Health Promotion Bill [HL]

Lord Kamall Excerpts

2nd reading
Friday 2nd December 2022 Lords Chamber

[Lord Kamall (Con)]

My Lords, I congratulate the noble Lord, Lord Addington, on securing time to debate the Private Member’s Bill. I approach this debate with three words in mind: apathy, sympathy and empathy.

Let us start with apathy. During the debate on the then Health and Care Bill, I reassured your Lordships of the Government’s commitment to a national plan for sport and physical activity, and that it would be published later this year. I also informed noble Lords that the Government were working across departments—and I referred to the health promotion task force, led by the Health Secretary, and pledged to keep your Lordships up to date on the progress. I believe that it was this commitment that convinced my noble friend Lord Moynihan to withdraw his amendment.

Unfortunately, in response to a recent Written Question, the Department of Health and Social Care explained that the health promotion task force was not a part of an updated Cabinet committee structure. To be fair, the Answer also explained that the Government’s Our Plan for Patients would address preventable ill health through collaboration across government and the National Health Service. However, it gives the impression that the Government’s approach to health promotion now appears to be one of apathy—or, perhaps more kindly, lethargy. One of the ironies is that part of encouraging physical activity is to overcome individuals’ apathy. Whatever the true picture, I am afraid that there is now a perception that the Government cannot be bothered to take health promotion seriously. I hope my noble friend the Minister will be able to address this perception head-on.

However, this is where I also feel sympathy—indeed, sympathy for my noble friend the Minister, since none of this is his fault. These decisions were made way above his pay grade. While noble Lords can attach no blame to him I hope that, by challenging the Government in this debate, they will empower him to raise your Lordships’ concerns with his department and across government.

My disappointment at the Government’s apparent apathy and my sympathy for my noble friend the Minister leads to my empathy, since I completely understand and share the concerns of the noble Lord, Lord Addington, in bringing forward this Private Member’s Bill. I share the noble Lord’s concerns about the lack of progress, but I am afraid that I will have to respectfully disagree with some of his Bill. One reason why I welcomed the establishment of OHID is because I hope that having the word “disparities” in the name of the organisation will force it to do what it says on the tin—that is, to identify and address health disparities, as the noble Baroness, Lady Uddin, said. This reminds me in some ways of the debate when many noble Lords asked for mental health to be explicitly on the face of the then Health and Care Bill, even though health is generally understood as both physical and mental health.

Whether we term it health improvement, health promotion or health creation, I know that noble Lords agree that it is important, but I hope that we can move on from the debate around health improvement, which seems sometimes to be reduced to the question of whether you burn off calories versus reducing calorie intake. It should not be a question of either one or the other. We can argue about the data and whether reducing calorie intake is more effective than physical activity, but surely the important thing is to encourage both. Indeed, some believe that physical activity may lead to less calorie consumption. A 2019 article in the International Journal of Obesity concluded that

“15-week exercise training appeared to motivate young adults to pursue healthier dietary preferences and to regulate their food intake.”

But everyone is different. There are also studies of people with eating disorders doing excessive exercise followed by binge eating, so we really need to understand it at the level of the individual.

I think that most noble Lords would agree that we should all do more to encourage physical activity. Fortunately, a lot has changed since my youth, when it was about selecting the best and forgetting about the rest. If you did not make the first or second team, you were more likely to be discouraged and give up. Unlike the noble Lord, Lord Addington, I am unable to refer noble Lords to the register of my interests, although I really wish I could for this debate. I was still playing five-a-side football into my 50s and playing with people 30 years younger, and my wife expressed some concerns. I needed allies, so I went to see my physiotherapist, hoping that she would be my ally, and she said, “I’m afraid I agree with your wife—you should give up playing football with people 30 years younger than you.” But that does not stop one from doing physical activities. Nowadays we see more clubs in local communities encouraging people to play sport, no matter their ability. We also see an emphasis on physical activity rather than just sport, encouraging individuals to find the physical activities that they enjoy the most—or perhaps dislike the least.

During my brief time in the Department of Health and Social Care, I became interested in the idea of social prescribing, helping people with physical and mental health conditions through the power of music, the environment, arts and physical activity. I recognise that there is scepticism from some clinicians, but I have heard of so many positive stories of people for whom it worked. But with an ageing population and increased pressures on the state, we should also remember that the state cannot do this all or alone. We need to encourage more local neighbourhood civil society groups, which better understand the people in their local communities. By asking the Government to be more involved, we should be wary that they do not squeeze out civil society but better co-operate and co-ordinate cross-government initiatives in partnership with it.

To sum up, I am disappointed by the Government’s apparent apathy in promoting better health. I sympathise with my noble friend the Minister, since none of this is his fault, and I empathise with the noble Lord, Lord Addington, and his frustration at the lack of progress, even though I disagree with renaming OHID. I end with a question to my noble friend the Minister. Now that the health promotion task force no longer exists, how will the Department of Health and Social Care drive cross-government action to improve health outcomes?