Adult Social Care: Long-term Funding

Liz McInnes Excerpts

Thursday 28th June 2018 Commons Chamber

[Mr Betts]

Yes, I completely agree. I could not refer to every specific recommendation in my statement. The hon. Gentleman is referring to paragraph 78 of the report, where it states that instead of care being delivered to people, they could receive a cash payment so their family members could do it in a way that suits them best.

[Liz McInnes (Heywood and Middleton) (Lab)]

I congratulate my hon. Friend on the report and on the work of the Committees to deal with this very difficult subject. In my constituency, we have a problem with nursing care homes closing and being converted into residential care homes, because of a problem with recruitment and retention of nursing staff. I am glad he mentioned that the care being given has to be good quality. Will he say how the increased funding would help with that situation and give us the nursing home beds we need?

ME: Treatment and Research

Liz McInnes Excerpts

Thursday 21st June 2018 Westminster Hall

[Carol Monaghan]

Indeed. Many people have written to me about their experience of GET, but some of the most upsetting examples are of children who were forced through a programme of GET and ended up with life-changing disabilities as a result.

[Liz McInnes (Heywood and Middleton) (Lab)]

I am grateful to the hon. Lady for mentioning my constituent, Merryn Crofts, whom I will speak about later. Merryn’s mum, Clare, said to me that Merryn was put on GET and that it made her condition worse. Everything that the hon. Lady says is backed up by the testimony that Clare gave me—I just wanted to share that with her.

[Carol Monaghan]

I thank the hon. Lady for her intervention. Merryn’s is not an isolated case, and neither are those of my constituents—I am sure that Members present have all heard constituents describe the same situation.

The PACE trial, which recommended CBT and GET, influences how health insurers and the DWP make their decisions. Insurance companies refuse to pay out unless a programme of GET has been undertaken, and many people who apply for benefits are told that they must carry out GET—or, indeed, that they appear well enough to work. PACE is unique in UK medical history, in that it was part-funded by the DWP. The links of some of its main authors to health insurance companies are troubling. One of those authors, Professor Michael Sharpe, states in his briefing for the debate:

“Several of the investigators had done small amounts of independent consultancy for insurance companies, but this was not relevant to the trial. The insurance companies played no part in the trial.”

I will leave hon. Members to make up their own minds about that.

Healthcare professionals worldwide are starting to take note. The US Centres for Disease Control and Prevention and the Health Council of the Netherlands have both abandoned GET. If those countries acknowledge the flaws of GET, why are ME sufferers in the UK having to fight so hard for similar acknowledgement? The ME community hopes that GET will not feature in the NICE guidelines for ME treatment after they are revised.

Some argue that CBT is provided as a treatment for many illnesses, including heart disease and cancer, and that ME patients’ rejection of it is irrational. The key difference is that cancer patients receive biomedical treatment in addition to CBT, rather than having CBT to the exclusion of biomedical interventions. Biomedical treatment for ME is woefully lacking. There are reports from the US that certain antiviral drugs improve the condition, but without properly funded research to identify biomarkers for ME, we do not have the answers.

Diagnosis is currently based on a patient presenting with known symptoms. Although there is no biomarker for ME, that does not mean there is no biomedical test for it. The two-day cardiopulmonary exercise test, which can objectively document the effects of exercise, could be used as a diagnostic tool. In simple terms, people with ME perform adequately or even well on the first day but have reduced heart and lung function on the second. That relates to the point made by the hon. Member for Alyn and Deeside (Mark Tami) about the DWP and the fact that someone’s presentation may be good one day but not the next.

That protocol involves two identical tests separated by 24 hours, the collection of gas exchange data and the use of an exercise bike to measure work output accurately. That type of testing reveals a significant performance decrease on day two among people with ME, in terms of their workload and the volume of oxygen they consume before and during exercise. Results from a single test may be interpreted as deconditioning, which may lead to harmful exercise being prescribed. However, the objective measurements of the two-day test remove the issues of self-reporting bias and the question of effort—in other words, the results cannot be faked.

Those results support the strong and consistent patient evidence of the harm that can occur as a result of inappropriate exercise programmes. However, there are moves afoot to categorise ME as a psychological condition. NHS guidelines on medically unexplained symptoms class ME as such a condition. The Royal College of Psychiatrists states:

“Medically unexplained symptoms are ‘persistent bodily complaints for which adequate examination does not reveal sufficient explanatory structural or other specified pathology.’”

--- Later in debate ---

[Liz McInnes (Heywood and Middleton) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Gapes. I thank the hon. Member for Glasgow North West (Carol Monaghan) for securing this very important debate.

Merryn Crofts, who has already been referred to in this debate, is one of just two people in the UK who have had myalgic encephalomyelitis recorded as the cause of death. She was my constituent and lived in Norden in the Rochdale area of the Heywood and Middleton constituency. I spoke with her mum, Clare, this week, who told me that the reports about Merryn in the newspapers did not really cover the whole of Merryn’s condition. Clare wanted to be here today to hear the debate, but could not travel to London because of a new baby in the family, so I hope that she is able to watch the debate back home in Rochdale. I send my best wishes to her and to the new baby.

[Stephen Pound (Ealing North) (Lab)]

As do all of us.

[Liz McInnes]

Indeed, from all of us. Merryn met all the diagnostic criteria set by NICE, and the Canadian consensus criteria, for a diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome. Merryn was totally bedbound. She physically could not get out of bed. She suffered so badly from postural hypotension that she blacked out if placed in a sitting position or even if her bed was raised slightly. She was hypersensitive to noise, light, touch and movement. She suffered so badly from pain—head, muscle, neurological and stomach pain—that she could not get out of bed. Her GP had worked in a hospice for 10 years, looking after cancer patients, and said that in that job she could not always take away pain, but she could manage it. In Merryn’s case, the GP said that her pain was unmanageable. Although Merryn was on diamorphine and ketamine, she was still in pain. Any kind of stimulus, even just a nurse walking in to the room, was an exertion to Merryn. She was permanently on syringe drivers and receiving injections. She was permanently nauseous.

The terms ME and chronic fatigue syndrome are often used interchangeably, but Merryn’s mum tells me that fatigue was the least of Merryn’s symptoms. In her view, the use of the term chronic fatigue syndrome should be abandoned, as myalgic encephalomyelitis is about so much more than just fatigue.

Merryn was only 15 years old when her illness started. For the first year, she was not housebound and she used to go out in a wheelchair, but as her condition worsened she became unable to go out. She went from a young girl who loved life, with passions for drama and acting, to a housebound patient, whose family had to do more and more for her, even things like chatting on her behalf on social media—simple things that she was no longer able to do on her own.

I mention social media because Merryn was helped a great deal by the online ME community. Her mum tells me that Merryn always wanted positive support and was very choosey about who she communicated with. She did not want to speak with people who exuded negativity, but she was part of a big online ME community, which included people such as ballet dancers and sportspeople. That raises the issue of whether research should look at the lifestyles of those who contract ME and whether there is a susceptibility that can be exacerbated by leading an active life and pursuing strenuous sports or vocations.

Merryn’s mum is critical of the PACE guidance given by NICE and attributes the worsening of Merryn’s condition to it. She tells me that Merryn thought she could push through the condition and keep going, although her family really wanted her to slow down. Sadly, it was only when the family contacted a private medical practitioner that Merryn was given the advice to slow down and told that she needed to rest. The specific advice given was,

“Whatever you feel you can do, only do 50% of it.”

Merryn’s mum feels very strongly that had Merryn been given that advice when her condition started, she might not have gone on to develop severe ME, and she strongly urges that the NICE guidelines should be reviewed. Merryn’s mum said,

“If the PACE trial were a drug, it would have been banned by now.”

I hope and I am sure that the Minister will refer to that in his response.

Merryn’s family are still very involved in the ME community and they run the “MErryn’s Legacy” Facebook page, which raises money for research and includes fundraising activities such as skydiving and climbing Ben Nevis: impressive feats that are done on behalf of the ME community as representative of the things they would like to do but are unable to because of their condition. The fundraisers do those activities on their behalf.

We need to invest more in research into ME. The best research, as has already been mentioned, is being done in the States. Here it is very much funded by charities and tends to concentrate on psychological issues rather than physical changes such as inflammation of the brain and changes to the central nervous system, and we need to do much more research into the physical aspect.

Nancy Klimas is a major ME researcher based in Miami. She has more than 30 years’ professional experience and has achieved international recognition for her work on ME. She compares patients with severe ME, like Merryn, with those in the terminal stages of HIV/AIDS infection in terms of the levels of pain that they suffer. Many comparisons can be drawn between HIV/AIDS and ME. When HIV was first identified it was thought to be incurable and a certain death sentence, but incredible research has produced advanced treatment with retrovirals, which, although they do not provide a cure, can be used to manage the disease, and it is no longer the death sentence that it was.

In comparison, ME is not seen as a death sentence, but, as Merryn’s case sadly shows, it can be fatal. It is also described as a kind of living death. The work done on HIV/AIDS shows how powerful good research can be. I hope that in future, following investment in ME research, we may also see great advances made in the treatment and knowledge of ME.

We also need to invest more in training for our doctors, especially general practitioners who are the clinicians likely to be the first port of call for those suffering with ME. Our GPs need the skills to recognise the signs and symptoms and to signpost patients to the appropriate specialists. I hope that the Minister might be able to refer to those points in his response. I am immensely grateful to Merryn’s family for sharing so much with me and for allowing me to tell her story.

Health and Social Care

Liz McInnes Excerpts

Wednesday 9th May 2018 Ministerial Corrections

[Caroline Dinenage]

On the date of publication, the hon. Lady will be aware that this was an independent report prepared by the University of Bristol and commissioned by NHS England, which wanted to look into this really important issue, and because it was an independent report, it did not formally alert us to publication. We are investigating through NHS England and others why that happened.



The following is an extract from the Urgent Question answered by the Minister of State for Care on 8 May 2018.

[Liz McInnes (Heywood and Middleton) (Lab)]

The front page of the report is clearly dated December 2017, so will the Minister clarify and explain why, as she has stated today, her Department did not have sight of it prior to its publication?

[Caroline Dinenage]

I completely hold my hands up. I am not trying to mislead the House in any way. It is an independent document and the University of Bristol decided when it was going to be published. It was published on Friday without permission from or any kind of communication with the Department of Health and Social Care. I do not know what communication the university had with NHS England, but no information was passed to us. The beauty of having an independent document is that it can be published when the organisation sees fit and the Government will have to respond to it.

[Official Report, 8 May 2018, Vol. 640, c. 553.]

Letter of correction from Caroline Dinenage:

An error has been identified in the answer given to the hon. Member for Heywood and Middleton (Liz McInnes) on 8 May 2018.

The correct answer should have been:

Learning Disabilities Mortality Review

Liz McInnes Excerpts

Tuesday 8th May 2018 Commons Chamber

[Caroline Dinenage]

Yes. Specific work on early detection of the symptoms of sepsis, pneumonia, constipation and epilepsy and on the effective use of the Mental Capacity Act 2005 in urgent care settings is already under way.

[Liz McInnes (Heywood and Middleton) (Lab)]

The front page of the report is clearly dated December 2017, so will the Minister clarify and explain why, as she has stated today, her Department did not have sight of it prior to its publication?

[Caroline Dinenage]

I completely hold my hands up. I am not trying to mislead the House in any way. It is an independent document and the University of Bristol decided when it was going to be published. It was published on Friday without permission from or any kind of communication with the Department of Health and Social Care. I do not know what communication the university had with NHS England, but no information was passed to us. The beauty of having an independent document is that it can be published when the organisation sees fit and the Government will have to respond to it.[Official Report, 9 May 2018, Vol. 640, c. 8MC.]

Oral Answers to Questions

Liz McInnes Excerpts

Tuesday 8th May 2018 Commons Chamber

[Mr Hunt]

That is an excellent initiative from Scotland, and it shows why we all benefit from being in the United Kingdom together. Yes, we will look at it very closely.

[Liz McInnes (Heywood and Middleton) (Lab)]

In tackling childhood obesity, will the Health Secretary declare his support for Jamie Oliver’s AdEnough campaign and get rid of pre-watershed television advertising of junk food to our children?

[Mr Hunt]

That is one of a number of measures that we are looking at. We are absolutely determined to do something about this. One in 10 children starts school obese, and by the time they leave primary school the figure is one in five. We cannot wait any longer.

Breast Cancer Screening

Liz McInnes Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

I am very happy to make that commitment.

[Liz McInnes (Heywood and Middleton) (Lab)]

I hope that the independent review will investigate this, but is the Secretary of State aware of any instances of GPs inquiring why patients who should have had a final breast screen were not invited to have one?

[Mr Hunt]

That is a very good question. I am not aware of any such instances, but that is exactly what we want to look at in the review. It does seem strange that people who were expecting to be invited did not come forward, and that their not receiving an invitation did not set any hares running. That is one of the things that we need to look at.

Bowel Cancer Screening

Liz McInnes Excerpts

Tuesday 1st May 2018 Westminster Hall

[Nick Thomas-Symonds]

I am sure that all hon. Members would join me in sending their very best wishes to the hon. Gentleman’s father-in-law. I would be grateful if the hon. Gentleman passed those on. I welcome the cross-party support for reducing the screening age. I referred to Bowel Cancer UK, and I should point out that I have been pleased to do a number of runs to raise money for that charity through sponsorship.

I realise that we must deal with two other things to ensure that lowering the screening age and improving the screening process across the UK is effective. First, pathology capacity must be increased, because there will obviously be vastly more samples to deal with. Secondly, we need high-quality colonoscopy capacity to deal with the increased numbers of people referred on for further investigation as more sensitive tests yield further results that need to be checked out.

[Liz McInnes (Heywood and Middleton) (Lab)]

I extend my condolences to my hon. Friend on the sad loss of his mother. I worked in pathology before I became an MP, and I am grateful to him for mentioning it and the increase in capacity that will be required if it is found to be indicated clinically that we need to reduce the screening age to 50.

[Nick Thomas-Symonds]

I am grateful to my hon. Friend for her sympathy and for bringing her experience to bear on the debate. Such increased capacity will be so important.

That we need to be ambitious on pathology and colonoscopy capacity should not deter us from the ultimate goal, however; I want to see every eligible person across the United Kingdom have access to the best and most effective screening methods, so that we can finally defeat this cancer. Saving lives—giving more families more precious moments with their loved ones—should be the only incentive we need to make progress.

Oral Answers to Questions

Liz McInnes Excerpts

Tuesday 20th March 2018 Commons Chamber

[The Minister for Health (Stephen Barclay)]

My neighbour is correct that I know the hospital, not least because my son was born there, and he is absolutely right to highlight the importance of the work done at King’s Lynn and of the staff there. In the Budget the Chancellor signalled his additional commitment for the “Agenda for Change” staff, and those discussions are ongoing.

[Liz McInnes (Heywood and Middleton) (Lab)]

T3. My constituent, Rebecca, is a podiatrist. Last week she told me that the care that she provides is having to be rationed because of a combination of insufficient funding and staff shortages. What assessment has the Minister made of the impact of the removal of the NHS bursary on the training of future podiatrists, and what action will he take to address the funding shortage?

[Stephen Barclay]

The reality is that the number of places is increasing, even if the number of applications is lower. The Government have signalled their commitment on pay. We have more clinicians, doctors and nurses, and we are treating more people. That is part of the success of the NHS under this Government.

Mental Health Services: Children and Young People

Liz McInnes Excerpts

Thursday 8th March 2018 Commons Chamber

[Steve Brine]

I am sure my colleague the Under-Secretary of State for Health, the hon. Member for Thurrock (Jackie Doyle-Price), who is responsible for mental health, will be taking that up as she considers responses to the Green Paper. My hon. Friend the Member for Horsham (Jeremy Quin) is absolutely right to raise that issue and I thank him for doing so.

[Liz McInnes (Heywood and Middleton) (Lab)]

With increasing numbers of university students having mental health problems, what action will the Minister take to ensure better joined-up care, with better communication between home and university GPs and student welfare services?

[Steve Brine]

As a former student union president, I think that is a very good point. One key proposal in the Green Paper is about the new mental health support teams, which will be very important in that. The hon. Lady is right to say that they should work across higher education as well as the earlier forms of education.

Diabetes

Liz McInnes Excerpts

Monday 26th February 2018 Commons Chamber

[Liz McInnes (Heywood and Middleton) (Lab)]

I am grateful for the opportunity to talk about this very important health issue. I should first declare an interest as an active member of the all-party parliamentary group on diabetes, ably chaired and led by my right hon. Friend the Member for Leicester East (Keith Vaz).

We have come a long way with the treatment of diabetes since 1921, when Banting and Best isolated insulin from dog pancreases, and then, working with Scottish physiologist J. J. R. MacLeod, purified a form of insulin that was suitable for human treatment from cows’ pancreases. This was at the time, and remains, a major scientific and Nobel-prize winning breakthrough. Before insulin therapy was discovered, diabetes was a deadly illness. The first medical success was with a boy with type 1 diabetes—14-year-old Leonard Thompson, who was successfully treated in 1922. Close to death before treatment, Leonard bounced back to life when treated with insulin.

Now, almost 100 years later, we understand a lot more about diabetes. We are able to explain the difference between type 1, an autoimmune disorder that is treatable by insulin; and type 2, insulin resistance or insufficiency, much more influenced by other health factors such as obesity and physical inactivity. We also know that a diagnosis of diabetes is no longer a death sentence. Nevertheless, diabetes remains a serious illness that affects 4.5 million people in the UK.

[Keith Vaz (Leicester East) (Lab)]

I congratulate my hon. Friend on all the excellent work she does as vice-chair of the all-party group on diabetes. She mentioned those who have diabetes, but there are still about half a million people who have type 2, as I do, but do not know that they have it. Does she agree that prevention is the most important thing that we can do to try to help those who have type 2 but are not aware that they have it?

[Liz McInnes]

I thank my right hon. Friend for that intervention. I think he must have read my speech, because I will be talking about the prevention of type 2 diabetes, and how important it is that we are aware of that and also make the population aware of the measures they can take.

There are more people living with diabetes in the UK than with any other serious health condition—more than dementia and cancer combined. The complications of diabetes are many. They include eye, foot and skin complications; anxiety and depression; hearing loss; gum disease; neuropathy; infections; slow wound healing; strokes; heart failure; heart attacks; lower limb amputations; renal problems; and early death.

[Christine Jardine (Edinburgh West) (LD)]

The diabetes crisis is one of the fastest growing health crises of our time. As the hon. Lady says, the physical consequences are well known, but recent research by Diabetes Scotland has shown that the stress, isolation and trauma of managing an invisible but life-threatening condition can have serious implications for a person’s emotional wellbeing. Does she feel that we need to look at offering support and increased provision of psychological support for diabetes sufferers?

--- Later in debate ---

[Liz McInnes]

I absolutely agree. The hon. Lady makes an excellent point, and I will cover that later in my speech.

As the hon. Lady says, the number of people living with diabetes is rising fast. Every day, around 700 people are diagnosed—that is one person every two minutes. It is estimated that by 2025, 5.2 million people will be living with diabetes. With 10% of the total NHS budget being spent on diabetes every year, it is important that we talk about treatment, prevention and the future of diabetes care, particularly as 80% of these costs are spent on the complications of diabetes, many of which are avoidable through better care.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on securing the debate. I declare an interest, as a type 2 diabetic, like the right hon. Member for Leicester East (Keith Vaz). There are some 100,000 people with diabetes in Northern Ireland at present, and we have the largest number of type 1 child diabetics in the whole of the United Kingdom. The issues in Northern Ireland are very acute. Does she agree that the NHS should widely fund not only insulin pumps for children with type 1 diabetes, but training, to ensure that children can use those pumps, to make their lives better? I think it is important that we do so.

[Liz McInnes]

The hon. Gentleman makes an important point. I will talk about the technologies that are available for the treatment of diabetes and about education and information, so I hope I will answer his question later in my speech.

The hon. Gentleman emphasises the point that I was going to make, which is that it is really important that we listen to the voices of those living with diabetes. The charity Diabetes UK recently published a report entitled “The Future of Diabetes”, based on a consultation with more than 9,000 affected people. Those people said that, as well as a need for a better understanding and awareness of diabetes, there are a number of ways in which diabetes care can be improved.

In 2016 the Care Quality Commission produced a report entitled “My diabetes, my care”, based on a survey of a smaller number of people, but it came to very much the same conclusions. People living with diabetes want more support for their emotional and psychological health. The effect of varying blood sugar levels on mood and the relentless need to manage the condition can affect mental health.

[Mr George Howarth (Knowsley) (Lab)]

I am grateful to my hon. Friend for giving way; she has been very generous. Is she aware that some young type 1 diabetics manipulate their insulin to get rapid weight loss, and that they struggle to get treatment because on the one hand, they need psychological support, and on the other, they need advice from diabetologists? Does she agree that, if we started to bring all those different support services under one roof, it would make the route to dealing with young people who have that problem much easier?

[Liz McInnes]

My right hon. Friend makes a very important point. In the APPG on diabetes, we have discussed the issue of young diabetics self-medicating with insulin to keep their weight down. That emphasises the point I was going to make, which is that all healthcare professionals should receive training so that they can routinely support emotional and mental health and, importantly, know when to refer to specialist support.

[Rachael Maskell (York Central) (Lab/Co-op)]

Young people find it incredibly difficult to do glucose testing. The FreeStyle Libre device is a mechanism through which young people can have regular testing without that fear. However, they have to go through an individual funding request to access that. Should that not be available on the NHS?

[Liz McInnes]

I completely agree, and I will discuss FreeStyle Libre patches later on. I am beginning to feel like everybody here has had sight of my speech before I have even delivered it.

The next point arising from the survey is that people living with diabetes want better access to healthcare professionals who understand diabetes. Many respondents said that they felt they were being treated as a condition and a set of symptoms rather than as a human being.

[John Howell (Henley) (Con)]

I feel I want to ask a question just to participate. Given that lifestyle choices play a big part in type 2 diabetes, what value does the hon. Lady put on the information courses that are made available to people to help them to manage such lifestyle choices?

[Liz McInnes]

The information and education courses are really important in helping to manage the condition. I will come on to talk about that very subject later in my speech.

To go back to the role of specialists, I know from my involvement with the all-party group on diabetes that the role of the diabetes specialist nurse is valued by many. Evidence shows that diabetes specialist nurses are cost-effective, improve clinical outcomes and reduce the length of stay in hospital. With rising numbers of diagnoses of diabetes, I ask the Minister to encourage employers to respond to this with appropriate workforce planning.

The third point from the survey is that people want better access to technology and treatments. Diabetes treatment is ever evolving and advancing, but 28% of those who took part in the survey reported problems in getting the medication or equipment they needed to manage their diabetes. The Minister may recall that last year the Prime Minister was seen at an event wearing a FreeStyle Libre glucose monitoring device, which has already been mentioned. It is this type of non-invasive device that makes life so much easier and more manageable for those living with diabetes, and it is a great example of the technological advances taking place today. This device is designed to liberate patients from the hassles of routine finger prick testing. However, so far, only one third of CCGs and health boards have placed FreeStyle Libre on the formulary, demonstrating the problem faced by many in obtaining access to new technology.

The fourth point is that there is also a need for education and information to be widely available. No one should be given a diagnosis of diabetes without also being informed of where to go for information and support. People’s ability to self-manage is essential for the successful management of diabetes. Self-management reduces the risk of complications and demand on health and care services.

[Sandy Martin (Ipswich) (Lab)]

Does my hon. Friend agree that children with type 1 diabetes require particular understanding from the teachers in their school if they are to stay safe, and a proper dispensation to eat when they need to eat and to do blood tests when they need to do so? Will she join me in urging the Department for Education to make the guidance to schools on type 1 diabetes more prescriptive?

[Liz McInnes]

My hon. Friend makes an excellent point. It is actually the fifth point of the survey—support and understanding at work and school—and I will go on to talk about that. He explained the whole point very well, and I totally agree with him.

To go back to the education programmes, the National Institute for Health and Care Excellence recommends that people should be offered a course around the time of diagnosis of type 2 diabetes, and six to 12 months after diagnosis for people with type 1 diabetes, with annual reinforcement and review. The Care Quality Commission survey found that, in general, people who had attended structured education courses were very positive about their experiences. The majority of people said that it was helpful in improving their knowledge and ability to self-manage. People identified benefits, including improved understanding and knowledge about their condition; improved self-control and management, such as diet and exercise; and the opportunity to discuss concerns and share information with other people. However, there was a clear theme of people saying that, although the courses were helpful, they wanted more opportunities to attend refresher sessions.

The fifth point is that people living with diabetes want more support and understanding at work and school. Good care at school is vital and all schools should have an effective care plan in place. For those in work, an understanding and informed employer can make the difference between that person being able to continue in productive work, and being forced to leave because of difficulties in managing their condition while at work.

Finally and most importantly of all, people living with diabetes want hope for the future. Once diagnosed, people live with diabetes for the rest of their lives. They want to know what is being done to work towards a world where diabetes can be prevented and cured. It is for that reason that I asked for this debate—so that we can discuss research, funding, awareness, treatment, support, information and education for those living with diabetes.

[Karin Smyth (Bristol South) (Lab)]

Does my hon. Friend agree that groups such as the Bristol South Diabetes Support Group are really important in bringing together volunteers to support people across the country? Does she support those volunteers, who not only supplement the work of the NHS but give people the confidence to manage their work?

[Liz McInnes]

My hon. Friend makes a very important point. It is up to healthcare professionals to encourage those voluntary groups to get together, to enable people to give each other support. That was one of the findings of the Diabetes UK survey: people wanted to come together to offer each other support.

[Jim Shannon]

Further to that point, this morning’s news reported on the millennium child and an increase in diabetes as a result of diet. Does that not underline exactly what the hon. Lady has argued today, which is that we need to do something now? If the millennium child—the adult of tomorrow—is going to have high levels of obesity and diabetes, there is a real need for a strategy right now.

[Liz McInnes]

I completely agree with the hon. Gentleman’s very important point. I was struck by that item on the news first thing this morning. It is coincidental that it was announced today and I will refer to it in my concluding remarks.

For type 1 diabetes, research priorities include reducing hypoglycaemic episodes, exploring the effectiveness of different insulins and technologies, and research into the artificial pancreas, which monitors blood sugar levels and automatically injects the right amount of insulin.

For type 2 diabetes, people want to know whether their diabetes can be cured, for example through surgery or very low calorie diets. Encouraging work is being done on low calorie diets, and a trial funded by Diabetes UK—the diabetes remission clinical trial—showed that almost half of type 2 diabetics who took part were in remission after 12 months.

We need to help people to reduce their risk of developing type 2 diabetes, and that means tackling the reasons for the increasing rates of obesity, particularly childhood obesity. The PREVIEW project—prevention of diabetes through lifestyle, intervention and population studies in Europe and around the world—showed that a weight loss of 10% of baseline weight can decrease insulin resistance, which is a causative factor in diabetes, and this is expected to reduce by 85% the three-year risk of developing type 2 diabetes.

In conclusion, I have two requests for the Minister. The first is that we build on progress being made through the NHS diabetes programme and commit to sustained transformation funding at current levels of £44 million a year until at least 2021. The NHS diabetes programme sets out to improve the treatment and care for people with diabetes. Investing now will allow us to reap substantial financial and social benefits in the future.

My second request is that we strengthen the childhood obesity plan, including measures on labelling and junk food marketing. Just this morning, Cancer Research UK called for the same action. I am sure that the Minister will appreciate that taking steps to tackle childhood obesity will improve the health of the nation and have an impact on all obesity-related illnesses, not just diabetes. We want mandatory traffic-light labelling on all processed foods and mandatory calorie labelling in the out-of-home sector. We also want a commitment to introduce a ban on the marketing of junk food on TV before the 9 pm watershed.

The childhood obesity plan is key in helping us realise a world where fewer people live with diabetes and where it is easier to live a life with a low risk of developing type 2 diabetes. However, as we heard on the news just this morning, the millennial generation are predicted to be the most obese yet, and it is vital that the Government act now to avoid a diabetes health crisis in the future.