Diabetes

George Howarth Excerpts

Wednesday 8th September 2010 Commons Chamber

[Mr George Howarth (Knowsley) (Lab)]

I congratulate my right hon. Friend on choosing this subject for debate. Will he also pay tribute to the work of the Juvenile Diabetes Research Foundation for the work that it is doing to try to highlight the difficulties of young people with diabetes?

[Keith Vaz]

I certainly will. As the House knows, my right hon. Friend has a debate next Wednesday in which he will explore the issue of young people and diabetes. I know that his own daughter is a sufferer of type 1 diabetes. I certainly pay tribute to the work that that organisation does. These voluntary organisations are of great importance in raising awareness.

It is not just diabetes itself that causes problems, it is also the complications and other conditions that arise from having it. For example, diabetes is the leading cause of blindness, amputation, renal disease and cardiovascular disease. Some 4,200 people in England are blind due to diabetic complications, and that number increases by 1,280 a year. Some 100 people a week lose a toe, foot or lower limb due to diabetes, and cardiovascular disease is a major cause of death and disability in people with diabetes, accounting for 44% of fatalities among people with type 1 diabetes and 52% among people with type 2. Diabetes is also the single most common cause of end-stage renal disease. It is evident that suffering from diabetes is detrimental to a person’s general health, especially when it is not managed effectively.

Diabetes currently costs the NHS 10% of its annual resources, and in the next 15 years the costs will continue to escalate significantly as the prevalence of diabetes increases. The NHS cannot allow or afford the diabetes explosion to continue. Diabetes and its complications cost the NHS about £9 billion each year, which, as I have said, equates to £1 million an hour. About 7% of that is attributable to the cost of prescription medicines, and a significant proportion is made up of the costs of treating serious long-term complications of the condition.

How do we avoid those costs, both human and financial? Early identification is the key. The later the diagnosis of diabetes, the higher the human and financial price that we have to pay. It is estimated that there are currently 1 million people living with diabetes in the UK who are simply not aware of having the condition. A fundamental problem is that type 2 diabetes is more often than not an asymptomatic condition. It is thought that many people with type 2 diabetes may have had it for nine to 12 years before diagnosis. As I said, it was sheer chance that I turned up in my doctor’s surgery that morning to be told that I had type 2 diabetes. Raising awareness of diabetes and making testing available is therefore essential if we are to get a grip on the problem.

I could mention a number of organisations, including Diabetes UK, and I pay tribute also to the Silver Star organisation, which was established in Leicester some years ago and continues to campaign among the south Asian community in particular. Such organisations are vital because the NHS cannot do it all on its own.

Diagnosis does not necessarily mean that a sufferer is getting the care and help that they need. It is thought that approximately 40% of people in the UK with diabetes are in poor diabetic health, which means that their condition is not being effectively regulated. Of all the reasons why people are liable to diabetes, obesity has been identified as having the strongest association with type 2 diabetes. Almost two in every three people in the UK are overweight or obese, and the National Audit Office suggests that 47% of type 2 diabetes cases in England can be attributed to obesity. That puts an extremely high number of people at risk of contracting it.

The most deprived people in the UK are two and a half times more likely than average to have diabetes at any given age. That is surely symptomatic of the inequalities that exist not just in our health system but in our society. Type 2 diabetes is up to six times more common in people of south Asian descent and up to three times more common among people of African and Afro-Caribbean origin. Although we must raise awareness in all sections of society, it is clear that knowing which groups are at the highest risk gives us an advantage in targeting campaigns and prevention programmes.

I welcome the Minister to the Dispatch Box. Whenever I have raised the issue with him, he has been extremely helpful and listened very carefully to what I have had to say. I am sure that when he responds, he will tell us about the programmes that currently exist, some of which were started by the previous Government. If there is one thing that I wish to stress to him, it is the need to prevent the condition rather than treat it. With the inevitable changes in our NHS—there will be reductions in some areas in the context of the coalition Government’s overall commitment to keep health expenditure at last year’s levels—the more we can spend on preventive work, the better it is in the long run. If we spent the £1 million an hour that we currently spend on treating diabetes on preventing it, in the long run, some of those in the Chamber tonight who are younger than me, and their children and grandchildren, will benefit greatly.

I shall conclude by raising one local constituency issue. About a year ago, I had a meeting with the then Health Secretary and the chief executive of the local primary care trust, Mr Tim Rideout, who recently informed me that he is leaving Leicester to go to London to work on the commissioning programme. I thank him and the PCT staff for their work, and I am sure that when the Minister meets him, he will find that he is an excellent officer of the NHS. Leicester was promised a state-of-the-art diabetes centre of excellence. In fact, when we went to see the then Health Secretary, we did not even ask for money—it was in the budget, so very unusually, a delegation led by an MP did not ask for money. We were told by the PCT that £6 million was in the budget and that a centre of excellence would be created in Leicester, principally because of the high calibre of diabetes experts in the city, and obviously because the diaspora who live there mean that it is the best place to conduct such research.

However, I understand that that money is no longer available because the PCT is to be scrapped. I know that budgets are very tight indeed, but I hope that the Minister will consider whether there are any resources that will allow Leicester PCT to fulfil its ambition of creating a centre of excellence, not just for the people of Leicester, but for the people of our country, so that we can be a leading part of diabetes prevention in Europe and the rest of the world.

I ask people in every country that I visit about their diabetes figures. I was recently told in the Gulf that 20% of the population of Dubai have diabetes or are susceptible to diabetes. Sometimes, people have the condition but do not realise that they have it. I was also recently in Kenya, where the figures were very high indeed. When I was there, I was told that you, Mr Speaker, will be leading the delegation next week to the Commonwealth conference. People in Kisumu, which is my wife’s place of birth, told me that it, too, has a diabetes explosion. They need not so much medicines, but food to enable them to change their diets. As in the Gulf, many of the community eat dates and, in the Asian community, sweets, especially at festival times. We could control diabetes if people changed their diets.

I know that this is an Adjournment debate and that it is not in prime time, but I am delighted to see so many right hon. and hon. Members here. If we act now, we can save the health service a huge amount of money and save lives. I hope that the Minister agrees.

--- Later in debate ---

[Mr Burstow]

I am grateful for that point. I will say a little about guidelines in a moment, because good news is on the way in that regard.

I was talking about the public health role of local authorities that we are developing. It will be supported by a dedicated ring-fenced budget and the implementation of a new health premium, which will allow local areas to target reductions in health inequalities, including inequalities associated with diabetes and other cardiovascular diseases. We are also committed to working with industry on a new public health responsibility deal to ensure that business takes action together with others to support the nation’s health.

On early intervention and diagnosis, the right hon. Gentleman is right to emphasise the importance of identifying pre-diabetes. There are two developments that relate to the role of GPs. First, the National Institute for Health and Clinical Excellence is developing guidance on preventing adult pre-diabetes in the first place. This will be published next year and will inform and support local public health strategies and others, as I have already described. Secondly, NICE is also preparing guidance on preventing pre-diabetes from progressing to type 2 diabetes. That will be a valuable tool in our fight against diabetes, and will help GPs and other health professionals to advise and support people at risk, hopefully to stop the disease in its tracks.

The right hon. Gentleman is right that earlier intervention and better diagnosis is crucial. NHS Health Check, which was introduced by the last Government, can prevent more than 4,000 people a year from developing diabetes, and could detect 20,000 cases earlier, so it can be, and should be, a very powerful means of detecting and supporting people at risk.

[Mr George Howarth]

Before the Minister moves on to the wider issues, I want to make a point about GPs and how they can be helped, which he was talking about. One of the difficulties is that often GPs are ill equipped to diagnose diabetes in the first place, and there is an argument for them to be given a series of protocols on how they should deal with certain symptoms. That would lead them towards a proper diagnosis, so I hope that he will consider something along those lines.

[Mr Burstow]

I will both consider it and hopefully have the opportunity to come back in next week’s debate and say a little more about it.