Diabetes

Diane Abbott Excerpts

Wednesday 9th January 2013 Westminster Hall

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

I congratulate the hon. Member for Torbay (Mr Sanders) on securing this debate. I am struggling with the aftermath of a new year flu, so I hope that my voice will hold out.

I should declare an interest: I have been diagnosed as a type 2 diabetic. As always, I follow humbly in the footsteps of my right hon. Friend the Member for Leicester East (Keith Vaz); I have spent 25 years doing that. I am grateful for the opportunity to speak on behalf of Her Majesty’s Opposition about diabetes, one of the leading health threats in the UK. As we have heard, there are 3.7 million people in this country living with the disease. As we have also heard, it is a particular issue for people of south Asian and African and Caribbean descent in our big cities. I am hopeful that one thing that will emerge from the changes to the NHS is more local targeting, both by clinical commissioning groups and in public health, of local issues and local demographics. We cannot engage with diabetes unless we also engage with local specifics in our cities and regions.

As we have heard, diabetes costs the NHS one tenth of its budget—more than £10 billion a year. We have heard in detail about foot care and amputations, but the general problem is that diabetes is a gateway condition to hypertension, stroke, kidney problems and amputations, leading to early death. I was struck by the figure given by my hon. Friend the Member for Blaenau Gwent (Nick Smith) of 23 amputations in Blaenau Gwent. It makes one stop to think about the human reality of diabetes in communities.

The fact that diabetes is a gateway condition makes early diagnosis and engagement so important. It is important to be mindful of the new NHS architecture. It is not just a question of asking Ministers to do more; we must also take the debate to a local level, with CCGs and directors of public health, because healthy living issues will fall to directors of public health and local authorities, rather than Government, to deliver. We can also look to local authorities that have been innovative about healthy living issues by offering free swimming lessons and so on.

We have heard about the basic health service treatments and checks that people should have. The Minister will be aware that the Public Accounts Committee’s report was critical of the management of adult diabetic services in the NHS. The report said that every year, 24,000 people with diabetes die simply because their disease has not been effectively managed. That is not a satisfactory figure in the 21st century for one of the world’s leading economies. Although people now know what needs to be done for people with diabetes, the Public Accounts Committee found that progress in delivering the recommended standards of care and achieving treatment targets has been depressingly poor.

What is the Department’s response to the Public Accounts Committee’s report? What can the Minister tell us about improvements in policy and service in line with the Committee’s recommendations? Does the Department of Health have a plan for ensuring the effective implementation of the NHS health check programme after the NHS reorganisation in April?

I would also like to say a word about children and young people with diabetes. As many as one in four young people are diagnosed with type 1 diabetes. The UK has the highest number of children diagnosed with diabetes in Europe and, sadly, the lowest number of children attaining good diabetes control. Christine Cottrell, a diabetes nurse specialist from Warwick, told The Daily Telegraph last July:

“We are even getting children as young as seven with Type 2 diabetes”.

It is an important public health issue, and the prognosis is not good:

“These children end up having heart attacks, or losing a limb, or their sight, in their 30s and 40s.”

I know that it is difficult in a Westminster Hall debate to bring up issues that cut across Departments, but has the Minister had discussions with her colleagues in the Department for Education about what support could be offered to schoolchildren and young people to manage their diabetes effectively and prevent the development of early complications? What efforts are being made to ensure that both staff and pupils are aware of the nature of diabetic epileptic attacks, which can take place in schools, and the best way to assist sufferers in an emergency?

What steps are the Government taking to increase the number of people not previously diagnosed with diabetes who receive diabetes testing? What was said earlier about the role of pharmacists was an interesting suggestion. Do the Government have a plan in place to make the public aware of the symptoms of diabetes sufferers? Are there any plans for a nationwide public awareness campaign? On prevention, we know that the new NHS commissioning board will be mandated to prevent diabetes. I know that it is perhaps not reasonable to say that GPs do not perform things that are not targeted exactly as well as things that are, but is the Department considering introducing diabetes testing targets for GPs?

The Public Accounts Committee inquiry to which I referred earlier heard that out of 20 trusts that needed to improve their diabetes care, only three accepted the offered help. That is not reassuring. How can the Minister ensure that care through health providers meets the targets set by the Secretary of State? As clinical commissioning groups and directors of public health take over some of those responsibilities, what can the Department do to ensure that diabetes is on their agenda?

On some of the more general issues around diet and healthy eating, although diabetes management, foot care and preventing diabetes from becoming a gateway to even more serious conditions are important, the most important thing that we can do in medical and public health terms is consider diet and healthy eating and other prevention matters, particularly for young people. Most experts agree that the excessive consumption of sugar is a factor in both obesity and diabetes. Increasingly, people are saying that sugar is addictive.

Colleagues have mentioned some important things to engage with in terms of policy, such as minimum pricing for alcohol, about which the Government are consulting and which is supported by Opposition Members. We suggest looking at the sugar composition of some foods, particularly those targeted at children. Most parents want to do their best, and I hope that the advertising campaign launched by the Minister will shed some light on such issues for parents. However, how many parents know that Coco Pops are one third sugar? People joke about it, but although most parents would not sit their child down to breakfast and put a bar of chocolate in front of them, they will give them a bowl of Frosties or some children’s cereal, which can have a higher proportion of sugar than a bar of chocolate. Opposition Members are saying that we need to consider legislating to ensure that the proportion of sugar in some foods that are directly targeted at children can be brought down.

I am glad to advance Her Majesty’s Opposition’s position on diabetes. I congratulate the Government on what they have done up until now, but there is more to be done, both in locking in a concern for diabetes locally when clinical commissioning groups and directors of public health take up their new responsibilities and dealing with the broader issues of healthy eating and a healthy lifestyle and the preponderance of sugar in modern processed food.

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

It is a pleasure, as ever, to serve under your chairmanship, Mr Crausby. I pay tribute to my hon. Friend the Member for Torbay (Mr Sanders) for securing this debate and to every hon. Member who has spoken. As you may have gathered, Mr Crausby—and as those hon. Members who have heard or will hear or read about the debate will gather—this is a huge topic. We could have had a 90-minute debate simply on diabetes 1 and diabetes 2. We could have other debates about the causes of diabetes 2. I am the first to put my hands up and admit that, until I was lucky and fortunate enough to be appointed last September to the position that I hold, I did not know a great deal about diabetes, but, goodness me, I have learned a great deal in the months since my appointment. I thank the all-party group on diabetes, chaired by my hon. Friend, for all the great work that it does. I paid the APPG a flying visit and learned a lot; a number of matters were raised with me that caused me great concern.

I hope that you will forgive me, Mr Crausby, if this sounds like a mutual admiration society, because in many ways it is. The right hon. Member for Leicester East (Keith Vaz) and I go back many years. I pay tribute to him for all the work that he has done. I know about his Silver Star charity and I look forward to its coming to Beeston in my constituency and to the van doing some work there. That highlights one thing that has come out of this debate and goes to the heart of the Government’s reforms of the NHS: the remarkable work that can be done and now has to be done locally to ensure that we improve the diagnoses and treatments—in addition to other matters raised by hon. Members—because it is fair to say that, although many localities share common themes, this disease will be more prevalent in certain communities, even down to ward level. My hon. Friend the Member for Southport (John Pugh) raises concerns and, as ever, ideas. My hon. Friend the Member for Torbay makes a good point about how we can ensure that these improvements are delivered locally.

I pay tribute not only to the work of Silver Star, but to Diabetes UK, which must be an outstanding charity, because such was its ability to campaign on this issue that it persuaded Mr Paul Dawson, a constituent of mine who has suffered from diabetes 1 for many years, to visit me on Friday. I thought that that was just a remarkable coincidence, but he told me that Diabetes UK suggested that he visit me. The serious point is that he raised concerns, as a sufferer of diabetes 1, that I had heard at the APPG, so I had already taken up many of those, notably what seems to be a rationing of strips. Frankly, this is bonkers; people with diabetes who use strips need to use them and often need to use many in a day. I am not happy if there is any form of rationing of those strips. I have already met officers in the Department and inquiries are being made of primary care trusts, and beyond. Mr Dawson also told me about the great advances, which I have already alluded to, that have been made in medicine, which my hon. Friend the Member for Southport and others have mentioned.

I have been asked a number of questions and I cannot answer them all in the short time available, but I undertake to answer every question in letters.

[Ms Abbott]

The issue of rationing strips has been brought to my attention. What would the Minister suggest that people do if their general practitioner is attempting to ration strips?

[Anna Soubry]

I am concerned about it. It is unacceptable. I have already held a meeting with my officials and they are making further inquiries. I discussed with Mr Dawson what was happening locally in CCGs, which is where this will make a difference, when we see the power of our doctors and other health professionals to commission services, and the power and influence that patients and sufferers of diabetes will have. I am told that NHS Diabetes has now identified a diabetic lead in every CCG. There is an opportunity, through the reforms, to ensure that we now deliver locally as we should. All hon. Members who have contributed to this debate have identified a failure in respect of good outcomes and good practice throughout the NHS, right through to local level. That needs to be, and is being, addressed as a matter of urgency.

I have been alerted to problems with glucose meters and pumps—various new advances in technology. Some of this excites me. However, I am still concerned if there is not the availability that there should be, right across the NHS, notably for all sufferers of diabetes 1.