in that circumstance. However, the biggest increase has been in energy bills, which we have sought to protect people from. I am glad to see that prices are forecast to reduce in future. Actually, gas futures prices are down 71% for next year, so things are starting to get better. Is it challenging right now? Yes.

NHS Dental Contract

Baroness Boycott Excerpts

Thursday 1st December 2022 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend, and I declare an interest: my wife is a dentist, although she is not practising at the moment. This is one of those rare occasions when it is a case not of announcing new spend but of making sure that the £3 billion we spend is fully utilised. To answer the question directly, it is absolutely right that we need a radical package to make sure that dentists are contracting against their UDAs and finding working in this space worth while and profitable, so that we get the full use of that. I will happily come forward with further proposals, planned for 2023, on what we are going to do in this space.

[Baroness Boycott (CB)]

My Lords, one reason why young children now go into hospital and have anaesthetics is to have all their teeth out, largely as a result of sugary diets. As we see through our Feeding Britain network, a lot of children do not have toothbrushes and definitely do not have toothpaste. Scotland has been trialling some really efficient systems whereby dentists go into school, give out free toothbrushes—which a lot of toothbrush manufacturers will happily supply—and get children into the habit of cleaning their teeth. Given the massive absence of dentistry, which will take a long time to fix, can the Government look at a simple measure such as that, which would greatly improve the nation’s teeth, especially our kids’? It is a nightmare to have all your grown-up teeth taken out at eight years old; you are stuck with lousy teeth for ever, and it is not fair.

[Lord Markham (Con)]

I agree, and I understand the problem. I also agree that we need to look at a broad range of measures. I was delighted that we passed the statutory instruments on water fluoridation recently, and we should look at new ideas. I was also delighted to see oral health advice included in the new family hubs being set up. We are willing to look at measures that work elsewhere as well, such as free toothbrushes in Scotland.

Childhood Obesity

Baroness Boycott Excerpts

Monday 17th October 2022 Lords Chamber

Asked by

[Baroness Boycott]

To ask His Majesty’s Government what is their strategy to prevent childhood obesity?

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

We are working with the food industry to ensure that it is easier for people to make healthier choices and increase progress on the reformulation of foods. In addition, there is a range of support to help children living with obesity and being overweight to achieve and maintain a healthier weight.

[Baroness Boycott (CB)]

I thank the noble Lord for that very brief Answer. I wondered whether, in the current spirit of U-turns, the noble Lord could tell the House whether the Government will reverse their initial idea of reviewing the policies agreed by the previous Tory Government to ban two for the price of one offers on unhealthy food and to restrict advertising of foods high in fat, sugar and salt to kids during the times they watch TV. Health campaigners and medical professionals have called the possible reversal of this decision staggering and an incredible blow to the health of this country. I would be grateful for anything the noble Lord could add.

[Lord Markham (Con)]

I thank the noble Baroness for bringing this issue before us. I know that she is a passionate campaigner in this area, with a strong track record. I like to believe that we have had a multi-pronged strategy, because this is a complex area. Look at the four areas the OECD recommends in terms of addressing this complex issue. First, on information and education, we have been working very strongly on education programmes, labelling and the traffic lights, and with menus and restaurants. Secondly, on increasing healthy choices, again, we have worked with industry on recipes. Thirdly, on modifying cost, obviously the sugar tax has shown big reductions there. Lastly, on the restrictions on promotions and placements, again, 1 October saw us change the way items are presented to take away some of the problems of pester power. There is a big formulation of approaches. It is probably appropriate at the moment, with so much going on, that we seek to review their success. I know that the delay in the timings is all about giving ourselves that opportunity.

Sugar Reduction Programme: Bread

Baroness Boycott Excerpts

Wednesday 25th May 2022 Lords Chamber

[Lord Kamall (Con)]

That is a very sensible suggestion. Across government, and with the Office for Health Improvement and Disparities, we are trying to work with both the food-supply industry and retailers to look at how we can pull customers towards healthier products and work with companies to reduce sugar, salt and other bad things in terms of food reformulation to make sure that we have a healthier population in the longer term.

[Baroness Boycott (CB)]

My Lords, in respect of the cost of living crisis and healthy food, why do the Government not make automatic enrolment in Healthy Start vouchers immediately happen? At the moment, only about 60% of people take up this good measure to spend on healthy food. This would certainly be a good counteraction to the delay in banning two for the price of one on sugary foods.

[Lord Kamall (Con)]

On the direct question that the noble Baroness asked, I will have to go back to find out more and will write to her. The Government are very keen on some campaigns that she will be aware of, such as the Better Health campaign, launched in July 2020. In January 2022 it took over from Change4Life. We now have the NHS Food Scanner app; with a quick scan of a barcode, families can see how much sugar, saturated fat and salt is in their everyday food and drink. There is also a campaign on on-demand video, as well as on YouTube, and we encourage people to download the app from the App Store or Google Play. More campaign resources are available, and I am sure that noble Lords would like to help promote them.