Office for Health Promotion
Lord Moynihan Excerpts(3 years ago)
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Lord Moynihan
To ask Her Majesty’s Government what plans they have for the new Office for Health Promotion to take over responsibility for co-ordinating and leading efforts to improve the health of the nation in (1) tackling obesity, (2) improving mental health, and (3) promoting wellbeing and an active lifestyle through affordable access to sport, fitness and recreational facilities.
Lord Moynihan (Con) [V]
My Lords, I beg leave to ask the Question standing in my name on the Order Paper and reinforce all the plaudits rightly directed at our outstanding Lord Speaker.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, we are redoubling our efforts on obesity, mental health, well-being and other aspects of prevention. That is why the Office for Health Promotion will operate from within the Department of Health and Social Care. It will be directed by the professional leadership of the CMO and it will drive forward our prevention strategy. It will focus on reducing health inequalities and its approach will be proactive, predictive and personalised interventions.
Lord Moynihan (Con) [V]
This welcome government initiative has the potential to lead on vital cross-departmental work to improve physical and mental health, well-being and active lifestyle measures for all ages. Does my noble friend agree that this agenda deserves a well-being statement and budget from the Treasury, as in New Zealand? Given the critical importance of the nation’s health and the widespread interest shown in this Question, will my noble friend accept a request for an online meeting involving interested Peers and officials appointed to the OHP?
Lord Bethell (Con)
My Lords, I absolutely endorse my noble friend’s points. This is an extremely important agenda which we are getting behind in a very big way. I also completely acknowledge and recognise the enormous amount of interest from noble Lords in this agenda; we have taken a number of Questions on this and I celebrate the fact that noble Lords have as much interest as they do. I would be very glad to arrange such a session as my noble friend suggests.
Folic Acid
Lord Moynihan Excerpts(3 years ago)
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Lord Bethell (Con)
The noble Baroness puts the statistics persuasively. The numbers I have are slightly different, but her gist is right. I hope to return after purdah to revisit this important subject.
Lord Moynihan (Con) [V]
As the noble Baroness, Lady Jolly, just said, does the Minister agree that it is high time that we followed Australia, which mandated the addition of folic acid to wheat flour for making bread? As long ago as 1988, folic acid fortification of all enriched grain product flour was fully implemented in the United States and Canada. It is time to say yes to the long-running campaign of the noble Lord, Lord Rooker; it should be a departmental priority on 7 May.
Lord Bethell (Con)
I reassure the noble Lord and others who have pressed this point that it is a departmental priority. There has of course been a pandemic and that has slowed things down. I cannot avoid that fact, but we are very much returning to the prevention agenda in the round and the issue of folic acid in particular.
Body Mass Index
Lord Moynihan Excerpts(3 years ago)
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Lord Moynihan (Con)
My Lords, the noble Lord, Lord Addington, will not be surprised if I turn to sport to assess the effectiveness of BMI as a medical guideline. Ashling O’Connor, one of the finest sports journalists of her day, wrote at the turn of the century about the need for the Ministry of Defence to take note of modern sports science after its long-held physical standards for new recruits were excluding exceptional candidates, including top rugby players. The Army’s weight limit, based on the BMI classification, was based on a calculation that divided height in metres squared by weight in kilograms. That would have discounted many Olympic gold medal winners.
Much was made at the time of the case of the two finest Olympians this country has produced. Sir Matthew Pinsent would not have been admitted to the ranks, as he weighed more than 17 stone, because, standing 6 foot 4 inches, his BMI would have been above the limit of 28. Sir Steve Redgrave—five times rowing gold medallist in an exceptionally tough endurance sport and in my opinion the finest athlete this country has ever produced—would only have sneaked in under the bar, with a BMI of 27.6. Ray Stevens, winner of a silver medal in judo in Barcelona in 1992, would definitely not have qualified at 6 foot and 15 stone, despite being able to bench press for 25 reps and run competitive half marathons. It is therefore not surprising that the English Institute of Sport discounts the outdated BMI test in favour of a more sophisticated method, such as skinfold callipers which squeeze subcutaneous tissue, and dual energy absorptiometry and body scanners measuring bone density.
Of course, we should place BMI in context, which, with slight variations over time, is your weight in pounds times 703 divided by your height in inches squared. Being based simply on height and weight, it takes no account of body fat percentage, muscle mass, bone thickness or genetic disposition to a certain frame. It assumes that everyone has the same percentage of lean tissue and fat tissue and it takes no account of those athletes who clearly have much more lean muscle mass than the average person. These facts seriously challenge the base assumptions behind the BMI formula. It exaggerates thinness in short individuals and fatness in tall and muscular individuals. The higher muscle content—in other words, lean mass—in athletes skews BMI, as lean mass is approximately 22% denser than fat tissue.
Although BMI has been adopted by the WHO as an international measure of obesity, it lacks a theoretical basis, and empirical evidence suggests that it is not valid for all populations. What can be said in its favour is that it is simple: it is a rough and ready calculation to an indirect health indicator of obesity or being overweight. I would expect the use of BMI to decline as a useful test and new measures such as the Bod Pod and hydrostatic weighing to take prominence, not least by the World Health Organization.
Having heard my noble friend Lord Addington’s speech, I have no doubt that all his points, and those made by other speakers, will be taken into consideration by the Government. I look forward to hearing from the Minister.
Covid-19: One Year Report
Lord Moynihan Excerpts(3 years, 1 month ago)
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Lord Moynihan (Con)
My Lords, today we are considering a range of important measures for the immediate future and the gradual and phased aspirational exit strategy from the epidemic. I say to my noble friend Lord Lansley that I believe that it has to be aspirational, because we cannot conceivably predict with accuracy the numbers involved and have to remain flexible in our approach to the road map, however difficult that may be. I remain supportive of the Government’s approach to the pandemic and the success of the vaccine programme, which requires only a brief look over our shoulders to Europe to see just how difficult the planning and implementation of such a programme has been. I also welcome the caution expressed by government in light of the new high levels of infection in many European Union countries.
In my view, the way out of the crisis has always been a race between vaccine and virus. Add to that the challenge of encouraging as close to universal vaccination as possible with the ability of existing vaccines to protect against new variants and you have the key determinants. While we aspire to return to some normality, there will be—as the noble Baroness, Lady Finlay, rightly said—some long-term changes in behavioural patterns that will be welcome, including instinctive social distancing and improved hygiene. But I ask my noble friend the Minister whether the Government are also planning to deliver a booster jab for the whole population towards the end of the year, similar to the annual flu jab, taking into account any changes to variants and our response to those variants at the time. How advanced are any plans for a Covid booster?
In all our debates looking to the future, I have argued for the need for government to focus on delivering a “build back fitter” programme so we can address the serious challenges with an exceptionally unfit cohort of young people, who are understandably bored, necessarily denied access to team sports and physical education, leading an impoverished lifestyle and suffering from loneliness. As we emerge from lockdown, affordable access for everyone to an active lifestyle—to clubs, fitness centres and dual-use school facilities—and local community engagement with sport and recreation will be essential. The emphasis has to be on affordability and access.
The Minister has responded to this by assigning the DCMS to be the lead department. While I respect his comments, I suggest that it is his department which should take the lead. The well-being and fitness of the population is the strongest deterrent to high-cost calls on the NHS for healthcare provision ranging from widespread obesity to many more related conditions. I hope that the pathway out of this crisis will lead to a more active population than in any year of our lifetimes. That should be our goal, but it requires preparation and engagement now. Government leadership is needed for a national plan for an active lifestyle.
Nowhere is this more important than for disabled people, whose lives have been the hardest hit by Covid-19. For many disabled people the key loss has been their confidence—confidence which, for the visually impaired, has been dented by lack of engagement with society and the habit which comes from commuting and the normal daily lives they once enjoyed. The Activity Alliance’s annual disability and activity survey found that:
“Twice as many disabled people felt that coronavirus greatly reduced their ability to do sport or physical activity compared to non-disabled people”.
The pandemic made disabled people feel that they do not have the opportunity to be as active as they want to be compared to non-disabled people. A fear of contracting the virus, the impact on their health, and a lack of space and support to be able to exercise safely at home have been significant barriers for disabled people, and almost a quarter of disabled people stated that they had not received enough information about how to be active during the pandemic.
Sport England is doing excellent work with its £20 million Tackling Inequalities fund to try to reduce the negative impact of Covid-19 on activity levels among disabled people and underrepresented groups. But the £20 million in the fund needs to be substantially increased—it certainly needs to be doubled.
Priority out of lockdown is now essential for disabled people. I hope my noble friend the Minister will prioritise the requirements of the disabled, providing some sunshine after rain for so many people whose confidence has been knocked, which in turn has added to their substantial existing challenges caused by impairment and disability.
Health and Social Care Update
Lord Moynihan Excerpts(3 years, 1 month ago)
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Lord Bethell (Con)
My Lords, the CQC has pronounced its report on do not resuscitate orders, which is absolutely crystal clear. I wholly endorse its findings and recommendations.
Lord Moynihan (Con)
My Lords, I warmly congratulate the Government on the management of the vaccine programme. As we emerge from the epidemic, will the Government commit to a major health policy initiative to ensure that all young people engage in a more active lifestyle, participate in sport and recreation, gain affordable access to gyms, swimming pools, leisure facilities and dual-use school facilities used by local communities, and to tackle what is the least fit generation of young people in over 100 years? Does my noble friend agree that affordability and access are the critical components in this context?
Lord Bethell (Con)
My Lords, the policy on sports is best left to colleagues at the Department for Digital, Culture, Media and Sport, but on a personal level I emote complete sympathy with my noble friend’s sentiments. I may be naive in this matter but I cannot help hoping that this pandemic will have led to a feeling across the country that the health of the nation has to change—it has to change emphatically, not only through diet but the amount of activity taken. This nation has an opportunity to embrace a lifestyle with more outdoor activity and exercise and a greater commitment to healthy living. That is a reasonable ambition, not just for my noble friend but for the whole country, and I support it entirely.
Covid-19
Lord Moynihan Excerpts(3 years, 3 months ago)
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Lord Bethell (Con)
The noble Lord is, as ever, cutting to the chase. The role of hotel staff, transport to and from airports and the flight crew themselves is incredibly important. As the noble Lord probably knows, the outbreak in Melbourne that hit Australia hard was caused in part by the bus drivers from the airport to hotels becoming vectors of infection. That created an unfortunate outbreak, which was hit extremely hard with a long lockdown to squeeze out the outbreak. We are putting in all the right, responsible measures to segregate crew, keep them apart from the rest of the population and ensure that they are, wherever possible, vaccinated against the virus so that they cannot be vectors of transmission.
Lord Moynihan (Con) [V]
My Lords, having flagged up the quarantine restrictions, tens of thousands of people from around the world have been returning to the UK in advance of Monday’s deadline to avoid unaffordable costs in hotel bills. This is resulting in many connecting flights across the UK being unexpectedly packed. I understand that this is leading to large numbers of passengers, on arrival at major UK satellite airports, waiting shoulder to shoulder around baggage carousels for their luggage, without airline or baggage-handling staff in evidence, no social distancing and a serious risk of exhausted passengers with low resistance being prone to Covid infection. Will my noble friend the Minister consult colleagues and ensure rigorous application of all social distancing restrictions around all domestic baggage carousels over the remaining three days and beyond?
Lord Bethell (Con)
My Lords, I am grateful for the question but my information is slightly different from that articulated by my noble friend. Passengers overseas have heard the message loud and clear, and there has not been, as far as I understand, the kind of rush that he describes. In fact, there has been a lot of sensible behaviour by passengers. We are grateful to London Heathrow, London Gatwick, London City, Birmingham and Farnborough, which to date are the authorised red list airports and have put in place exactly the kind of social distancing measures around transit from the aircraft to the PCP, from the PCP to the baggage hall, and from the baggage hall to the transport to the hotel. A huge amount of thought has been put into the personnel, signage and arrangements to ensure that that is done in a way that applies the best possible hygiene measures.
Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) Regulations 2021
Lord Moynihan Excerpts(3 years, 3 months ago)
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Lord Moynihan (Con)
My Lords, I support these regulations, which, as the Minister stated, include a reference to an exemption for elite athletes who train or enter competitions, and it is to that subject I wish to direct my remarks.
A recent review launched by the Home Secretary and still under consideration in Government concerns the current status of elite sports remaining exempt when travel quarantine rules are introduced. This needs to be seen in the context of the likelihood of the Olympic and Paralympic Games going ahead—despite the armchair critics who say otherwise. Given that there are only 23 Mondays before the opening ceremony, the detailed, careful and safe approach being taken by the International Olympic Committee and the Tokyo organising committee is first rate and, barring another spike in Covid-19 in Japan, it should be the showcase televised sporting event across the globe in 2021.
The proposal that athletes should be limited to the athletes’ village and competition venues on arrival, and that regular testing will be a feature of the Games, is commendable. All participants will be expected to undergo a period of quarantine before travelling to Tokyo. In this context, I encourage the Government to open early discussions with the British Olympic and Paralympic associations to plan arrangements, should it not be possible to organise training camps close to Japan.
On arrival, the athletes will be subject to frequent testing, including at the airport and the village. All sensible moves are clearly being taken to ensure the athletes’ village will be the safest place in Japan. The price of not going downtown during the Games is a wise price to pay to prioritise their health, with athletes arriving only five days prior to their competition and departing a maximum of two days afterwards.
In passing, and should there be no crowds, I look forward to the first scientific study which demonstrates that athletic performance should be even better in the absence of the body heat generated by tens of thousands of spectators. The IOC is wise to wait until March or April before making a decision on the presence or otherwise of spectators. For—and this is the key point—the interests of the athletes, not the administrators or sponsors, should always come first.
Those athletes who have failed to observe the exceptional restrictions here in the UK have been rightly named, shamed and penalised. The vast majority who have followed the rules—not least in the Premier League—have provided much needed respite for the television-watching British population in lockdown. With such exceptional and comprehensive measures in place, I congratulate my noble friend on continuing with the current status of exemption of elite sports from these regulations and, I hope, from future travel quarantine rules. Should that not be the case, it would result in increased losses for national governing bodies, many of which are on the threshold of administration. It would remove opportunities for training and competition—including the rest of the Six Nations, which is already successfully under way—and cause further problems for all sports men and women if the quarantine requirement for athletes to stay in airport hotels for 10 days after arrival was introduced for this currently exempt group.
The scientists are publicly on record as recognising that, with the exceptional measures already in place, this is a very low-risk group. I thank my noble friend for taking representations on this and know that, from his diligence and concern for the athletes, the steps being taken by sport and the close co-operation between the sector and government have delivered sensible, safe and appropriate measures.
In the context of the advantages to international training and pre-Olympic competition schedules, I hope the athletes will be able to secure vaccination immediately after—and only after—the completion of vaccination among all vulnerable groups in society. This will considerably help those Olympic and Paralympic athletes seeking selection and, with them, their immediate entourage of coaches and support staff. This is all the more important as the momentum for international vaccine passports increases.
International Year of Health and Care Workers
Lord Moynihan Excerpts(3 years, 3 months ago)
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Lord Bethell (Con)
The noble Baroness is right. Those involved in domiciliary care, particularly part-time, make an extremely important contribution. We are naturally concerned about how they are contracted and their educational needs supported. We would like to think more about how part-time domiciliary care staff in particular, who make such a valuable contribution, can be further supported.
Lord Moynihan (Con)
My Lords, does my noble friend the Minister recognise that nurses remain at the heart of the world’s response to the Covid-19 pandemic? As key to the restoration of health systems that have been neglected during the crisis, will the Government support calls by the International Council of Nurses fundamentally to reset preparedness and response systems and work towards the global requirement for an additional 10 million nurses by 2030?
Lord Bethell (Con)
My Lords, we massively value the contribution of nurses from all areas. In fact, that recognition has manifested itself in practical terms; we are growing the nursing workforce and are committed to delivering 50,000 more nurses, putting the NHS on a trajectory for sustainable long-term supply in the future. That journey includes giving eligible nursing students an additional £5,000 of funding per academic year. I cannot say more clearly or loudly how much the contribution of nurses to our healthcare system is appreciated. We will do everything we can to ensure that it is recognised.
Health Protection (Coronavirus, Restrictions) (Self-Isolation and Linked Households) (England) Regulations 2020
Lord Moynihan Excerpts(3 years, 4 months ago)
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Lord Moynihan (Con)
My Lords, as we enter the epic phase of vaccine versus virus, the exemptions in these regulations for elite sportsmen and sportswomen are welcome. The related debate over the timing of their vaccination and that of their entourages has now become a key issue. The president of the International Olympic Committee, Thomas Bach, is to be praised for saying that athletes should not jump the queue in front of those in greater need of vaccination. I agree with him. No one wants to see the world of elite sport given advantage over the most vulnerable in society, namely those most likely to require hospitalisation if they were to contract Covid.
Canadian Richard Pound, who is closely associated with the World Anti-Doping Agency, called overnight for the immediate prioritisation of Canadian athletes in the first wave of vaccinations in his country. He was wrong; “not yet” would have been a more considered view.
Moving through the tiers of those most in need of vaccination, I urge the Government to recognise the pressures that our athletes, both Olympic and Paralympic, are under to qualify for selection for the Games. Selection criteria vary by sport. Some need to qualify soon; others, in the summer. Sport by sport, I urge the Government to work with the Olympic governing bodies to determine the latest possible time it would help Olympic and Paralympic hopefuls to be vaccinated. I believe that they will find that the end of February is broadly the consensual point, but it is vital that this comes after the most vulnerable in society.
In so doing, I hope that the world of international sport also considers the global and not just national socioeconomic inequalities associated with Covid-19. First-world countries will benefit from the vaccine first, with supplies to developing countries lagging significantly behind, some potentially after the Games. While the whole sporting world hopes that the Olympic and Paralympic Games will take place this summer, all involved need to work to ensure that selection processes are fair, that opportunities are taken to optimise performance preparation and that the interest of the world’s athletes is critical, but not more important than the most vulnerable in society.
Covid-19: Vaccinations
Lord Moynihan Excerpts(3 years, 4 months ago)
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Lord Bethell (Con)
Those who are not registered with GPs and would like to take the vaccine need to register with GPs. We have put in place provisions to allow easier registration processes, we have updated our data arrangements and we are expecting a large number of people to seek out registration. That will be one of the benefits of the vaccination programme: clearer, better records of those in this country who are part of the NHS family.
Lord Moynihan (Con)
My Lords, last month, my noble friend the Minister was hoping to receive advice from the World Anti-Doping Agency for our Olympic and Paralympic sports stars preparing for the 2021 Tokyo Games on the specific point of whether MRNA vaccines were prohibited under the WADA code. I understand that the vaccines have been deemed safe and acceptable for use within the guidelines, protocols and rules of the WADA prohibited list. If this is the case, will my noble friend ask his department: to publish WADA’s detailed advice; what testing capability our national anti-doping agency—UKAD—has for synthetic messenger RNAs; and for information on when all elite sportspeople can expect to be vaccinated so that they can train and compete safely?
Lord Bethell (Con)
I am grateful to my noble friend for his championship of this important point. It is not necessarily the role of the department to rule on this matter, but I note that UK Anti-Doping welcomed the World Anti-Doping Agency’s publication of its view on the vaccine. We welcome that moment and I very much hope that it provides the reassurance that athletes are looking for.