Children’s Health: Ultra-processed Foods

Lord Evans of Rainow Excerpts

Wednesday 25th October 2023 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, I thank the noble Baroness, Lady Jenkin, for securing this short debate and for her excellent introduction. Since very soon after I came into your Lordships’ House, I have been working on a project: to get a Minister to say “ultra-processed foods”. I have hope that we may see that project delivered today, as that is the subject of the whole debate.

I have thrown out a large amount of what I was going to say, because I want to directly respond to the noble Lord, Lord Krebs, for whom I have the greatest respect. However, I entirely disagree with a large part of what the noble Lord said. We know that there are significant problems with the peer-reviewed research process. We know this from what happened with big tobacco and pesticide companies. We have a huge problem with commercial interests in the research process. If you look behind where most of the attempts to challenge and question the NOVA classification system comes from, you do not have to look very far to find commercial interests.

As one of example of that, just last month in London the Science Media Centre hosted an event questioning whether there was any problem with ultra-processed foods and if they are all absolutely fine. The Guardian looked into this and discovered that three of the five participants on the panel had either received financial support from UPF manufacturers or hold key positions in organisations funded by them. They include companies such as Nestlé, Coca-Cola, Pepsi and Unilever.

I point the noble Lord, Lord Krebs, to a specific recent study. The noble Lord suggested that we were talking about either the nutritional content or whether food was ultra-processed. This is a study that covers both areas. The study is by Julia et al in the European Journal of Nutrition. It is based on the French NutriNet-Santé cohort study, so it is an observational study. The conclusions say that

“nutritional quality and ultra-processing should be considered as two correlated but distinct and complementary dimensions of the diet”.

So, yes, the amount of fat, lack of micronutrients and nutritional quality is a problem, but ultra-processing is a problem too. This is a very solid 2023 study demonstrating that.

Very briefly, I want to focus on young children, as the noble Baroness, Lady Jenkin, has pointed us to. We have a huge problem with the diet of young children in the UK. That is now demonstrably obvious in all the health dimensions, whether obesity or height. We are not giving children the chance to develop in the way they should.

I will pick out one deeply shocking figure. Think about the size of child between a year and a half and three years old—quite small. Some 65% of one and a half to three year-olds in the UK drink, on average, one adult-sized can of soft drink a day. One of the things that has not been focused on enough is that, as has been said, this is nutritionally attractive and, arguably, addictive—the paper is strong on that. But you are filling a child up with empty calories or, if the drink is low calorie, with no calories at all, and there is no space for the child to eat the vegetables and fruit that they should.

As others have said—I was going to major on this more—look at all the products in supermarkets directed at children, with cartoon characters all over them, and with messages about health directed at the adults. We are profoundly misleading parents about what their children should be eating—by “we” I mean the multi- national food companies, which are making massive profits from making our children ill.

[Lord Evans of Rainow (Con)]

My Lords, I ask noble Lords to keep note of the four-minute speaking time, please. We still have to hear from the Front Benches and the Minister.

NHS and Social Care Funding

Lord Evans of Rainow Excerpts

Wednesday 11th January 2017 Commons Chamber

[Mr Hunt]

I agree that staff numbers are critical, but we have, since 2010, 1,500 more doctors in our A&E departments and 600 more consultants. Across the NHS, we have more than 11,000 additional doctors, so we do recognise the pressures that the NHS faces. Indeed, we have 1,600 more doctors than this time last year, so we are doing a great deal to solve the problem.

[Graham Evans (Weaver Vale) (Con)]

Does my right hon. Friend agree that we need to learn best practice in the NHS? The hospitals that manage to integrate health and social care, such as those in Wigan and Salford which have managed to create those beds, are providing examples of best practice from which the whole NHS can learn.

[Mr Hunt]

My hon. Friend is absolutely right. It is a mistake in this debate to try—as I understand Opposition parties want to do—to boil this all down to the issue of Government funding when there is actually a lot of variability in the country. At this time of year, which is always difficult, some hospitals are doing superbly well in extremely challenging circumstances. We have just heard about some of the hospitals that are doing well, and there are a number of them.

--- Later in debate ---

[Dr Whitford]

The whole prevention and public health message is crucial, and that is one of our other challenges. I am very grateful to the Secretary of State for no longer talking about a figure of £10 billion, because the increase in the Department of Health’s budget is actually £4.5 billion. Part of that relates to the reduction in public health funding, just at a time when we need to move it on to a totally different scale. Whether that is children or, indeed, adults doing the daily mile—perhaps we should run up to Trafalgar Square and back every lunchtime, which I am sure would do us all a power of good—we need to invest in such preventive measures. One of my points is that when we end up desperate—patching up how the NHS runs, or dealing with illnesses we did not bother to prevent—we always end up spending more money.

[Graham Evans]

The hon. Lady knows how much I respect her and what she says. As the chairman of the all-party group on running, I endorse the daily mile and encourage all adults to do it. Park runs, which happen across the nation, are a good example. There is huge expertise in Scotland, so can NHS England learn from Scotland? What is best practice, and will she give us some examples of it in hospitals and hospital trusts in Scotland that we can take away and learn from?

[Dr Whitford]

The whole issue comes down to sustainability, which is obviously the idea behind the sustainability and transformation plans. As those who have heard me speak about STPs will know, I support the idea in principle. The idea is to go back to place-based planning on an integrated basis for a community. The difference in Scotland is that we have focused on integration. We got rid of hospital trusts in 2004, and we got rid of primary care trusts in the late 2000s—in 2009 or 2010. Since April 2014, we have set up integration joint boards, where a bag of money from the NHS and a bag of money from the local authority are put on the table and a group sit around it and work out the best way to deal with the interface and to support social care. Anyone in the Chamber or elsewhere with family members who have been stuck in hospital will know that people get into a bickering situation: Mrs Bloggs is in a bed so the local authority is not interested, because she is safe there, and the local authority is instead busy with Mrs Smith, who has fallen off a ladder trying to put up her curtains and who is not considered safe because she is leaving the gas on. Such boards get rid of all that perverse obstruction.

Junior Doctors Contracts

Lord Evans of Rainow Excerpts

Monday 18th April 2016 Commons Chamber

[Mr Hunt]

The hon. Lady is right that I sprinted here—I was a little concerned that Defence questions might not last the full hour, although they did, and I am sure Mr Speaker is pleased about that. The point I would make about the ballot, which did receive the overwhelming support of junior doctors, is that it happened before they knew what the deal on the table was. On the heated issue of Saturday premium rates, we ended up with a proposal where the Government agreed to pay premium pay on Saturdays for any doctors who work one Saturday or more a month. At the moment, therefore, we have this extreme step—the withdrawal of emergency care—to boost the pay of doctors who work less than one Saturday a month. I think many members of the public will say that that is not proportionate.

[Graham Evans (Weaver Vale) (Con)]

Let us be clear: this is an old-fashioned wage dispute, run by one of the most militant long-standing trade unions. My constituents are asking why the highest-paid NHS workers should be paid extra for working Saturdays when some of the lowest-paid NHS workers are not.

[Mr Hunt]

My hon. Friend is right. Doctors who strike will need to explain that to paramedics, healthcare assistants and nurses working in their own operating theatres. In the end, that issue is why this strike is happening. The BMA said in writing in November that it would negotiate on Saturday pay; it went back on its word in February. As a result, this is the only outstanding issue, and we now have this extreme step—the withdrawal of emergency care. I find that very hard to justify.

Dementia Care Services

Lord Evans of Rainow Excerpts

Wednesday 9th September 2015 Westminster Hall

[Edward Argar]

In addition to the hon. Gentleman’s many talents, which are well known in this House, he appears to be a mind-reader, as I was about to come on to that subject, having visited a similar memory café on Monday. He is absolutely right to highlight and pay tribute to the work of such places. On Monday, I went to the Syston community centre, where our local Alzheimer’s Society group was holding its regular Poppies memory café session for about 30 carers and people with dementia. As I am sure the hon. Gentleman did on his visit to his local memory café, I met some amazing people and it was a fantastic session. My memories of that session, and the lessons I learned from it, remain with me; I continue to reflect on them. However, across the UK, including in my region—the east Midlands and Leicestershire—the access to and coverage of such vital services remains patchy; that was a message I got loud and clear from the people I spoke to. As I suggested, that session left me in no doubt about the vital role of dedicated and passionate carers, including the amazing people whom the hon. Gentleman and I met, in helping people with dementia.

[Graham Evans (Weaver Vale) (Con)]

I am most grateful to my hon. Friend for securing this debate, and he has made some powerful points. I would like to share with him some things that we are doing in Cheshire, and indeed in Weaver Vale. Dementia awareness is so important. My staff have received dementia awareness training, so that we can identify people with dementia. Also, our local town centres are dementia-friendly, which is significant. It enables people to come out as families and they are made most welcome in town centres, such as that of Northwich. Does my hon. Friend agree that town centres across the country should be dementia-friendly?

[Edward Argar]

Yet again, it appears that another hon. Member has the facility of reading minds and anticipating speeches, because I was about to say that there remains too little understanding of dementia in our communities, despite the progress made, and dementia-friendly communities and workplaces can play a hugely important role in supporting both those who have dementia and those who care for them.

I encourage the Minister to push all Government Departments to become dementia-friendly workplaces, and to keep talking about dementia and raising awareness of it. I also encourage her to keep the NHS talking about it. I know that other hon. Members—not least the shadow Minister, the hon. Member for Oldham East and Saddleworth, who is chair of the all-party group on dementia and possibly the only dementia champion in this House—will continue to raise these issues, as the shadow Minister has done over many years.

A recent survey showed that 25% of 18 to 25-year-olds are keen to learn and understand more about dementia, as opposed to only 15% of those aged 55-plus; that was a 2012 YouGov survey, so it is relatively recent. While it is encouraging that young people are keen to understand and learn more about dementia, those figures are still far too low.

NHS Reform

Lord Evans of Rainow Excerpts

Thursday 16th July 2015 Commons Chamber

[Mr Hunt]

I do not blame doctors; I do not blame the unions. I blame Ministers from the hon. Lady’s Government who gave consultants an opt-out at weekends that has had a catastrophic impact on patient care. I am delighted that she supports seven-day care, but it was not in the Labour manifesto; it was in the Conservative manifesto, and we are putting in extra money—£5.5 billion more than Labour was promising—to ensure that we can pay for it.

[Graham Evans (Weaver Vale) (Con)]

I welcome the changes that my right hon. Friend has announced today in turning the NHS into a learning organisation rather than a denial machine. Does he agree that there should be a best practice industry standard for healthcare in this country, which learns and compares itself with other countries’ healthcare systems, such as Germany, France and Canada?

[Mr Hunt]

That is a very interesting idea, and I am happy to take it away. I am a strong believer in learning from best practice all over the world. Sometimes it is difficult to gather the data, but it is an interesting idea.

Oral Answers to Questions

Lord Evans of Rainow Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Alistair Burt]

I welcome the hon. Lady to her place. Briefly, there is a £1 billion fund to improve, over the next five years, GP surgeries and premises and access to GP practices. It is an important part of the process of improving access to GPs, which is good not only for patients but for GPs, who can feel fully engaged in their work without being overburdened. This support should certainly help.

[Graham Evans (Weaver Vale) (Con)]

5. What steps he plans to take to improve dementia diagnosis and care.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Following a sustained effort to improve dementia diagnosis rates in the last Parliament I am pleased to report that in England we now diagnose 61.6% of those with dementia, which we believe is the highest diagnosis rate in the world. But there is much work to be done to make sure that the quality of dementia care post diagnosis is as consistent as it should be.

[Graham Evans]

I thank my right hon. Friend for his answer. A long-standing Weaver Vale constituent, Mrs Gladys Archer, successfully looked after her husband for many, many years at home until he was admitted to hospital for a routine operation. Following a misdiagnosis, he has had to go into a care home with all the personal cost and trials and tribulations that that involves. Will my right hon. Friend look into that case, and highlight what measures are in place and how we can improve matters so that we can stop patients with Alzheimer’s or dementia suffering when they are admitted to hospital?

[Mr Hunt]

I thank my hon. Friend for raising that case and I will happily look into it. That is a perfect example of why we need to change the way we look after people with long-term conditions, such as dementia, out of hospital. If we can improve the care that we give them at home and give better support to people such as that man’s wife, we can ensure that the kind of tragedy my hon. Friend talks about does not happen.

NHS

Lord Evans of Rainow Excerpts

Wednesday 5th February 2014 Commons Chamber

[Mr Hunt]

With great respect to the hon. Lady, it was under her Government that we had the horrific tragedy of ambulances circling round hospitals because hospitals did not want to admit them in case they missed their four-hour A and E target. There is a lot of pressure in the system, but the fact is that 3,000 more people every day are being seen within four hours than when her Government were in power. That is something that A and E departments up and down the country can be rightly proud of.

[Graham Evans (Weaver Vale) (Con)]

I have had reason to visit my accident and emergency four times with my young son, who is 10 years old and an enthusiastic rugby and football player. On those four occasions—for a broken nose, a damaged knee, damaged ankles and damaged elbows—we were seen within minutes for pain relief and were out of A and E within two hours.

[Mr Hunt]

That is exactly what is happening in so much of the country. Despite a lot of pressure, our A and E departments are holding up extremely well. I wonder how the staff in that hospital would feel about the constant running down of the NHS that we get from the Opposition.

Let us look at the figures that the right hon. Member for Leigh quoted in more detail. How does he get the number he quoted for the worst winter for a decade?

Oral Answers to Questions

Lord Evans of Rainow Excerpts

Tuesday 26th November 2013 Commons Chamber

[Mr Hunt]

I have to pay tribute to my right hon. Friend, because he has been talking about the integration of health and social care for a lot longer than I have, and he is absolutely right. I would add to his list one other really important thing we are doing: we are making sure that whatever part of the system someone is in, doctors can access their GP medical record—with their permission—because that information is vital in showing their allergies, medical history and previous admissions. Breaking down the barriers that prevent that from happening is one of the things that has not been picked up but is in the GP contract.

[Graham Evans (Weaver Vale) (Con)]

7. What steps his Department has taken to ease the short and long-term impact of winter pressures on NHS services.

[The Secretary of State for Health (Mr Jeremy Hunt)]

In the short term, a record £400 million has been assigned to help the NHS cope with winter pressures this winter, with £250 million announced in August—much earlier than before. For the long term, we will provide better out-of-hospital care for the frail elderly, by restoring the link between GPs and older patients, and looking to integrate the health and social care systems.

[Graham Evans]

Will my right hon. Friend join me in praising the outstanding work of Age UK and, in particular, Age UK Cheshire, which serves my constituency? It is raising older people’s awareness of seasonal impacts on health and offering support to prevent unnecessary pressures on the health service.

[Mr Hunt]

I am delighted to do that. As these are the last Health questions before Christmas, all of us would want to pay tribute to the voluntary organisations that do an extraordinary job of making sure that vulnerable older people do not get lonely over the Christmas period. It is heroic what they do—when we are with our families, they are looking after other people—and we should salute them all.

NHS Risk Register

Lord Evans of Rainow Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Andy Burnham]

Let me make this point, and I will give way in my own time.

People talk of confusion and drift, of a huge loss of experienced staff and established relationships and of an NHS in which no one knows who is making the decisions. That leads to concerns about the risks being run with our NHS—risks to patient safety, service standards and in relation to the efficiency challenge. The chief executive of the NHS confirmed that to the Public Accounts Committee when he said:

“I’ll not sit here and tell you that the risks have not gone up. They have.”

So, that is a fact. The Prime Minister who promised to protect the NHS has put it at risk. That much is clear, but what are the precise risks that the Health Secretary and the Prime Minister are taking with the NHS, and how serious are the risks? Does not the public have a right to know what they are? You would think so, would you not, Mr Speaker, given how much the NHS matters to people and how utterly so many people with long-term illnesses and disabilities depend on it.

[Graham Evans (Weaver Vale) (Con)]

When the right hon. Gentleman was Secretary of State he refused a freedom of information request to publish risk registers in September 2009. Why was that? Was he aware of the request, and why did he not publish?

[Andy Burnham]

I will come to that in a moment. If the hon. Gentleman is patient, I will answer his point directly.

Given the risks that are being taken, and given how much the NHS matters to people and how utterly they depend upon it, particularly those with long-term illnesses and disabilities, one would think they had a right to know about the risks that the Secretary of State is running with their health service. Well, one would be wrong. Instead, Members of this House and of another place have been asked to approve the most far-reaching reorganisation of this country’s best-loved institution by a Government who have not had the courtesy to give them the fullest possible assessment of its potential impact on the NHS.

Oral Answers to Questions

Lord Evans of Rainow Excerpts

Tuesday 10th January 2012 Commons Chamber

[Paul Burstow]

As far as I am aware, no assessment has been made to analyse the number of unpaid interns. What is very clear, however, is that when NHS organisations are using people to provide services as volunteers, that is clearly separate from what would be regarded as paid employment. That is clear in the strategy we set out last year and clear in the advice and guidance provided by the Cabinet Office as well.

[Graham Evans (Weaver Vale) (Con)]

2. What recent representations he has received on access by NHS patients to drugs invented and developed in UK laboratories; and if he will make a statement.

[The Secretary of State for Health (Mr Andrew Lansley)]

Representations received have strongly supported the Government’s “Strategy for UK Life Sciences”, which was published on 5 September. Speeding up clinical trials approval, enabling the unique NHS clinical databanks to support research, the early adoption of new medicines and other initiatives will bring NHS patients the fullest benefit from innovation and will promote growth in UK biosciences.

[Graham Evans]

What steps are being taken towards closer collaboration between the NHS, industry and our world-class universities to drive improvement and innovation in the NHS for the benefit of current and future NHS patients?

[Mr Lansley]

I am grateful to my hon. Friend. He rightly highlights an area where we are clear that innovation can be considerably supported, and not only by the academic health science centres, which were established under the last Government. As the life sciences strategy set out in early September made clear, we want to create academic health science networks across the NHS so that higher education, industry and the NHS can work together to bring about the greatest possible innovation to the benefit of patients.