(2 years ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
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The hon. Gentleman would be aware, had he heard some of what I said earlier, that the performance payments in relation to the period since the timetable reduction have yet to be evaluated independently. Clearly, the evaluation will take into account the actual situation of the delivery of the contract. As this is an independent evaluation, he will appreciate why it is not one I will personally do as a Minister and it is right that it is under that process. As we have touched on, the Government have made it clear to Avanti that significant improvements need to be made in its service. It has a plan to implement for December, which it is confident will deliver a major improvement in the service it is operating. We look forward to seeing it implement that.
I am grateful to the Minister for meeting me a week ago today to discuss Avanti West Coast services to north Wales. He knows that those remain abysmal. Whereas there are normally six direct services a day, there is now just one, if it is not cancelled. What assurances has he received from the company that it will able to return to near normality by December, as promised?
The assurances that Avanti is giving are that its plans for December will restore the majority of direct services into north Wales. DFT officials are engaging daily with Avanti, as I have touched on, because we do not just want to accept an assurance that the service will be better. Clearly, we want to have verified plans for it to be better. We are seeing additional train drivers coming in and we are reassuring ourselves that Avanti’s plans for December do not include the use of driver rest-day working, because the withdrawal of that prompted the major issues in its timetable. Clearly, we would not want Avanti’s improvement plan to be based on that factor. That is where we are at the moment. We are assured that it has the plan to restore the majority of services in December, but clearly we are engaging with Avanti daily and will see what happens in December, and that will then prompt what we do on the long-term franchise.
(7 years, 7 months ago)
Commons ChamberIt is true that the Health Committee—myself included—has called for additional measures, but the plan as it stands is certainly a step in the right direction. I will come to further points in due course.
One in five children starting primary school is overweight. By the end of primary school, it is one in three—quite a striking figure. The inequality between communities is also striking. Some 60% of five to 11-year-olds in the poorest neighbourhoods are obese; the figure reduces to just 16% in the most affluent areas. That translates into regional variation.
My hon. Friend is making an important point about the fact that there is a higher growth in obesity rates among those from the most deprived backgrounds. People who live on one side of a particular hill in Torquay live for 13 years longer on average than those who live on the other side. Does he share my concern that those sorts of stats could get worse?
Indeed. I strongly believe that the measures outlined in the Bill go some way to tackling that situation.
Perhaps the main health effect of obesity among children is tooth decay. It is the main source of hospital admissions for five to nine-year-olds, with some 26,000 admissions, probably in England alone, and 179,000 teeth—if not more—extracted among the age group each year. Some 25% of children in the age group have tooth decay, and 90% of those cases are estimated to be preventable. Of course, sugar is a key cause of the problem. As for older children, 46% of 15-year-olds have tooth decay, and £129 million was spent on the extraction of teeth in under-18s between 2012 and 2016.
The impact of obesity on adults is even more concerning with tooth decay and, in no particular order, type 2 diabetes mellitus, cardiovascular disease, gastro-oesophageal reflux disease, gallstones, osteoarthritis, sleep apnoea, infertility, pregnancy problems, mental health problems, liver and kidney disease, and—last but certainly not least—cancer. At least 13 types of cancer have been implicated with obesity. In fact, obesity is thought to be the biggest cause of preventable cancer after smoking. More than 18,100 cases of cancer in the UK per year are estimated to be thanks to obesity. Those types of cancer include some well-known ones such as breast, bowel, endometrial, oesophageal and pancreatic. There is an impact on the NHS of an estimated £5.1 billion per annum, and a cost to the economy in general—£27 billion a year down to lost productivity, unemployment, early retirement and welfare benefits.
It is vital that we recognise the extent of the problem posed to the health and wellbeing of ever-rising numbers of people by the obesity crisis. How should we target this? Well, it is believed that there is a genetic susceptibility to obesity. That is not to say that all obesity is down to genetics, but it is thought that the inheritance of several genes—polygenic susceptibility—leads some to an increased drive to eat. Much has been said over the past decades about personal responsibility, education and exercise. Education and exercise do have an important place, but the reality is that they have not succeeded as the main way to target the problem.
We have an issue with more sedentary lifestyles and an obesogenic environment, whereby unhealthy, high-calorie foods are so easily available around us. Calorie intake sadly overwhelms most people’s efforts to exercise those calories off. Personal responsibility certainly drives many—perhaps those with the intellectual and financial resources to follow the path to deal with the problems they face —but it is not easy. In any case, children cannot be expected to exercise personal responsibility, because they do not have their own freedom of choice. Various measures are important in tackling the crisis, including reformulation targets by Public Health England and others, which will reduce sugar, fat, calories and so on in the foods that children eat.
Advertising is also important. Advertising restrictions have recently been expanded from television to other media such as social media and advergames, but more could be done if necessary. Labelling is important, and Brexit offers an opportunity in more flexibility in labelling our products. Promotions and discounts in supermarkets and elsewhere are critical. The issue of local authorities’ planning powers for takeaways and so on has been mentioned on a number of occasions.