Diabetes

Lord Vaizey of Didcot Excerpts

Wednesday 9th January 2019 Westminster Hall

[Sir John Hayes]

I hope that the Minister, in respect of that excellent intervention and my earlier remarks, will say how he will ensure that that kind of vital education is provided in a format and at a point that works for everyone. This is about getting to people by a means and at a place that will penetrate, have effect and be comprehensible. The objectives in the long-term plan are right, but how we deliver those objectives has become the vital next step.

We have already spoken in this debate about technology. A flexible approach to the provision of technology, as well as education and support, is critical. Once equipped with information and skills, people must have access to, and the choice from, a range of technologies to help them to manage their condition in everyday life, as my right hon. Friend the Member for Ludlow (Mr Dunne) mentioned a few minutes ago. For people with type 2 diabetes, that is about ensuring access to the required number of glucose test strips. In the rapidly developing world of type 1 technology, insulin pumps and continuous glucose monitors can radically transform lives.

Decisions on which technologies are available should be made with reference to advice from clinicians, patients and, perhaps most importantly, health economists, who will help to determine value to the NHS.

[Mr Edward Vaizey (Wantage) (Con)]

Will my right hon. Friend give way?

[Sir John Hayes]

I will give way, but I want to make my point before I do so, and it might well inform and inspire my right hon. Friend’s intervention: it concerns me that, in contrast to medicines, medical devices and now digital solutions do not have clear processes for appraisal and subsequent funding once approved.

[Mr Vaizey]

My right hon. Friend has indeed inspired me. I do not have diabetes, but I tried a FreeStyle Libre sensor because a constituent of mine is involved in the company. Given my right hon. Friend’s remarks, he seems to agree with me that a robust process of cost-benefit analysis would show that the more people who were issued with that device, the more the health service would save in the long term from people being able to avoid catastrophic incidents because they could monitor their glucose levels much more effectively.

[Sir John Hayes]

I agree entirely with my right hon. Friend. In the modern idiom, we need to be technology-neutral about that, because the field is changing rapidly. As new technology comes on stream and improves, we need to be sufficiently responsive to and flexible about those changes to ensure that people get the very best, latest technology available to them, for the reasons he gave.

The limits on self-management by the restrictions on technology inhibit people’s wellbeing, confidence and, thereby, opportunities. I want to ensure that the provision of technology is consistent throughout the country. There are suggestions that such provision is patchy, that some places are better than others and that some of our constituencies are not getting all that they deserve. The Minister will not want that, because he is an extremely diligent and resourceful Minister—I know that from previous experience—and I want him to tell us how he will ensure that the technology is appraised properly, is delivered consistently and, accordingly, will change lives beneficially.

--- Later in debate ---

[Sir John Hayes]

Entirely; in fact, I call on the Minister to do just that: will he introduce a mandatory front-of-pack traffic light labelling system, which is supported not only by my hon. Friend but by 83% of the population when asked whether that should happen? The Minister will be in tune with popular opinion; he will become something of a popular hero by responding to my hon. Friend’s request, which I amplify.

[Mr Vaizey]

We have Belisha beacons—could this not be the moment for Brine indicators?

[Sir John Hayes]

It could indeed. Not only that—I wonder whether we might consider a watershed on the advertising of junk food. Wherever children go, they face adverts suggesting that they eat all kinds of foods. As children, we never ate those things, did we? We were not exposed to the same kind of seductive, alluring advertising suggesting that children should consume that kind of food. There is an argument for cracking down, and Government have a role to play. Again, that kind of watershed on junk food advertising is supported by 76% of the population. The Minister would be a double hero if he did that.

Fitness matters, too. There must be a focus on exercise, given that studies illustrate that regular exercise pays dividends in respect of health and wellbeing, including diabetes. That is why we should not build on playing fields, close down sports halls and concrete over green spaces where people walk, play, run and enjoy all the opportunities to get healthy.

There is a link between poverty and ill health, as Members in the Chamber know very well. Although 6.6% of Britons have diabetes, that percentage falls markedly in wealthy areas. In Richmond upon Thames, 3.6% of residents have diabetes; in Bradford, the number rises to 10.4%. In south Lincolnshire, where my constituency is located, 7.3% of people have been diagnosed as diabetic. Such health inequalities must be addressed. It is with that in mind that I have campaigned so hard for the protection and maintenance of our parks and green spaces, which are often the only places that communities in less advantaged areas have to exercise, play sport and get healthy. In the case of diabetes prevention, do we perhaps take too puritanical an approach by rigidly pursuing individual outcomes? As I said, contrast that with what I described as the democratisation of the debate and the wider view that I have begun to outline today.

I commend, finally, the work of Government and the NHS on moving towards a fresh approach to diabetes in the NHS long-term plan, with a commitment to double the number of diabetes prevention programmes to 200,000 places. None the less, hon. Members will agree that that is a fraction of the 12.9 million people who are at high risk. Will my hon. Friend the Minister say how he plans to take a measured approach and appraise the evidence for all available solutions that might reach the wider population, beyond those targeted special programmes for that relatively small number—well, 200,000 is not a tiny number, but it is a relatively small proportion of the total number of people at risk of contracting diabetes?

Much commendable progress has been made, but it is now time for the Government to do several things. First, they must intensify their public information campaign and encourage everyone to speak about their own type 2 diabetes with their healthcare professional. Secondly, they should ensure that healthcare professionals offer a range of proven solutions, be that education or technology to enable self-management, or the resource to facilitate prevention at scale. Thirdly, they should continually review a rapidly changing environment and update the House on the tough political decisions being made to tackle this crisis of immense proportions. Politicians can no longer afford to abnegate their responsibility to a so-called expert class driven by bureaucracy. Too much is at stake. I know that the Minister will not be able to respond now to all my points, but I invite him to meet me and other concerned colleagues once he has had a chance to reflect on some of the issues, so that we can take the debate forward.

I began with C. S. Lewis, and I will end with him as well:

“We all want progress…If you are on the wrong road progress means doing an about-turn and walking back to the right road and in that case the man who turns back soonest is the most progressive man.”

I do not think we are entirely on the wrong road, but we must be honest about what more we can do. That is not for our own interests or sake, and it is not even for the Minister’s heroic reputation, which I championed earlier. It is for all those who are suffering, or who might suffer, from the crippling illness that is diabetes.