Health: Non-communicable Diseases

Lord Collins of Highbury Excerpts

Thursday 6th October 2011 Lords Chamber

[Lord Collins of Highbury]

My Lords, I, too, congratulate the noble Lord, Lord Crisp, on initiating this debate. I have huge respect for the work that he has done and continues to do in promoting better health here, and globally, through his experience of the National Health Service, his involvement as a fellow of the Institute for Healthcare Improvement and, above all, his leadership on global health. In his book, Turning the World Upside Down, the noble Lord highlights the most striking thing about health in the 21st century which is, he says, the way the world,

“is now so interconnected and so interdependent. This interdependence is changing the way we see health, creating a new global perspective and will affect the way we need to act”.

As we have heard, the UN conference has set out plans to tackle non-communicable diseases such as diabetes and heart disease, which now pose a greater global burden than infectious diseases. As has been said in this debate, lifestyle-related diseases are now the leading cause of death worldwide, killing 36 million people a year. Much of that toll, as we have heard, is in low and middle-income countries and that is where efforts must be focused.

However, as we have also heard, Europe today has a high prevalence of non-communicable diseases, such as cancer, diabetes, cardiovascular diseases, obesity disorders and musculoskeletal disorders, which together cause 86 per cent of deaths in the EU. According to the EU, the causes of these diseases can be attributed to the interaction of various genetic, environmental and, especially, lifestyle factors—including smoking, alcohol abuse, unhealthy diets and physical inactivity. Linked by these common risk factors, many of these diseases are, as we have heard, preventable. Spreading access to effective treatment more evenly across the EU would bring significant health and economic benefits to all EU countries.

At this point in my contribution, I feel I must declare an interest; in fact, I should say interests. When I read the WHO report on this subject, I realised that I was very much a victim of my own bad lifestyle. Five years ago, I stopped smoking and subsequently put on weight. As the noble Lord, Lord McColl, has said, I think that I ate too much. I then took on a very stressful job, as my noble friend Lord Kennedy said, as general secretary of the Labour Party. I discovered soon after taking that job that I had high blood pressure. As a result of further tests, I was told that I had very high cholesterol levels and to cap it all—my noble friend Lord Kennedy has already outed me in this respect—I was formally diagnosed as a type 2 diabetic. Early diagnosis and the excellent response of the NHS means that I have a chance of avoiding the worst consequences of these diseases, but would it not have been better if I could have avoided them in the first place? Early preventive action not only saves lives, it also saves money.

This is where I also want to amplify the conclusions we have heard from the WHO report, which focused on affordable actions that all Governments should take. First, as we have heard, there should be measures that target the population as a whole such as high taxes on tobacco and alcohol, and smoke-free indoor workplaces and public places, as well as campaigns, more importantly, to reduce salt and dangerous fats. I very much understood some of the comments about some agencies that are trying to stop us making progress in this area. Secondly, there should be other actions focusing on individuals such as screening and early treatment, which I have already mentioned in my own case. As I said in my maiden speech to this House, the personal is the political. It was the smoking ban that prompted me to stop smoking, while my local swimming pool provides an excellent service enabling me to deal with some of the stressful elements of my life—I go swimming every morning—and that screening led to my early treatment for diabetes. These are the factors that influenced my health. Unfortunately, no one yet has found a cure for my addiction to chocolate but maybe that will come.

A telling fact for me in the WHO report, as the noble Lord, Lord Crisp, said, is that the total cost for adopting these strategies in all low and middle-income countries would be £7.2 billion a year. In comparison, the cumulative costs of heart disease, chronic respiratory diseases, cancer and diabetes in poorer countries are expected to top £4.4 trillion between 2011 and 2025—an average of nearly £316 billion a year—according to the World Economic Forum. Many countries have already adopted the public health interventions that have seen marked reductions in disease incidence and mortality. The WHO monitored the progress of 38 countries taking steps to address cardiovascular disease at both population and individual levels over the space of a decade. All recorded substantial decreases in exposure to the risk incidence of disease and death toll; proof, if we ever needed it, that there are affordable steps which all Governments can take to address non-communicable diseases.

It is also a fact, as we have heard, that men and women in low-income countries are around three times more likely to die of non-communicable diseases before the age of 60 than they are in high-income countries. In the 2008-2013 EU health programme, the main activities focus on raising public awareness, improving knowledge and reinforcing preventive measures. To support these actions, it proposes networks and information systems across member states to generate a flow of information along with analysis and exchange of best practice in the public health field. As the noble Lord, Lord Crisp, has said, we need to promote a strong global approach involving integrated action on risk factors combined with the efforts to strengthen health systems towards improved prevention and control. I therefore urge the Minister to support positive intervention on this important global health issue and, as the noble Lord, Lord May, said, to have action—not just words.