Childhood Obesity and Diabetes

Anna Soubry Excerpts

Wednesday 24th April 2013 Westminster Hall

[Keith Vaz]

The hon. Lady is absolutely right. I do not want to steal lines from the Minister’s speech, but when she recently addressed a forum on diabetes, that was exactly what she said: diet is extremely important. We are all busy people and when we walk into the Tea Room for our cup of tea, we are faced with Club biscuits, Jaffa Cakes, Victoria sponges—plural—and all kinds of other things that entice us, so even if I go in saying that I must have a banana or an apple, I end up, as the hon. Member for Strangford has seen, picking up a Club biscuit. The hon. Member for Mid Derbyshire is absolutely right: diet is crucial. That is why I wish the newly appointed diabetes tsar, Dr Jonathan Valabhji, the best of luck in dealing with those figures.

How do we cope with this situation? There are practical steps that health care providers, local authorities and the general public can take, but the key is prevention. The new NHS health checks will offer those aged between 40 and 74 a check to assess their risk of heart disease, stroke, kidney disease and diabetes. If only I had had that check when I was 40, I would have discovered six years earlier that I had diabetes. However, new research revealed by the university of Leicester on Friday suggests that the checks could detect at least 158,000 new cases of diabetes or kidney disease, but they are not being taken up. I pay tribute to the work of Professor Kamlesh Khunti of Leicester university, who was behind the research that revealed the number of cases that could be discovered. The health check has enormous potential to find those in the early stages of diabetes or even with symptoms of pre-diabetes.

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

I apologise, Mr Davies, for what may become something of a love-in. I will probably pinch some of the right hon. Gentleman’s speech, and I pay tribute to the great work that he has done. Does he agree that great work has been done in Leicester with the health checks that are being rolled out there? The approach is forward-thinking. Anyone who registers with a doctor and is in the right age group automatically gets a health check. The work is also being driven by the excellent charity with which the right hon. Gentleman is associated. Does he agree that real, positive work is being done in Leicester from which the rest of the country can learn?

[Keith Vaz]

Absolutely. I thank the Minister for her kind words. I know that she has to pass Leicester in order to get to London and I know that she has made a number of visits to the city; she was there recently. I thank her for the compliment that she has paid to Leicester and to Silver Star. The Government must not miss this opportunity to set targets for GPs, because it is only through setting targets that we can secure real change.

Another avenue that could be explored is the role of pharmacies in testing for diabetes. According to the Royal Pharmaceutical Society, there are more than 10,000 community pharmacies in the UK. I believe that those pharmacies are under-utilised. My mother, before she died, had absolute faith in her local pharmacist. Of course she listened to her doctor and she got her prescription. On occasion, she would listen to her son and her daughters. However, the person she really respected was the pharmacist, and because pharmacies are on the high street, they are available to local people, so they can get their tests. The benefits of testing for diabetes in pharmacies are twofold. Bringing testing into the community because the pharmacies are there means that hundreds of thousands of people who have not been diagnosed with the condition can discover whether or not they have it and, more importantly, it would reduce the pressure on already over-burdened GPs.

Finally, I want to talk about the new landscape of health care and its role in tackling diabetes. The Health and Social Care Act 2012 offers an unparalleled opportunity to revolutionise diabetes care and prevention. I warmly welcome the introduction of health and wellbeing boards, which will put local councils firmly in the driving seat to address public health. I have always believed that local authorities have a role in providing those services. Importantly, the boards will be able to work with charities, such as Diabetes UK, which have done outstanding work over many years and provided so much help to so many people. The first thing I did when I discovered I had diabetes was become a member of Diabetes UK. I receive constant updates about what I should do and a little loyalty card, which I have not used yet, but it has the telephone number.

It would be remiss of me not to bring up Silver Star, which the Minister mentioned and with which I am privileged to be associated. It targets at-risk communities. Indeed, having been established in Leicester, sent buses to Mumbai and Goa, and supported charitable work in Yemen, the charity opened its first London diabetes centre in Edgware only two weeks ago with the help of Mr Speaker, in the place he was born—not quite the hospital, because Edgware general is down the road. He was born in Edgware however, and it was great to have him back to open the new unit.

The charity has sought—this takes us back to the point made by the hon. Member for Mid Derbyshire—to deal with issues relating to children and sport; the importance of diet; and the role of parents and professionals. On Friday, the charity and I will unveil the winners of a painting competition held by Silver Star in association with Leicester City football club. All the school children of Leicester were asked to paint a picture showing the importance of a healthy lifestyle. I thank the football club’s chairman, Mr Raksriaksorn, and his son Top for naming the charity as one of their charities of the year and for working with it to ensure that children realise the importance of sport. I hope that on Friday not only will the winner of the competition be announced, but Leicester City football club will at last get into the play-offs where we belong, as it is one of the last games of the season.

The health clock on diabetes has reached 11.59 pm. We need either to toughen the responsibility deal or to pass legislation. Schools need to take immediate action to remove vending machines that sell sugary drinks. We need local councils to give fewer planning permissions for fast-food outlets near schools, or, better still, no planning permissions. We need a radically different approach to ensure that everyone at risk is tested for diabetes. If we do not do so, the NHS will be overwhelmed and it will not only affect our generation, but our children’s generation. That is why we must act now.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health (Anna Soubry)]

It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the right hon. Member for Leicester East (Keith Vaz) on securing this debate and pay tribute to him for all the work that he has done over the years on the issue of diabetes and the subsequent work that flows from that in relation to obesity. It has been a pleasure to have his Silver Star van come in to my constituency, and I know that it has gone into many other constituencies as well.

I congratulate the right hon. Gentleman on the work of his charity not just in this country but in India. It was a great pleasure earlier this year to go to India for the first ever Anglo-Indian conference on diabetes. Unfortunately, there is a higher prevalence of diabetes in the south Asian community. It is one of the subjects that I will touch on in what will inevitably be a short speech, notwithstanding the fact that this is a large topic.

If I do not answer all the questions that have been raised in the debate today, I will reply to hon. Members in writing. I agree with the right hon. Gentleman that we must wage a war on sugar, fight fat and that we must all engage in the battle of the bulge. In relation to Ella’s Kitchen, I have seen its excellent report and have asked to meet the group. The right hon. Gentleman is absolutely right about the role that pharmacies can play. I pay full credit to Boots, which is already beginning to do that work, and to Diabetes UK—it is a great charity—which is the chosen charity of Tesco.

I want to talk about the great work that Silver Star and Diabetes UK have done with Boots testing people for diabetes, weighing and measuring them and finding out their blood sugar levels. Following that, we want to ensure that there are then referrals to dieticians, nurses and even GPs where that is necessary. We want to make sure that it all flows and works together.

I pay full tribute to my hon. Friend the Member for Torbay (Mr Sanders), who chairs the all-party group on diabetes. I will not repeat all the statistics that he gave. He rightly made the point about the difference between type 1 and type 2 diabetes; type 2 diabetes has a clear link to being overweight or obese, and I pay tribute to all the fine work that he has done.

The hon. Member for Inverclyde (Mr McKenzie) made a fine point about vending machines in schools. I completely take the point, if I may say so, that he made about academies. I have already spoken to the Secretary of State for Education on that issue. He knows my views on it, but equally I understand why he wants to ensure that our academies are free from—if I can put it this way—central control. Nevertheless, I have made that very valid point.

The hon. Gentleman made a compelling comparison between our statistics on diabetes and our statistics on cancer. We do not flinch—none of us—from talking about how we can prevent cancer. We do not flinch from talking about the fact that cancer is something that kills many people. Of course, many people live with cancer and there are great success stories. Obesity, as everyone attending this debate knows, is effectively a killer. If we were absolutely honest about it, if obesity were a disease, Governments of whatever political colour would have taken action many, many years ago to tackle the growing problem—no pun intended—of obesity and being overweight, notably in our children.

I could use up most of the remainder of my speech effectively debating with my hon. Friend the Member for Southport (John Pugh). Having listened to the hon. Member for Hackney North and Stoke Newington (Ms Abbott), there is a great danger of this “love-in” extending to my shadow as it were, because I absolutely agree with many of the things that she said in response to my hon. Friend. However, we need to take these points away.

Let us talk about something that did not exist when I was young—the concept of snacking. I was positively told not to eat between meals. If we now look in the real world at how young people live and at what they feel is acceptable, it includes going into the many coffee shops that exist. I have no problem with coffee shops, but young people go in and have a large coffee—not a small one, and we could talk endlessly about portion control; I absolutely get that point and think that it is valid—which has syrup in it. It might have marshmallows on top, and then perhaps another little dollop of cream, because it is just a snack, a treat or elevenses. “And by the way”, they say, “I think I’ll have one of those very nice muffins.” They do not know how many calories that is. I absolutely agree that they do not understand that, and there was a great outbreak of nodding at the point made by my hon. Friend the Member for Southport. That is why I absolutely congratulate all those places that have put up on their boards the number of calories in different foods.

The hon. Member for Hackney North and Stoke Newington is right that it is a surprise to people—even to supposedly intelligent, grown-up people such as ourselves—when they find out the calorific content of foods that we see and perceive as treats and snacks. Equally, I want to make it clear that we should never demonise any food. There is nothing wrong with chips, or burgers; what is important is that it is all good food in moderation.

I thank the hon. Member for Strangford (Jim Shannon) for his very kind words, and I will only say this in relation to the team he supports: come on Nottingham Forest. Moving on to more serious matters, I thank him and other hon. Members for raising the profile of diabetes and accordingly raising the issue of obesity. It is a difficult subject, because when we start to talk about people’s weight, they take it personally, and rightly and understandably so. There are many people who say, “Well, it’s not the role of Government to tell people what they should or shouldn’t eat”. They are absolutely right; it is not my role to tell people what they should or should not eat. However, it is the role of the Government, as stewards of the NHS, to make sure that the NHS budget is spent as responsibly and sensibly as possible. We know that obesity costs, not just in human terms but in NHS terms; it costs billions of pounds.

It costs in human terms as well, and many of us who see children who are overweight or obese are upset and concerned about that, because we know that many of those children will not only suffer from health issues—that is one of the things that I learned when I went to see a project in Rotherham, and I will discuss that project in a moment—but will be bullied. Many of them are unhappy that they cannot, as they perceive it, join in the sport or physical activity enjoyed by their friends. There is a real human cost to overweightness and obesity.

I will not repeat the many facts and figures that have quite properly been given in this debate. However, 1.3 million children are obese, which is one in six children. According to the national child measurement programme, which is the programme in England whereby we measure 1 million children—so, if I may say so, we know what we are talking about—4.1% of boys and 2.9% of girls are morbidly obese. That is serious stuff; 17,400 children are morbidly obese.

As has been identified, there is a clear link between obesity prevalence and deprivation. That is why this is a health and equalities issue; not just because citizens from south Asian backgrounds and indeed, I believe, from Afro-Caribbean and African backgrounds have a higher prevalence of type 2 diabetes. We know that 12.3% of reception children who are overweight or obese are from the most deprived backgrounds, as opposed to 6.8% who are from the least deprived backgrounds. I do not know why, but we cannot use the word “poor” anymore. By year 6, 24.3% of overweight and obese children are from the most deprived backgrounds, compared with 13.7% from the least deprived backgrounds.

I perhaps used the wrong language some months ago when I talked about the responsibility that falls upon us all as individuals, because we all take responsibility for our own health and, most importantly, for the health of our children. I was talking to the Food and Drink Federation about the responsibility that I believe it, too, bears, for reasons that I will not go into in too much detail. However, I put forward the fact that those who are overweight and obese as children are more likely to come from the most deprived backgrounds. There was much criticism, misreporting and all the rest of it, and, if I may say so, some political cheap shots were aimed at me. However, I hope that those facts speak loudly, and I also hope that everybody takes this away: the reason why I feel this way with such a passion is that if someone comes from a poor, deprived background, they have enough problems as a child, and enough bad things going against them to prevent them from having a great start in life, without the burden of being overweight or obese.

[Ms Abbott]

The Minister referred to fat children being bullied. Does she agree that being fat as a child can be the beginning of a downward spiral? They feel fat and ungainly; they are unwilling to take their clothes off for PE, particularly girls, so they take less and less exercise, so they get even fatter. It is a downward spiral.

[Anna Soubry]

Yes, I agree, and I also think that there is no doubt that there is a link between being overweight or obesity and mental health. Which comes first, I do not know, but it is certainly all connected.

The call for action on obesity set out the steps that we are taking to help people to make healthy choices. That is what we aim to do: provide people with the education and knowledge they need, then ensure that they have the opportunities and options to make healthy choices. We have the national child measurement programme; we have change for life. The hon. Member for Strangford may like to know that 1 million families have joined change for life, and 684,000 people have downloaded the “Be food smart” application.

There is much more that we can do, and obesity in children is one of my absolute top priorities. I want to know why we have stopped weighing pregnant women. It seems absolutely bonkers. I am looking at the advice that we give to new mothers on how to feed their babies, and I am also looking at the role of health visitors, midwives and our great NHS workers. As I have said, in Rotherham there is a wonderful project, which anyone who has an interest in this subject really needs to go and see, because one of the things that is happening there is that everything is integrated. The project has been up and running for three to four years, and the NHS, dieticians, GPs, nurses and health visitors all work with schools, teachers and the local authority—in many ways, it is driven by the local authority. It is a wonderful experience, where the project workers do not demonise food, but look with kindness and care at the causes of problems. They help people, not only with their diet through the information that they provide, but by helping them to exercise.

I have completely run out of time. In no way have I completed my speech, and I apologise profusely for that. However, I pay credit and tribute to everybody who has signed up for the responsibility deal. There is much more that we can do; I completely accept that. Nevertheless, I would say that the labelling on packaging is something that we are particularly proud of. We are getting a standardised system that will enable people to make healthy choices and take responsibility. I could talk about schools and the great work that they are doing, but that will have to be the subject of a letter.

[Philip Davies (in the Chair)]

Order. We now come to the next debate.