Food, Diet and Obesity Committee Report
Lord Brooke of Alverthorpe Excerpts(5 days, 7 hours ago)
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Lord Brooke of Alverthorpe (Lab)
My Lords, I am extremely grateful to the noble Baroness for her introduction. She has been a wonderful chair; she had to handle some difficulties—some internal tensions—but she managed to bring the committee through, and we produced a wonderful report. It is a bit like the one that the noble Lord, Lord Krebs, previously produced, which again offered a whole range of recommendations, but not many of them were implemented at the time. I came to the committee with some reluctance—as the clerk, Stuart, knows—because I felt that I had spent many years, 20 years ago, doing so much work on Select Committees and yet so little was implemented. I came back reluctantly, but I have a very strong interest, as most of the House knows, in sugar addiction and how we should address that and try to change it.
A week ago, I told the Minister that she would have a rough morning today. I start by expressing my gratitude to her, as well as to our Financial Secretary, the noble Lord, Lord Livermore. In the October Budget the Government made a Statement to extend the range of the levy over a wider front than we had done previously. Not a great deal of publicity was given to it, but it was a move in the right direction. So our principal recommendation has been partially addressed already—but only partially. I suspect that it will not be addressed a great deal further on a wider basis, so we have to deal with the reality and the changing circumstances in which we find ourselves.
The soft drink levy should be extended, but I know that the Government will run into great difficulties with that. If we get into a war with the Americans on trade, we will have to retaliate. I suggest to the Government that we should have tariffs of 25% on a few of the American products that are causing us difficulties—Coca-Cola, Pepsi, KFC and McDonald’s; you name them—they are responsible for the excess calories that we consume. That will probably not happen, but I hope that it will be borne in mind.
There are issues on which the Government have given indications that they are trying to do something. They talked about weighing and measuring. We have had a scheme for weighing and measuring children since 2008. Notwithstanding that, we now find that our children are heavier. The Government have hinted recently that they intend to extend this to all adults, and that GPs will be required to weigh and measure people. I have no objection to that. We will have a great deal of data again, but I suspect that we will end up with an indication that people are still getting heavier—unless we take action.
The action I suggest is that we look at what has been happening—or not happening—with children and at where there has been no follow-through with children identified as overweight. Here I thank the people in Blackpool who gave us a great two days; we got down to the nitty-gritty on some of these issues. We heard from the public health officials about the great difficulties they had when they identified children who were overweight; they had problems with parents who would not help. It is about how we find a way through to take action for children.
We should spend some time looking at AI. Children use technology in a way that we do not, so that may be an opener for us. For example, noble Lords who look at ChatGPT or its alternatives will know what facilities and availabilities are coming online—what comes with AI is not all negative—and that could be used to find a way forward. We should try to bring people together in groups, in a way that we currently do not; we do it only with children, but maybe we should do it with adults.
I come from the background of a 12-step programme. I was in real trouble with my health. At 40, I was told that, if I did not stop drinking, I would die. I joined a 12-step programme—it cost nothing—and I have been in it for 43 years. I am still here, at age 82.
Noble Lords
Lord Brooke of Alverthorpe (Lab)
That 12-step programme has helped me address the problems I had with my weight. I was overweight in my 60s, and when I got to the end of my 70s I was on the cusp of type 2 diabetes. I did a 12-step programme, entirely free of charge, and I got my weight back down and avoided having to take tablets and injections. I hope that we will look at the 12-step programmes and the available alternative programmes; they should be put through social prescribing, which we are failing to use to its full advantage.
On the new food strategy, I share the views of the noble Baroness, Lady Walmsley, on happiness. We should involve the food and manufacturing industry, because, at the end of the day, it will still be there and we have to find ways to do business with it. My complaint is that we do not have one of the 10 big worldwide manufacturers on the committee. Why do we not have the people with whom we need to engage? For example, why have we not involved Nestlé, which spends so much time with children’s food and baby food? I ask the Minister to bring in even bigger players than those we have so far.
The solution that the Government will eventually light on will be the anti-obesity drugs. It is the way that government invariably goes—I regret that, but I suspect that it will be the case.
I am running out of time. Finally, we did not look at alcohol in our review. Alcohol is a major contributor to obesity, but we did not have the time to do that. I hope that, when we come back, we will spend some time looking at the anti-obesity drugs, which will cost a fortune and be in widespread use.
NHS Dentistry
Lord Brooke of Alverthorpe Excerpts(2 weeks ago)
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Baroness Merron (Lab)
As the noble Lord suggests, tooth decay is the main reason that five to nine year-olds are admitted to hospital. That is a scandal, and one that we are seeking to tackle. My ministerial colleague, Stephen Kinnock, has made reform of the dental contract an early priority and continues to collaborate with the British Dental Association and other representatives on what is, of course, a shared ambition to improve access to treatments for NHS dental patients. I wish I could give an exact date to the noble Lord; I am not in a position right now to do so. On water fluoridation, as the noble Lord said, an extra 1.6 million people across the north-east will benefit from a water fluoridation scheme following quite a lengthy process and that will start in 2027-28.
Lord Brooke of Alverthorpe (Lab)
My Lords, dental problems put extra pressures on A&Es, particularly at the weekend when it is difficult to get access to a dentist. Does she recall that a group of dentists has suggested that we should create 40 mini-A&E centres around the country, under the NHS, open seven days a week? I believe that suggestion worked its way through to the Minister. If she is not able to give an immediate answer, would she write and put the reply in the Library for others to see?
Baroness Merron (Lab)
As I said, it will be ICBs delivering the extra 700,000 urgent dental appointments each year. They will be best placed locally to decide how to do it. It may well be through the means that my noble friend said, but the duty on them will be to ensure that those are available. The appointments will be most heavily weighted towards the areas where they are needed most, although appointments will be available across the country. I welcome my noble friend’s suggestion but how the extras are provided will be a matter for local decision-making.
National Cancer Plan
Lord Brooke of Alverthorpe Excerpts(1 month, 3 weeks ago)
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Baroness Merron (Lab)
I am glad to hear the noble Baroness making statements about the quality of care she continues to receive, and I wish her well. She makes a good point about screening; some 15 million people are invited to screenings and about 10 million take them up. For bowel cancer screening, we have reduced the age to 50 to incorporate more people. That is very welcome, but I take on board exactly what the noble Baroness said: the tests that are painful or embarrassing all have to be dealt with. As part of the review of screening programmes, there is a constant, repeated look at how communications can be improved to target those who need the screening, and to try to be more creative. I refer again to the community diagnostic centres, which are where people need them to be and are less worrying than, for example, going to a hospital. I take the point about painful screenings, but, for us, it is also important to talk about the alternative, because without that screening I am afraid that the outcomes will be far worse.
Lord Brooke of Alverthorpe (Lab)
My Lords, I am grateful to the health service for saving me. Come this Friday, it will be six months since I was in the Royal Marsden—last summer, on my holiday—having my bladder and prostate removed. Here I am now, surviving. I had to struggle today to get into Parliament; farmers are protesting about money that needs to be raised to fund the NHS.
I return to the point about honesty that the noble Lord, Lord Kamall, raised at the beginning. You can have all the plans under the sun, but if you do not have the money or the will—and the plans to raise the money—you will not deliver them. I believe there is a question missing at the end of this invitation on the consultation: “Could you please suggest some ideas on how to raise the additional funds required to deliver these plans?” There are alternatives to those that we currently use. It is beholden on both the Conservative Party and the Liberal Democrats to be giving some attention to suggestions—which they would support—whereby we would raise additional money to fund the NHS, as our Government are endeavouring to do at the moment.
I would like the Minister to consider exploring a variety of options: how we might be more flexible in raising funds for the NHS, get the private sector more involved in new experimentation that needs to take place, and get the wider public more involved—perhaps by share interest in PPPs to fund particular operations and exercises; say, for a hospital such as the Chelsea and Westminster. Ask all the hospitals around the country what they would like to have. Could they involve their people? Could they involve the private sector? Could we explore a new model? It will not be done overnight but it needs to be done.
Health: Obesity
Lord Brooke of Alverthorpe Excerpts(2 months, 3 weeks ago)
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Baroness Merron (Lab)
I thank the noble Lord and commend the organisation that he refers to—there are a number which are working very hard on this. We take a great interest in and seek to learn from such groups. This is a matter not just for the Department for Health and Social Care; it crosses government. We collaborate across government, particularly in pursuit of our health mission.
Lord Brooke of Alverthorpe (Lab)
My Lords, does the Minister agree that alcohol is a substantial contributor to obesity and a range of related diseases? Is she aware that, notwithstanding promises given, the previous Government did not force the drinks industry to show calorific effects of their products on labels and consistently opposed doing it? Would our new Government be prepared to look at that and introduce such changes?
Baroness Merron (Lab)
I thank my noble friend for raising that point. We are in the process of reviewing the evidence on front-of-pack nutrition labelling, which can include bottles as well as foods. We will consider whether any further action is needed to support healthier choices.
Diets: Fat
Lord Brooke of Alverthorpe Excerpts(5 months ago)
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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(5 months, 2 weeks ago)
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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(1 year, 1 month ago)
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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(1 year, 4 months ago)
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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(1 year, 5 months ago)
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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(1 year, 6 months ago)
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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.