Premature Deaths: Heart and Circulatory Conditions

Lord Brooke of Alverthorpe Excerpts

Tuesday 6th February 2024 Lords Chamber

[Lord Markham (Con)]

Yes. Those are all key measures that we need to take and, I like to think, are making progress on. I thank the noble Baroness for her work and all the noble Lords who have been working on the Times Health Commission, which is a valuable contribution to this debate. I mentioned digital health checks. I have seen technology where holding your phone up in front of you can test your blood pressure and your heart rate. We need to verify that, but I think that is definitely the way of the future as well.

[Lord Brooke of Alverthorpe (Lab)]

Can the Minister say why the Government are refusing to review the regulations governing children’s meals? We know that the sugar content in them is too high and that our children are eating too much sugar. This needs to change, yet the Government refuse to look at the regulations and enforce them properly.

[Lord Markham (Con)]

I am not quite sure that I agree with the word “refuse”, but I agree with the noble Lord that healthy food in all environments is a good thing. I know that the delay happened because it was originally planned for 2020 or 2021, I think, and then the pandemic got in the way. I freely accept that the review now needs to take place. We are not refusing to do it, because it is an important part of the armoury.

National Health Service: 75th Anniversary

Lord Brooke of Alverthorpe Excerpts

Thursday 30th November 2023 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to my noble friend Lord Hunt of Kings Heath for his—as expected—truly amazing speech. He is a man with great experience of the health service, both before he came into this House and, in particular, while he was serving here as a Minister. He is a man of great value; he is one of the few politicians around who resigned on principle on an issue. He resigned over Iraq. I was one of those who was on the wrong side and I admire him greatly for the work he has done and what he continues to do.

As he mentioned—as did the Baroness, Lady Pitkeathley—I also spoke on this way back in 2003. I also spoke in 2018, when we were celebrating 70 years. What particularly interested me then was that the standing of the NHS in the eyes of the public was very high. I thought it was a great opportunity for us to try to take this jewel. The NHS is something which binds us together. As the previous speaker just said, it is important that we go back to that and find ways in which the public attitude, as it presently stands, is reversed.

I suggested in 2018 that we ought to think about creating a national charity for people to participate in and leave gifts in their wills to, and so on. The Government said no, because some trusts already have their charities and that would undermine them. Well, some trusts do have them and they are very successful, but, if you examine it, you will find that the ones getting great amounts of money are in wealthy areas. In the dispossessed areas, where we have the worst health and growing rates of ill health, you will find that charities either do not exist or, if they do, not much money is going in. I would be prepared to put something in my will—not for Chelsea and Westminster, which I am close to, but for the NHS. The money would then be redirected to the areas of poverty where we need to be making the greatest changes.

If we look at what is happening, as my noble friend Lord Hunt pointed out, we are starting to see for the first time in near history that life expectancy is halting and going in the other direction. If you live in Westminster, your life expectancy is going to be of the order of 86 years, but if you are in Manchester it is down to 77 or 78—and this is happening against a background of general decline in many areas of the health service.

I hope the Minister might still give some thought to the idea that we should try to find ways of having far greater involvement of the public. The charity approach was one idea. When Alan Milburn was Secretary of State, he tried to find ways to get more people involved. They even explored the idea of shares in the NHS, so that people were making a personal commitment to it. I still believe there is merit in going back to some of those issues.

Covid has of course made a difference, and we should not deny that—the Minister will, without a doubt, labour this point in defending the state we are in. When we came into power in 1997, the health service was in a mess and, as was said, it is in a mess again. We have to find our way forward. Care in particular has to be addressed, and we have a plan there, but I believe that the way forward will be to try to involve more people in building a base for revising our approach to it. I appeal to the Minister: the Government made promises in 2019 but have not delivered on anything, so would they be prepared to consider working closely with the new Government, if Labour comes to power, to try to take care out of the Punch and Judy that we have had so much in the past—to come together and to shift care away from political disputes between the parties? I hope the Lib Dems might be willing to give their support to that entirely different approach to care, because it is so desperately needed.

I wonder why this review of Covid is going on until 2026. How much money will be spent on it before it is completed? Would it not be better spent on trying to address some of our current problems in the health service? With Covid, some underlying causes needed addressing. The first was age—and care is the way we start to address that properly. The second was the underlying cause of weight: 50% of the deaths attributed were attached, for a variety of reasons, to people being overweight. The Government have a number of proposals for change, but have fallen well short. They made a grave mistake in winding up Public Health England—at least it was seen as a focal point for campaigning, and it was coming out with strategies that were noticed. We have completely lost focus on where we go in campaigning on obesity, and I hope that, when my party comes to power, it will address that more than it has been addressed in the past. The third area that was identified in the Covid review was the disproportionate number of people of colour who suffered badly. As was mentioned, a recent report says that people of colour are still gravely disadvantaged in health terms compared with the white population. We need to find new policies to address that difficulty and to turn it around so that people start to feel that they are a better part of the community than they are now.

My appeal overall is to try to take certain areas where we are failing to make progress out of the Punch and Judy of politics, to develop new relationships that would move us forward on issues that we have all had policies on for years but have not made progress on. I hope the Minister spends some time, in responding, on the need to get the public more involved than they have been and to get some unity of purpose between the parties in the areas where we have still not made any movement but should have.

Ultra-processed Food

Lord Brooke of Alverthorpe Excerpts

Thursday 26th October 2023 Lords Chamber

[Lord Markham (Con)]

I have said many times that the prize is reformulation. I do not think that any of us should have a problem per se with the food if the bad stuff is taken out. Diet Coke is a perfect example. It is not particularly good for you but not bad for you either, so why should Coca-Cola not be able to advertise Diet Coke? If you take out the bad stuff, we should encourage industry because advertising works. It wants to advertise, so if it is encouraged to take out the bad stuff, that is a big incentive.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, as far as I recall, it was said that we should keep it simple and that the focus should be on sugar. When will the Government look at children’s school meals, review the regulations and reduce the sugar in children’s free school meals?

[Lord Markham (Con)]

The noble Lord makes a very good point. A healthy start to life is vital, which is why I am very pleased to say that we have the highest level of free school meals ever, with every infant school kid and a third of children overall having a free school meal. On the composition of those foods, I know that this was planned but was stopped due to Covid. The timing is now being reviewed again, because things move on in terms of the content and healthy foods.

Children’s Health: Sugar

Lord Brooke of Alverthorpe Excerpts

Tuesday 12th September 2023 Lords Chamber

Asked by

[Lord Brooke of Alverthorpe]

To ask His Majesty’s Government what assessment they have made of the impact of sugar on children’s health.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

The Scientific Advisory Committee on Nutrition undertook a comprehensive assessment of sugar intake and health in its 2015 report Carbohydrates and Health. In 2023, it looked specifically at children aged one to five. SACN concluded that reducing the intake of sugar would lower the risk of tooth decay and weight gain in children and adolescents. The Government have an ambitious programme to reduce children’s sugar intake, which includes the soft drinks industry levy.

[Lord Brooke of Alverthorpe (Lab)]

I thank the Minister for his reply. One area where the Government have failed to take the action they should is to encourage the industry to reformulate food more than it is doing at the moment—to take out sugar and substitute the alternative, organic, healthy sweeteners that are available. Would the Government look into this and do some more work? Would they be prepared to invite companies that are willing to enter public/private partnerships to start doing that?

[Lord Markham (Con)]

First, I recognise all the work the noble Lord does in this space. Secondly, I completely agree that reformulation is the big prize as part of this. The House will remember me mention before that Mars, Galaxy, Bounty and Snickers have all reformulated their food, as has Mr Kipling and his “exceedingly good” cakes—they are compliant cakes as well. There is a lot being done here, but there is more to do. We meet the industry all the time and are very happy doing so.

MMR Vaccine

Lord Brooke of Alverthorpe Excerpts

Thursday 20th July 2023 Lords Chamber

[Lord Markham (Con)]

Yes. That is where we really see UKHSA coming into its own in terms of taking an intelligence-led approach. The concern came from its modelling: its epidemiologists brought this up as a concern, which led to the alert going out on 14 July. Likewise, it is looking into other categories and, where there are those concerns, it will come out and suggest such outreach programmes.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I refer to the question asked earlier by the noble Lord, Lord Young, about the high level of absence of children from school at the moment; I believe the present figure is in the order of 24%. What special steps are being taken there, where the appeal to the school will not make any difference yet we have to try to get to the homes of the individual parents?

[Lord Markham (Con)]

As mentioned, there are outreach programmes, particularly for home-schooled children or children who are not there. There are also programmes in community centres, with the idea of trying to pick them up in as many places as possible. Obviously, there is concern about certain communities that are harder to reach than others. That is particularly the case in London, as I mentioned earlier. That is where we are trying to specifically target those community centres with outreach work.

Food: Two-For-One Offers

Lord Brooke of Alverthorpe Excerpts

Wednesday 19th July 2023 Lords Chamber

[Lord Markham (Con)]

I am aware of the Amsterdam initiative. Off the back of that, the OECD said that there were four main strands to what countries should be doing: first, information and education, such as the good examples I spoke about; secondly, increasing healthy choices through the reformulation of foods, which again is something we are doing; thirdly, the modifying of costs—the sugar tax, which has reduced sugar consumption by as much as 40%, is a perfect example of that; and, fourthly, restrictions on where product placement should take place. I am absolutely familiar with the initiative in Amsterdam, and am pleased to see that we have taken action on a lot of those things.

[Lord Brooke of Alverthorpe (Lab)]

Is the Minister not ashamed about what has happened to children’s health while the Conservatives have been in power since 2010? We have more obese children than ever before, and a plethora of policies which would work if implemented, yet so many are delayed. Will the Minister give a commitment to go back and look at the regulations governing children’s school meals? They were changed in 2014, with permission granted to give children more sugar. The Government were reviewing this in 2019 and 2020, but that stopped because of Covid. Will the Minister give a commitment again to start a review? Even if they cannot implement it, the next Government could.

[Lord Markham (Con)]

The noble Lord is correct: good school meals are fundamental to all of this. My understanding is that the review is something that the Government are looking to do, but I will happily provide more details on what the plan is.

Ultra-processed Food

Lord Brooke of Alverthorpe Excerpts

Tuesday 18th July 2023 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend. We are focused on the sugar, salt and saturated fat content. It is not the fact that food is called ultra-processed, per se. We would not discourage people from eating whole- meal bread, but wholemeal bread is considered to be a processed food. The action we are taking is for a reduction in sugar, salt and saturated fat.

[Lord Brooke of Alverthorpe (Lab)]

The Minister is focusing on reducing fats, salt and sugar in meals. When are the Government going to reduce those elements in school meals for children?

[Lord Markham (Con)]

Absolutely. That is why we are at the highest level of free school meals for children ever. More than a third of children are now receiving free school meals, including all infant schoolchildren. The noble Lord is correct that a healthy start to life is vital, and if we can make sure that children are getting a good, nutritionally balanced school meal, that is a good start to life.

Community Health Services: Waiting Lists

Lord Brooke of Alverthorpe Excerpts

Wednesday 12th July 2023 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend. This was actually a conversation of a big task force summit that we had just last week. We commented that a lot of people have pregnancy plans, for instance, which might say that they want to have birth planned at home; a lot of people will have “Do not resuscitate” plans; what we do not have enough of are frailty plans, which say, “I don’t want to go into hospital. I’d rather be cared for at home. I know it might mean that I don’t live for quite as long, but that’s my preference”. I think there is a whole debate that we need to have to start to move towards that, and to make sure we have that support in the community to do it as well.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, is the Minister aware of the spare capacity of therapists in the private sector, some of them specialising in the mental health of children? As we have such long waiting lists for children and mental health, why is that not being used?

[Lord Markham (Con)]

The noble Lord is correct, and my understanding is that we are looking to use the independent sector more and more. I will check and verify this, as it was from the briefing probably about three or four months ago, but my belief is that about 51% of the physiotherapy that we use is from the private sector. I absolutely agree with the noble Lord that we need to use the independent sector more and more in these situations—something pioneered by the noble Lord, Lord Reid, over there.

NHS National Health Inequalities Improvement Programme

Lord Brooke of Alverthorpe Excerpts

Thursday 25th May 2023 Lords Chamber

Asked by

[Lord Brooke of Alverthorpe]

To ask His Majesty’s Government whether the NHS National Health Inequalities Improvement Programme plans to review and improve the nutrition of free school meals.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

The focus of the NHS healthcare inequalities improvement programme is the delivery of healthcare services. Free school meals are outside its remit. The Department for Education continues to keep school food standards under review. The current standards provide a robust yet flexible framework to ensure that pupils in England continue to receive high-quality and nutritious food. Developing healthy habits early in life can influence health in childhood and reduce the risk of diet-related diseases in later life.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the Minister for his reply. Who actually is responsible if one tries to change the formulation of school meals for children? In previous debates on obesity, he has stressed the importance of reducing calories. The Government have estimated the number of calories that need to go down to get child obesity down. As we are giving children so much sugar in school meals and such highly processed food, why do they not run a trial with less sugar and healthier food than we are doing at the moment to try to deliver on the calorie objective, which he has talked about previously?

Social Care: Workforce Strategy

Lord Brooke of Alverthorpe Excerpts

Wednesday 22nd March 2023 Lords Chamber

[Lord Markham (Con)]

Absolutely. I speak as an ex-carer myself. Caring is part of everyone’s role, as has been quite rightly written about. Part of this is about the people we are employing. I am glad to say that we are managing to increase recruitment, which is not easy in the age of full employment. It is about the parts that you and I—all of us—can play in care in the community, and organising domiciliary care so that we can have a full wraparound service.

[Lord Brooke of Alverthorpe (Lab)]

My Lords, on seeking to increase the size of the workforce, could the Minister give an indication of whether there will be more overseas workers? They have made such an important contribution in the past but have run down in numbers latterly, yet people want to see more coming from overseas.

[Lord Markham (Con)]

Yes, and I am delighted to say that it is working. We will have granted 57,000 visas towards that in the last year, which is a big increase on previous years. It is fundamental, and a fine tradition of our health and social care services, that we can use overseas workers.