Stroke Treatment

Lord McColl of Dulwich Excerpts

Wednesday 27th March 2024 Lords Chamber

[Lord Markham (Con)]

The stroke quality improvement for rehabilitation—SQuIRe—services are where we are trying to take best practice from London, France and around the world and roll it out. The good news is that we have the model; it is based on a national model for an integrated community stroke service. We have got that in 65% of locations, with the goal of making it 75%.

[Lord McColl of Dulwich (Con)]

My Lords, as there are 40 million people at risk of stroke because they are obese or overweight, would it be a good idea for the Government to recommend, as I have done for some time, that people have one fewer meal a day? That would reduce their weight and their expenditure.

[Lord Markham (Con)]

My noble friend is correct that weight and obesity is a major factor in all sorts of conditions, including strokes. Encouraging people to eat correctly, in a healthy manner, is absolutely the right way to go.

As this is the last time that I will see your Lordships, I wish all noble Lords a happy Easter. I for one am looking forward to the break.

Cancer Research UK Report

Lord McColl of Dulwich Excerpts

Tuesday 5th December 2023 Lords Chamber

[Lord Markham (Con)]

Absolutely. I thank the noble Baroness for the work that she does in this field. I welcome the manifesto, specifically on rebuilding the global position in research. We have done a good job on that: we have gone from a position of 26% of the clinical trial responses being in time to international standards to over 80%. The biggest prevention method that anyone could take is to stop smoking because, as we know, that is the biggest cause of lung cancer, so we are introducing steps to prevent smoking. On early diagnosis, we have introduced an excellent example in lung cancer. Some 60% of people used not to be detected until they were stage 4, which is often too late. Now, through the mobile lung cancer units, we are detecting 70% at stage 1 or 2, where they have a 60% chance of survival. Across the field, we are doing a lot on this that we can feel proud of.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister recognise that one of the causative factors of cancer is obesity? Some 40 million people in this country are obese, and according to the latest estimate it is costing £100 billion a year. Is it not time to adopt the campaign technique that Norman Fowler—now the noble Lord, Lord Fowler—successfully conducted in the 1980s? He had the courage to state the truth and make sure that it was successful.

[Lord Markham (Con)]

Yes, we are taking extensive action on the obesity front. As well as being a major cause of cancer, it is the cause of a lot of ill health. We have taken a lot of action against 96% of the reasons given in obesity research on calorific intake, with regard to what people buy in supermarkets. Also, the soft drinks industry levy—the sugar tax—has decreased sugar in drinks by at least 14%.

Children’s Health: Ultra-processed Foods

Lord McColl of Dulwich Excerpts

Wednesday 25th October 2023 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords, in this debate it is very important to consider the science and history of the obesity epidemic. The history is that the food industry in the 1960s promoted a low-fat, low-fibre diet, which makes people eat more and become obese. Science has exposed the errors of the food industry; the science is that when fat enters the duodenum, it releases from the duodenal mucosa a hormone called CCK, which delays the emptying of the stomach and makes the patient feel full early on in a meal. It is a beautiful mechanism for preventing obesity, which is why the food industry hates that mechanism and keeps on recommending a low-fat diet, which is so tasteless that it had to add large quantities of sugar to entice people to eat its rather tasteless products.

A recent study from Canada revealed that thousands of children fed on whole milk, with plenty of fat, were much less likely to be obese than those who were not so fed. Unfortunately, the Department of Health seems to be obsessed with low-fat diets, in spite of the evidence. I even had a letter just last month from a Parliamentary Under-Secretary for Health, who again recommended a low-fat diet.

The removal of fat and fibre, in the form of wholemeal bread and vegetables, increases appetite and obesity. That is why we must ensure that food contains plenty of fibre and the right kind of fat. Highly processed foods appeared many years later than the beginning of the obesity epidemic and much more work needs to be done to determine exactly how appetite stimulators are supposed to work.

Another important misleading aspect is the great emphasis on telling obese people that the whole subject is so confusing, difficult and multifactorial. It is just telling them, “Well, it’s just one of those things, and you don’t need to bother too much”. They say anyway that it is genetic. What do they mean by that? It does not matter what your genetics are, there is only one way of becoming obese: by putting too many calories into the mouth. We need much more scientific work to reveal how much genetics could increase obesity. There has also been an attempt to glamorise obesity, stating that you can be “fat and fit”. The paper that purported to make that claim is very superficial and incomplete.

In summary, we need to emphasise the fact that the removal of fat and fibre and the insertion of sugar has caused the obesity epidemic. We do not need complicated formulae like BMI. It is best to keep things simple. A simple slogan is: if your waist measurement is more than half your height, you are eating too much of the gross national product and you are on the road potentially to a premature death from a variety of very unpleasant diseases.

Children’s Health: Sugar

Lord McColl of Dulwich Excerpts

Tuesday 12th September 2023 Lords Chamber

[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.

[Lord McColl of Dulwich (Con)]

My Lords, is the Minister aware that, in Canada, thousands of children have been fed on whole milk for many years, and their problems with obesity do not exist? The food industry has deliberately promoted a low-fat diet. It is a lousy diet that tastes horrible; that is why they have had to shovel in such vast quantities of sugar. Could the Minister ensure that the Department of Health no longer advocates a low-fat diet? Fat going into the duodenum acts on the stomach, making it empty more slowly and therefore giving the feeling that the patient has had enough.

[Lord Markham (Con)]

I think one of the things that, hopefully, I have learned in the almost year that I have been answering Questions is when I know the answer to a question and when I do not. I am afraid this is one of the examples of the latter. I will happily look up the Canadian example of the use of whole milk and write to the noble Lord on it.

Adult Social Care: Challenge Procedures

Lord McColl of Dulwich Excerpts

Wednesday 19th April 2023 Lords Chamber

[Lord Markham (Con)]

Yes, absolutely; a large part of it is from central government funding and a large part is from local authority funding, given local authorities’ ability to use a precept and increase council tax. Of the 153 local authorities, 151 have taken that opportunity to increase the council tax.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree that in talking about the costs of health and social care, we seem to have forgotten that 40 million people in this country are moving slowly towards suicide by putting too many calories in their mouths, which is costing £27 billion every year?

[Lord Markham (Con)]

I will answer quickly to allow a final question, but yes, our anti-obesity strategy is very much about that.

Bread and Flour Regulations 1988

Lord McColl of Dulwich Excerpts

Tuesday 7th February 2023 Lords Chamber

[Lord Markham (Con)]

I am very aware of the range of scientific advice on this. I am also aware that the official results of the consultation, which will come out, are not clear cut. A sizeable number of people, 40%, are anti-fortification. As ever, it is about trying to get that balance right. We completely agree on the direction of travel. There is some scientific advice that at too high a level there is a potential masking of pernicious anaemia in the elderly. This is the first step. Let us get all the evidence. The critical thing is getting that first step right.

[Lord McColl of Dulwich (Con)]

My Lords, can my noble friend the Minister find out exactly how many people are involved in the decision-making on this subject? How often do they meet?

[Lord Markham (Con)]

I do not know the precise number; I know there are many stakeholders in this. The devolved Administrations have been involved in all of this. Part of the delay is because, once we go ahead, we have to notify the EU, because of the Northern Ireland elements of it, and that is a six-month notification. We also have to notify the World Trade Organization. All these aspects mean that this is not as quick as we would want, and then we need to let the industry have time to adjust. It is a process involving many people, but we are getting there.

Excess Deaths in Private Homes

Lord McColl of Dulwich Excerpts

Tuesday 10th January 2023 Lords Chamber

[Lord Markham (Con)]

I am definitely seized with the urgency. I was able to speak to Sir Chris Whitty about a number of those, including last summer. The heatwave was a factor then: we had over 2,500 excess deaths caused by the heatwave over those couple of weeks. There were multiple factors. You have heard me say, again from Sir Chris Whitty, that cardiovascular disease is a real concern: for those three years that people missed going to their primary care appointments, they did not get their blood pressure checked in the same way, and we did not get the early warning indicators. That is another thing that you will hear me talk further about, so that we can get ahead of the curve, because those are the areas of excess death that we risk in future.

[Lord McColl of Dulwich (Con)]

My Lords, have we not forgotten something? When we blame all sorts of factors for these excess deaths, have we forgotten that there are 44 million people in this country suffering from the disease called obesity and all the complications that arise from that? This means that these people are moving inevitably to a premature death from a variety of very unpleasant diseases.

[Lord Markham (Con)]

My noble friend makes a good point that prevention is a key part of this agenda, as is the role that we all take in our individual health and well-being. Obesity is included as a key part of this as well. We need a four-pronged approach that tackles the things that we as individuals need to address as well, to make our own lifestyles healthier.

NHS Dental Contract

Lord McColl of Dulwich Excerpts

Thursday 1st December 2022 Lords Chamber

[Lord Markham (Con)]

I thank the noble Lord. As I mentioned, dental deserts are very much a part of the package we are looking at. To give noble Lords an idea of the sense of direction, another approach to the workforce issue is a modular escalator system, and we are talking to the BDA about training. For instance, on the way to becoming a fully qualified dentist, might a dentist become part-qualified, allowing them to do some dental nurse treatments, thereby adding to that capacity in the meantime? These are all measures we are looking at to increase the workforce.

[Lord McColl of Dulwich (Con)]

Can the Minister tell us what proportion of the population is actually receiving fluoride in their drinking water?

Childhood Obesity

Lord McColl of Dulwich Excerpts

Thursday 17th November 2022 Lords Chamber

[Lord Markham (Con)]

I agree that health visitors play a vital role. We all know that a good start to life with healthy eating is a good foundation for the rest of your life. We also know that a lot of the problems around adult obesity obviously start in children under the age of five. I completely agree on continuing to strive to do better in government. I will answer some more questions on the actions we are taking, from which the noble Lord will see that we are very active.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree that, as 40 million people are obese in this country, marching inevitably to a premature death from a variety of very unpleasant diseases, it would be a good idea to encourage them to have one less meal a day? This might encourage children to follow suit and put fewer calories into their mouths, which would help prevent them developing type 2 diabetes before they are 10.

[Lord Markham (Con)]

My Lords, I agree that we—both as the Government and in general—need to be clear about what our recommended calorific intake is each day. Whether you choose to change that by eating one less meal, or however else you distribute your eating across the day, it is our role to help educate people on healthy eating. I agree that it is an issue and a big cost to both the health service and the economy. Our latest estimates are that it could cost the economy as much as £58 billion a year, so it is a critical message to get across.

British Heart Foundation: Tipping Point Report

Lord McColl of Dulwich Excerpts

Tuesday 8th November 2022 Lords Chamber

[Lord Markham (Con)]

The House will agree that we provide some very detailed information on excess deaths. That is quite sufficient at this time.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree that, when we talk about increasing mortality, there is a very obvious cause for this? Some 40 million people in this country are obese and moving inevitably to very premature deaths from a variety of very unpleasant diseases. This could be prevented if they had one fewer meal per day.

[Lord Markham (Con)]

My noble friend is referring to the healthy eating agenda, which we very much support. It is a key component of health and enjoyment of life. The more we can do in that department, the better. We have taken some very solid steps on sugary drinks and, more recently, on the product placement guidelines, to show that that is central to our beliefs.