Diets: Fat

Lord Brooke of Alverthorpe Excerpts

Thursday 31st October 2024 Grand Committee

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am most grateful to the noble Lord, Lord McColl of Dulwich, for this debate. I pay tribute to his long and consistent work in this area. He is experienced in a whole range of different aspects of this, having been a surgeon, and probably knows more about the gut than I ever will. My contribution is one of gratitude for having a peg on which I can hang a coat and pick up several other topics related to obesity.

Obesity, like drink or drugs, comes from filling the empty hole inside us. It can lead to greed, excess and, as we see in many areas, premature death, or certainly an unhealthy later life. It represents a great cost to the NHS and we have to continue working on it. I declare an interest as a member of the Food, Diet and Obesity Committee, which has just produced the report Recipe for Health. We did not focus excessively on fat, but I am sure that colleagues who are better qualified than I may make contributions on that topic.

We did not focus on the new drugs either. I am worried about what lies ahead with the changes in prospect from those drugs. I shall say a little more about that. In the committee, to the extent that I was able to attend, I focused primarily on the fundamental problem of excess sugar being consumed, particularly by children, who I worry about, and the consequences of that. The major reason why children go to hospitals and A&E is dental problems, which in the main arise from sugar.

Like our committee, I should have liked to see taxes introduced to reduce the amount of sugar that we find in soft drinks and elsewhere, but we did not get that yesterday in the Budget. Instead, we got a reduction in the price of alcohol—what a surprise. Our report did not look at the point the noble Lord, Lord McColl, raised about the effect of alcohol on obesity. I welcome my noble friend the Minister, who is listening to me again on this topic. I have been campaigning for years that we should show calories not just on menus but on all drinks. The one area of drinks that is excepted, of course, is alcohol. The previous Government were looking at that and undertaking consultation. I do not know whether they ever concluded it, so could my noble friend say whether they did? She may not have the answer to hand, but could she write to us? If it was concluded, what is the outturn of that exercise and when will we see a Labour Government prepared to introduce calories to labelling on alcohol? Some of her forebears spoke in favour of it when I was campaigning for this over a decade ago. It is sugar that worries me.

The new drugs will be used and needed, but we have to avoid some of the difficulties of lack of regulation and oversight that we have had in the past when new drugs have been introduced. I have done work over many years on addiction related to drink and drugs. I did work on heroin in the early part of this century, when methadone was introduced in lieu of heroin to try to reduce harm. We were spending next to nothing in 2005 on methadone. I cannot now get from the Government a precise or even a round figure on what we are spending currently on methadone, but the rumour is that it is about £1 billion a year, when you take into account not just producing it but the way it has to be administered and the secondary trading that takes place. This is the danger that I bring to the Committee’s attention, which we must be aware of. Unless we keep strict controls on the new drug, we could see it mushroom and spread very quickly indeed—and we could even see secondary markets start to develop. I hope that the Minister is aware of that.

Can we look for incentives to get the food and drinks industry to change its approach? I know that some of them are willing to have conversations about trying to have better formulas in foods, and I hope the Government will be prepared to move on that front.

Food and Drink Industry: Processed Sugar

Lord Brooke of Alverthorpe Excerpts

Monday 14th October 2024 Lords Chamber

Asked by

[Lord Brooke of Alverthorpe]

To ask His Majesty’s Government what steps they are taking to engage the food and drink industry in reformulating their products to reduce processed sugar in favour of healthier natural alternatives.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, last month, as part of our health mission shift to prevention, we published the Government’s response to the consultation on banning junk-food advertising to children, putting the legislation on track and encouraging industry to reformulate and reduce sugar levels in products. There is continued engagement with industry to support action and understand the challenges that are faced in order to make the necessary changes and we continue to review the balance between mandatory and voluntary incentives to reduce sugar in everyday food and drink.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the Minister for her reply. I noted the reports about the shift; I wonder whether I can persuade her to shift the Government a little further. I endeavoured to persuade the previous Government that we should engage in further discussions in a round-table way with the food and drink industry to try to reduce the amount of processed sugar. I seek to persuade the Minister to convene a round-table meeting of those in the private sector interested in trying to effect reformulation in food and drink and to let us see something positive actually happening.

[Baroness Merron (Lab)]

We certainly want to reduce sugar intake, and I commend my noble friend for his campaigning on this issue. I know he will continue, rightly, to press me on this. We want to ensure that we learn from experts and will welcome further research in this area. We already have regular meetings with industry and monitor the progress being made. The ultimate prize is not just about looking at reducing sugar and replacing it with sweeteners but finding that our palates are encouraged to adapt to a rather less sweet taste, and that will be the best way forward.

Premature Deaths: Heart and Circulatory Conditions

Lord Brooke of Alverthorpe Excerpts

Tuesday 6th February 2024 Lords Chamber

[Lord Markham (Con)]

Yes. Those are all key measures that we need to take and, I like to think, are making progress on. I thank the noble Baroness for her work and all the noble Lords who have been working on the Times Health Commission, which is a valuable contribution to this debate. I mentioned digital health checks. I have seen technology where holding your phone up in front of you can test your blood pressure and your heart rate. We need to verify that, but I think that is definitely the way of the future as well.

[Lord Brooke of Alverthorpe (Lab)]

Can the Minister say why the Government are refusing to review the regulations governing children’s meals? We know that the sugar content in them is too high and that our children are eating too much sugar. This needs to change, yet the Government refuse to look at the regulations and enforce them properly.

[Lord Markham (Con)]

I am not quite sure that I agree with the word “refuse”, but I agree with the noble Lord that healthy food in all environments is a good thing. I know that the delay happened because it was originally planned for 2020 or 2021, I think, and then the pandemic got in the way. I freely accept that the review now needs to take place. We are not refusing to do it, because it is an important part of the armoury.

National Health Service: 75th Anniversary

Lord Brooke of Alverthorpe Excerpts

Thursday 30th November 2023 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to my noble friend Lord Hunt of Kings Heath for his—as expected—truly amazing speech. He is a man with great experience of the health service, both before he came into this House and, in particular, while he was serving here as a Minister. He is a man of great value; he is one of the few politicians around who resigned on principle on an issue. He resigned over Iraq. I was one of those who was on the wrong side and I admire him greatly for the work he has done and what he continues to do.

As he mentioned—as did the Baroness, Lady Pitkeathley—I also spoke on this way back in 2003. I also spoke in 2018, when we were celebrating 70 years. What particularly interested me then was that the standing of the NHS in the eyes of the public was very high. I thought it was a great opportunity for us to try to take this jewel. The NHS is something which binds us together. As the previous speaker just said, it is important that we go back to that and find ways in which the public attitude, as it presently stands, is reversed.

I suggested in 2018 that we ought to think about creating a national charity for people to participate in and leave gifts in their wills to, and so on. The Government said no, because some trusts already have their charities and that would undermine them. Well, some trusts do have them and they are very successful, but, if you examine it, you will find that the ones getting great amounts of money are in wealthy areas. In the dispossessed areas, where we have the worst health and growing rates of ill health, you will find that charities either do not exist or, if they do, not much money is going in. I would be prepared to put something in my will—not for Chelsea and Westminster, which I am close to, but for the NHS. The money would then be redirected to the areas of poverty where we need to be making the greatest changes.

If we look at what is happening, as my noble friend Lord Hunt pointed out, we are starting to see for the first time in near history that life expectancy is halting and going in the other direction. If you live in Westminster, your life expectancy is going to be of the order of 86 years, but if you are in Manchester it is down to 77 or 78—and this is happening against a background of general decline in many areas of the health service.

I hope the Minister might still give some thought to the idea that we should try to find ways of having far greater involvement of the public. The charity approach was one idea. When Alan Milburn was Secretary of State, he tried to find ways to get more people involved. They even explored the idea of shares in the NHS, so that people were making a personal commitment to it. I still believe there is merit in going back to some of those issues.

Covid has of course made a difference, and we should not deny that—the Minister will, without a doubt, labour this point in defending the state we are in. When we came into power in 1997, the health service was in a mess and, as was said, it is in a mess again. We have to find our way forward. Care in particular has to be addressed, and we have a plan there, but I believe that the way forward will be to try to involve more people in building a base for revising our approach to it. I appeal to the Minister: the Government made promises in 2019 but have not delivered on anything, so would they be prepared to consider working closely with the new Government, if Labour comes to power, to try to take care out of the Punch and Judy that we have had so much in the past—to come together and to shift care away from political disputes between the parties? I hope the Lib Dems might be willing to give their support to that entirely different approach to care, because it is so desperately needed.

I wonder why this review of Covid is going on until 2026. How much money will be spent on it before it is completed? Would it not be better spent on trying to address some of our current problems in the health service? With Covid, some underlying causes needed addressing. The first was age—and care is the way we start to address that properly. The second was the underlying cause of weight: 50% of the deaths attributed were attached, for a variety of reasons, to people being overweight. The Government have a number of proposals for change, but have fallen well short. They made a grave mistake in winding up Public Health England—at least it was seen as a focal point for campaigning, and it was coming out with strategies that were noticed. We have completely lost focus on where we go in campaigning on obesity, and I hope that, when my party comes to power, it will address that more than it has been addressed in the past. The third area that was identified in the Covid review was the disproportionate number of people of colour who suffered badly. As was mentioned, a recent report says that people of colour are still gravely disadvantaged in health terms compared with the white population. We need to find new policies to address that difficulty and to turn it around so that people start to feel that they are a better part of the community than they are now.

My appeal overall is to try to take certain areas where we are failing to make progress out of the Punch and Judy of politics, to develop new relationships that would move us forward on issues that we have all had policies on for years but have not made progress on. I hope the Minister spends some time, in responding, on the need to get the public more involved than they have been and to get some unity of purpose between the parties in the areas where we have still not made any movement but should have.

Ultra-processed Food

Lord Brooke of Alverthorpe Excerpts

Thursday 26th October 2023 Lords Chamber

[Lord Markham (Con)]

I have said many times that the prize is reformulation. I do not think that any of us should have a problem per se with the food if the bad stuff is taken out. Diet Coke is a perfect example. It is not particularly good for you but not bad for you either, so why should Coca-Cola not be able to advertise Diet Coke? If you take out the bad stuff, we should encourage industry because advertising works. It wants to advertise, so if it is encouraged to take out the bad stuff, that is a big incentive.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, as far as I recall, it was said that we should keep it simple and that the focus should be on sugar. When will the Government look at children’s school meals, review the regulations and reduce the sugar in children’s free school meals?

[Lord Markham (Con)]

The noble Lord makes a very good point. A healthy start to life is vital, which is why I am very pleased to say that we have the highest level of free school meals ever, with every infant school kid and a third of children overall having a free school meal. On the composition of those foods, I know that this was planned but was stopped due to Covid. The timing is now being reviewed again, because things move on in terms of the content and healthy foods.

Children’s Health: Sugar

Lord Brooke of Alverthorpe Excerpts

Tuesday 12th September 2023 Lords Chamber

Asked by

[Lord Brooke of Alverthorpe]

To ask His Majesty’s Government what assessment they have made of the impact of sugar on children’s health.

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

The Scientific Advisory Committee on Nutrition undertook a comprehensive assessment of sugar intake and health in its 2015 report Carbohydrates and Health. In 2023, it looked specifically at children aged one to five. SACN concluded that reducing the intake of sugar would lower the risk of tooth decay and weight gain in children and adolescents. The Government have an ambitious programme to reduce children’s sugar intake, which includes the soft drinks industry levy.

[Lord Brooke of Alverthorpe (Lab)]

I thank the Minister for his reply. One area where the Government have failed to take the action they should is to encourage the industry to reformulate food more than it is doing at the moment—to take out sugar and substitute the alternative, organic, healthy sweeteners that are available. Would the Government look into this and do some more work? Would they be prepared to invite companies that are willing to enter public/private partnerships to start doing that?

[Lord Markham (Con)]

First, I recognise all the work the noble Lord does in this space. Secondly, I completely agree that reformulation is the big prize as part of this. The House will remember me mention before that Mars, Galaxy, Bounty and Snickers have all reformulated their food, as has Mr Kipling and his “exceedingly good” cakes—they are compliant cakes as well. There is a lot being done here, but there is more to do. We meet the industry all the time and are very happy doing so.

MMR Vaccine

Lord Brooke of Alverthorpe Excerpts

Thursday 20th July 2023 Lords Chamber

[Lord Markham (Con)]

Yes. That is where we really see UKHSA coming into its own in terms of taking an intelligence-led approach. The concern came from its modelling: its epidemiologists brought this up as a concern, which led to the alert going out on 14 July. Likewise, it is looking into other categories and, where there are those concerns, it will come out and suggest such outreach programmes.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I refer to the question asked earlier by the noble Lord, Lord Young, about the high level of absence of children from school at the moment; I believe the present figure is in the order of 24%. What special steps are being taken there, where the appeal to the school will not make any difference yet we have to try to get to the homes of the individual parents?

[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.

Food: Two-For-One Offers

Lord Brooke of Alverthorpe Excerpts

Wednesday 19th July 2023 Lords Chamber

[Lord Markham (Con)]

I am aware of the Amsterdam initiative. Off the back of that, the OECD said that there were four main strands to what countries should be doing: first, information and education, such as the good examples I spoke about; secondly, increasing healthy choices through the reformulation of foods, which again is something we are doing; thirdly, the modifying of costs—the sugar tax, which has reduced sugar consumption by as much as 40%, is a perfect example of that; and, fourthly, restrictions on where product placement should take place. I am absolutely familiar with the initiative in Amsterdam, and am pleased to see that we have taken action on a lot of those things.

[Lord Brooke of Alverthorpe (Lab)]

Is the Minister not ashamed about what has happened to children’s health while the Conservatives have been in power since 2010? We have more obese children than ever before, and a plethora of policies which would work if implemented, yet so many are delayed. Will the Minister give a commitment to go back and look at the regulations governing children’s school meals? They were changed in 2014, with permission granted to give children more sugar. The Government were reviewing this in 2019 and 2020, but that stopped because of Covid. Will the Minister give a commitment again to start a review? Even if they cannot implement it, the next Government could.

[Lord Markham (Con)]

The noble Lord is correct: good school meals are fundamental to all of this. My understanding is that the review is something that the Government are looking to do, but I will happily provide more details on what the plan is.

Ultra-processed Food

Lord Brooke of Alverthorpe Excerpts

Tuesday 18th July 2023 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend. We are focused on the sugar, salt and saturated fat content. It is not the fact that food is called ultra-processed, per se. We would not discourage people from eating whole- meal bread, but wholemeal bread is considered to be a processed food. The action we are taking is for a reduction in sugar, salt and saturated fat.

[Lord Brooke of Alverthorpe (Lab)]

The Minister is focusing on reducing fats, salt and sugar in meals. When are the Government going to reduce those elements in school meals for children?

[Lord Markham (Con)]

Absolutely. That is why we are at the highest level of free school meals for children ever. More than a third of children are now receiving free school meals, including all infant schoolchildren. The noble Lord is correct that a healthy start to life is vital, and if we can make sure that children are getting a good, nutritionally balanced school meal, that is a good start to life.

Community Health Services: Waiting Lists

Lord Brooke of Alverthorpe Excerpts

Wednesday 12th July 2023 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend. This was actually a conversation of a big task force summit that we had just last week. We commented that a lot of people have pregnancy plans, for instance, which might say that they want to have birth planned at home; a lot of people will have “Do not resuscitate” plans; what we do not have enough of are frailty plans, which say, “I don’t want to go into hospital. I’d rather be cared for at home. I know it might mean that I don’t live for quite as long, but that’s my preference”. I think there is a whole debate that we need to have to start to move towards that, and to make sure we have that support in the community to do it as well.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, is the Minister aware of the spare capacity of therapists in the private sector, some of them specialising in the mental health of children? As we have such long waiting lists for children and mental health, why is that not being used?

[Lord Markham (Con)]

The noble Lord is correct, and my understanding is that we are looking to use the independent sector more and more. I will check and verify this, as it was from the briefing probably about three or four months ago, but my belief is that about 51% of the physiotherapy that we use is from the private sector. I absolutely agree with the noble Lord that we need to use the independent sector more and more in these situations—something pioneered by the noble Lord, Lord Reid, over there.