Smoking: E-Cigarettes

Debate between Earl Howe and Lord Rennard

Tuesday 3rd February 2015 Lords Chamber

[Earl Howe]

My Lords, the noble Lord is correct. The Cochrane review concluded that the quality of the evidence overall is low because it is based on only a small number of studies. The National Institute for Health Research has recently commissioned a large randomised control trial to examine the efficacy of e-cigarettes compared with nicotine replacement therapy when used within the UK’s stop smoking services. That project is due to end in 2018 and will certainly improve our current understanding.

[Lord Rennard (LD)]

My Lords, does my noble friend agree that we need a public health education campaign to persuade people that there are absolutely no health benefits whatever, or indeed any merit, in becoming addicted to nicotine, and that the promotion of devices such as e-cigarettes should be purely for the purposes of encouraging people to be weaned off their addiction to tobacco with nicotine, as tobacco is still killing nearly 300 people every day in this country?

Health: Sugar Consumption

Debate between Earl Howe and Lord Rennard

Wednesday 6th February 2013 Lords Chamber

[Lord Rennard]

To ask Her Majesty’s Government what plans they have to help people reduce their sugar consumption.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, we have challenged business, through our responsibility deal calorie reduction pledge, to take action to help people eat fewer calories. This can include helping reduce sugar consumption. Businesses are already taking action; for example, soft drinks manufacturers which are signed up to the calorie reduction pledge are reducing sugar and calories in their drinks, and we are looking to others to join force.

The Government are also helping consumers to reduce their calorie intake by providing practical advice through NHS Choices and via the Change4Life campaign.

[Lord Rennard]

My Lords, does the Minister agree with the Secretary of State for Health that legislation may be required in this area if other measures do not succeed? In the mean time, does he think consideration needs to be given to changing tax regimes so that the tax may be rather higher on very sugary soft drinks, and rather lower on drinks that are less full of sugar? Does he also think that we may need to restrict the amount of sugar provided in some products, such as breakfast cereals targeted at children, so that parents either as consumers themselves or watching their children can see how many spoons of sugar are going on to their cereal, rather than simply accepting the amount of sugar already produced by the manufacturers?

[Earl Howe]

My noble friend asks a number of questions. I am sure he will have welcomed, as I did, the announcement a few days ago by two major manufacturers of sugary drinks that they were substantially reducing the sugar content of their drinks. This is in part a result of the engagement that we have had with the food industry, which, in public health terms, is taking on responsibility for the products that it makes.

While there are advocates for taxation, in 2012 my department reviewed the international evidence of the effect of taxation on people’s consumption of food and drink. There is very limited empirical evidence, certainly from literature, but also in practice that that has an effect on body weight or health outcomes. There is a range of possible unintended consequences, including swapping for other foods which may be even less healthy than the ones that we are trying to cut out.

Tobacco: Control

Debate between Earl Howe and Lord Rennard

Tuesday 19th June 2012 Lords Chamber

[Earl Howe]

My Lords, across government we recognise the need for Ministers or officials from other government departments to meet the tobacco industry within the parameters set under the framework convention. There may be legitimate operational reasons why such meetings might be necessary—for example, Her Majesty’s Revenue and Customs sometimes meets the tobacco industry to discuss measures to reduce the illicit trade in tobacco. So it is not as if all government departments have closed their doors, but there is a very specific issue to do with Health Ministers and health officials.

[Lord Rennard]

My Lords, I declare my interest as an unpaid director of Action on Smoking and Health. Does the Minister recognise that any dealings he has with the tobacco industry will be with an industry that is responsible for the deaths of around 300 of its own consumers every day in this country alone, and that any claims that that industry makes must be treated with very great scepticism given its knowledge over many years of the connection between smoking and lung cancer and the addictive properties of nicotine—facts which it well knew but denied for many decades?

[Earl Howe]

My Lords, my noble friend makes some very powerful points and he is right. Smoking is the biggest preventable cause of death in England. It causes more than 80,000 premature deaths every year. Tobacco use is a significant cause of health inequalities in the UK. One in two long-term smokers will die as a result of smoking. That demands that we take this issue very seriously indeed.

Health: Diabetes

Debate between Earl Howe and Lord Rennard

Wednesday 1st February 2012 Lords Chamber

[Earl Howe]

My Lords, much will depend on the way in which primary care engages with those in social care to ensure that the residents of care homes, who need diabetes care management, receive it properly. We very much want to see that joined-up commissioning arise from the reforms that we are currently in the process of debating in your Lordships' House. The noble Lord makes a very good point. We have many tools at our disposal. There is no shortage of guidelines in this area. Much will depend on the training of care home staff and a lot of work is going on under the aegis of the National Clinical Director for Diabetes in this area.

[Lord Rennard]

My Lords, does the Minister agree with the 15 checks or services promoted by Diabetes UK that every person with diabetes should receive or have access to? In particular, does he agree that they should have access to high-quality, structured education, firmly embedded in the NHS, based on a programme such as that for type 1 diabetics, promoting dose adjustment for normal eating?

[Earl Howe]

My Lords, the answer to my noble friend is yes. Those checks and services are firmly supported by NICE, by the National Service Framework and by the NICE quality standard. I also agree with him that structured education is fundamental if we are to ensure that patients can self-manage. A number of tools are available for that. He mentioned one for type 1 diabetics that has the acronym DAFNE—dose adjustment for normal eating—and for type 2 diabetics there is DESMOND—diabetes education and self-management for ongoing and newly diagnosed.

Health: Diabetes

Debate between Earl Howe and Lord Rennard

Tuesday 1st November 2011 Lords Chamber

[Earl Howe]

I agree fully with the noble Baroness that sugar and the sugars contained in alcohol are a major feature in the obesity problem and in the incidence of type 2 diabetes.

[Lord Rennard]

My Lords, will the Minister undertake to look at the report published today by the Primary Care Diabetes Society on keeping people with diabetes out of hospital? Will he agree to look in particular at evidence suggesting that greater provision of insulin pumps or more use of bariatric surgery may be very cost effective to the NHS and, in the wider economic sense, a significant saving to the public purse rather than an expense?

[Earl Howe]

I shall certainly do so. In relation to insulin pumps, we know that more has to be done to increase the uptake, in line with NICE recommendations. The current operating framework highlights the need to do more to make these devices available. Bariatric surgery should be seen as a last resort, but in some cases it is the right option. It is not an easy option because surgery comes with risks, and anyone undergoing it needs to make significant lifestyle changes. But I am sure that my noble friend’s messages are well taken in the medical community.

Health: Diabetes

Debate between Earl Howe and Lord Rennard

Thursday 14th July 2011 Lords Chamber

[Earl Howe]

The noble Lord, Lord Harrison, is quite right. England, along with the devolved Administrations, leads the world in this area. It is the first time that a population-based screening programme has been introduced on such a large scale. We are committed to continuing it. More people with diabetes are now being offered retinopathy screening than ever before and to higher standards, despite the increasing number of people with diabetes. The latest data that I have show that 98 per cent of people with diabetes have been offered screening for diabetic retinopathy during the past 12 months.

[Lord Rennard]

My Lords, is the Minister aware that people with diabetes are twice as likely to be admitted to hospital as people without diabetes? Will he undertake to look at best-practice models, such as that of the University Hospitals of Leicester, where diabetes specialist nurses have been stationed in the accident and emergency department and are able, in many cases, to advise against admission to hospital and provide more appropriate treatment and support? This is believed to have saved the University Hospitals of Leicester around £100,000. Diabetes UK estimates that, if rolled out nationally, such good practice might save the NHS up to £100 million a year.

[Earl Howe]

My Lords, I am aware of that excellent beacon of good practice in Leicester, which is an example that we welcome. It is an approach that is already being taken in other parts of the country. The NICE quality standard for diabetes states that people who have the condition, and who have experienced hypoglycaemia that requires medical attention, should be referred to a specialist diabetes team for advice and support to reduce admissions in exactly the way that my noble friend described.