Childhood Obesity and Diabetes

Diane Abbott Excerpts

Wednesday 24th April 2013 Westminster Hall

[Keith Vaz (Leicester East) (Lab)]

It is a huge pleasure for me both to serve under your chairmanship during this important debate, Mr Davies, and to raise the issue of childhood obesity and type 2 diabetes. In 2007, after a chance testing by my local GP, Professor Azhar Farooqi, who is now the clinical commissioning group lead in Leicester, I was diagnosed with type 2 diabetes. Before I discovered that I had diabetes, it was not really a subject that I was aware of. Since then, it has become my passion inside and outside Parliament.

I begin by paying tribute to the Minister, who has truly revitalised the debate on obesity and diabetes since becoming a Minister. I agree with what she said, in her interview with Total Politics this week, about the public health Minister’s job. I have deleted one or two words, but she said that

“this is not a soft…girly option, it is a…serious job”,

and she is absolutely right. That is why I am delighted to see, on the Opposition Front Bench, the shadow Minister for public health, my hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott), who entered the House with me in 1987.

I am also delighted to see so many other Members of Parliament who have either raised the issue of diabetes or have been involved in campaigns. There is the hon. Member for Strangford (Jim Shannon), who, like me, is a type 2 diabetes sufferer; the hon. Member for Mid Derbyshire (Pauline Latham), who has raised the matter many times in the House; and my hon. Friend the Member for Inverclyde (Mr McKenzie), who was in the Chamber, but has popped out. There is also the hon. Member for Southport (John Pugh), the hon. Member for Morecambe and Lunesdale (David Morris), who is my next-door neighbour in Norman Shaw North, and last but not least, the hon. Member for Torbay (Mr Sanders), who is the chairman of the all-party parliamentary group on diabetes and who, for many years, has raised the issue with such passion.

Childhood obesity has become an important political issue. The NHS report, “Statistics on Obesity, Physical Activity and Diet”, of February 2012, stated that in 2010, about 30% of boys and girls were classified as either overweight or obese. The study found that 17% of boys and 15% of girls were obese, which is an increase from 11% and 12% respectively in only 15 years. The factors that cause childhood obesity are a major part of the debate. A recent study by University college London found that 30% of the difference between the bodyweight of one child and another can be explained by their genes. However, genes alone cannot explain the rapidly increasing incidence of childhood obesity.

The ever-increasing numbers of overweight children must be addressed, or we will have a generation of obese children growing into obese adults. It will be a generation at risk from the associated dangers of being overweight, including having type 2 diabetes. Unless we do something about that trend now, the twin epidemics of obesity and diabetes will overwhelm the NHS.

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

Does my right hon. Friend agree that whereas a generation ago, if a child was overweight, adults used to say, “They will grow out of it”, we cannot afford that type of complacency now?

[Keith Vaz]

My hon. Friend is absolutely right. I hope that by securing the debate and by hearing the contributions of hon. Members, we can get a pathway to try and show that complacency will actually help people to get diabetes. That is why I hope that hon. Members will join me today in a war on sugar, a fight against fat, and a battle against the bulge.

We must address three key areas. The first is the role of Government in facing the obesity epidemic head on. That is closely linked to the second key area, which is the role of food and drink manufacturers. The responsibility deal was a flagship of the previous Secretary of State for Health, who is currently Leader of the House. It was launched in March 2011, but I am sorry to say, it appears to have failed. Voluntary agreements with industry have made little impact. The headline pledge to cut 5 billion calories a day is simply incalculable, arbitrary and misleading.

The Department of Health, in response to a parliamentary question of mine, said:

“It is not possible to measure the exact contribution of business’ actions to changes in consumers’ calorie consumption.”—[Official Report, 6 February 2013; Vol. 558, c. 339W.]

By February 2013, 122 companies had signed up to one or more of the responsibility deal’s six pledges, but it is what happens afterwards that really matters. Those pledges, sadly, in my view—I am ready to be convinced otherwise when the Minister replies—have, at best, paid lip service to the Government’s aim of getting the nation to eat more healthily, drink less, be more active, and have healthier working lifestyles.

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[Keith Vaz]

I thank the hon. Lady for her intervention. I fear that she may have seen a copy of my speech, because she has mentioned the very issues that I intend to raise. All three areas are extremely important. It is not one area alone that can deal with the issue; it is a combination of all three factors.

The first factor is the manufacturers. Coca-Cola pledged to reformulate its best-selling drinks to reduce calorie content by at least 30%, but it has chosen not to reformulate its classic, full-fat Coca-Cola, the world’s most popular drink. A can of full-fat Coca-Cola has eight teaspoons of sugar. If the responsibility deal is to be truly believed, it has to be more robust. The pace of change among food and drink companies must be dramatically increased. The only alternative to the responsibility deal, in my view, is legislation.

Last year, I introduced a private Member’s Bill, the Diabetes Prevention (Soft Drinks) Bill, to reduce sugar content in soft drinks by 4% and to establish a programme of research by requiring manufacturers of soft drinks to reinvest part of their profits in diabetes research. In 2010, 14.5 billion litres of soft drinks were consumed in the United Kingdom. According to research by Professor Naveed Sattar of the university of Glasgow, the average person in the UK consumes between a fifth and a quarter of their daily calorie allowance through non-alcoholic drinks. Those are somewhat hidden calories. Professor Sattar said:

“This analysis confirms that many people are perhaps not aware of the high calorie levels in many commonly consumed drinks.”

The consumption of sweetened soft drinks clearly has a part to play in the increasing waistline of the nation.

Attempts to legislate on the issue have been rather unsuccessful. In September 2012, New York’s mayor, Michael Bloomberg, introduced a ban on super-size fizzy drinks to tackle the city’s obesity problem. The ban was overturned in the New York supreme court by a coalition of drinks companies and industry groups.

Legislation has not been limited to sugary drinks. In October 2011, the Danish Parliament passed a so-called fat tax on foods containing more than 2.3% saturated fat. The tax was scrapped after concerns were raised about its adverse effect on the economy as increasing numbers of Danes crossed the border to purchase food in Germany. Clearly, that would be less easy if we did such a thing in England, because of the ability to go to Scotland and Wales.

The hon. Member for Mid Derbyshire mentioned schools. She is absolutely right. The third key area is the role of schools in childhood obesity. Healthy eating in schools has been given a real boost by initiatives such as Jamie Oliver’s “Feed Me Better” campaign, which successfully attempted to transform lunch-time menus. However, many schools still have vending machines offering fizzy drinks and sugary snacks. We should issue an ultimatum: schools should remove all vending machines by 31 December this year. That would go some way towards addressing the problem of bad nutrition in schools.

[Ms Abbott]

Does my right hon. Friend agree that it is regrettable that the new academies are not subject to the same regulations in relation to food and not having vending machines? Surely the strictures that apply to state schools should apply to the new academies.

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[Mr Iain McKenzie (Inverclyde) (Lab)]

It is a pleasure, Mr Davies, to serve under your chairmanship. I also thank my right hon. Friend the Member for Leicester East (Keith Vaz) for securing this important and timely debate. Across the UK, childhood obesity is soaring and, with it, diabetes. We need to deal with childhood obesity sensitively and robustly, and we must not make the mistake of thinking that one solution will fit all children. Obesity in childhood is a complicated condition and can have many different causes. Childhood obesity often persists into adult life, and adults who are obese as children have a higher risk of diseases associated with obesity, particularly type 2 diabetes, hypertension, cardiovascular diseases and, yes, even cancer.

The UK has one of the highest levels of childhood obesity among developed countries. I will take a moment to discuss what has been happening in Scotland, because we share that problem. In fact, it is probably multiplied. In common with most of the developed world, Scotland is experiencing an obesity epidemic, and the west of Scotland heads up all the wrong health leagues in Europe. Scotland has one of the highest levels of obesity among OECD countries. Only the USA and Mexico have higher levels. Recent figures show that 26% of adults in Scotland are obese and 65% are overweight. For children, the corresponding rates are 15% and 31%.

Worryingly, the prevalence of type 2 diabetes is increasing rapidly in Scotland, as well as across the UK, with the largest part of the increase likely to be due to poor diet and low levels of physical activity, resulting in increased levels of obesity. Our diet in Scotland was a response to a life spent in the heavy industries, but it is totally unsuitable for a career spent in front of a computer screen. Activity levels are far too low to burn off our daily calorie intake. To give children the best start in life, early-life interventions need to begin before and during pregnancy, continue through infancy into early years settings, such as nurseries and childminders, and carry on into primary school.

In my constituency of Inverclyde, we have had to take steps to address the growing problem. Many years ago, we started to educate children and parents about healthy eating. In primary schools, our classes are in competition to see who the healthiest eaters are and which are the most active classes in their school. Our schools have sports co-ordinators, who introduce and encourage kids to participate in a wide variety of sports. It is not only that—our schools link up with local sports clubs to encourage kids to continue to be active after school and at weekends.

As we heard from my right hon. Friend the Member for Leicester East, we continue to have vending machines in our schools, but in Inverclyde we have put healthy foods in them. Fizzy drinks are no longer available in our schools; the only thing that can be bought from vending machines is water. Granted, it is difficult to get companies to participate in that, but our schools have been encouraged to do it off their own bat, if need be. Fast food and mobile vans have been banned from within a one-mile radius of our schools, so that if a child—especially those in secondary schools—wishes to partake in fast food outlets, at least they have to walk a distance to get there and back.

The early years offer the best opportunity to put in place healthy behaviours around food and physical activity, which will hopefully be sustained into adulthood. Central to that is the involvement of families. Encouragement must start within families to adopt a healthy lifestyle and eat healthier foods. Today, 15 out of every 100 primary school children in Scotland aged between four and a half and five and a half are dangerously overweight. Diabetes is a serious condition that causes heart disease, stroke, amputations, kidney failure and blindness, and more deaths than breast and prostate cancer combined.

Almost a quarter of a million people in Scotland have diabetes. New statistics in the annual Scottish diabetes survey show that the number of people with the condition has continued to increase alarmingly by about 10,000 a year. The majority of those people will have type 2 diabetes, a form of the disease that can be caused by an unhealthy lifestyle and can be so easily prevented. Across all four nations in the UK, we have seen a huge rise in childhood obesity.

We know that losing weight is about more than just altering your diet, but people are different. There are burners and storers. Storers find it difficult to lose weight, but love food—and love the wrong food—and do not take to exercise too keenly. Those additional factors lead to their heading in the wrong direction with their weight, and that can subsequently lead to diabetes. Let us not assume, however, that all is well with the thin people whom we meet, because poor diet can cause problems. We clearly need an approach that combines diet, exercise, the education of children—and, crucially, the education of parents—and psychological support. We need to increase physical activity at primary school and carry that on into secondary school. We need to encourage leisure activities for children to get them involved in sports and away from their computers and TV screens.

[Ms Abbott]

Does my hon. Friend agree that, while all the things he said are important, it is also important that children take an intelligent interest in what they are eating? In that respect, Martha, the young woman in Scotland who photographed and blogged about her school lunch, is an example of a young person who is engaged in food quality.

[Mr McKenzie]

I absolutely agree with my hon. Friend and I will give her an example. During my time in local government, I took the opportunity of taking a few school meals with the kids. Was the message getting across? Yes, because they told the teacher that I had only two pieces of fruit and had not taken my five pieces of fruit. The message gets across if it is emphasised time and again.

As I said, we need to increase physical activity at primary school and carry that on into secondary school. The competition for young people’s leisure time has never been greater. Many prefer to play a sport on the Wii than try it for real. The issue is not only with the young, but with the elderly. A unique group called the Globetrotters has recently been set up in my area. It encourages the elderly to be more active and its members have, in their actions—their steps are counted and their trips are mapped out— walked to the moon and are on their way back. “Walking to the moon and back” is the group’s most ambitious trip to date. The Globetrotters is a fantastic example of what can be done from a perspective of physical exercise not needing to be that challenging.

The food industry, as we have heard, needs to take responsibility for the fizzy drinks and sweet foods targeted at children. Healthy eating patterns, as we know, are formed in childhood and taken into adulthood, and new research has warned that suffering obesity as a child may take a bigger toll on health in adulthood than was previously thought. If we do not put in place a varied approach to tackling obesity, a major and irreversible time bomb will be ticking away at our children’s and our nation’s health. Obesity will cost the NHS billions. Obesity-related illnesses already cost the NHS an estimated £5.1 billion a year. If we are to get to grips with it, we need to do a lot more together, starting right now, before the problem becomes worse and the NHS can no longer cope.

[John Pugh (Southport) (LD)]

I pay tribute to the right hon. Member for Leicester East (Keith Vaz), who introduced the debate, for his characteristic generosity in congratulating all the other Members present; that is very much a feature of his style.

Let me start with the assumption that an obese child is an abnormality in some sense or other. It is not normal in nature for children to be obese; what is rather more normal is for people, as they get older, to find it difficult to stop being obese. If we think of portraits of obesity in literature, we think of Billy Bunter in the ’40s. Then, obesity was seen, in a very naive way, as a consequence of childhood greed, because it was a rare and not well-understood phenomenon. An earlier example is the plump lad in Dickens—I think he was called the fat boy—who was actually a thyroid victim. However, such children were unusual enough in those days to be pointed out; they were not at all a standard thing. Now, as all of us have recorded, the phenomenon of obese children is no longer a rarity in an advanced society.

Last week, the Minister and I attended an event organised by the all-party group on obesity, although I do not think she was aware I was there. A very earnest man told us we need to be careful about every extra Mars bar we eat every day; otherwise, we would increase our weight exponentially and eventually end up with serious problems. He was particularly horrid about egg custards and the like. Although what he said was probably broadly correct, I could not help thinking that it was not really sensible for any of us constantly to calculate exactly how much we had eaten, whether we had eaten too much or too little and by how much. I was slightly reassured by some research that came out after that event, which said, as the hon. Member for Inverclyde (Mr McKenzie) has just done, that there is more to this issue than meets the eye. If people become plump, it is not just a question of over-supply; it is sometimes to do with their glands and their endocrinology—whether they are burners or storers.

I recognise that this is a complex problem, but the fact of the matter is that the nations that have an obesity problem, as many advanced nations do, always have three principal characteristics: a relatively unlimited supply of food, easy access to that food—in other words, it does not have to be cooked or prepared in a long, elaborate way and can simply be grabbed—and a sedentary lifestyle. I do not see any of those changing any time soon. All three are probably necessary before nations have an obesity problem, and all three are, in many respects, here to stay.

I am therefore a little sceptical about claims that there is an easy solution to this problem. While other Members were speaking, I wrote down some of the solutions that were advocated, and every one can be faulted in some way. School dinners were mentioned. I used to be a teacher, and I used to see children walk past pictures of big, rosy apples, lettuces and things like that, before going straight for the pizza and chips. I was sometimes aware of how futile and ineffectual healthy eating programmes can be. The reality is that school dinners—many of us have experienced them—have never been notably healthy or low in calories, because it is assumed that children need lots of energy to get through the day. Working hard on school dinners and children’s choices is not, therefore, necessarily an easy solution.

A tax on fattening food was mentioned, and I am sure you would not warm to one at all, Mr Davies. The reality is that most food, if we eat enough of it, is fattening, with the possible exception of lettuce and something else, which requires more calories to eat it than we get from it—[Hon. Members: “Celery.”]

On education, the British public are not particularly lacking in knowledge about the things that make them fat and the things that are likely to have a less adverse effect. They are probably not quite as acutely aware as they should be about the calories in individual things. One of the easier ways of addressing some of the problems we have with alcohol is reminding people what the calorie intake from a glass of wine or a pint of beer actually is. However, that is not an automatic or a simple solution either.

Changes in family lifestyle were mentioned. Parental responsibility is important, but, at the same time, people’s lifestyles will be under increasing pressure in many ways—there is no evidence they will be under less pressure.

[Ms Abbott]

I am listening with interest to what the hon. Gentleman is saying, and I will respond to some of it in my remarks. He does not think the general public are ignorant of what food contains or the calorific value of food. However, people are often shocked to find that there is sugar in things such as baked beans and tomato ketchup; they often do not know how much sugar and fat there is in processed food. People who want to do right by their child will feed them these so-called breakfast cereal bars, but they do not understand how much sugar and fat there is in them.

[John Pugh]

There are benefits to the approach I outlined, although the people who are most acutely aware of the calorific content and the quality of their food are those who are already halfway to solving the problem. However, many people do not get even to that first base, and that is where public health messages have an impact.

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

I congratulate my right hon. Friend the Member for Leicester East (Keith Vaz) on securing this important debate on childhood obesity and diabetes. We know the parameters of the problem: on current trends in childhood obesity, more than half of British children will be obese or overweight by 2020. A particular concern of mine, as the representative of an inner-city constituency, is that children in the poorest decile are more than twice as likely to be obese compared with those in a more affluent or middle-class decile. It is curious that, generations ago, obesity was a challenge faced by the well-off. We now live in a society, both here and in north America, where obesity is often a disease of poverty. I will return to that point.

We also know that diabetes is the No. 1 health threat in the UK, where 3.7 million people live with the disease, and as the Royal College of Paediatrics and Child Health has told us, care processes and outcomes for children with diabetes in England and Wales remain significantly worse than those for adults, which is what makes this debate so important. Thinking on the issue has changed. When I was a child, people said of a child who was a bit chubby, “Oh, they’ll grow out of it.” It was not seen as anything to worry about. We now know that overweight children become overweight adults, with all the associated health problems.

As always, the hon. Member for Southport (John Pugh) made an interesting speech, but he said a few things that perhaps need amplification. He seemed to say that it was inevitable that there would be a problem of obesity in advanced societies. I was in Finland last week, and Scandinavian countries—Finland, Sweden, Denmark—do not have our problems with obesity. That is for all sorts of reasons, one of which is that Governments have taken the issue seriously and made what were sometimes hard decisions to try to change public health outcomes.

The hon. Gentleman seemed to imply that school dinners are not necessarily part of the solution. I believe that, certainly for primary school age children, being exposed to a range of healthy foods and having healthy school dinners makes a difference to outcomes for diet. I also believe that it is worth educating school children about diet. There has been a complete turnaround of public attitudes to smoking over the past 30 years. Many things contributed to that, including Government action, but it was also due to the role of education and public heath campaigns. I believe that, in the medium term, we can do that for healthy eating and diet issues.

We therefore know the parameters of the problem and that, as has been said, it cannot be fully accounted for by genetics; it is due to a mix of a more sedentary lifestyle and the consumption of far too many calories through the eating of more fatty, salty and sugary products. We should note, however, that one reason why people eat more fatty, salty, sugary and processed foods than they did when we were children is that they are marketed aggressively at families and children. I want to talk about pester power. If a child sees endless advertisements for Ronald McDonald, the parents, even if they know better, find themselves under great pressure when they are out to purchase foods that they know in their hearts are probably not the best for their children. An occasional treat is one thing, but the problem relates to when such foods are not just an occasional treat, but have become the mainstay of a child’s diet.

Government Members have talked about parental responsibility. I believe in that, but we must bear it in mind that childhood obesity and related conditions, such as diabetes, are issues not just for the child and their family, but for us as a wider society that is concerned about the health and well-being of all our people. To be blunt, there is also the cost of childhood obesity and of diabetes, hypertension and all the related conditions. I think that fully 20% of the NHS drugs budget currently goes on drugs for diabetes. It is all very well to talk about parental responsibility, and about the nanny state as opposed to the Pontius Pilate state, but I think that the state owes its people a philosophical responsibility, and we certainly owe the taxpayer a practical responsibility to do something about the financial consequences of the growing wave of childhood obesity and diabetes.

[John Pugh]

I want to take the shadow Minister back to her remarks about marketing. I genuinely accept much of what she said, but there is this phenomenon: firms such as Waitrose tell us that it spends a lot of time promoting healthy options, presumably to customers who can afford to shop there, but nevertheless records that people buy more convenience food from it. The fact that we go for convenience food is not just a direct result of marketing.

[Ms Abbott]

The hon. Gentleman has to understand that the problem is multifaceted and needs multifaceted solutions, one of which is more parental responsibility. The role of supermarkets, and what and how they market, is part of the problem. I live in east London, which is very varied demographically, and I can go half a mile to one supermarket that largely serves working class people—at the front and centre it has unhealthy foods—and half a mile in the other direction to Waitrose, which has fruit and wine. Supermarkets are part of the issue.

Hon. Members may remember the case last year of what The Sun newspaper described as the fattest girl in the UK. She became so obese that the back wall of her house had to be knocked down, and she had to be taken out of the house with a crane and taken to hospital. The point about her is that she had been obese all along, but had been sent to a health farm in America and had lost a considerable amount of weight. She and her mother were reported as saying that the day she came back after several months in the US on a healthy diet, her mother somehow did not have any healthy food in and sent out for fish and chips. With some obese children, it is almost an issue of co-dependency. If we are to work effectively with childhood obesity, we have to work with the family—whatever that family unit constitutes. Will the Minister tell us what action her Department is taking on marketing and promotions, and how it intends to encourage the reformulation of food products, because we need to reduce the high salt and sugar content of breakfast cereals and other items that are marketed at children online?

On the role of local authorities, we should—and I have said this more than once—move public health to local authorities. There are challenges to such a move, but also great opportunities. Potentially, it could mean an end to silo working, because in an ideal world, the education, environmental and leisure services departments work alongside public health professionals to achieve better public health outcomes. We must not forget that for every pound that is spent on things that affect our health, only 10%, I think, is spent by the NHS. The rest is spent by housing and leisure departments. Moving public health to local authorities represents a tremendous opportunity to deal with diabetes and obesity-related issues.

This has been a friendly debate, and people have fallen over themselves to be nice to each other, but let me perhaps insert a slightly cautious note. The great Professor Terence Stephenson, chair of the Academy of Medical Royal Colleges and of the Royal College of Paediatrics and Child Health, said this in relation to responsibility deals:

“The food industry cannot be relied upon to help lead the policy response to obesity. This is not a criticism of the food industry. It would be extraordinary if an industry with a duty to make profits for shareholders should act against its mission to push products and sell as much of them as possible. Asking the food industry to solve the problem is counter-intuitive; you would not put Dracula in charge of a blood bank.”

Of course it is fine to co-operate with industry, but industry must know that the Government are serious and that, in end they will legislate if it does not co-operate. Responsibility deals are fine in principle, but if industry thinks that it is all carrot and no stick, we will not get the results that we all want.

[Keith Vaz]

We must have a timetable. If we go for just a voluntary deal, everyone will sign up, but if there are no benchmarks and no timetable, this will just drift on for ever. The idea was a very good one, but it lacked teeth.

[Ms Abbott]

That is my exact point. Of course we want co-operation with industry, but there must be teeth—sanctions or at least the possibility of legislation—and, above all, there must be a timetable.

When it comes to childhood obesity, the most important thing is early intervention. Medical evidence shows that overweight children have, in proportional terms, gained most of that weight before they start school, so what we do in the very early years is absolutely key. Will the Minister tell us whether the Government plan to take action on training health professionals in weight management in accordance with the National Institute for Health and Care Excellence guidelines as well as emphasising the importance of parenting style and parents’ lifestyle when children’s weight is considered? Interesting research shows us that 70% of boys who have overweight fathers are overweight themselves, and 90% of girls who have overweight mothers are also overweight, which is why we stress the importance of early intervention and working with the family in an holistic way. We are talking about not any one measure but holistic working. Will the Minister tell us whether she is working with her colleagues in the Department for Education on these matters? In particular, is she following the example of Finland, where there is a high uptake of healthy free school meals, which means that children are getting accustomed to what is a proper balanced meal?

Furthermore, will the Minister tell us what she will do about the situation in academies and free schools, because they are exempt from the nutritional standards that apply to other schools? They can have machines selling fizzy drinks. Is the Minister looking at planning legislation and making public health a criteria in planning, which would make it much simpler to ban fast food shops around schools?

We appreciate the energy and enthusiasm of this Minister, but, partly because of the reliance on responsibility deals, not everyone is swept away with what the Government are doing around health, nutrition and obesity. A few months ago, Jamie Oliver said:

“This whole strategy is just worthless, regurgitated, patronising rubbish.”

Does the Minister agree that firmer and more comprehensive proposals are needed to encourage active travel and make the built environment more accessible for young pedestrians and cyclists, and that we need to take action on junk food advertising and promotions of such foods in stores?

Finally, the Public Accounts Committee report into the management of diabetes services in the NHS recently highlighted the need for action from central Government on reducing the rising numbers developing type 2 diabetes. It said:

“The Department of Health and Public Health England should set out the steps they will take to minimise the growth in numbers through well-resourced public health campaigns and action on the risk factors for diabetes”.

I understand that campaigners such as Diabetes UK have expressed their disappointment that the Government have rejected that proposal. Will the Minister tell us today why the Government chose to reject such sound recommendations made by a highly respected Committee of this House? Does she not agree that the rejection of the Committee’s recommendation might lead some observers to think that the Government will listen only to the food industry on obesity?

It is clear to me, and to all those who have campaigned for years on these issues, that self-regulation and voluntary targets alone will not work. Diabetes UK, the royal colleges and others are all coming together to call for a more robust approach to the regulation of the food and drink industry. However the Government appear a little reluctant about such a move.

Once again, I congratulate my right hon. Friend the Member for Leicester East on securing this important debate. I do not believe that there is any one measure that can impact on the matter of childhood obesity and diabetes. I have touched on some of the practical issues, but there are many others, such as culture and ideas of parenting. There is a generation of young women whose notions of parenting are limited. They hear advertisers say, “Give your child this healthy bar and that makes you a good mother,” and they do not have the information to think beyond that. Diabetes is the No. 1 public health issue facing us now, and childhood obesity gives a premonition of even worse public health problems to come. I wait with interest to hear what the Minister has to say about the points that I and some of my colleagues have raised in this interesting 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.