Cardiovascular Disease: Prevention

Jas Athwal Excerpts

Thursday 13th February 2025 Westminster Hall

[Jas Athwal (Ilford South) (Lab)]

May I say what an honour it is to serve under the chairmanship of such a multi-talented, multi-functional Chair?

[David Mundell (in the Chair)]

You can speak for as long as you want. [Laughter.]

[Jas Athwal]

I thank the hon. Member for Strangford (Jim Shannon) for securing this important debate.

Cardiovascular disease changes lives, takes lives and robs families of loved ones. I speak from personal experience: my father has been gone for 29 years and my mother for 28 years because of cardiovascular disease, so I know it absolutely robs families of loved ones. Across the UK, cardiovascular disease alone is responsible for one in four premature deaths. Beyond the personal impact it has on families, cardiovascular disease also places an enormous burden on our NHS, costing more than £7.5 billion per year. Preventive medicine and early detection can save lives, keep families together and reduce the burden on our NHS.

While preventive measures can take many different forms, which my colleagues have addressed today, I will focus on early diagnosis, as I know personally how critical it can be. In 2023, having cycled 85 miles on a Sunday, I felt the healthiest and strongest I had ever felt in my life, but one precautionary test taken purely to reassure myself that I was fit shattered my illusions and changed my life, but ultimately saved it. I was diagnosed with chronic heart disease. Within weeks, I had a triple heart bypass. Had I not taken that test, I believe that I would not be here today. Early detection saved my life, and it can save millions more.

In my constituency of Ilford South, a community-based study was conducted across four GP practices by Dr Laskar and Professor Lloyd from Barts hospital. Non-specialist healthcare workers used handheld echocardiogram devices to screen 518 local people. The study found that 22% of those screened were referred for specialist assessments, potentially saving the lives of one in five of those screened. The study in Ilford South demonstrates how we can detect serious conditions early without requiring expensive hospital visits later.

As my hon. Friend the Member for Dudley (Sonia Kumar) just said, prevention and early intervention save lives. By investing in local healthcare services and using tools such as the handheld echocardiogram device, we can catch problems sooner, treat people faster and relieve pressure on our overstretched hospitals sooner. Early diagnosis is not just a medical advantage, but lifesaving. It delivers more time with loved ones, less strain on our NHS and a future in which fewer lives are cut short. We have a golden opportunity to prolong life and to give the gift of life, and I urge the Minister to grab it with both hands.

--- Later in debate ---

[Stephen Kinnock]

This has been an interesting debate on so many levels. I thank you for that clarification, Mr Mundell.

I was just talking about the fact that around 70% of the CVD burden is preventable, and that the causes include obesity, high blood pressure, high cholesterol and smoking. All those factors can be reduced by behaviour changes, early identification and treatment. In England, the NHS health check is a free check-up for people between 40 and 74. It is a wide-reaching programme delivered by local authorities in England. This CVD prevention programme aims to prevent heart disease, stroke, diabetes and kidney disease, as well as dementia for older patients. It engages over 1.4 million people a year and, through behavioural and clinical interventions, prevents around 500 heart attacks or strokes annually.

I agree with the hon. Member for Strangford that the National Audit Office report shows that there is still so much more to be done. That is why we have asked officials to be more ambitious, developing policy proposals for how that programme can go even further. In the meantime, we are focused on delivering a new digital NHS health check, available through the NHS app, so that people can assess, understand and act on their CVD risk at home. We want to make it easier for people to access that programme, especially our constituents who have caring or childcare responsibilities, or cannot easily get to their GP surgery during opening hours. The creation of a state-of-the-art national digital NHS check service will improve access to this lifesaving check.

The hon. Member was right to mention diabetes as a key risk for CVD. Each year, the NHS health check identifies 22,000 people with high blood sugar who are referred on to primary care for further assessment and management. GPs can refer people at risk of developing type 2 diabetes into the Healthier You NHS diabetes prevention programme. The programme has been highly effective: some 35,000 people have been referred to it by their GP, and over 20,000 have started the programme since September 2020. For people who complete that programme, it can cut the risk of developing type 2 diabetes by 37%. For those who already have diabetes and are overweight or obese, the NHS type 2 path to remission programme is available. This joint initiative between NHS England and Diabetes UK aims to support eligible people with type 2 diabetes to achieve clinically significant weight loss, improve blood glucose levels and reduce the need for diabetes-related medication. A recent study found that almost a third of patients with type 2 diabetes who completed the programme went into remission.

Around half of heart attacks and strokes are a result of high blood pressure. A third of adults have high blood pressure and, worryingly, almost a third of these conditions are currently untreated, meaning that over 4 million people do not know that they have high blood pressure. It is often referred to as the silent killer, as high blood pressure is largely symptomless. The tragedy is that the treatment is so cheap and effective. We could prevent around 17,000 heart attacks and save more than £20 million in healthcare costs alone over three years just by treating 80% of patients on target.

The hon. Member for Strangford also mentioned high levels of cholesterol as a key risk factor in CVD. For every three NHS health checks delivered, one person is found to have high cholesterol, and there are well-known health inequalities in CVD affecting underserved communities in England. Addressing undetected and poorly managed high blood pressure and raised cholesterol is key to preventing CVD and reducing health inequalities.

There are effective drug treatments. Statins are readily available and very cheap. They can reduce an individual’s risk of CVD in four to six weeks. If we improve treatment rates for people with CVD to 95%, more than 18,000 CVD events, such as heart attacks and strokes, may be prevented over three years. We will look closely at how we can get that done. The hon. Member for Strangford called for the introduction of Lp(a) tests. As I mentioned, that is not currently recommended by NICE guidelines. I have taken account of his other remarks, including his request for a meeting and engagement with system partners. The Minister for Public Health and Prevention will take all those requests on board. She is the right person for him to meet, given that she leads in this policy area.

Smoking costs health and care services £3 billion a year—resources that could be freed up to deliver millions more appointments, scans and operations. The cost of smoking to our economy is even greater, with around £18 billion lost in productivity every year. Smokers are a third more likely to be off work sick, which is why we introduced the Tobacco and Vapes Bill: the biggest public health intervention in a generation. It will break the cycle of addiction and disadvantage, and put us on track towards a smoke-free UK. That will make a real difference in constituencies where smoking contributes to the cycle of poverty and ill health. We are also supporting local stop smoking services with an additional £70 million this financial year.

Today’s debate has shown what a challenging and complex area this is. The shadow Minister, the hon. Member for Hinckley and Bosworth (Dr Evans), raised a range of issues. I will ask the Minister for Public Health and Prevention to write to him on all his points, many of which I think would be best dealt with in correspondence.

[Jas Athwal]

The Minister makes powerful points. Does he agree that we should consider a wider, holistic approach, taking into account planning and advertising—for instance, children going to school and having access to the proliferation of chicken shops and fast-food shops, and being exposed to, on average, 13 to 15 junk food adverts? That would help to limit the number of heart diseases later down the line.

[Stephen Kinnock]

My hon. Friend is right that prevention should focus on as early as possible in the life of our young people. Bad habits form at early ages. That is not helped by the behaviour of some aspects of our economy, and the way in which products are advertised. It is essential that we move to a model of prevention that is a partnership between the Government, our communities and business. We are taking action against the advertisement of certain products before the 9 o’clock watershed. We are also cracking down on energy drinks, which are really pernicious in terms of the amount of sugar, caffeine and other deeply unhealthy components they contain.

My hon. Friend is right that we are genuinely all in this together. We need that partnership with the private sector, and a change in mindset around healthy and nutritious food. That needs to be put into schools through community health, and through working with parents and communities to change the habits of our country. We have a gargantuan challenge ahead of us, but our Government are absolutely committed to facing it, and that prevention strategy will be at the heart of our 10-year plan. It is one of the key shifts from sickness to prevention.

That leads me to my closing remarks. We have seen today what a challenging and complex area this is. It is a challenge that requires sustained action on a number of risk factors, but I assure colleagues that this Government will leave no stone unturned in getting premature deaths from heart disease and stroke down by a quarter for people under the age of 75 within the next year.

In my contribution, I have sought to demonstrate our commitment to getting on with the shift from sickness to prevention with our cast-iron commitment to expanding NHS health checks, the shift from hospital and community by making it easier for people to get checks at their convenience and at home, and the shift from analogue to digital through an innovative and expanded digital service. I once again thank the hon. Member for Strangford for securing this important debate, and thank all hon. Members across all parties for their excellent contributions. Watch this space: we will continue to work on this issue with focus and at pace.

Obesity: Food and Diet

Jas Athwal Excerpts

Monday 20th January 2025 Commons Chamber

[Jas Athwal (Ilford South) (Lab)]

I thank my hon. Friend the Member for Stroud (Dr Opher) for securing this much-needed debate. I also thank the right hon. Member for Wetherby and Easingwold (Sir Alec Shelbrooke) for sharing his testimony about how he lost 7 stone in such a short time—I tip my turban to him.

I have my own story. I lost 2 stone in two months because of what a doctor told me. Forget the nanny state: he said to me in no uncertain terms, “If you don’t lose weight, you won’t be here in a couple of years’ time.” I went home reeling from that news and did exactly what he told me to do. I lost the weight, had a fantastic body mass index and then I went back for my tests.

However, let me be clear: people cannot undo 20, 30 or 40 years of damage. If we lose somebody, we wish we could have had an extra day to say goodbye, to thank them or just speak to them one more time. Obesity, which leads to so many other diseases, robs people of five, 10 or 15 years of their lives, and means grandchildren are not able to speak to their grandparents. Why? Because those grandparents have passed away. We have to take that on board and counter it.

When I went back for my tests, I asked for an extra test, because I am one of those people who likes to be told—I am quite vain—how fit and healthy I am. I asked for an extra scan, and I got it. To my shock and horror, that extra scan revealed one of my arteries was completely blocked and the other, the left anterior descending artery, affectionately known as the “widow maker”, was 95% blocked, even though I had cycled 85 km the previous day. Very quickly, I went into Barts hospital where I underwent triple heart bypass surgery, and I lived to tell the tale. It was all because of years of decline.

While some conditions cannot be avoided, obesity can. When I say that my BMI was 27, the answer is always that BMI is not something to be relied on, but it is the best scale we have. In Ilford South, where 75% are from the Asian subcontinent, 25 is not the BMI number we should be looking at—it should be 23. I am struggling myself, because my BMI is hovering at 24. Another cultural shift is needed—it Is a cultural problem—because when people look at me, having lost 2 stone, they say, “Are you okay? You look unhealthy.”

[Sir Alec Shelbrooke]

I chuckled to myself when the hon. Gentleman said that, because people ask me if something is seriously wrong. He emphasises the point that weight, whether thin or fat, is a stigmatised subject. Even when people are trying to get themselves healthy, they get criticism. We have to expose that and get on top of it.

[Jas Athwal]

I absolutely agree. People have come round to check on me and ask me whether I really am okay or if I have an underlying problem, because I have lost so much weight. The only downside to losing weight is that it is very expensive—I have needed a new wardrobe.

Obesity is the leading preventable cause of death. Imagine the prize of an extra five, 10 or 15 years with loved ones: tackling obesity can give people more time with those they love. Obesity costs the NHS billions of pounds and impacts many livelihoods. In my constituency of Ilford South, obesity rates are 10% higher than in the rest of London. My neighbours and their loved ones are struggling and suffering unnecessarily.

The obesity crisis is threefold. Access to affordable, healthy food has decreased, while the prevalence of processed food and fast-food outlets has increased. In Ilford, the number of fast-food outlets has grown by a staggering 47.1% in just the last 10 years. Nearly a third of children in my constituency are overweight. They are bombarded with adverts everywhere on their way to school. Even worse, youth clubs have dwindled, leaving many young people with fewer warm places to go after school to enjoy themselves, exercise and socialise.

The affordability of healthy food, the accessibility of unhealthy food and reduced support for young people have fostered an environment in which unhealthy habits are growing. People do not even know how to cook, which causes a crisis of obesity, robs children of the best start in life and sets them up for a lifetime of health problems. We need to be bold enough to confront the growing trend, which is why we are here today. To tackle the accessibility of unhealthy food, Redbridge council set out a local plan to ban fast food outlets 400 metres from school gates, but were they banned? They were not. The Mayor of London’s plan says the same thing. We need to give planning policies the necessary teeth to stop fast food outlets opening right outside schools, and the adverts that bombard our children on the way to and from school.

To increase the affordability of healthy food, we have to work with charities. In Redbridge, we are working with a food bank to create facilities to store fresh fruit and vegetables. Last Friday, I had the privilege of being shown the food bank’s new premises, which we had been working on for the past 18 months. I was shown the cold storage where we will store vegetables. It was mentioned earlier that food banks should be able to store vegetables, because that is the healthy way forward. To give young people a place to go after school, we led investments in local youth centres. We need a holistic approach. We need to look at not just food itself but everything in society.

On a national scale, we have to make changes to protect young people from obesity. The Government must do that by fulfilling our Labour manifesto commitment to ensure that children are no longer exposed to TV adverts for junk food. We have banned paid online junk food adverts, preventing the overexposure of young people to unhealthy, processed and fatty foods, but we can and must do more. As has been mentioned two or three times, we must move away from viewing obesity through the lens of judgment, and confront the ways we have allowed unhealthy choices to be the easiest choices. We must break down the barriers to healthy eating, prevent the manipulation and exploitation of young people, and support everyone to live healthier lives.

Income Tax (Charge)

Jas Athwal Excerpts

Tuesday 5th November 2024 Commons Chamber

[Jas Athwal (Ilford South) (Lab)]

Our NHS is literally a lifeline for so many of us across the country. Last year, I witnessed that at first hand. From riding 85 miles on a Sunday, I went for precautionary tests on the Monday. To my horror, the arteries around my heart were completely blocked. It was an incredibly difficult time for me and my family, but the NHS was there for me: the doctor, the cardiologist who told me the news in such a nice way it felt as if nothing was wrong, the surgeon who operated on me very urgently because that needed to be done quickly due to the potential impact it could have had on me, and the nurses who nursed me back when I needed the care the most. Like so many in this Chamber and across the country, the healthcare professionals—the doctors, nurses and administrative staff—are the reason I am able to stand here today in good health to address the Chamber. Among them are the very neighbours who took care of me during my time in hospital.

As Members are all too well aware, however, the NHS is far from perfect. Tory austerity decimated the NHS and the covid mismanagement added fuel to the burning fire engulfing the NHS. Our waiting lists are at record levels: 7 million people waiting for elective treatments; 10% of patients now waiting 12 hours or more in A&E; and 350,000 people a year waiting for mental health support. This is the worst crisis for our NHS since its formation 76 years ago.

Protecting our NHS is crucial, so that people can get the treatment they need, when they need it. Whether it is a heart bypass like mine, a transplant or cancer treatment, this Labour Budget delivers a decisive shift from the disastrous—

[Madam Deputy Speaker (Judith Cummins)]

Order.