Calorie Labelling (Out of Home Sector) (England) Regulations 2021

Baroness Fall Excerpts

Thursday 22nd July 2021 Lords Chamber

[Baroness Fall (Con) [V]]

My Lords, all crises give way to opportunity, the chance to reassess and adapt, and Covid is no different. Eighteen months on, we are confronted with some really difficult issues. Among these are the growing reality that some have fared better than others in terms of their health, livelihood, prospects and mental health. It is right that the Government should focus on the reasons for these disparities and seek to find some answers.

One such issue is obesity. We have been shocked to see the growing evidence of how Covid has adversely affected those deemed overweight or obese, and Covid is not the only vulnerability for this group. They are susceptible to type 2 diabetes, heart disease and many types of cancer. Recent surveys have talked about 64% of our population being overweight or obese, and childhood obesity is among the highest in western Europe. This is a substantial group, and alarm bells should be ringing. It is certainly the time for a national conversation about how we address this problem. We have heard much in recent days about initiatives to improve the nation’s diet, a sugar and salt tax, or getting the nation to eat more fruit and veg. While Ministers consider whether any of these proposals should make it to the statute book, we have an immediate task of assessing this one, the calorie labelling legislation, today.

I am very sympathetic to the intent here. I see the urgent need to raise awareness of the effect that obesity has on health, but we need to do this in a way that takes account of some of the complexities of the issue and does not miss the mark. With this in mind, I draw attention to three concerns. First, I fully support the objective of increasing transparency around what we eat, especially aimed at larger establishments and chains, which greatly impact the eating habits of our nation. People will not choose healthy unless they know what they are eating, and in many cases they simply do not know. But calorie counting is a blunt instrument to crack a complex issue. Calories also impact different people in different ways and take no account of the energy they use. So why not flag a healthy or unhealthy option or operate a traffic light system instead?

My second concern is that we need to deliver a strategy that does not look like an attack on those with limited budgets. Tone is important here, and a real understanding of choice and the financial reality of stretched household budgets. Real choice means that affordable healthy options are available. We should be putting pressure on companies to lower sugar and salt content in their products rather than taxing consumers, which hits low-income families.

My third concern is the focus of this short debate; that is, the effect of this initiative on eating disorders, which are sky high, especially among the young, and which destroy lives and blight many others, as many have said, especially the noble Baroness, Lady Wheatcroft. I therefore have sympathy with some of the reservations raised by the noble Baroness, Lady Bull, today. Young people have been shut up at home, missed exams, missed each other and have had their prospects blighted, so it is no wonder that eating disorders have rocketed, and we already had a grave problem before. We have no evidence or data to suggest what impact calorie labelling will have on eating disorders but it does not take a huge jump of imagination to work it out. We should not have a tin ear to these concerns. Good policy should be creative and targeted and should not disregard the plight of a minority who are adversely affected just because a greater number are set to gain.

I support the Government in their endeavour to tackle the difficult but important issue of obesity. I do not speak in regret, but I ask the Minister to take note of some of the concerns raised today.

Eating Disorder Services: Referrals

Baroness Fall Excerpts

Monday 17th May 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness refers to a perennial issue in any national health service, which is the inevitable concentration of expertise in some hubs where there is particular specialist knowledge. But she is entirely right that we should try to avoid excessive travel. That is why community eating disorder services are so important, because they bring the treatment as close as possible to the people who are suffering.

[Baroness Fall (Con) [V]]

My Lords, the noble Baroness, Lady Bull, is quite right to raise this important issue today. Young people have had their lives turned upside down over the last year, their plans put on hold and their prospects blighted and, with a sense that they have lost control, it is hardly surprising that we have seen a huge rise in mental health issues. Can the Minister give us an indication of the waiting rates at the moment, especially for those diagnosed as urgent cases? Is it his view that we have enough practitioners? If not, does he have any plans to discuss the need for more training and a recruitment drive?

[Lord Bethell (Con)]

My Lords, my noble friend puts it extremely well. Young people have been under huge pressure during the pandemic. It is a huge tribute to the young people of Britain that they have borne it so well. I do not have to hand the statistics on waiting lists that she asked for, but I would be glad to write to her with the details. We are recruiting right across the NHS at the moment; it has been an extremely successful recruitment round, and those kinds of recruits will go to services such as those dealing with eating disorders.

Health: Eating Disorders

Baroness Fall Excerpts

Tuesday 19th January 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness may not have heard my answer to the previous question, where I cited the large number of beds opened in the last year, totalling more than 30 across the country. I recognise that more beds are needed for those who have particularly acute disease, but the large prevalence of the disease among hundreds of thousands of young girls and boys also means that community care has to be at the heart of our response to this condition.

[Baroness Fall (Con) [V]]

My Lords, this autumn, charities such as Place2Be have recorded a notable increase in issues of self-harm, suicidal thoughts and eating disorders. The impact of shutting schools has been huge, and we will not know the legacy of that for a long time to come. I am reassured to hear the Minister say that he is as concerned as I am to look at ways to deal with this, but will he and others consider making school teachers the first priority for receiving the vaccine, after the most vulnerable and aged in our population, so that schools can open as soon as possible?

[Lord Bethell (Con)]

My Lords, we recognise the contribution of charities to this mental health challenge, and £10.2 million of additional funding has been allocated to mental health charities. We also recognise the importance of keeping schools open: no Government could have tried harder to keep schools open than this one. However, the allocation of the vaccine is based on morbidity—we have to protect those whose lives are most threatened and that is why the JCVI has put the prioritisation list in the form it has.

Mental Health Services: Young People

Baroness Fall Excerpts

Thursday 24th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, provision for young people is at every level of the health service. It includes direct school interventions through the programme I discussed earlier, it is within the NHS, where we have an enormous emphasis on eating disorders, and it is in young adult care. The provision of £9.2 million to charities during Covid included charities that support young mental health and eating disorders, and it remains a major priority for the Government.

[Baroness Fall (Con) [V]]

My Lords, I congratulate all those who worked so tirelessly to make sure that students have gone into higher education this autumn. However, let us be honest: a lot of young people going to these places are sitting in their rooms, lonely, having virtual lessons and very little social interaction, and that will have a huge effect on their mental health. I urge Ministers to take responsibility for the mental health of our students as they are social distancing.

[Lord Bethell (Con)]

My noble friend Lady Fall is right that the plight of students is tough; going to college will not be like it was in our days. That is why the DfE is putting together a Covid catch-up package of £1 billion, which will include support for universities and for the mental health of students.

Hospitals: Patient Safety

Baroness Fall Excerpts

Thursday 21st May 2020 Lords Chamber

[Lord Bethell]

I am afraid that at the moment, I cannot give a precise and thorough answer to the perceptive and very detailed question asked by the noble Baroness, but I will be glad to.

[Baroness Fall (Con)]

We pay tribute to all those doing so much to help Covid-19 sufferers. However, we must not lose sight of others, such as cancer sufferers, who are being adversely affected by being afraid to go for diagnostics, having surgery and treatment cancelled, low supplies of key drugs such as painkillers, and research budgets being hit. Can the Minister reassure the public about this and tell us what he is doing to address these problems?

[Lord Bethell]

The situation of cancer patients is of grave concern. We have restored all the treatments, surgery and other systems necessary for treating cancer, and we have put in place testing facilities so that those with suppressed immunity can be tested and therefore enter treatment centres with confidence. It is a situation that we maintain under review, and we are working hard to ensure that drugs and painkillers are in ready supply.

NHS: A&E Waiting Time Target

Baroness Fall Excerpts

Tuesday 21st January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Lord always asks astute questions. Winter is a challenging time. Over 2 million people attended A&E last month, and we have to pay tribute to the dedicated NHS staff for seeing over 70,000 people every day—the highest number in December ever. Although we have more NHS beds open this winter than last, our A&Es have had to treat more people. The A&E waiting standard is being looked at by clinicians, who are considering whether it is appropriate, given the changes that have occurred in clinical standards. The five key reasons considered for moving away from the standard include: the standard does not measure total waiting times; the standard does not differentiate between the severity of conditions; the current standard measures a single point in an often very complex patient pathway; and there is evidence that processes, rather than clinical judgment, are resulting in admission or discharge in the period immediately before a patient breaches the standard, which is a perverse incentive. The Government will not do anything without public consultation and clinical recommendation. We will wait to see that, and no decision will be made until that comes forward.

[Baroness Fall (Con)]

My Lords, let us not get distracted from the key issue here, which is that our A&Es are under enormous pressure. One reason is that people find it very difficult to see a GP, and that is why I think we can all welcome the announcement that we will see some more GPs. When might we see some progress on the ground?

[Baroness Blackwood of North Oxford]

My noble friend is absolutely right. We need to improve access to community care to make sure that people are diverted away from inappropriate visits to A&E. We have said that we will recruit over 6,000 doctors in GP practice, and we are working on that as we speak. We are also increasing the number of GP practices within A&E so that people can be diverted into appropriate care when they go to A&E inappropriately. The evidence is that already around 10% of those attending A&E are streamed into those GP practices, and we are currently trying to increase that provision.

Child and Adolescent Mental Health Services

Baroness Fall Excerpts

Wednesday 24th October 2018 Lords Chamber

[Lord O’Shaughnessy]

I recognise that there is variability across the country. Indeed, waiting times vary, which is not acceptable. That is why a new four-week waiting time standard is being trialled as part of the Green Paper I mentioned. I should also point out that new, community-based eating disorder clinics are being set up so that people do not have to go to an A&E environment and can access something that is better for them, frankly, both more easily and locally.

[Baroness Fall (Con)]

My Lords, I start by commending the Government for their important work in this area. It remains true that many people who seek help are often either not helped at all or put on a waiting list. Can the Minister outline the exact thresholds that are used when many people who seek referral are turned away? In the interests of transparency, it would be important for us to know what they are.

[Lord O’Shaughnessy]

I thank my noble friend for her question. The definition is a “diagnosable mental health condition”. That is the performance target, or threshold, we work against. At the moment, unfortunately, only around 30% of children and young people with a diagnosable condition access care and treatment but we are clearly trying to increase that figure.

Mental Health: Young People

Baroness Fall Excerpts

Thursday 9th February 2017 Grand Committee

[Baroness Fall (Con)]

I thank the noble Baroness, Lady Massey of Darwen, for securing this important debate and for drawing our attention to the pivotal role that parents play in supporting young people with mental health problems. We bring our children into a complex and difficult world, in which the lines between private and public are blurred and which operates 24/7 in 360 degrees through the likes of Facebook and Instagram. Our children never get a day off. Of course, older generations have always gazed with incomprehension at their children, bemoaning the lost values of their youth, and we are no different. Nor are we unusual in wanting to do our best for them, not just because as parents it is our duty, but also because we have an obligation as a society to care for our young. They are, after all, our future.

I am deeply troubled by the serious rise in mental health issues among children and young people in Britain today and the often inadequate help they are receiving, which puts enormous strain on them and their families. A lightning review by the Children’s Commissioner in May last year stated that as many as one in 250 children were referred to what is known as CAMHS by professionals. Of those, 28% were not allocated a service at all and 58% went on a waiting list. These are children in desperate need of help, who are often being turned away or asked to wait a long time for treatments, left with no one else to turn to but their parents. Parents often try to do all they can to help, but they are not trained specialists and can feel alone and overwhelmed by the responsibility and at times frightened for the safety of their child.

The recent paper “There for you” says:

“The practical impact on parents can be extensive. In order to care for their young people, many have to take time off work, go part-time, take unpaid leave, or resign from jobs entirely”.


There seems to be a corrosive combination of factors at work: a rising demand for help; frozen health budgets; a system of tough thresholds, which means that many referrals are turned away altogether; and long, painful waits for those who are lucky enough to get referred. Too often, by the time help is at hand the situation has deteriorated and the child may face no other option than being admitted to hospital. That is a terrible outcome for everyone. Taking the child out of their social environment, away from their families and friends, can make recovery times far longer and more painful and puts enormous pressure on parents, given that many of these places and sought-after beds are in hospitals miles away.

We have a serious problem, but one that I hope we are finally waking up to. I commend the Government’s recent intervention in this area and look forward to hearing more when their Green Paper comes out later this year. I especially welcome their focus on training teachers in schools, although I hope that that is extended to primary schools, where mental health issues so often begin.

However, diagnosis is one thing; treatment is another. We will never get to the heart of this problem while there are still rigid thresholds, rejected referrals and unacceptable waiting lists. We must try to intervene earlier and more aggressively. I also wonder whether we should not be looking for more creative solutions, working together with schools and the voluntary sector—perhaps in setting up drop-in clinics where parents and children might seek support from outside the system.

I welcome the concerns echoed across the Committee today and ask that we keep our eye on the ball, for we cannot afford to let things go on as they are.