Health Services (North-West)

Diane Abbott Excerpts

Thursday 11th July 2013 Commons Chamber

[Mr Hunt]

The other point the right hon. Member for Leigh (Andy Burnham) made was that we should not make these changes to A and E services when those in other hospitals are under pressure. It is important that I remind the House of what he did when he was Health Secretary. After 2004-05, Labour missed its A and E targets in 12 quarters but closed or downgraded 12 A and Es. Now, in Wales, the A and E target has not been met since 2009, yet Labour is embarking on a big reconfiguration programme with his full support. So it is one policy when Labour is in opposition, another when it is in power. There is one person who agrees with the right hon. Gentleman, and he was campaigning in Trafford on Friday—Len McCluskey. When it comes to a choice between supporting local doctors or the unions, the Opposition support the unions.

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

On a point of order, Mr Speaker.

[Mr Speaker]

Order. We cannot have points of order in the middle of a statement. The Secretary of State has been asked specific questions and I know that he will now respond without any delay to those specific questions and nothing more. Other Members wish to contribute and there is other business. The Secretary of State is an extremely important man, of course, but there are a lot of other people involved, too, and we need to get on and hear them. I call the Secretary of State to respond briefly.

--- Later in debate ---

[Mr Hunt]

We are absolutely clear that we will not proceed with A and E reconfigurations unless the outcome will be an improvement in clinical care. That applies across the country as well as in Trafford.

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

On a point of order, Mr Speaker.

[Mr Speaker]

I say to the hon. Lady that it is only exceptionally that points of order are taken between statements, and if they are taken they must relate to the matter just discussed, which I rather suspect hers will. I am not going to have a general debate; I shall take one point of order from the hon. Lady.

[Ms Abbott]

I am grateful to you, Mr Speaker. Is it in order for a Secretary of State for Health to announce the closure of another Member’s A and E, which is a very serious matter for all MPs, without making any effort whatsoever to even advise the Member concerned that they might wish to attend the Chamber the following day?

[Chris Ruane (Vale of Clwyd) (Lab)]

It is quite simple.

Oral Answers to Questions

Diane Abbott Excerpts

Tuesday 11th June 2013 Commons Chamber

[Anna Soubry]

Yes.

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

The Minister is aware that smoking is the biggest single cause of health inequality, and she will know that the Labour Government took difficult, complicated and controversial decisions that were successful in driving down smoking from 27% to 20%, saving thousands of lives. Why are this Government stalling? When will they announce a decision? Or is it that the business interests of Lynton Crosby matter more to these Ministers than the health of the nation?

[Anna Soubry]

I am sure that Mr Crosby would be grateful for that bigging-up. I can assure the hon. Lady that, as she knows, if standardised packaging was as simple as she tries to suggest, no doubt the last Government would have introduced it in some way. I am proud of the fact that we have made sure that the point of sale legislation has been achieved. As she knows and as I have said before, this is a difficult and complex issue. It requires a good and healthy debate. Let us bring on that debate. Perhaps the Opposition would like to use one of their Opposition days to bring it forward. I will be more than happy to take part.

Mental Health

Diane Abbott Excerpts

Thursday 16th May 2013 Commons Chamber

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

I apologise to the House for not being present for the debate’s opening speeches, which was due to circumstances beyond my control. I certainly meant no lack of respect for this debate; I think these Backbench Business Committee debates have been one of the more important and successful innovations of this Parliament, and mental health is a particularly important subject.

I congratulate the right hon. Member for Sutton and Cheam (Paul Burstow) on leading the debate in a detailed and informative fashion, and my hon. Friend the Member for Bridgend (Mrs Moon), who raised a number of important points, including alcohol abuse and its impact on mental health—those two issues are inextricably linked. I follow the hon. Member for Totnes (Dr Wollaston) in saying that if we are concerned about addressing alcohol abuse, one issue—although not the only issue—must be to do something about the flood of cheap alcohol that is overwhelming some of our communities, and put in place a minimum price for alcohol. I am glad to say that that is the Labour party’s policy.

I congratulate the hon. Member for Broxbourne (Mr Walker) on his speech. I remember a similar debate last year in which he made a moving speech about his experience, which resonated country-wide. Since then, he has shown great leadership in the mental health all-party group. He made a number of important points, including the fact that although the NHS can be good at managing symptoms, it is not necessarily so good at addressing their underlying causes. I will return to that issue when I mention Atos later in my remarks.

I am sorry to have missed the remarks of my hon. Friend the Member for North Durham (Mr Jones). He is always well worth listening to, and he too received country-wide respect for his contribution to last year’s debate on mental health when he spoke about his personal circumstances for the first time on the Floor of the House. He made a number of important points, including that mental illness and depression are equal opportunity conditions. They do not discriminate; they affect all social classes and backgrounds.

The hon. Member for Romsey and Southampton North (Caroline Nokes) spoke about a number of issues, including borderline personality disorders and the way that eating disorders affect women and girls. She made the important point that, although we sometimes associate mental disorders with socially marginalised communities and persons, eating disorders can affect the most high-achieving, educationally focused girls. That issue should not be trivialised because it is harming the life chances, health and well-being of many young women up and down the country.

My good Friend the hon. Member for Islington North (Jeremy Corbyn) made an important speech about mentally ill people in prison. When getting caught up with the “prison works” narrative, it is worth remembering how many people in prison are either illiterate or simply mentally ill, and if we want to contain the number of people in the prison estate, we must address the mentally ill. My hon. Friend also mentioned black and minority ethnic communities and mental health, and I will return to that point later.

The hon. Member for Totnes made an important speech and mentioned social exclusion and BME mental health. My hon. Friend the Member for Croydon North (Mr Reed) made an important speech about Olaseni Lewis and the issue of black and minority ethnic persons detained under the Mental Health Act 1983. I am glad that the Minister has agreed to meet my hon. Friend and engage with him and the family on that issue. The hon. Member for Harrogate and Knaresborough (Andrew Jones) also made an important speech.

My hon. Friend the Member for Bolton South East (Yasmin Qureshi) made a speech about—among other things—the importance of a holistic treatment for mental health issues and taking account of people’s different cultural backgrounds, which I thought was important. There was, as always, an interesting and provocative speech from the hon. Member for Southport (John Pugh), and I was interested to listen to the hon. Member for Battersea (Jane Ellison) who spoke about mental health and female genital mutilation—if it had been my choice, her speech could have gone on longer. I thought she raised important issues, and the House should respect the lead that she has shown in addressing the issue, which is difficult for people outside the affected communities to address. If in future some young girls are not subjected to that child abuse because of her work, she will deserve the congratulations of this House. The hon. Member for Finchley and Golders Green (Mike Freer) also made an important contribution.

We have heard figures for the incidence and prevalence of mental health problems, and because it is a Cinderella service and a Cinderella issue it is always worth reminding people that one in six people in Britain is affected by mental illness at any one time. In other words, almost every family will have experience of mental health. It is not something that happens to other people, but something that happens in our own families. One in four of us will suffer from mental illness at some point, and by 2030 depression will be the leading cause of disease around the world, costing the NHS a further £10 billion a year. The criminal justice system will also pick up the bill because 70% of those in our prisons have a mental illness. Mental health problems cost British business almost £26 billion a year.

The subject has been addressed by my right hon. Friend the Member for Doncaster North (Edward Miliband) who made an important speech to the Royal College of Psychiatrists in October last year. The key points he made are worth reporting and concern the importance of breaking down stigma—something that the House dwelt on at length in last year’s debate—and the importance of parity of esteem for mental health within the NHS. My mother was a mental health nurse in Huddersfield, and her hospital was a former Victorian workhouse on the fringes of Huddersfield. Having an old workhouse outside the city for mental health issues, and mainstream health services in the centre, illustrates the lack of parity of esteem for mental health in relation to the services we offer, and also to practitioners at every level within mental health services.

Finally, my right hon. Friend the Member for Doncaster North mentioned the importance of mental health in our society, and argued that good mental health does not start in hospitals but in workplaces, schools and communities. He took the opportunity last October to announce the formation of a taskforce on mental health in society, which will look in particular at employers and the role they play.

[Jeremy Corbyn]

Perhaps my hon. Friend can help me. I hope that the taskforce will also look at issues surrounding the voluntary sector and its excellent work within the mental health service, as well as the dangerous tendency of franchising out mental health services to the private sector by some mental health trusts that do it for profit rather than care.

[Ms Abbott]

My hon. Friend’s points are well made.

Let me consider the future for mental health and set out for the House how important the role of local authorities can be in addressing the social determinants of mental ill health. Public health has become the responsibility of local authorities. They have a ring-fenced public health budget, and despite all their pressures and difficulties—which I do not seek to minimise—there is an opportunity for local authorities to do important and interesting work, bringing together education and housing with health care to address mental health problems and intervene in them early.

I was shocked to hear of a social housing project near King’s Cross that, presumably to make its tenants more manageable, did not want to give tenancies either to people who had a history of rent arrears or to people who had a history of mental health problems. Such things need to be highlighted and addressed. Sitting responsibility for public health with local authorities could address mental health, particularly in respect of early intervention and preventive work with children in schools.

I gave a speech this morning on the crisis in masculinity. We need to focus on the mental health challenges that face men. Whether it is because they are unwilling to come forward or because of stress in society, we know that, during a recession or economic downturn, suicide rates among men increase. Suicide is currently the biggest cause of death among under 35s. In planning services nationally and locally, we need to pay particular attention to that issue among others.

The hon. Member for Totnes made an important point. She said that, in our desire to reduce health tourism—a desire supported by the Opposition—there is a notion that people will need their passport when they turn up to see their GP. That runs the risk of making it harder for the socially excluded to access health care—many simply do not have a passport or such documentation.

I will not speak at this point about the merits or otherwise of the welfare reforms, but there is a lot of anecdotal evidence that they are having an effect on the mental health of some who are caught up in the system. There is a lot of anecdotal evidence that Atos, as it is currently configured and as it currently operates, does not meet the needs or seem to understand the problems of people with mental health challenges.

[Mark Hendrick]

I am sure that my hon. Friend, like many other hon. Members, has come across many constituents attending surgeries who are developing serious mental health problems purely and simply because of the pressures caused by the reforms to the benefits system. I am finding that people who are mentally ill and do not know it are getting worse—they are under pressure from the benefit changes that have been made and those that will take place in future.

[Ms Abbott]

I am afraid that there is increasing evidence that worry about the changes and about the threat of the changes is causing a lot of stress for people with mental health issues. Social services and health authorities must be mindful of that.

[Mr Charles Walker]

I apologise to the hon. Lady because I am about to leave the Chamber—I am chairing a debate in Westminster Hall in a moment. I agree entirely that Atos should not be a blunt instrument used to beat those who have mental illness. We need a system that empowers people with mental illness to re-enter the labour market, and not one that terrifies them.

I endorse the hon. Lady’s views on young men. Young men need to feel part of something and they need to feel wanted by their community. They need to have a job and a role. If they do not have those things, they join gangs. Her point about young men was beautifully and perfectly made.

[Ms Abbott]

I entirely agree with hon. Gentleman. Changes in society and economic changes such as the collapse of manufacturing and of de-industrialisation have left many young men unclear about their role, which puts tremendous pressure on their health and well-being.

Before concluding, I want to say a few words on black and minority ethnic persons and mental health. It has been known for at least 25 years that BME persons are disproportionately present in the mental health system. We are more likely to be diagnosed as schizophrenic, less likely to be offered talking therapy, and more likely to be offered drugs and electro-convulsive treatment—the hon. Member for Totnes touched on that important point. There is therefore a great deal of fear and anxiety about approaching the mental health system on the part of some of our BME communities. Very often, mothers will be trapped at home with sons who have serious mental challenges. I have dealt with cases in which they are assaulted in their own homes, but are so frightened of the system that they will stay trapped rather than take their sons for treatment. That is a real problem. We must monitor what is happening and use the voluntary sector. We need to ensure that minority groups do not hold back from presenting with mental health problems. The later people present, the more severe the problems.

Mental health is the biggest financial burden on the health service. It will affect the families of all hon. Members in the Chamber in our lifetimes. There is much to be concerned about in mental health trends. For instance, there is a rise in mental health issues among young people. Fully half of lesbian, gay, bisexual and transgender youngsters are self-harming.

As I have said, there is a relationship between an economic downturn and a rise in suicides of men under the age of 35. None the less, there is the possibility of progress. I believe that there is now less stigma about mental health than there was a generation ago, and the debate we had last year on the Floor of the House played its part in helping to lessen it. I think there is more understanding about some of the contributory issues than there was a generation ago, and I believe that public health going to local authorities opens up the possibility of innovation in mental health, working together with the voluntary sector.

I am grateful to the right hon. Member for Sutton and Cheam for securing the debate. I hope that it is part of a process of parity of esteem that will improve the outcomes for so many of our men, women, family members and communities.

--- Later in debate ---

[Norman Lamb]

My right hon. Friend makes a very good point and I completely agree.

The hon. Member for Romsey and Southampton North (Caroline Nokes) spoke again about eating disorders—I took part in a debate that she secured in Westminster Hall. She talked about the role of parents, the nightmare of a child—I will call them a child—over the age of 16 deciding to refuse treatment and the horror that parents sometimes go through when they are not listened to sufficiently by clinicians dealing with their loved one’s condition. She also mentioned type 1 diabetes sufferers, and I would be interested to hear more about that.

My hon. Friend the Member for Harrogate and Knaresborough (Andrew Jones) is no longer here. Oh, yes he is! He has moved to a different place, just to confuse me. He talked about the low diagnosis rate for Alzheimer’s and dementia in his area. He also stressed the importance of the recognition of mental health by the Government, which I think he welcomed.

The hon. Member for Bolton South East (Yasmin Qureshi) talked about the importance of accessing appropriate and culturally sensitive care and treatment. That is incredibly important, as is getting the approach right for each individual and giving them the power to determine their priorities. She made those points well. She also stressed that the picture round the country was very variable. That is more the case in mental health than in physical health. Some areas have great services, some of which I have witnessed, but in others they are simply not good enough.

[Ms Abbott]

On the question of culturally appropriate care, does the Minister agree that it can extend to quite mundane matters? There are mental health wards in this country with large numbers of BME people in them. Those people sometimes do not have the right hair care or the right music, or they might not have their culinary needs addressed. Those things can be really disturbing for someone who is already in a mentally fragile condition.

[Norman Lamb]

Yes, I completely agree. This is about treating people as individuals, and with dignity and respect. Those things are important to people and they should be treated as such.

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.

--- Later in debate ---

[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.

--- Later in debate ---

[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.

--- Later in debate ---

[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.

Oral Answers to Questions

Diane Abbott Excerpts

Tuesday 16th April 2013 Commons Chamber

[Dr Poulter]

In his time in office, my right hon. Friend did a tremendous amount to promote the cause of mental health and to get parity of treatment between mental and physical health. That is exactly what we propose to do with the money going into the talking therapies—to get in place those early interventions, not just for adults, but for children, too. We shall be taking that work forward in earnest in the years ahead.

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

Does the Minister agree that the most important form of early intervention is for the public to get prompt advice on their symptoms? Does he share my concern that a leaked report on the national performance of the 111 line shows that the service is in crisis with staff shortages, delays, abandoned calls, 11-hour waits for call-backs, staff being wrongly diverted to attend cats with diarrhoea and ambulance crews going without breaks for 12 or more hours? Is this not a trademark Government shambles?

[Dr Poulter]

The hon. Lady will be aware that it is important not to rush the roll-out of any service. That is why we kept in place the NHS Direct service in areas where rolling out the 111 service has been slower. A lot of good work is going on in early intervention; it focuses on giving local authorities the budget and the powers to make a difference to local communities. The Labour party should get behind that and do much more to support it. It is this Government who are making a difference in early years, and I hope that the Opposition can support us on that.

Oral Answers to Questions

Diane Abbott Excerpts

Tuesday 26th February 2013 Commons Chamber

[Dr Poulter]

The hon. Gentleman is right to highlight the fact that the trust has handled this issue badly at a local level, but, as he will know, decisions about local health care reside with local trusts. The point is this: if we look at the plans, the trust is talking about selling off land that is mostly not used for clinical purposes and reinvesting that money in front-line patient care: investing £10 million in improving the maternity department, which has already benefited from £750,000 from the Government only this year; £2.9 million in the same-day treatment centre to support A and E and treat patients faster; and £1.9 million for a new undergraduate education centre and library. Those assets are being sold off to directly influence and improve patient care, which has to be a good thing.

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

Is the Minister aware of how angry and concerned Londoners are about the threats to their health service—not just about the £17 million property sales at the Whittington and the drop in bed numbers, but about the threat to four A and Es in north-west London and, of course, the A and E in Lewisham? Ministers have accused campaigners of overstating the case. Is that not a complacent attitude? Surely doctors and residents on the ground know the value of these services better than Ministers in Whitehall. Is he aware that Londoners came out in unprecedented numbers to fight for Lewisham hospital and will continue to fight for the best possible NHS services in our region?

[Dr Poulter]

The hon. Lady is absolutely right to highlight the fact that service changes have to be clinically led, meet the tests we have outlined and engage with communities effectively, but the point is that the previous Government also redesigned and changed services, very often for the benefit of patients. When the redesign of services is clinically led and services are better delivered for patients, that has to be a good thing so let us look at these proposals. If they are clinically led, let us see whether they deliver improved care for patients, and if they do, it is the right thing to do.

Suicide Prevention

Diane Abbott Excerpts

Wednesday 6th February 2013 Commons Chamber

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

I congratulate the hon. Member for South Antrim (Dr McCrea) on opening the debate so ably. As we have heard, suicide is a particular problem in Northern Ireland, but the problem exists throughout the British Isles. I also congratulate my hon. Friend the Member for Bridgend (Mrs Moon), the hon. Member for Pudsey (Stuart Andrew) and the right hon. Member for Belfast North (Mr Dodds) on their extremely thoughtful contributions.

It is easy to blanket a debate on suicide in sociology jargon, but the truth is that, while any death in a family is tragic, there is something about suicide that is uniquely tragic. I say that as a mother. It must always leave family members asking themselves, “Is there something that I could have done? Were there signs that I could have noticed?” If suicide is a cry for help, family members must be left asking themselves until the end of their lives, “Why did I not hear that cry in the first place?” There is certainly something peculiarly tragic about suicide.

Of course, the individual causes of any particular suicide are never straightforward, and they are certainly not amenable to any top-down, one-size-fits-all, command-and-control solution, but I think it is agreed across the House that positive changes in society can make a difference to individual lives, and that we can offer even better support to bereaved families.

We know that suicide is not just a matter of mental health; however, it is related to mental health issues. I stress that Labour is committed to tackling the stigma attached to mental illness. One in four of us will suffer a mental illness at some point in our lives, and, as has been said by my right hon. Friend the Member for Doncaster North (Edward Miliband), the leader of my party, mental illness

“is the biggest unaddressed health challenge of our age.”

I should be grateful if Ministers could give me some assurances about mental health spending. According to some indicators, it has been cut in real terms. It is difficult to develop an effective suicide prevention strategy unless the basic spending is there.

I think that, once we have cut through the sociological jargon, it is clear that the recently rising levels of suicide must be related to the fragmentation of families and societies. Once upon a time, a generation ago, young people could reasonably expect to live in the same street as their mothers and other relatives, or around the corner from them. Young men growing up could reasonably expect a secure job, probably the same as that done by their fathers, and perhaps, in some parts of the country, in the place where many members of their community worked. That increasing fragmentation of families and societies—which is not the fault of any political party or any Government, but is partly due to the nature of the society we live in and to globalisation—must lead to less resilience in families and communities, and must make the issue of suicide more pressing.

As Members will have heard, the latest suicide figures issued by the Office for National Statistics for England and Wales show an increase in the number of people who have taken their own lives. In particular, there appears to have been a significant increase between 2010 and 2011. As we heard in a number of contributions, historically more men complete suicide attempts. We have also heard interesting contributions about the rise of cyber-bullying triggering suicide. There was a very sad case here in London a few weeks ago. A girl committed suicide because she was very upset about the pictures of herself in a compromising position that were going around via mobile phones and on the internet. We have also heard about the particular problems of suicide in prisons and young offenders institutions.

Some Members tentatively tried to explore why men are three times more likely than women to take their own lives. In England, for men under 35 suicide is the second most common cause of death, and that is clearly a particular issue in Northern Ireland. In the 1990s, suicide rates for young men aged 15 to 24 reached an all-time high. They were at the highest levels since the 1920s. Research by both the British Medical Journal and Mind found that during times of recession the mental health of men is put at particular risk. Mind’s YouGov survey found that almost 40% of men are worried or low at present, and the top three issues playing on their minds are job security, work and money. The report identifies unemployment as increasing the risk of suicide among men under 35; young men who took their own lives often did so in their period of worklessness. The chief executive of Mind, Paul Farmer, has said:

“The recession is clearly having a detrimental impact on the nation’s mental health but men in particular are struggling with the emotional impact. Being a breadwinner is something that is still crucial to the male psyche so if a man loses his job he loses a large part of his identity putting his mental wellbeing in jeopardy. The problem is that too many men wrongly believe that admitting mental distress makes them weak and this kind of self stigma can cost lives.”

The reasons for committing suicide are complex and often very individual, but the tough economic climate and social factors such as insecurities around work and housing, social isolation and substance misuse are felt particularly strongly by young and middle-aged men. For many middle-aged men, financial problems or redundancy can cause feelings of shame and hopelessness, and can feel impossible to overcome.

Young men and women of the lesbian, gay, bisexual and transgender community have not yet been mentioned in our debate. The Stonewall survey found that 50% of LGBT young men and women had attempted self-harm. We need to look at the particular needs of that group, both in relation to mental health and suicide and self-harm.

The Government have published a strategy called “Preventing suicide in England—a cross-government outcomes strategy to save lives”. It has two key aims: to reduce the suicide rate in England, and to support people better who have been bereaved or affected by suicide. However, the strategy does not make specific recommendations, so in the reorganised system it will be up to clinical commissioning groups and local directors of public health to take action in local areas. I hope this debate will serve to flag up the widespread concern that is felt about this. There is also an issue to do with spending.

Let me say a few words about Labour’s record on mental health. We made important progress on mental health, with the national service framework early on and then the improving access to psychological therapies programme towards the end of our time in office. Along with cancer and coronary heart disease, we made mental health one of our top three clinical priorities, and by 2007 we were spending more than £1 billion more on mental health services than in 2001, which is a real-terms increase of 25%. However, we believe there was more we could have done, which is why my right hon. Friend the Member for Leigh (Andy Burnham) has taken up this issue strongly. There is no question but that if we have an impact on mental health issues, we also have an impact on the problem of suicide.

Labour would like to see more work done on internet safety, to bear down both on internet bullying and on sites that, tragically, help young people to find out about suicide and may well encourage copycat suicides. We want to rewrite the NHS constitution to give patients the same legal rights to therapies for treating mental illnesses as they already have for drug treatment and treatments for physical illness. We want to ensure that training for all professional staff in the NHS includes dealing with mental health issues. If we are to meet the mental health challenge, and so meet the challenge of dealing with increasing levels of suicide, we have to realise that it is not just an issue for the NHS; we have to bring together public services, such as education and the police, to work with business and employers. That is why my right hon. Friend the Leader of the Opposition has announced the formation of a taskforce to draw up a strategic plan for mental health, which will be chaired by Stephen O’Brien, a good friend of mine and the chairman of Barts and the London NHS Trust.

We have heard about the particular problem in Northern Ireland, and it is sad to think that a generation are living almost with a traumatic disorder in the aftermath of the troubles. Again, I congratulate my friends from the Democratic Unionist party on bringing this issue to the Floor of the House in the British Parliament so that we can put it in the wider context and understand the tragedy.

Every suicide is an individual tragedy. Every person who commits suicide is not amenable to anything that government might do; we will always find that two people—two men or two young women—may be almost exactly the same but when faced with precisely the same circumstances they will choose a different path. There is nothing government can do about that, but we can do something about the therapies and mental health services available. We can do something to support and sustain families. When I say “families”, I do not just mean a man and a woman with a certificate and 2.2 children; I mean the many varied patterns of family we find in our society. We can do more to support families and communities. In particular, we can do more to support grieving families, and we can do our best as a House to ensure that, day by day, year by year, fewer people in the British isles feel that they have nothing worth living for.

Oral Answers to Questions

Diane Abbott Excerpts

Tuesday 15th January 2013 Commons Chamber

[Norman Lamb]

From April, local authorities will be responsible for commissioning services. Because we have seen this really impressive increase in funding for public health, local authorities will have the ability to maintain and indeed improve sexual health services for their local communities. That is something of which we should be proud.

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

On the sexual health strategy, the Minister will be aware that nearly half of the national incidence of HIV is in London, so what steps will be taken from April to co-ordinate the prevention of HIV London-wide?

[Norman Lamb]

I am very much aware of the situation in London, and I acknowledge that some good work has already been undertaken there. Local authorities are very much aware of their responsibility that will apply from April and are already working with clinical commissioning groups in London to ensure that comprehensive services are in place for the London community.

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.

Oral Answers to Questions

Diane Abbott Excerpts

Tuesday 27th November 2012 Commons Chamber

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

On the question of vulnerable groups, does the Minister support the proposal of the hon. Member for Bracknell (Dr Lee) to ration NHS drugs, either by adopting the Danish system in which people have a personal budget for drugs and have to pay to top up, or by removing the right to free prescriptions for long-term conditions such as diabetes? Does she appreciate how much harder that would make life for millions of people in vulnerable groups, or is this the real face of the coalition on the NHS—drug rationing?

[Anna Soubry]

At my ministerial surgery last night, which has been somewhat scorned by Opposition Members, I met my hon. Friend the Member for Bracknell (Dr Lee) and discussed his proposals at length. I do not agree with his proposals, but I welcome the debate. There is nothing wrong with a healthy debate. However, on this one, he and I disagree.