Alcohol Duties

Lord Brooke of Alverthorpe Excerpts

Tuesday 2nd November 2021 Lords Chamber

Asked by

[Lord Brooke of Alverthorpe]

To ask Her Majesty’s Government what assessment they have made of the impact that the changes to alcohol duties announced in the Budget statement on 27 October will have on alcohol-related (1) hospital admissions, and (2) deaths.

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

The reform of alcohol duties will simplify duty rules and tax drinks in proportion to their alcohol content. This should create a financial incentive for manufacturers to reformulate their products, therefore giving consumers a greater choice of lower-strength products. This would support individuals to drink within the Chief Medical Officer’s guidelines. The Office for Health Improvement and Disparities plans to make an assessment of the potential impact of these proposals on consumption and associated harms.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I regret that the Minister has not actually answered the Question. All the evidence indicates that if the price of alcohol goes up, people drink less and are healthier. If the price of alcohol goes down or the duty goes down, people in fact drink more. More people go into hospital and more people die. Instead of relying on the industry to decide whether manufacturers will reformulate their drinks, as the Minister just indicated, the Government should take a firm lead and put the health of the nation first. They should not be handing out a £3 billion cut in this way. Will the Minister please go back to the Chancellor and tell him that we need a policy that will lead to better health, not worse?

[Lord Kamall (Con)]

Many public health officials, for many years, have criticised the system of alcohol taxation, particularly the EU’s system of taxation. Now that we have left the EU, we are free to set our own law in this area. Given the criticisms from the World Health Organization and many other think tanks, we can now set taxation based on the volume of alcohol.

Health: Type 2 Diabetes

Lord Brooke of Alverthorpe Excerpts

Tuesday 12th October 2021 Lords Chamber

Asked by

[Lord Brooke of Alverthorpe]

To ask Her Majesty’s Government what assessment they have made of the data analysis by Diabetes UK, published on 6 October, which suggests that one in three adults in the United Kingdom could be at increased risk of developing type 2 diabetes by 2030.

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

I thank noble Lords for giving me a pause for breath; I appreciate the patience they have shown me today. The Government welcome Diabetes UK’s research in increasing our understanding of diabetes and are committed to reducing and preventing type 2 diabetes, particularly in those groups who are more at risk of developing it and face poorer outcomes. This is why the Government launched the NHS diabetes prevention programme and the healthy weight strategy to look at ways to tackle weight gain and reduce children’s exposure to high-fat and high-sugar foods, including using digital tools to reach key groups.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the Minister for that reply and welcome him to his new post. He has had a baptism of fire today and has come through reasonably well—so far. We wish him well and good health too. Does he agree that one of the major and most successful initiatives of recent years was Mrs May’s move in 2018 to introduce a sugar tax on fizzy drinks? Employers have been persuaded to reformulate their product. Will the Government now extend that taxation over a wider front on food and drinks? Can they start giving some thought to possibly following the substance of that approach on fat and see whether we can move towards taxing it?

[Lord Kamall (Con)]

I first thank the noble Lord very much for his warm welcome and his modest appraisal of my performance thus far. I am told that, coming from him, that is high praise indeed; he may disagree afterwards. As he knows, the Government are committed to this, but one thing we always have to look at in introducing new laws, bans or taxes is unintended consequences. Before I came to this role, I read some research which said that there were unintended consequences of some of the sugar taxes; for example, did they force people from poorer families or poorer communities to buy alternative, cheaper brands of the same drinks with the same sugar content, or did they just take the hit to their pockets and pay more? Were the outcomes any better? When looking at some of the programmes being put in place to tackle type 2 diabetes and the taxes proposed, it is important that we make sure it is all evidence-based and work out whether there are unintended consequences. If there are, we must find other ways to make sure we tackle obesity and some of the other issues that lead to type 2 diabetes.

Flu Vaccination and Blood Test Cancellations

Lord Brooke of Alverthorpe Excerpts

Tuesday 14th September 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I reassure the noble Lord that we have strained every sinew to deliver the most impactful flu vaccination programme in the history of the country. We have expanded the range of the flu vaccination and the number of vaccinations available. The NHS depends on us keeping people out of beds. That is why we are highly focused on this.

[Lord Brooke of Alverthorpe (Lab)]

Will the Minister answer the question asked by my noble friend Lady Thornton about the BMA’s feeling sufficiently concerned that it suggested a meeting of COBRA? COBRA could have discussions with the Armed Forces and perhaps we could use some of their drivers. There are answers to some of these problems.

[Lord Bethell (Con)]

This is not a driver problem; it is a delivery problem.

NHS Update

Lord Brooke of Alverthorpe Excerpts

Thursday 22nd July 2021 Lords Chamber

[Lord Bethell (Con) [V]]

My Lords, I am also enormously grateful for the contribution of NHS staff at all levels and from all parts of the United Kingdom. This pay settlement is based on the recommendations of the pay review body. We said that that was the mechanism we would follow, and we are following it; in that respect, we are doing what we said we would. I reassure the House that recruitment to the NHS is extremely strong. We are hitting our targets on the recruitment of 50,000 nurses and our targets for GP trainees and in other parts of the NHS.

[Lord Brooke of Alverthorpe (Lab) [V]]

My Lords, I welcome the Minister’s offer to meet the noble Baroness, Lady Hollins, to discuss her devastating report. We should be ashamed to see the way some of our people with learning disabilities and our autistic young people have been treated. I would like to know whether the Government’s action plan can give some realistic dates on when there is likely to be proper service and support given within local communities and within homes that should be created for them.

Secondly, on Covid generally, I have been double-jabbed with Pfizer, so it is unlikely that I will go into hospital, but I have Covid. I would like to pick up on the question from the noble Baroness, Lady Brinton—what are the figures for the number of people who have had their vaccinations but are now starting to suffer from Covid? This is not flu; it is quite different from flu. You get the jab for the flu and you stay clear of it. With this, you get the jabs but you can get it just the same—and I have been suffering. Why are the Government giving mixed messages that people are now going back to normal? This is just not the case. We are sending out mixed messages and giving the impression that we have this “freedom day”. Yes, there will be freedom, but there will be freedom to spread on a scale that we have not experienced latterly. So I hope the Government will be cautious with the mixed messages they have been issuing and they will underline that having the double jab does not necessarily mean that people are clear of catching the disease.

[Lord Bethell (Con) [V]]

The noble Lord has my profound commiserations. It is an extremely tough and nasty disease, as he rightly points out. Even for those who have had two jabs, if they get the disease it can still be a really horrible experience, which he has at this moment.

He is not quite right, though, on the mixed messages. We have been crystal clear from the very beginning, even before the first vaccine arrived, that the vaccination was not going to be a panacea in itself. It will not prevent all people from getting all Covid diseases for all time, immediately. These things are incremental. The societal impact of the vaccine is to drive down the infection rate to the point that R is below one; that is the objective. But, in the meantime, those who have had the vaccine not only remain infectious but can be heavily symptomatic, and I am very sorry for the position he is in. Incidentally, that is also true of the flu vaccine; it is not a 100% vaccine, but it does an enormous amount to break the chain of transmission and to reduce the spread of flu on exactly the same basis.

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

Lord Brooke of Alverthorpe Excerpts

Thursday 22nd July 2021 Lords Chamber

[Lord Brooke of Alverthorpe (Lab) [V]]

My Lords, I am grateful to the Minister for in effect taking up much of my speech, so I will not repeat it, because I would be speaking broadly in favour of what the Government are endeavouring to do, but arguing, as I have done in my amendment, that they have not gone far enough. The Government’s Achilles heel is that they do not yet move on labelling on calories in sugar and in alcohol, and the Minister quickly skirted around that topic.

Before coming to my arguments, I want to express that I greatly sympathise with many of the arguments that the noble Baroness, Lady Bull, has advanced. I have a lot of experience in this field; I have a friend whose daughter recently committed suicide and I have another friend who presently has a granddaughter seriously ill in hospital. It is a growing problem and is not easily resolved.

On the other hand, we have this massive problem with obesity, and we cannot deny it. Covid has driven it home more forcefully than ever before. Close to 130,000 people have died from Covid, many of them with underlying conditions linked directly to obesity and, in particular, to type 2 diabetes. NHS data indicates that 26% of those who have died had type 2 diabetes.

I speak as someone with a little experience; I am on the cusp of type 2 diabetes. The NHS has put me on a nine-month course to try and get me to change my eating habits, particularly in relation to the amount of sugar I consume. Part of that has been about me checking what I am eating and drinking, what its calorific content is, and what the sugar element is. So I welcome a step that moves towards greater openness and gives me the information I need to try to avoid becoming a type 2 diabetes patient. That is possibly on the cards if I do not take the appropriate steps.

There is no simple solution to obesity; I freely concede that. A whole range of measures have to be addressed in different ways. Small steps will make up a big leap forward. Regrettably, sometimes when we are trying to find solutions and we are all working with similar problems, we end up with contradictions and conflicts. Today we have a degree of conflict arising. It is not easy to find harmony and the only way we will do it is by continuing to talk to each other and trying to move forward in a friendly and comradely way.

I believe the Minister has fallen short with the regulations that he has produced. They do not go far enough. The Government know perfectly well that, of the calories obese people consume, 10% come from alcohol, yet they consistently resist displaying sugar and calorific content on labels for drinks. When this comes into play in February next year, you will be able to go into a restaurant and see what the calorific effect will be. You will be able to see what the calories are in food and in any non-alcoholic drink you may have—a fizzy or non-fizzy drink—and how much sugar is in it, but, if you pick up a pint of lager, you will have no idea what effect it will have on your health and well-being, or whether it is contributing to obesity. That must change. The Government must break their link with the powerful drinks industry—and before long they will have to. They know in their heart that they must do it, and the sooner they address the issue, the better for the country as a whole.

--- Later in debate ---

Tabled by

[Lord Brooke of Alverthorpe]

At end insert “but that this House regrets that the Regulations do not extend to alcohol, even though mounting evidence shows that it is a significant contributor of co-morbidity and obesity, one of the major underlying causes of the nation’s 128,481 COVID-19 deaths, the highest number in Europe; and calls on Her Majesty’s Government to require the publication of the calorie content of alcohol by the end of 2021 in order to improve the people’s well-being and good health.”

Amendment to the Motion not moved.

Women’s Health Outcomes

Lord Brooke of Alverthorpe Excerpts

Thursday 8th July 2021 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I join others in expressing my gratitude to the noble Baroness. She is a great campaigner and is prepared to reach out across all Benches. That is much required with the problems we face.

I think I am probably the first to mention football, but I mention Denmark and congratulate it on the work it does with women. Denmark ranks the highest in the whole world in presenting a community in which women have equality; it respects and does not abuse women. Women are treated as well as men at work and in health terms. It is a great country and should be proud of what it has done.

We could learn a lot from Scandinavia about how we treat each other, and in particular how we treat women. Look at what Denmark does with justice—restorative rather than punitive justice, which we engage in so much in this country. Do noble Lords know that Denmark does not fill its prisons? In fact, it invites neighbouring countries with a surplus of prisoners to send them to Denmark. That is because of the way it approaches its problems.

Similarly, we find that Denmark deals with issues we have here, where women are abused because of alcohol—that and a whole range of other topics were mentioned earlier—in a quite different way. We really ought to learn that we should visit others and invite them here to try to help us with some of our problems. Basically, I think it does so well because, as in other Scandinavian countries, the inequality in wealth is so minimal by comparison with what we experience. We cannot run away from that.

My noble friend Lord Rooker and the noble Baroness, Lady Greengross, raised Sir Michael Marmot’s continuing work on inequality and the need to get incomes and salaries closer together, in the way that we had 30 or 40 years ago. This is fundamental to health and so many aspects of what happens in society. I look to the Minister to see whether the Government are doing work on it.

This morning I listened to Nadine Dorries talk on a Zoom exercise about the coming review. There have been 112,000 responses to the strategy. Like others, I look forward to seeing whether something positive comes out of it and that we have attached to it a firm action programme.

Like others, I spoke on the great report from the noble Baroness, Lady Cumberlege, but when is the action coming? What are the Government going to do with that? When will we see the action programme presented to the House?

Social Care and the Role of Carers

Lord Brooke of Alverthorpe Excerpts

Thursday 24th June 2021 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the noble Baroness, Lady Jolly, for giving us this debate, and for the contributions made by other noble Lords. In particular, I picked up what the noble Baroness said about care homes and the number of unfilled beds. Having watched television and seen people who have gone through the difficulties of Covid, I am not surprised that many questions are now being raised about care homes and what people should do with their loved ones. Looking to the longer term, maybe we should ask whether people working at home, being remunerated at home and, in turn, caring for loved ones there is the way forward. The best quality of care we can give anyone—young or old—is love. In the first instance, this comes primarily from family members and friends all around.

The right reverend Prelate the Bishop of Carlisle set a challenge. I was interested to hear that the Church is looking at this. I hope that it will be radical. A radical solution is available, though the Government would certainly not embrace it. Back in the 1990s, the Government would not embrace the national minimum wage. We now need to move towards a universal basic income. In due course, we shall be faced with AI and a lot more people will be unemployed. Many more will want to work from home. Many would be willing to spend their time caring for and looking after loved ones if they were remunerated, as the noble Lord, Lord Monks, has just said.

I am looking for a radical response in the longer term. If the Government do not have that within them, I would hope that my own party might start looking at something as radical as a universal basic income. We might try to start a conversation with the Lib Dems, the Greens and the SNP, as well as with Cross-Benchers. We should bring together a crowd of people who see that we need really radical and fundamental solutions that address future changes and some of the lessons that we have learned from Covid.

There needs to be a levelling up, and levelling up means a redistribution. The noble Lord, Lord Rooker, spelled out very clearly the whole range of available options. There are many more. We cannot run away from it. If we are to do the job and care for people properly, we have to pay for it. Those of us who can afford to pay should do so willingly and be prepared to see that the problems of the past are not repeated. When AI comes in the future, much money will be spent on unemployment benefit. That could be redirected into a positive return, which would be about better lives at home, people working from home and looking after their loved ones.

Office for Health Promotion

Lord Brooke of Alverthorpe Excerpts

Thursday 29th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am grateful to the Royal College of Nursing and the noble Baroness for that extremely constructive and thoughtful suggestion. That is exactly the kind of cross-government, inter- departmental suggestion that the OHP will focus on. I will be glad to take that to the OHP and make it clearly.

[Lord Brooke of Alverthorpe (Lab) [V]]

Does the Minister agree that, whichever office is in charge of it, any successful obesity strategy must engage with the so-called hard-to-reach groups in society? As many play the National Lottery, scratch cards and so on, will the Government consider how this link might be used to incentivise and reward players for moves to better and healthier eating, drinking and exercising? As the National Lottery franchise will soon come up for renewal, will the Government consider changing its remit so that it is more focused on health than at the moment, or even consider taking a stake and creating a public/private partnership with a focus on not just cash prizes but better health rewards for the nation?

[Lord Bethell (Con)]

My Lords, Covid has been an extremely important educational experience; we have backed off from using the idea of “hard to reach”. Instead, we try to be much more effective at making ourselves approachable for the kinds of people the noble Lord talks about. He is entirely right that the levelling-up agenda means nothing if it does not mean levelling up health outcomes; we are very focused on addressing the kind of health inequalities he refers to. That will be a central mission of the whole project.

Alcohol Harm Commission: Report 2020

Lord Brooke of Alverthorpe Excerpts

Thursday 22nd April 2021 Grand Committee

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am most grateful to my noble friend Lady Finlay for her powerful introduction. I declare an interest as one of the members of her commission, which she so admirably steered to producing such a wonderful report.

In the limited time that we have, I want to focus on calories. I have been banging on about calories since the Labour Government were in power and about the need for calories to be shown on labels for alcohol. Why is the drinks industry exempt from telling people what they are consuming and what it might do to them?

I am pleased that we are starting to make some progress. There is a firm recommendation in this report and I hope that the Minister will be positive. One of the old excuses for why we could not do anything was that we were in the European Union and legislation and regulations there prevented us from acting unilaterally. We have now come out of Europe and we now have the freedom to do as we choose. I look to see whether the Minister will take sides on this issue, now that he has the freedom to do so, if required.

I had a useful conversation this morning with Sir Keith Mills, who has been appointed by the Prime Minister to review the way in which incentives might be used to encourage people to reduce their weight and exercise more. He is looking at new technologies; there are some developments taking place that are of some significance. I see that the Minister is nodding in agreement, so perhaps when he comes to respond he might say a little more about that. A change would allow an app, on our mobile or on our wrist, to tell us, for all items that have calories marked on them, just what we are purchasing. We would know what is in our shopping basket while still in the supermarket. That would be a big change. We should not permit the drinks industry to be exempt from that change.

I hope that the Minister will assure us that the consultation will be concluded soon and the Government will come out with a strong indication that, for the first time ever, we will have formal labelling on alcoholic drinks.

Body Mass Index

Lord Brooke of Alverthorpe Excerpts

Thursday 22nd April 2021 Grand Committee

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the noble Lord for tabling the Question. We may be debating some of these broadly related issues in even greater depth in the future, because the facts of life are that we have one of the unhealthiest populations in the whole of Europe. We now have some opportunities to review what we have been doing and what we might need to do in the future to improve our health. I have been given a good briefing by Diabetes UK, and I express my gratitude to it because I am one of those on the cusp of developing type 2 diabetes. That has been identified by two factors: a blood test and a BMI measurement with my doctor.

Without any doubt there are problems for those with eating disorders, and we need to address them, but we must be careful to ensure the right balance in dealing with the country’s health problems. The reality is that we have a greater problem—the numbers are much bigger—with people with excess weight than with those with too little weight.

While we acknowledge that there can be challenges in using and interpreting BMI as a measurement, as the noble Lord pointed out, the call for it to be scrapped could negatively impact on the care of those such as myself who are at risk of diabetes. Used appropriately, BMI can provide valuable information for care focused on individuals that does not discriminate against anyone. It is important that healthcare professionals take a person-centred approach to discussing weight and health, use appropriate language and consider the use of BMI based on individual circumstances. There are instances where the use of BMI may not be appropriate, so healthcare professionals should take a person-centred approach to weight and health. We hope that the integration of care outlined in the White Paper will boost the role of personalised care.

BMI is also an important tool for monitoring the population’s overall health and informing policy decisions. If we do not have that, we have to know what the alternative is to be able to make such assessments about the state of the nation’s health. Most recently, BMI data has been fundamental in the rollout of the QCovid population risk assessment, which identified 1.7 million people at increased risk of hospitalisation and death from coronavirus and enabled them to be added to the shielding list in March 2021. Without the use of BMI, that kind of population-based intervention would not have been possible and many lives would have been put at risk. I argue that we must retain what we have at the moment until something better is found.