NHS Dental Contract

Lord McColl of Dulwich Excerpts

Thursday 1st December 2022 Lords Chamber

[Lord Markham (Con)]

I thank the noble Lord. As I mentioned, dental deserts are very much a part of the package we are looking at. To give noble Lords an idea of the sense of direction, another approach to the workforce issue is a modular escalator system, and we are talking to the BDA about training. For instance, on the way to becoming a fully qualified dentist, might a dentist become part-qualified, allowing them to do some dental nurse treatments, thereby adding to that capacity in the meantime? These are all measures we are looking at to increase the workforce.

[Lord McColl of Dulwich (Con)]

Can the Minister tell us what proportion of the population is actually receiving fluoride in their drinking water?

Childhood Obesity

Lord McColl of Dulwich Excerpts

Thursday 17th November 2022 Lords Chamber

[Lord Markham (Con)]

I agree that health visitors play a vital role. We all know that a good start to life with healthy eating is a good foundation for the rest of your life. We also know that a lot of the problems around adult obesity obviously start in children under the age of five. I completely agree on continuing to strive to do better in government. I will answer some more questions on the actions we are taking, from which the noble Lord will see that we are very active.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree that, as 40 million people are obese in this country, marching inevitably to a premature death from a variety of very unpleasant diseases, it would be a good idea to encourage them to have one less meal a day? This might encourage children to follow suit and put fewer calories into their mouths, which would help prevent them developing type 2 diabetes before they are 10.

[Lord Markham (Con)]

My Lords, I agree that we—both as the Government and in general—need to be clear about what our recommended calorific intake is each day. Whether you choose to change that by eating one less meal, or however else you distribute your eating across the day, it is our role to help educate people on healthy eating. I agree that it is an issue and a big cost to both the health service and the economy. Our latest estimates are that it could cost the economy as much as £58 billion a year, so it is a critical message to get across.

British Heart Foundation: Tipping Point Report

Lord McColl of Dulwich Excerpts

Tuesday 8th November 2022 Lords Chamber

[Lord Markham (Con)]

The House will agree that we provide some very detailed information on excess deaths. That is quite sufficient at this time.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree that, when we talk about increasing mortality, there is a very obvious cause for this? Some 40 million people in this country are obese and moving inevitably to very premature deaths from a variety of very unpleasant diseases. This could be prevented if they had one fewer meal per day.

[Lord Markham (Con)]

My noble friend is referring to the healthy eating agenda, which we very much support. It is a key component of health and enjoyment of life. The more we can do in that department, the better. We have taken some very solid steps on sugary drinks and, more recently, on the product placement guidelines, to show that that is central to our beliefs.

Childhood Obesity

Lord McColl of Dulwich Excerpts

Monday 17th October 2022 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords, could the 40 million people in this country who are obese or overweight be encouraged to become familiar with the medical fact that, if they were to make do with one less meal a day, it would help their health and the NHS and they would live to a normal age not plagued by dozens of very unpleasant diseases?

[Lord Markham (Con)]

I thank and agree with my noble friend. He is correct. The cost of obesity to the NHS amounts to around £6.5 billion a year; obviously, this is in addition to not being very good for the people concerned in terms of healthy lifestyles. That is why we have a programme of action, as I outlined. This is something we feel it is important for us to get on with, not just for children but, as the noble Lord referred to, to help adults in this area as well.

Diabetic Prevention Programme

Lord McColl of Dulwich Excerpts

Thursday 23rd June 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Lord makes an important point. When I speak to experts, policy officials and people working on diabetes, one of the things they say is that the Government cannot reduce obesity alone; efforts also have to include businesses, health professionals, schools, local authorities, families, individuals, community groups and civil society. We all have to come together collectively. There clearly are programmes in schools to encourage people to eat more healthily, but I am sure the noble Lord would recognise that, when we were children, we had programmes about not smoking, sex education and people not drinking alcohol. We would come out of them and say, “I’m never going to drink alcohol or smoke cigarettes again.” Two years later, we were all at parties and what were we doing? We have to make sure that it is impactful all the way through life, not just at that time.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree with the recently published scientific evidence that fasting is actually good for you and that missing an occasional meal would be a good thing, especially for preventing diabetes?

[Lord Kamall (Con)]

As my noble friend will be aware, there are always debates in scientific circles on this. There are different types of fasting regime as well. For example, during Ramadan lots of mosques expounded it as a great example of something that is not only spiritual but good for your physical health. It does depend. Other studies show that it depends on who is doing it and their other circumstances.

National Institute for Health and Care Excellence

Lord McColl of Dulwich Excerpts

Monday 23rd May 2022 Lords Chamber

[Lord Kamall (Con)]

I know I have the answer here somewhere but I cannot find it, so I commit to write to the noble Baroness.

[Lord McColl of Dulwich (Con)]

My Lords, can the Minister kindly inform NICE and the Department of Health that they are misleading the nation and have done for years in telling them that all the calories we eat are used up in exercise? That is not true and has never been true. Only a fraction of the calories we eat are used up in exercise. Could the Minister do something about NICE and the Department of Health?

[Lord Kamall (Con)]

I will try my best. If I may, I shall use this opportunity to respond to the noble Baroness’s earlier question. We have seen horizon scanning in regulatory science, which means that ILAP is at the forefront of cutting-edge developments. It is open to commercial and non-commercial, and UK-based and global developers of medicines. As I said, I will write to the noble Baroness with more detail. On doing something about NICE and the NHS, I have constant meetings with the NHS, as do other Ministers. One of the challenges that came up during the passage of the Health and Care Bill—I know that noble Lords who have been Ministers previously made this point—was that Ministers here have to respond on issues but decisions are quite often taken at NHS level.

International Healthcare Outcomes

Lord McColl of Dulwich Excerpts

Thursday 19th May 2022 Lords Chamber

[Lord Kamall (Con)]

When one looks at these reports, one sees that one area where the UK clearly needs to improve is on cancer. One of the great issues of this is diagnosis. As many noble Lords will know, when we look at the waiting lists and the backlog, we see that 80% of those people are waiting for diagnosis. It is essential that we tackle that. For children, the one-year survival rate has risen in recent years. We will continue to focus more on diagnosis, including community diagnosis centres.

[Lord McColl of Dulwich (Con)]

My Lords, in discussing the various factors involved, does the Minister agree that one of the main ones is that 71% of the British people are overweight or obese? Obesity impairs the immune system and leaves patients vulnerable to all kinds of illnesses which put an enormous burden on the NHS. Does he agree that the answer is for people to buy fewer calories and put fewer calories into their mouths?

[Lord Kamall (Con)]

The Government are doing a lot on the anti-obesity strategy in conjunction with the Office for Health Improvement and Disparities. We have brought together a number of issues. We have existing actions to halve childhood obesity by 2030 with new interventions. We have invested large amounts in weight management services. However, it is not only about reducing the calories taken in but about burning off those calories and getting the right balance between activity and consumption.

Health and Care Bill

Lord McColl of Dulwich Excerpts

Lords Hansard - Part 2 & Report stage
Tuesday 1st March 2022 Lords Chamber

[Baroness Whitaker (Lab)]

My Lords, I rise to support Amendments 30 and 34. On Amendment 30, I echo the widespread concern of the professional bodies and expressed by the noble Baroness, Lady Finlay, that rehabilitation should be a core service in the NHS. It is inseparable from healing, and healing is often impaired if rehabilitation is not there.

On Amendment 34, it will be important to know whether the proposed integrated health boards will be in contact with services outside the NHS where health can be a critical factor, such as education and criminal justice. As we said in Committee, many speech and language professionals are not NHS employees. How will they be brought into the integrated system?

[Lord McColl of Dulwich (Con)]

My Lords, I shall speak to Amendment 62 in my name and those of the noble Baronesses, Lady Hollins and Lady Walmsley, and the noble Lord, Lord Jones of Cheltenham. I thank them, and the Alzheimer’s Society and Alzheimer’s Research UK, for their support of this amendment.

People with dementia will be one of the largest groups of people to see the benefits of the integration of health and social care services and, therefore, the benefits from the Bill. Currently, there are 900,000 people living with dementia in the UK and, without a disease-modifying treatment available after diagnosis through the NHS, they get the majority of their support through the social care system.

This amendment relates to Clause 21, which ensures that integrated care partnerships prepare an integrated care strategy. These new strategies will be a powerful way to bring together various currently disparate bodies to work towards the same aims. Topics discussed within these strategies will be given consideration across the health and social care systems, consideration that too often people living with dementia have lacked, leaving them falling through the cracks between the various systems. This amendment therefore suggests that each strategy should explicitly consider the needs of people living with dementia. There are two areas where integration could provide particular benefits, which I will touch on briefly.

The first is diagnosis. A diagnosis is incredibly important for people living with dementia, as it allows them to plan for the future, arranging their housing and care needs, putting themselves forward for clinical trials and ensuring that they have first access to the most innovative treatments, while also unlocking access to vital extra support in the short term. This does not just help the individual. By providing the right support at the right time, we can reduce pressure on the NHS. That is why NHS England rightly has a target that two-thirds of all people living with dementia will have received a diagnosis. This was consistently met from 2015 until the pandemic. As people visited their GPs less frequently, clinicians were diverted to other areas and individuals had little access to memory clinics. The rate dramatically fell from 67.6% in January 2020 to just 61% in January 2022. This has meant that, according to NHS data, an extra 35,000 people are now living in the dark about their dementia status. As we address the backlogs in elective treatment and cancer care, it is vital that we also tackle the backlog in diagnosis of dementia. To do so, we must have clear strategies in place, at local and national level.

I am proud that the UK is seen as a world leader in dementia research, as many noble Lords know very well. However, there are still barriers to us reaching our potential, including a lack of participants for research. This is not because there is low interest in participating in research among the public. According to Alzheimer’s Research UK, 69% of the public would be willing to take part in dementia research. However, 81% did not know how to volunteer. The NHS, as a single health system, has many advantages which give it great potential for data sharing between research and clinical practice, connecting those who want to take part in studies with those conducting the studies.

A valuable report recently released by the All-Party Dementia Group, Fuelling the Moonshot, recommended that all newly diagnosed patients receive a letter from the NHS within three months of diagnosis, explaining how they can take part in dementia research. Integrating dementia research with integrated care partnerships will provide other benefits. The benefits should, and would, flow in both directions. While research can benefit from better access to participants, it should also ensure that innovation, whether in treatments or models of care, can reach people living with dementia.

Sugar

Lord McColl of Dulwich Excerpts

Monday 24th January 2022 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for raising the success so far of the programme in reducing sugar in drinks. Between 2015 and 2019, we saw a 44% reduction in sales-weighted average total sugar in retailer and manufacturer-branded drinks subject to the soft drinks industry levy. The money raised through the soft drinks industry levy was not linked to any specific programmes or departmental spending. As the noble Baroness will be aware, departmental spend is allocated through spending reviews by the Treasury, and there is quite often some scepticism over hypothec—sorry, probably too much sugar, or not enough sugar—or hypothecated taxes, but we are committed to tackling childhood obesity through a number of different programmes.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree that the problem is not just sugar but the fact that people are putting too many calories of all sorts in their mouth? The real answer to the obesity epidemic and the Covid problem is to reduce the total number of calories going into the mouth. If your waist measurement is more than half your height, you are eating too much of the gross national product.

[Lord Kamall (Con)]

I thank my noble friend for that catchy slogan; I wonder whether we could use it in some of our campaigns. As he rightly says, it is not just sugar. There are concerns about ultra-processed foods, for example, but also the size of portions. Many noble Lords will be aware that, for some simple products, the portion sizes have increased over the years, and if you want to get a small portion you have to either buy something and share it with someone or throw away half of it. We are looking at all these measures to make sure that our diets are healthier, that we have the right balance with smaller portions and that people are doing exercise. It is one thing is to consume those calories but another to burn them off.

Eating Disorders

Lord McColl of Dulwich Excerpts

Monday 17th January 2022 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for raising the issue of the backlog as a result of the pandemic. We have seen eating disorder services continue to face increasing demand, especially as a result of lockdown and its mental health impact. The number of young people entering urgent treatment has increased by 73% between 2019-20 and 2021, and the numbers waiting for treatment have also increased from 561 to 2,083. To make sure that we meet the standard and get those waiting times down, we have invested an extra £79 million this financial year, and we are working with systems across the country to see how we can make sure that we address young people and adults who need access to this treatment.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree that it is a very serious condition that 71% of the British people over the age of 30 are obese or overweight? The problem with this is that it interferes with the immune system, which makes them much more vulnerable to all kinds of diseases, not least infections. If we want to deal with the next pandemic now, we have to get people to reduce their weight so that obesity does not interfere with their immune systems.

[Lord Kamall (Con)]

The question from my noble friend highlights the difficulty of dealing with such a sensitive area. You have to be very careful how you address the issue of obesity. For example, it is quite right that we want to get the rates of obesity down, because it does lead to a number of other conditions that we have discussed many times here. One thing that you have to look at, however, is the unintended consequence of any laws. One possible unintended consequence is that some of the measures to tackle obesity, such as looking at food labelling, might affect people who have eating disorders. Every time we look at the obesity strategy, therefore, we make sure that we consult charities that look after people with eating disorders to ensure that we have the right balance. We will not always get it perfectly right, but we will try our best.