Obesity

Lord Brooke of Alverthorpe Excerpts

Tuesday 5th January 2021 Lords Chamber

[The Lord Speaker (Lord Fowler)]

Could we have short supplementaries, please? I call the noble Lord, Lord Brooke of Alverthorpe.

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

My Lords, I declare an interest as a member of the all-party parliamentary group involved with the report. We recommended that the Government should build on their Better Health campaign with a public information campaign. Picking up on the last point of the noble Baroness, Lady Boycott, and on the Minister’s remark that he had tweeted about the 13 streams, is not the basic problem that the public are not aware that we are trying to run a campaign and that we need a clear relaunch? This is the opportune moment to do it, when we have such problems with Covid.

[Lord Bethell (Con)]

The noble Lord rightly alluded to the Better Health campaign, and I remind him that we did relaunch it yesterday. That went extremely well and got a lot of coverage. But there is only so much that government advertising can do; I do not think that we can advertise our way out of this problem. It is up to individuals to make their own decisions, it is up to GPs to give the support that people need and it is up to us as a society to accept that the health of the nation is important to its resilience and to its long-term health. Until those decisions are made, we struggle to make progress in this area.

Covid-19 Update

Lord Brooke of Alverthorpe Excerpts

Monday 30th November 2020 Lords Chamber

[Lord Bethell (Con)]

I am extremely grateful for the opportunity to remind the noble Lord that earlier today we published a fulsome programme of community testing. I would be very glad to send him a copy of it, because it lays out exactly the plan he has just described; I am hopeful that he will celebrate its publication. He is entirely right that infection rates have come down in Liverpool—not just because of mass testing but it has made a contribution—and I pay tribute to the mayor and people of Liverpool for their approach in recent months.

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

My Lords, does the Minister agree that when a country faces a common external threat—to use his phrase, an “enemy”—the best chance of success comes when it is united? If he does, and we are once again seeing splintering and divisions arising quickly after this further Covid Statement, will he speak to his colleague the Prime Minister and seek to persuade him to invite other political parties to get involved in a united approach; to invite Sir Keir Starmer, the leaders of the devolved Parliaments and the leaders of the other political parties so that we can move towards a co-ordinated and co-operative effort while this problem continues to blight the country? As he has demonstrated with Liverpool, there is a very strong case for people working closer together—not permanently, but temporarily—than they have done hitherto. This is required at a national and political level as well.

[Lord Bethell (Con)]

I share completely the noble Lord’s ambition for collaboration and a sense of national unity. I am grateful to the devolved Assemblies and the leaders of the nations for their collaborative approach, and to the leader of the Opposition for his support on a large number of matters. However, right now we need clear, simple, strong government, which is best supplied by the voted-in majority.

Health Protection (Coronavirus) (Restrictions) (England) (No. 4) Regulations 2020

Lord Brooke of Alverthorpe Excerpts

Wednesday 4th November 2020 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, the one thing that Covid-19 has done and continues to do is to puncture egos at the highest levels and in all parts of society throughout the world.

I have considerable sympathy with many of the points made by the amendments. In particular I believe that there is an overwhelming requirement, as many others have argued, for the Government to use the lockdown period to provide a strategy, a way for them to show that they have learned lessons from the first two lockdowns, that they are finding a way to exit it and that we are setting out on a course that will avoid the possibility that we could have a third wave early in 2021 followed by another lockdown.

Yesterday I asked the noble Baroness the Leader of the House:

“If the Government intend, as they state, to adopt a pragmatic and local approach again in the months ahead, is one of the lessons learned that this might be more successful if the Government seek to bring all the political parties, at all levels, into the process? Would the noble Baroness consider a joint plan of action along the lines suggested by”


others and

“her colleague and former Minister, the noble Lord, Lord Bridges of Headley?”

Listening to today’s many contributions makes the case even more strongly to me that we need wider involvement by people than we have had hitherto. The noble Baroness the Leader replied:

“The noble Lord is right that we need co-operation locally and nationally”—[Official Report, 3/11/20; col. 688.]


but she referred only to co-operation locally with the Liverpool experiment; she made no mention whatever of anything that might happen at national level.

I believe that the country is sick and tired at the lack of direction. We heard from the noble Baroness, Lady Mallalieu, that people despair of politicians and the bickering among them. I would have thought that the assembly here today could all come together, work together and find a way through. My plea is that, as we look forward, we should try to work together against a common enemy as we always have done in the past when we have been faced with such an approach. That is the way in which we will get the confidence of the Government behind us and we will be more likely to find solutions to these problems. If our good friend, my noble friend Lord Desai, had been brought in, he could have been helping to find a better way forward than we have at the moment.

Medicines and Medical Devices Bill

Lord Brooke of Alverthorpe Excerpts

2nd reading & 2nd reading (Hansard) & 2nd reading (Hansard): House of Lords
Wednesday 2nd September 2020 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I came in earlier today to listen to the Minister respond to the Question asked by my noble friend Lord Dubs on child obesity. I was pleased with what the Government announced in July—I thought it was a step forward—but then I was disappointed when I heard that Public Health England was to be dismembered. I had hoped that when the Minister responded earlier today he would have given a more positive response than he did. I was disappointed to hear that he was simply going out on consultation again to see what would follow and who would supervise the implementation of the policy. It is this kind of change of direction when we are making progress that disturbs people. That is why there have been so many criticisms made of what is happening in this area.

The Bill is needed; we are out of Europe, we need regulation and we are dealing with a technological, fast-changing world. The Minister, in presenting his case, talked about the difficulties we face in handling AI and with biotechnology, how we stay abreast of it and keep pace with it. He went on to give the example of mobile phones: how life has changed so dramatically in such a short space of time and how we have also run into difficulties. He spoke of how, having run into difficulties, the Government have learned that we need to have proper regulation of what is happening with online matters, particularly those relating to children and harm. They are now moving on that, but it has taken some years to get to that point. The Minister said that he was in a listening mood and asked how we should deal with these complex changes. Well, we try to learn from history. The history there is that we should have had a regulator in place earlier. We would then have avoided many of the problems that we currently have.

The noble Baroness, Lady Cumberlege, has come up with a range of recommendations in her warmly welcomed report that are so deserved by people who have suffered as a consequence of medical devices and treatment in the past in a way that they should never have suffered. So I suggest to the Minister that he answer the question himself. We need confidence in dealing with this; I am not going to deal with the technicalities relating to the report, particularly the regulatory report that many others here are well able to dissect and determine what is needed in terms of the law. In general political terms, the Government need to add something that will give people confidence in this piece of legislation. If the Minister is in a listening mood, he will have heard from almost every speaker that the Cumberlege report must be addressed. I ask him to answer one simple question, as there is a limit to the number of recommendations that the Government would be prepared to embrace. Is he prepared to think again about the possibility of having a patient safety commissioner to go along with this piece of legislation? If he were willing to take that step, it would be a big move in the direction that so many people in this Chamber want.

Covid-19: Obese and Overweight People

Lord Brooke of Alverthorpe Excerpts

Thursday 4th June 2020 Lords Chamber

[Lord Bethell]

My noble friend is recognised for her hard work in this area, and we all admire her championing of healthy living. The CMO’s advice is to focus on weight; that is the best way that you can prepare for winter, for the second spike, to defend yourself against Covid.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I welcome the very firm statement from the Minister and I welcome, too, the Prime Minister’s public statement about him accepting personal responsibility for his size. Can the Government, in taking this renewed, stronger position, recognise that the public need to have all the facts that they can about what they are eating and drinking? In many areas, they are left in the dark and therefore cannot make the right choices. On alcohol, for example, drinking has shot up during lockdown, yet people do not know how much sugar there is in alcohol; there is no proper labelling, including on calories. Can the Minister commit to ensuring that, in the review being undertaken, the public will know what choices they have to make and will know the facts about what they are eating and drinking?

[Lord Bethell]

The noble Lord makes a good case. Chapter 2 of the obesity recommendations makes it very plain that clear labelling and data play a critical and pivotal role in helping people to make choices, but so do interventions on the actual content on the food. We will look at both of those for future options.

Dementia: Accident and Emergency

Lord Brooke of Alverthorpe Excerpts

Wednesday 11th March 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is quite right that this issue is not limited to England. The devolved Administrations are very much focused on it. I will look into the relevance and possibility of the kind of meeting she describes.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, will the Minister say what today’s announcement of a freeze on alcohol duties—a continuation of the policy that the Government have pursued since 2012—will do to aid Alzheimer’s? Will it increase it or lessen it? What research is now being done to indicate that there is a clear link?

[Lord Bethell]

This Government are committed to science-based policy. There is undoubtedly a link between personal behaviours and outcomes later in life. Public policy should be aligned to create the best possible outcomes for all people in Britain. The noble Lord’s points are well made and we will follow them up.

NHS: Targets

Lord Brooke of Alverthorpe Excerpts

Thursday 6th February 2020 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am most grateful to my noble friend Lord Hunt for such a great and devastating speech. He has great experience in and insight into the NHS, and he does not lightly make attacks without good foundation behind them.

To the noble and gallant Lord, Lord Stirrup, I say that we have been here before. In 1997, the health service was in a hell of a mess and the Labour Government were elected to try to put right some of the problems we had with declining public services. It was done. The Blair and Brown Governments reversed the decline, in part by introducing targets, which were very successful indeed in many areas. Regrettably, since 2010, both the coalition Government and the Tory Government, for a variety of reasons, have dismantled some of those targets and we have suffered as a consequence. We argued that it was the wrong thing to do when they took away the target for the time that doctors should see patients. The Government’s cover was that they wanted to extend the availability of surgery from five days to seven days, but of course there were no extra staff to do that. In turn, we said that people would wait longer to see their GPs than they had in the past. Is that true? Yes: everybody is now complaining about the difficulty of accessing a GP of their choice.

We now have the argument about A&E targets. The Government want to abandon them. Why? It is a bit like the five people who have been sent to prison giving the Government cause for a major examination of the funding of the BBC. Whenever we see these changes coming, there is an ulterior agenda behind them. I hope that I am wrong on this and that the Minister will put me right, as I am sure she will.

Problems have been arising in A&E where the Government could have taken action. Yes, they are trying to deal with more people and yes, more patients are going there who should be going to their GPs rather than to A&E, but also—here I am banging on about my favourite subject, as noble Lords will know—more and more people are going there with alcohol problems. This causes great stress and strain to the staff involved and, in turn, great pressure on the number of beds that they go to afterwards. All the statistics indicate that the issue has got worse since 2010. Only yesterday in the Times, there was a report about the rising number of people who have been taken in, particularly from age 45 upwards, who are drinking too much and then putting pressure on the service.

When we look at what the Government have done in this area, it can be argued that they have taken steps that have made matters worse. A regulator was introduced in 2008 to ensure that duties on alcohol went up on an annual basis linked to RPI. What did the next Government do? In 2012, they abandoned that. Year on year, the Government have in fact been freezing duties or, in some cases, even reducing them. Has that helped the case and the numbers of people who are being affected by alcohol? No, it has made matters worse. Statistics show that beer duty has been cut by 18%, spirits and cider duty by 10% and wine duty by the low figure of 2%, so overall, we have lost £1.2 billion a year in income for the Government that could have been going into the NHS because of those changes. So who are the beneficiaries, and why? At the end of the day, the public have to pay for the people who end up in A&E and in hospital.

I hope that the Minister will be prepared to say something about this and the importance of campaigning on the public health side, which we have not mentioned greatly. I believe that changes in lifestyle need to be addressed more seriously than we have done in the past. I know that there is a Green Paper coming on that and I look forward to having a debate on it. In the meantime, urgent action can be taken. Can she persuade the Chancellor in the forthcoming Budget not only to restore the duty calculator linked to RPI but to add 2% to that figure? If she does that, we will start to see fewer people ending up in A&E and fewer people who work in the health service being unhappy, and we will have a healthier and happier community.

Eating Disorders: Provision of Care

Lord Brooke of Alverthorpe Excerpts

Tuesday 4th February 2020 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I too am extremely grateful to the noble Baroness, Lady Parminter, for securing this debate, for the great knowledge she has on the topic and for the great campaigning she has done. I am also grateful to the group that she accompanied last week, when we met the head of Public Health England to talk about this issue and some others. We were pressing PHE to perhaps review its approach.

I am also grateful to others who have contributed to this quality debate, and to my noble friend Lord Giddens. We once had a debate in his name on this topic. I looked it up today and way back on 25 February 2013, we identified some issues arising that needed addressing; here we are in 2020, with many of the same problems around. They may be on a bigger scale but call for similar solutions. Back in April 2013, I was one of those who helped create the All-Party Parliamentary Group on Obesity. We had not had one before but it got off the ground then. Look at what has happened between 2013 and 2020: on almost every count, obesity is now worse. There are very few areas in which we can point to progress.

I was at the London School of Economics last night—my noble friend Lord Giddens has strong past connections with it, as he was the head of the LSE. I was there to listen to an address by Professor Richard Layard—my noble friend Lord Layard, one of our colleagues. He was speaking on the publication of his latest book, which is on the topic of happiness. That relates directly to what we are debating this evening. What are we about with health? We seek a better life and happiness. My noble friend has done much work in this area in the past, particularly on mental health, and was closely associated with the introduction of talking therapies under the Blair Government. I think over 20,000 new staff came in to work especially in that area; it was not enough, but it was a major change. We now find many people complaining of having to wait too long before they get assistance on talking therapies, while the length of many courses on talking therapies has been reduced to a point where their impact is perhaps not quite so significant as previously.

I will not repeat all the points that my friend, the noble Baroness, Lady Hollins, made but we have a grave shortage, right across the board. We have shortages in addiction generally; in psychiatrists; in doctors, nurses and staff at many levels right across the mental health field. We look forward to having some comforting response, I am sure, from the Minister on how we are going to see improvements in those areas. They are sorely needed because we seem to have a shift from physical health into mental health, and the caseload is growing all the time.

I spent many years working on addictive issues. I have a personal history of problems with alcohol and drugs. I was on my knees and had to find a way forward, and I did that nearly 40 years ago. Since then, I have spent much of my life working with people with addictions—not just in alcohol and drugs but food, too, and at both ends of the spectrum with food. My dismay is that we have a divide between the approach on obesity and that often taken on eating disorders, when in fact there is so much commonality between them. As others have said, it is time that we started trying to bring some of these elements together, and to work closely in a more overarching way than in the past.

I am pleased that the Government have announced that they are to introduce a cross-departmental approach on a number of addictive issues. Can the Minister say why the subject we are talking about and obesity have not, so far as I can see, been specifically included? They are not being addressed within that approach. When will the work get under way? Can she give us a little more information about its timescale and who will be involved with it? What does she expect to come out from the new review that is being established? But overall, I welcome that development.

Having examined some different types of addiction, my experience is that in many areas they seem to have common themes running through them. Look at how we address it within Public Health England; it is interesting that it has separate units dealing with drugs, alcohol and the problems arising with food. We should look at the structures within that major organisation to see whether it is properly set up for prevention, given that the Government have now decided that they need a cross-departmental approach on reviewing addiction.

It is not easy to find solutions, particularly on anorexia. Among the addictions I have looked at, it is one that hits quickly and is very difficult to reverse. It also has quite dramatic impacts on families, relatives and other people around them. In looking for solutions we should not limit ourselves to dealing with the individual; families should be involved, too. We should look to have the widest possible participation, not just from professionals—we are short of them and need more—but more across the voluntary sectors. We should look at what alternatives may be available.

I am quite open in saying that I believe that there is a requirement for a spiritual approach. That is not something that we frequently talk about in the Chamber, but I have certainly seen many people whose lives have been written off yet who have found by one means or another, using the 12-step recovery programme, their way to a better, fruitful life. I am pleased to report that, in March, we will set up for the first time an all-party parliamentary group on this topic. The inaugural meeting will look at the 12-step recovery programme on addictions to see how it might be applied over the widest possible area to help people who have problems which seem difficult to resolve and who may find an answer in it. I would like to hear whether the Minister welcomes that development.

Health: Vaping

Lord Brooke of Alverthorpe Excerpts

Tuesday 14th January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

I am not quite sure I agree with the fundamental hypothesis of the noble Baroness’s question. If the normalisation hypothesis were true, we would not have expected to see smoking rates continue to decline as they have. Since 2013 smoking rates have fallen from 18.4% to 14.4%, and among young people regular use is very small. It is at 2% for those who have never smoked and is very rare or less, at 0.5%, for 11 to 15 year-olds.

[Lord Brooke of Alverthorpe (Lab)]

Will the noble Baroness be good enough to check the facts and assertions made by the noble Viscount, Lord Ridley? The facts are that during prohibition in the States, health improved and did not decline. Will she check that and give him the correct facts on it? Also, will she make sure that before we make any great changes on cannabis, we look very carefully indeed at what is happening in those states in America where cannabis is freely and openly sold for recreation purposes, and check on the number of people now dying from accidents and a whole range of associated problems? True, it is raising tax, but it is also raising many social problems.

[Baroness Blackwood of North Oxford]

I assure the noble Lord that when it comes to questions around medicinal cannabis and smoking, one of the reasons the UK is successful is that we approach our policy based on the most excellent evidence base. We are world-renowned for the approach we take to using evidence and putting it into policy most effectively. We are considered the European leader in smoking policy, in particular when it comes to our most recent tobacco control plan, and we will continue to be so.

Drugs: Methadone

Lord Brooke of Alverthorpe Excerpts

Monday 28th October 2019 Lords Chamber

Asked by

[Lord Brooke of Alverthorpe]

To ask Her Majesty’s Government what plans they have to assess the regulation, and the general effectiveness, of methadone.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, methadone is a cost-effective and evidence-based opioid substitution treatment. The National Institute for Health and Care Excellence has published several pieces of guidance on drug treatment. It recommends opioid substitute treatment with either methadone or buprenorphine, delivered alongside psychosocial treatment, as the front-line treatment for heroin dependency. There are no plans to undertake any further review.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the Minister for that reply. I am disappointed that the Government are not prepared to undertake a review. I do not want methadone treatment to end, but I believe that the cost is now becoming astronomical and have sent the Minister questions about this previously. People in the industry say that it now costs £1 billion a year, yet an increasing number of people are dying from methadone and a shortage of resourcing for support and advice. We are going nowhere. They are parked in a cul-de-sac. Should we not take a look at what alternatives may be available, where that kind of money could be put to better use and give people hope, rather than just abandon them?

[Baroness Blackwood of North Oxford]

I thank the noble Lord for his question. He will know that the DHSC does not collect data on the costs of supply of methadone centrally, as he has asked this question. However, I reassure him that Public Health England carried out an evidence review in 2017 on the effectiveness of drug treatment across the UK, which found that our outcomes are as good as or better than those internationally, including on effectiveness and value for money. However, we recognise the challenge of drug deaths and drug treatment across the UK and the challenge to local authorities. There will be an effective review of drugs policy, which will include Carol Black’s review of drugs.