Childhood Obesity Strategy

Maggie Throup Excerpts

Thursday 21st January 2016 Commons Chamber

[Dr Wollaston]

I thank the right hon. Gentleman for that and welcome what he describes. That movement is not just happening in City Hall, because it is being recommended within the NHS by Simon Stevens. I also congratulate Jamie Oliver and the many other outlets that are introducing such an approach. The other point to make is about public acceptability, because all the money raised goes towards good causes. As we have seen with the plastic bag tax, the fact that the levy is going to good causes increases its public support. That levy has been extraordinarily effective, as plastic bag usage has dropped by 78%. That is partly because we all knew we needed to change but we just needed that final nudge. That is what this is about: that final nudge to change people to a different pattern of buying. It has a halo effect, because it adds a health education message and that is part of its effectiveness.

[Maggie Throup (Erewash) (Con)]

I am a fellow member of the Health Committee, in which we also discussed ring-fencing the sugary drinks tax so that money could be put back into health education about obesity, particularly in schools, to prevent child obesity in the future. Could my hon. Friend speak a little more about that?

[Dr Wollaston]

I thank my hon. Friend and fellow member of the Health Committee for her intervention. At a time of shrinking public health budgets, there is a huge additional benefit from having this kind of levy, in that many of the other measures that the Minister will want to see in the strategy—on exercise in schools, teaching in cookery lessons and health education—could be funded in part through a sugary drinks tax. I hope she will look carefully at this idea and consider introducing it.

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[Will Quince]

I thank my hon. Friend and I would be delighted to take another look at that piece of research.

My hon. Friend has made a case for the sugar tax to protect the poorest, and I think that that was the point that she was just making. As I have mentioned, and this is a good point, the poorest children are the most likely to be obese. However, the statistics show that, in low-income households in Britain, soft drink purchases dropped by 14% between 2007 and 2013. Perhaps a 20% sugar tax on soft drinks is not very much to celebrity chefs such as Jamie Oliver and some of those who are pushing the idea of a sugar tax, but for those on the lowest incomes—who we know, proportionally, buy these products—about 12p a can or 37p per 2 litre bottle is a massive amount of money.

[Maggie Throup]

I think that the point is that we are talking about a tax on sugary drinks and there are alternatives, such as drinks with artificial sweeteners. We are not making it so that these people do not have a choice. There are two different sides of the argument.

[Will Quince]

I thank my hon. Friend for that intervention. As someone who spent five years working in the soft drinks industry, I think she makes a valuable point. We need to question what we want our children—and adults —to drink. Do we want them drinking sugar or sodium benzoate, acesulfame and aspartame? That is a whole separate debate that we can have. I tend to choose to drink diet variants myself, but those options are there and the industry is driving people towards those lower calorie drinks. Let us take Britvic Soft Drinks as an example. Members will notice that they can buy a 600 ml bottle of diet Pepsi or Tango for the same price as a 500 ml full-sugar variant. The industry is already encouraging behavioural change.

To return to the Mexican experiment, 63% of sugar tax receipts have been collected from low-income households and 37.5% of receipts came from those in poverty. As I mentioned before, particularly with soft drinks but across the board, labelling has never been better, nor has the choice for consumers. The industry is doing a huge amount of work to encourage behavioural change and do the right thing.

I am conscious of the time and that lots of Members would like to speak, so I will conclude. I welcome a debate on childhood obesity and a clear strategy to reduce it. There are a huge number of measures that we as a Government could take ourselves and that we could encourage businesses and organisations to take, but let us ensure that the strategy is based on solid evidence. I strongly believe that a sugar tax is not the answer.

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[Maggie Throup (Erewash) (Con)]

I am pleased to contribute to this debate as chair of the newly reformed all-party group on adult and childhood obesity. The group has been set up to bring together Members of both Houses and parliamentarians of all parties who want to explore the best ways to lower the obesity rate. There is no doubt that such a group is needed. It barely needs repeating, but two thirds of adults are obese or overweight, as are more than a third of children. Such a pressing public policy issue demands the constructive involvement of parliamentarians, and I welcome today’s debate as a means of highlighting the need for action. My vision is for the all-party group to become a forum for lively discussion of practical ways in which we can support people both to live healthier lives themselves and to help their children grow up healthy.

I understand why the role of the Government is a tricky one when it comes to tackling obesity. Some Government involvement is vital, but a Government cannot simply pass a law to make people eat healthier food and give healthier food to their children or legislate for a certain amount of exercise each day. What the Government can do is produce strategies, ideally for both children and adults, that lay out a longer-term solution for what is a long-term problem.

The worst thing that a Government could do would be to publish such proposals and then forget about them. Fortunately, the APPG will be there to keep an eye on the progress that is made, or not, and to work with the Government to promote what works and point out what does not work. I hope that Members on both sides of the House this afternoon, including my hon. Friend the Member for Colchester (Will Quince), with whom I usually agree, are interested in getting involved in the group, because all are welcome.

Let us focus specifically on childhood obesity, not forgetting that adults are role models. Our children are our future and it would be irresponsible as legislators not to take the future health of our nation extremely seriously. We must take whatever action is needed to address this issue. We can see the impact of obesity on the lives of adults in an increased risk of heart disease, diabetes and the life-changing complications that go with it, and cancer. All those medical conditions are life-limiting. Why would obesity have a different effect on children from the one it has on adults? It does not.

As my hon. Friend the Member for Totnes (Dr Wollaston) said, the Health Committee report on childhood obesity called for “brave and bold action”. That brave and bold action is needed from Government, the food and drinks industry, food outlets, educators and healthcare professionals. But let us not forget that all that will be wasted unless people take personal responsibility. This is a huge issue and fiddling at the edges will not work.

Today, there has been a lot of focus on the proposal for a sugary drinks tax. I was originally against it, but when I saw the compelling evidence, I changed my opinion, like my hon. Friend the Member for St Austell and Newquay (Steve Double). A sugary drinks tax should be just one of a range of measures. I believe that the food and drink industry can and should implement many of the measures that are needed without the need for legislation. The industry can make changes without legislation, given the will, and that is already happening.

In the run-up to this debate, I received many emails from organisations on both sides of the argument. I had one email from a leading supermarket, outlining the measures that it is taking. Those include reducing sugar in its range of breakfast cereals, chilled juices, fizzy drinks and yoghurts. I know that reformulations do not happen overnight, but I would like to think that the extra focus on obesity over recent months, including in Jamie Oliver’s campaign, has embarrassed manufacturers into making changes to their formulations in their own way, rather than as a result of legislation.

There is still more to be done. I am sure that we have all bought a newspaper from a well-known high street newsagents and been offered a mega-sized bar of chocolate at a special price. I do not know about my fellow Members, but if I want a bar of chocolate to eat while reading my newspaper, I will buy one without being asked—not that I do that, of course! What I am saying is that some manufacturers and retailers are taking the current and future health of our nation seriously and acting responsibly, but sadly others are not.

The causes of obesity are extremely complex and numerous, so it would be wrong of me just to focus on sugar. Fats, saturated fats and salt all have an impact on our weight, as does exercise. For adults—not for children, I hasten to add—alcohol also has an effect. It is because of this complexity that we cannot rely on just one measure. The Health Committee has made a range of recommendations, as has been outlined.

Regular exercise has a role to play. One of my local primary schools, Ladywood in Kirk Hallam, makes exercise fun. It is a member of the Erewash school sports partnership, it has active dinner playtimes and it links up with the secondary school, Kirk Hallam Community Academy, to take part in “This Girl Can”. We need to inspire young people at an early stage to make exercise a part of their way of life.

We must not forget that we need to consider cure as well as prevention. I have spoken to a number of healthcare professionals about this matter. Although it is important to recognise that people need to take personal responsibility for their own lifestyle, it is important not to stigmatise people who are obese. We must ensure that people recognise it as a condition, as they would with any other medical condition.

Obesity is a ticking time bomb. As politicians, we have a responsibility for the current and future health of our nation. I am ready to address it straight on.

Mental Health

Maggie Throup Excerpts

Wednesday 9th December 2015 Commons Chamber

[Mr Robin Walker (Worcester) (Con)]

It is a pleasure to follow the right hon. Member for Exeter (Mr Bradshaw). Like him, I want to talk about concerns raised by my constituents. However, I also welcome the £2 billion of extra funding that the Government have put into mental health, and the fact that we have put parity of esteem into law. My right hon. Friend the Member for North Somerset (Dr Fox) made a powerful case for the need to invest in in-patient capacity. In Worcestershire, I welcome the improvements made in the Holt ward in Newtown hospital, but there is clearly a need for more investment of that kind. It is also essential that we take on the remaining stigma around mental health, and I echo the words of support for brave colleagues who have spoken out on this issue.

Members of the Worcestershire Youth Cabinet have, over the last year, set themselves the challenge of raising awareness of mental health issues, combating stigma and providing better signposting and co-ordination for young people with mental health problems, and I commend their collective effort in this regard. In particular, I commend the passion with which my young constituent, Darian Murray, has spoken out on this issue, and the leadership he has shown in bringing together different groups from around the county.

[Maggie Throup (Erewash) (Con)]

Does my hon. Friend agree that young people are probably more able than older generations to talk about mental health issues?

[Mr Walker]

I agree with my hon. Friend. The way in which young people have spoken out about these issues is very impressive. As in many other areas, perhaps they are showing us the way in relation to taking on that stigma.

In that vein, I also welcome the excellent work done for people with learning difficulties by members of the Worcestershire People’s Parliament. In the hustings they organised during the general election, and in their subsequent campaigns on mental health, they have attracted cross-party support in Worcestershire. Attitudes towards mental illness have changed for the better in recent years, and I hope we will see further progress in the years to come.

I welcome the fact that the Under-Secretary of State for Disabled People, my hon. Friend the Member for North Swindon (Justin Tomlinson), has held a reverse jobs fair in his constituency to help people with disabilities of all kinds, but particularly with mental health issues, to find work. I am planning to copy his idea in the new year, and to work with local charities and businesses to promote opportunities for people with mental health and learning difficulties.

I have some concerns about a recent consultation carried out by the Worcestershire Health and Care NHS Trust on vocational centres for mental health. In Worcestershire, we have three such centres providing therapeutic support, re-enablement and support to people who might otherwise have difficulty getting back into work. One of the centres is in my constituency at the Shrub Hill workshop. Another is in the constituency of my hon. Friend the Member for West Worcestershire (Harriett Baldwin) at Link Nurseries. The third is in the constituency of my hon. Friend the Member for Redditch (Karen Lumley) at Orchard Place. Earlier this year, the trust launched a consultation on the future of those services, saying that the commissioners were reducing their budget by a third and implying that they were considering moving from three centres to two.

Many of my constituents contacted me to express their strong support for Link Nurseries and the Shrub Hill workshop, and a number of people gave examples of how the services had helped them to turn their life around. I have no doubt that my hon. Friends in neighbouring constituencies will have heard similar stories from their constituents. It became apparent that it was not necessarily the best use of resource for the trust to run the centres itself, and that there were many charities doing excellent work in that space that it could commission to do that. My hon. Friend the Member for West Worcestershire has been working with staff and supporters of the very popular service at Link Nurseries to see whether the service could be taken over as a social enterprise by staff, who could continue to deliver the service that has been offered with such success.

That is an approach I would support, and I have written to the trust and spoken to local commissioners to encourage them to explore it. I was pleased to see in an update from the trust today that the matter is under active consideration. It is, however, a matter of great concern that although the initial consultation suggested a move from three centres to two and a greater focus on outreach, the trust’s latest thinking appears to involve closing all three of the centres and replacing them with a single one as part of a hub-and-spoke model. It is small comfort that the proposed single hub would be in my constituency. We all recognise the benefit of having more outreach, but I have to question the whole approach of a consultation that appears to be cutting back on an important service, valued by service users, at a time when demand is apparent and the overall budgets of health commissioners are being increased. I urge the Minister to look into this matter and see whether he can do anything to encourage the commissioners to have another look.

Another aspect of mental health provision in Worcestershire that causes me concern is support for A&E. We piloted 24-hour mental health liaison for the A&E at the Worcestershire Royal hospital, and the acute trust and the health and care trust found it incredibly helpful. At the end of that pilot, both trusts asked for that support to continue. I note that the crisis care concordat calls for people to be given access to support 24 hours a day before crisis point, and to be given urgent and emergency access to mental health care. As the Secretary of State said, it is welcome that, since the concordat, the number of people going through mental health crises who are held in police cells has halved nationally. However, I am afraid that in south Worcestershire, the commissioners decided early in 2014 that the 24-hour cover was to be withdrawn, and replaced with a specialist nurse during the daytime and access to telephone support overnight. The Minister has given a helpful reply to written question on this matter.

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[Maggie Throup (Erewash) (Con)]

It is a pleasure to follow the thoughtful speech made by the hon. Member for Rochdale (Simon Danczuk). The issue of mental health is such an important one, and it cannot and should not be swept under the carpet any longer. I pay particular tribute to the right hon. Member for North Norfolk (Norman Lamb) for his work in this place during the last Parliament—he has definitely left a legacy.

How people talk about the issue of mental health is similar to how we spoke about cancer a few years ago. People did not talk about cancer because they hoped it would go away. Similarly, people have not been talking about mental health—they were hoping it would go away, but it has not done. Mental health, sadly, is not going away and the sooner that is recognised, the better. Putting mental health on a level playing field with physical health means that people are now talking about it. The issue of mental health and its impact has recently been recognised by an important group of young people. For the past seven years, Girlguiding UK has carried out a girls attitude survey, which canvasses the opinions of more than 1,500 girls and young women between the ages of seven and 21. As year-on-year surveys can be compared, it is interesting to note that five years ago the area of most concern to those surveyed was alcohol and drug abuse, whereas in the 2015 survey, published in early October, today’s cohort of girls and young women has changed that to mental health. I stress that those surveyed were not just girl guides, but a much wider audience of young ladies and girls across the country. That gives the survey validity and it needs to be taken seriously. What was concerning was that the survey showed a mismatch between what concerns young people and what parents think concerns young people. The girls taking the survey feel that their parents are worried about what they perceive as traditional risks such as smoking, drug and alcohol use and unplanned pregnancy, whereas their own top concerns are mental health and cyber-bullying. As we heard from my hon. Friend the Member for Worcester (Mr Walker), those young people are definitely not sweeping the issue under the carpet.

Further information coming out of the survey indicated that fewer than half the girls surveyed have talked about mental health in lessons at school, despite the majority saying that that is where they would most like to get information about it. In my short time as a Member of Parliament, I have had a number of cases in my advice surgery relating to mental health issues in young people, and this problem is not going away. Headteachers at my local schools have also highlighted to me the problem of mental health issues starting at a very young age. That is why I am planning in the new year to convene a round-table meeting with headteachers, the police, the local clinical commissioning group, charities and other interested parties. I want to find out what more can be done locally and what more should be done to help prevent mental health issues from arising, and I want to see whether there are any grass-roots solutions to the existing problems.

As constituency MPs, we have our own role to play. People turn to us for help on a daily basis, often as a last resort. Their issues vary, with some easier to resolve than others, but these issues can all cause a great deal of stress and pressure, which in turn mounts up and can be, for want of a better phrase, the straw that breaks the camel’s back. We may not have all the answers or be able to secure the right outcome for every constituent, but often we are the only people fighting their corner and we should do everything in our power to avoid situations deteriorating to such an extent that they could have a significant impact on a constituent’s mental health. At this point, I wish to take the opportunity to pay tribute to all our casework staff, who go above and beyond for local residents on our behalf, often with little recognition of their efforts.

Mental health is not exclusively a health issue. It crosses so many boundaries, including education, employability and family life—the list goes on, as we have heard from other hon. Members. Today’s debate, yet again, has served to keep mental health high on the political agenda. But along with the words, we must continue to take action, and I commend the Government on the work they are doing to ensure that we do have that action.

Sugary Drinks Tax

Maggie Throup Excerpts

Monday 30th November 2015 Westminster Hall

[Maggie Throup (Erewash) (Con)]

Sugary drinks are not just about obesity; dental decay is also an important issue, and it affects self-esteem.

[Dr Wollaston]

My hon. Friend is absolutely right. In our report, we highlight that the single biggest cause of admission to hospital for five to nine-year-olds is the need to have rotten teeth removed. Are any of us happy with that situation? It is absolutely woeful that we are not doing more to tackle it.

As I said, the primary purpose of the tax is not to be a pointlessly punitive measure; it is to nudge people towards healthier choices. However, if the Government went down that route, I think it would be more acceptable to the public if every penny from the levy was directed to helping the most disadvantaged children, who suffer the most harm. That would also answer the point about whether the tax is regressive. We must be able to demonstrate what can be achieved with it. At a time when public health budgets are being squeezed and we are possibly looking at a 3.9% reduction in the public health grant, we must not cut back on the very measures that could make the greatest long-term difference.

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[Maggie Throup (Erewash) (Con)]

I rise to outline why changing our habits when it comes to sugar in our diet is so vital. It is not just the fact that high sugar intake is likely to result in obesity; what is important is the likely impact of obesity on our health. Those who are obese have a higher risk of heart attack or stroke, of cancer, of suffering from tooth decay and of developing type 2 diabetes. The long-term consequences of those diseases are what we need to worry about. For example, too many people are diagnosed with type 2 diabetes when it is too late—when their condition has already caused damage to their kidneys, their heart, their eyes and their blood circulation, which can lead to amputation. Those things have a life-changing and life-limiting impact on a diabetic patient. A secondary consideration is the huge cost to the NHS and social services. It is estimated that type 2 diabetes costs the NHS some £9 billion a year, which is 9% of its budget, as my hon. Friend the Member for Totnes (Dr Wollaston) mentioned. More devastating is the effect on the sufferer’s everyday life, and that is what leads me to believe that we need to do whatever is in our power to lower the incidence of obesity.

Those are the reasons why I was delighted when the Health Committee decided to hold its first inquiry of the Session on the subject of childhood obesity, and why I agreed to reform the all-party group on adult and childhood obesity, with its first meeting planned for the new year. During the Select Committee’s inquiry, we heard some compelling evidence calling for brave and bold action on obesity. I am sure that the majority of Members here today will have read the report. A sugary drinks tax is just one of the measures that we highlighted.

A few months ago I was against a sugary drinks tax, because I am against extra taxation, but the compelling evidence that we heard changed my mind. As a nation we are facing a massive obesity problem, and we need to be bold and brave in what we do as a result. I was originally against the tax also because I believe in choice, but consumers will still have choice. They will be able to choose between buying a sugary drink and paying the levy, and buying a drink with artificial sweeteners and not paying the levy.

The evidence that we heard dealt with both reasons why I was against a tax. According to the report by the Scientific Advisory Committee on Nutrition, “Carbohydrates and Health”, which was published in July, soft drinks as a single source represent 30% of added sugar intake for 11 to 18-year-olds. That is a huge amount. For four to 10-year-olds, soft drinks make up 16% of added sugar intake. Such data cannot be ignored or swept under the carpet. A sugary drinks tax would surely serve to change habits, reduce sugar intake and therefore play a part in reducing obesity. That would have a huge long-term impact on health.

[Julian Knight]

My hon. Friend is making an excellent speech. I do not wish to be accused of being in the pay of “Big Sugar”, which sounds vaguely like a ’70s wrestler, but does she agree that public awareness and better labelling of products are more important than anything to do with a sugar tax? Through them we can help to reduce sugar intake and change attitudes.

[Maggie Throup]

I think the wrestler that my hon. Friend is referring to is called “Sugar Daddy”, not “Big Sugar”. The Health Committee’s report said that it is not one measure that will make a difference but a whole range of measures, and education is one of those measures. I agree with him on that, for sure.

Some manufacturers are already reformulating their sugary drinks and their food items. I hope that the measures laid out in the Health Committee’s report and other recent reports will speed up the process for every food manufacturer. We want to have that nudge effect. As our report clearly states, the tax should not be for ever. It is a speedy response to a growing problem, and it can work as other measures kick in. When the time is right, the tax can then be dropped. It is vital that the money raised through such a tax is ring-fenced to tackle the obesity crisis in children.

[Mark Pawsey]

Is there evidence that if price is increased, consumption will reduce? Was that part of the evidence that the Select Committee took?

[Maggie Throup]

I recommend that my hon. Friend reads the report. The evidence from other countries is that the implementation of a sugary drinks tax has reduced consumption considerably. It is important that we ring-fence the money from such a tax for education. As my hon. Friend the Member for Morley and Outwood (Andrea Jenkyns) said, education is extremely important. My hon. Friend the Member for Totnes, who chairs the Health Committee, also made that point. The money should not go into the general Treasury pot of money.

Just because we are focusing on sugary drinks in this debate, that does not mean that they are all we need to consider. In fact, if a sugary drinks tax was the only measure implemented, it would not be effective in tackling obesity and its long-term consequences, because sugar is not the only cause of obesity. Fats and other carbo- hydrates also play their part, as do lifestyles.

We have already talked about exercise. I recommend the Sky Ride project to everyone. It is about getting more people on bikes and caters for anyone, from the men in Lycra who want to cycle 100 miles a day to families. If we can get children on their bikes, getting more exercise, we can start to tackle the obesity problem in a fun way, which is a good way of doing it.

[Julian Knight]

My hon. Friend mentions cycling, and I concur; it is fantastic exercise, and its health benefits mean that regular cyclists live many years longer. Does she agree that one area we can improve is competitive sport in schools? Having more of that would bring about better health outcomes and better health among our young people.

[Maggie Throup]

I completely agree. I always enjoyed my competitive sports at school. I was a sprinter, and I played netball and rounders.

[Paul Flynn]

Wrestling?

[Maggie Throup]

Not wrestling, no.

The issue is partly about exercise, but it is also about food. There is more reliance on ready meals, takeaway meals and meals consumed in restaurants than ever there was in the past 30 years. However delicious the food is, as consumers we do not have control over what goes into it. The hon. Member for Warrington North (Helen Jones) talked about her domestic science lessons. I had a term and a half of those lessons, and I still use my pastry recipe to make my mince pies at Christmas. I know they have sugar in them, but at least I know what is going into them. The recipe book that I created in my domestic science lessons is well thumbed indeed.

We need to tackle every cause of obesity: price promotions; the deep discounting we have heard about; reformulations; the locations of takeaways, which seem to crop up near schools; marketing and advertising; and celebrity endorsements. We need to have clear and understandable labelling. I commend the idea of having the number of spoons of sugar on packaging. It is straightforward, simple and anyone can understand it. We also need more information from takeaway outlets and restaurants as to what we are eating. The list goes on and on.

Obesity is a problem that is not going away. As politicians, we can no longer ignore it. As the Health Committee’s report states, we need to take brave and bold action.

[Keith Vaz (Leicester East) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hamilton, and a pleasure to follow the hon. Member for Erewash (Maggie Throup) and four outstanding speeches. I could easily say I agree with everything I have heard and sit down, but this would not be Parliament if we said so few words, so I will add a couple of words.

Normally, I think Home Affairs Committee reports are stunning. However, the report that the hon. Member for Totnes (Dr Wollaston) has published today is an absolutely stunning report, which I hope will be a turning point in how the public and the Government look at the issue. I congratulate her and the members of her Committee on the work that they have done.

I also want to congratulate Jamie Oliver on the work that he has done and this amazing petition, which has managed to attract 151,782 signatures. This debate is an example of how Parliament can reflect the needs and wishes of the public. It was opened eloquently by my hon. Friend the Member for Warrington North (Helen Jones), with whom I spend many hours in the Tea Room, where we discuss food and other things of that kind. She spoke well, as did my hon. Friend the Member for Newport West (Paul Flynn).

I want to speak about various issues. I declare my interest as a type 2 diabetic. Mr Hamilton, you are also a type 2 diabetic, but you are better at taking the advice of the hon. Member for Erewash than I have been. She encourages people to cycle, and you went on a cycle ride from Leeds to Paris in support of diabetes; I walk to the tube. It is very bad. I keep saying to my wife that I want to buy an electric bicycle, and she keeps saying that I will never use it, but I use you as an example, Mr Hamilton —a paragon of what we should all follow.

[Maggie Throup]

Sky Ride is open to anybody of any age. I encourage the right hon. Gentleman to find his local Sky Ride starting point, buy a bike and go and enjoy it.

[Keith Vaz]

I will, but for me it will not be Sky Ride; it will probably be Skyfall. However, I will look up what the hon. Lady has suggested.

On the point made by hon. Members about Mexico, I met the Mexican ambassador and his amazing dog, Pepe, on Thursday last week at the Mexican embassy. The ambassador is also a diabetes campaigner, and he told me that the example of Mexico is a good one. The chair of the Health Committee, the hon. Member for Totnes, gave us the figures: consumption is down in Mexico, and the price differential provides an important nudge. The ambassador told me that Mexico is the biggest consumer of Coca-Cola in the world. That is why Mexico introduced the sugar tax, which is working, and it is important that our Government consider that tax.

However, we need to move further. I gave up sugar when my local GP diagnosed me with type 2 diabetes on an awareness day. He said, “Come along and be tested.” I was tested and he rang me the next day and said, “The good news is you’re on the front page of the Leicester Mercury, but the bad news is you’ve got type 2 diabetes.” I did not really know what it was, but I gave up sugar, which is a killer, immediately.

Whenever we talk about the sugar industry, it gets very worked up. I think we should go further and have a no sugar day. The last time I questioned the Prime Minister on the subject, about the time of World Diabetes Day last year, I suggested that the consumption of sugar should be stopped in No. 10 just for one day. Imagine if the Administration Committee, or the commissioners of this House, decided that just for one day, perhaps World Diabetes Day, there would be no sugar available in the Tea Room. When you got to the counter—I know you would resist it, Mr Hamilton—there would be no Club biscuits, no Jaffa Cakes, no Victoria sponge; just fruit and other types of food we can consume without increasing our sugar intake. There are a lot of examples of that happening. We need to take a proper course of action, apart from simply putting up taxes.

I commend the companies that have tried to do something about the issue. I went to a Waitrose store in Wolverhampton to look at what the manager had done. I am sorry, I did not tell my hon. Friend the Member for Wolverhampton North East (Emma Reynolds) about that—I was driving past and I had no time to text. The manager had taken all the no-sugar products and put them in a kiosk in the middle of the store. Rather than being shoved on the last possible shelf, they were in one kiosk with the words “no sugar”, so all the no-sugar stock was in one place. It is so much better when companies encourage their consumers to be responsible.

My hon. Friend the Member for Warrington North mentioned the responsibility deal, but I think it has failed. Voluntary codes do not work. The Government were right to introduce the deal under the previous Secretary of State for Health, but unfortunately it has not made much difference. We should get the companies in—perhaps invite them to No. 10—and get them round the table with the Health Secretary and tell them that they need to do much more to control the amount of sugar in their products.

I congratulate my hon. Friend the Member for Newport West on introducing his ten-minute rule Bill on labelling. On the point made by various hon. and right hon. Members—and Mr Jamie Oliver—if we simply put the number of teaspoons of sugar on the front of a product, that will be sufficient to allow consumers to make a proper choice. Rather that than having tiny lettering on the back of a product, which we do not always see. I would also like to see more products with the words “suitable for diabetics” on them. To give Marks & Spencer—and corporate Britain—credit, it has no-sugar chocolate. It tastes pretty awful compared with real chocolate, but at least it is there, and when you are desperate, you can reach for the drawer that says “no sugar”.

I want to ask those who produce sugary drinks to be a little less touchy and more touchy-feely. I was recently asked whether I supported the arrival of the Coca-Cola van in Leicester. I said I was against it because it would encourage young people to drink more Coca-Cola, which has seven teaspoons of sugar in each can, and there was a huge outcry. When I went to a football match two weeks ago at the King Power stadium—before Jamie Vardy scored his 11th goal—a man came up to me and said, “You are like the Grinch. You have ruined our Christmas, because you do not want the Coca-Cola van to come.” I thought Christmas was about the birth of Christ and the message of Christianity, but I now realise it is about not depriving people of their beloved Coca-Cola van, which they can go and worship on 17 December in Leicester.

We then discovered, thanks to the Mirror and the Daily Mail, that the Coca-Cola van is visiting some of the most obese cities in the country. It actually visits Coca-Cola’s best consumers. I had a very nice letter from Coca-Cola inviting me to come and meet the chairman in Atlanta, Georgia—I think I will go to the local headquarters in Reading—and I said, “All you have to do is put on the van the words ‘no-sugar Coca-Cola’, ‘Diet Coca-Cola’ or ‘Coca-Cola Lite’, and you can help change the habits of consumers.” That needs to be done, and I have an open invitation to Mr Oliver to come to Leicester on 17 December, not in an anti-Coca-Cola van, but in a van from which he can give out his good food and perhaps water instead of Coca-Cola. Perhaps he can follow the van around the country making sure we have good products given to young people.

The Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), the Minister with responsibility for diabetes, must feel a little alone given all the speeches that we have heard so far. I think she is committed to doing a great deal of work on diabetes. I had the pleasure of being with her in Asda on World Diabetes Day—not shopping, but raising awareness of diabetes in her constituency—along with Silver Star, a charity that I founded a few years ago. However, I think the Government as a whole are reluctant to take on the big companies. I hope that they will be bold in order to save lives and help the health of our nation, and that they will take an initiative that will encourage Health Ministers and Governments all over the world to do the same.

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[John Mc Nally (Falkirk) (SNP)]

I thank the hon. Member for Warrington North (Helen Jones) for securing this debate. I am grateful for the opportunity to speak in this debate on St Andrew’s day. Earlier today, I had a plate of cullen skink soup, followed by haggis, neeps and tatties, washed down with a tin of Irn Bru. [Interruption.] It was very enjoyable, and it was a delight to come in and smell it. By way of a disclaimer, I should inform hon. Members that my constituency is the birthplace of the wonderful Irn Bru, Scotland’s second national drink—I suspect hon. Members have an idea what the first is. To digress a wee bit, I am a supporter of a campaign, led by my constituents Paul Gilligan and David Reid and The Falkirk Herald, to reinstate an Irn Bru advertising mural outside the Howgate centre, as we now consider it a piece of social and civic art, such is the popularity of our drink.

I agree an awful lot with the hon. Members for Totnes (Dr Wollaston) and for Warrington North. I am a founder member of Central Rio FC, a football club in my area, and I had the privilege and pleasure of being its first coach. It has grown, and now about 400 to 500 children participate locally. It is a wonderful example of how our community works together. One of the first things that rang alarms in my head is that some of the children who came along would not drink water. Their parents said that they would drink only sugary drinks—Irn Bru, Coca Cola or whatever. We had to overcome that huge problem, so, again, I am delighted that we are having this debate.

[Maggie Throup]

On the point about sugary drinks and sports, does the hon. Gentleman think that a lot of confusion is created by the fact that sports drinks, which are supposedly good for people, are so loaded with sugar that they probably do as much harm as good, when balanced with the exercise that people are doing?

[John Mc Nally]

I could not agree more. That is one of the biggest problems. People drink lots of sugar, which gets them high quickly, but they then come down and go into a never-ending cycle of having to drink it again. It is an extremely worrying state of affairs for everybody, so I totally agree with the hon. Lady.

I believe that raising tax on sugary drinks would be an effective means of reducing childhood obesity. I thank all the MPs here, and I hope they all agree that Jamie Oliver should be applauded for setting up this petition and making use of his profile and that of the charity Sustain. I, for one, echo his concerns about the health and welfare of our future generations, and I share his belief that

“we can shift the dial on the epidemic of childhood obesity.”

I thank the right hon. Member for Leicester East (Keith Vaz), who is no longer in his place, for his diligent work in pursuing better public health awareness for the people of this country.

It is commonly known that sugar-sweetened drinks are associated with a higher risk of weight gain than similarly calorific solid food. Evidence indicates that there is a link between the habitual excess consumption of sugar, type 2 diabetes, and weight gain. A large study of European adults showed that there is a 22% increase in diabetes incidence associated with the habitual consumption of one daily serving of sugar-sweetened drinks. Sugar-sweetened drinks contribute a significant amount of sugar to children’s diets. A reduction in their consumption would, in my view, significantly lower the intake of sugar and therefore reduce obesity and the associated detrimental effects on personal health.

According to statistics released in 2014, 64% of adults in the UK are overweight or obese, which cannot be good for anybody. I am sure my hon. Friend the Member for Central Ayrshire (Dr Whitford) will talk about that fact later. International comparisons indicate that the UK has above-average levels of overweight and obese adults. The cost of our obese population is not just felt in the increased risk of a range of serious diseases, including type 2 diabetes, hypertension, heart disease and some cancers; there is also an economic cost. It is estimated that obesity costs the NHS up to £600 million in Scotland alone, and the McKinsey Global Institute estimates that the cost to the UK is equivalent to 3% of gross domestic product. The Scottish Government await the outcome of the Cochrane review on that issue.

Worryingly, for the majority of adults, obesity starts in childhood. Evidence shows that being obese in childhood increases the risk of becoming an obese adult. If we do not encourage adults and children to reduce their sugar intake, the economic costs and the cost to the NHS will continue to be a significant burden. Perhaps that is where a bit of libertarian paternalism is needed. As was said earlier, it is possible and legitimate to nudge people.

Antibiotics (Primary Care)

Maggie Throup Excerpts

Monday 23rd November 2015 Commons Chamber

[Maggie Throup (Erewash) (Con)]

First, I would like to declare an interest. Over 20 years ago, I was responsible for trying to launch a C-reactive protein point-of-care test, along with other point-of-care tests. The timing and circumstances were not right then, but things have moved on, and I believe the time is now right to get C-reactive protein point-of-care testing established in the primary care setting.

Last Monday was world antimicrobial day and that, along with the extensive media coverage over recent days about antimicrobial resistance and the vast difference between summer and winter antibiotic prescribing, makes this is a very timely debate. Antibiotics have been widely used to treat infections for more than 60 years, and without doubt the use of antibiotics has saved many millions of lives. I doubt if there is any right hon. or hon. Member who has never taken an antibiotic at some time in their life, but such extensive use of antibiotics has now become a real issue and a ticking timebomb.

Although new infectious diseases have been discovered nearly every year during the past 30 years, very few new antibiotics have been developed in that time, meaning that existing antibiotics are used to treat more and more infections. The consequence has been an increase in the prevalence of resistance to antibiotics, which in turn puts our ability to treat routine diseases in serious jeopardy. At present, treatment-resistant bacteria are responsible for approximately 25,000 deaths across Europe each year, which is a similar number to those dying in road accidents. The national risk register of civil emergencies has estimated that a widespread outbreak of a bacterial blood infection could affect 200,000 people in the UK. If it could not be treated effectively with our existing drugs, approximately 40% of those affected might die as a result, which is 80,000 people. There is an urgent need for action to slow the spread of antimicrobial resistance.

For a number of years, there has been a clear consensus among clinicians, academics and policy makers that antimicrobial resistance represents a major current and future danger to the foundations of modern medicine. In recognition of that danger, tackling the threat of antimicrobial resistance has been identified as a key priority by the Government, Public Health England and the chief medical officer. Just two years ago, the chief medical officer described the threat of antimicrobial resistance as

“just as important and deadly as climate change and international terrorism.”

I wish to focus on antibiotics in primary care and what measures can be taken to have a real impact on the way in which they are prescribed, which is currently almost like handing out a bag of sweets at the fair. In fact, 97% of patients who ask for antibiotics are prescribed them, whether or not they should have them. Owing to the popularity of primary care in the UK, that setting represents the part of the healthcare system where antibiotics are most likely to be prescribed, with 74% of them prescribed in that setting. International comparisons show that antibiotic resistance rates are strongly related to antibiotic use in primary care.

Despite guidance encouraging a reduction in antibiotic prescribing rates, nine out of 10 GPs say that they feel pressured into prescribing antibiotics. In the UK, we do like taking antibiotics. In 2013, data showed that 41% of residents had taken antibiotics in the previous 12 months, compared with a European average of 35%. Nationally, in 2013-14—the most recent year for which I have managed to get hold of the data—a staggering 41.6 million antibiotic prescriptions were issued, at a cost of £192 million to the NHS.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Lady on securing the Adjournment debate. She has outlined the issues and the epidemic potential among those who do not respond to antibiotics. Does she agree that we need something focused not just on England and Wales, but on the whole of the United Kingdom of Great Britain and Northern Ireland because this strategy has to help us all? In her submission to the House, will she say—perhaps the Minister could respond along the same lines—whether we should have a UK-wide strategy to address the issue for the constituents of all Members of the House and further afield?

[Maggie Throup]

I completely agree with the hon. Gentleman. It is not just a UK-wide issue; it affects the whole world. That is one of my concerns. We need to play our part to set the trend for the whole world, because this is a global issue.

As I said, antibiotic prescriptions in 2013-14 cost the NHS £192 million. What is more worrying is that many of the 41.6 million prescriptions were unnecessary and will undoubtedly have contributed to the growing issue of antimicrobial resistance. More than half the antibiotics used in primary care are for respiratory tract infections, most of which are viral or self-limiting.

So what can be done to halt the ticking timebomb? Just last Wednesday, Public Health England called for NHS patients to become “antibiotic guardians” by thinking carefully before asking for drugs and taking more care to prevent the spread of infections by washing their hands and accepting the flu jab. I believe that we can go even further in reducing the use of antibiotics in ways that are better for the patient and that save the NHS money.

[Kevin Foster (Torbay) (Con)]

I congratulate my hon. Friend on bringing this issue before the House. Does she agree that the big problem, which she has touched on, is that a lot of people put pressure on their doctors to give them antibiotics, falsely thinking that they will cure a cold, which is a virus, when antibiotics are only useful against bacterial infections?

[Maggie Throup]

My hon. Friend is right. That is what we need to make clear. People often do not understand that the causes of those illnesses are quite different.

My local clinical commissioning group, Erewash CCG, is working hard to empower patients to take responsibility for their health, very much along the lines of the antibiotic guardians idea. As part of the initiative, it wants patients to learn to recognise when it is right to visit the GP and when it is right to seek alternative advice, such as that of a pharmacist.

I want to come back to where I began: the little device that performs the C-reactive protein point-of-care test. I can tell that hon. Members are wondering what C-reactive point-of-care testing is. A point-of-care test is a diagnostic test that is quick and easy to perform. It can be used during a patient consultation or completed while the patient waits. It allows for immediate diagnosis and treatment choice. Such point-of-care tests are designed to be used by people who are not laboratory scientists.

A C-reactive protein point-of-care test is a blood test that measures the amount of protein called C-reactive protein in a person’s blood, using just a drop of blood from the finger. Evidence shows that the test can deliver significant benefits when used in the primary care setting. It is used in the primary care setting in several European countries and has been shown to reduce unnecessary antibiotic prescribing by empowering GPs to make informed decisions.

[John Glen (Salisbury) (Con)]

My hon. Friend is making a powerful case for how innovation in the NHS can be the key to securing significant savings and a change in the culture of antibiotic use among the general public. Does she agree that it is about time NHS England moved quickly and decisively to empower people to change their behaviour in respect of managing their own health?

[Maggie Throup]

I completely agree with my hon. Friend. That is exactly why I secured this debate. We need to move quickly because this is a ticking timebomb that we must address sooner rather than later.

Point-of-care testing can reassure patients that they do not need antibiotics and will recover without them. There is evidence that C-reactive protein point-of-care testing could reduce the number of antibiotic prescriptions issued in primary care for acute respiratory tract infections by up to 42%. That represents millions of prescriptions every year. It has been calculated that using C-reactive protein point-of-care tests in primary care has the potential to save £56 million a year in prescription and dispensing costs. At the same time, C-reactive protein point-of-care testing could make a significant contribution to the UK’s antimicrobial resistance strategy.

I am sure that all hon. Members will have visited a GP with a cough and a cold and feeling pretty bad, and thinking that a short course of antibiotics is just what is needed to get rid of the bugs. They expect to leave the GP’s surgery with a prescription for antibiotics and already start to feel better. The problem with that scenario is that there is a high probability that those antibiotics will be useless, because the cold is not a bacterial infection, but a viral or self-limiting infection that antibiotics will not touch. The consequences are far reaching. First, the drugs will have been ingested unnecessarily, and it is likely that antibiotics will have increased antimicrobial resistance in the population. Secondly, a prescription will have been issued unnecessarily, which is a wasted cost to the NHS.

Let us consider an alternative. The hon. Member will still visit their GP with a cough and a cold and feeling pretty bad, but now by using just a drop of blood from their finger, a C-reactive protein point-of-care test can be carried out and will give an almost instant result. If the level of the protein is low to medium, no antibiotics are needed. The hon. Member will leave the GP’s surgery without a prescription, but knowing that they will start to feel better without one. If the level of the protein is high, a prescription for antibiotics can be issued. Such a simple measure is better for the patient, does not add to the ticking timebomb of antimicrobial resistance, saves the need for a prescription, and saves the NHS millions of pounds. I am sure hon. Members will be asking why it is not happening already.

Such a simple test can also be used for more complex cases than coughs and colds. With the life-limiting condition idiopathic pulmonary fibrosis, GPs find it hard to differentiate between the ongoing condition and an underlying infection. An underlying infection, which could be tested by using the C-reactive protein point-of-care test, may require hospitalisation, but the ongoing condition would not. In such instances, it is not just about whether to prescribe antibiotics; it is about whether a hospital bed and all the resources alongside it are needed. Surely a low-cost, point-of-care test is worth its weight in gold given that scenario.

Despite recent reforms, the NHS still works in silos and is inflexible when it comes to funding a test that originally would be carried out in the hospital laboratory. The majority of testing required by primary care is done by block contract through the local hospital, and additional testing is seen as a cost burden on the GP—that was the barrier I hit more than 20 years ago.

Today, C-reactive protein is included as a recommended area of best practice within the National Institute for Health and Care Excellence clinical guidelines for pneumonia, which state that

“clinicians should consider a point-of-care C-reactive protein test for patients presenting with lower respiratory tract infection in primary care”.

That recommendation was made by the NICE guideline development group and based on antibiotic prescription rates, mortality, hospital admission rates, and quality-of-life outcomes. Antibiotic prescription rates were felt by the guideline development group to be the most relevant direct outcome influencing that recommendation.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

As my hon. Friend pointed out, antimicrobial resistance is a particular problem in emerging economies—in India in 2014, 58,000 babies died because of AMR. Does she think that it would be wise to use international development budgets to tackle that severe and growing problem?

[Maggie Throup]

My hon. Friend makes a good point and I completely agree with him.

When one prominent GP wanted to introduce the point-of-care test, he was refused funding. He is now funding it through other sources as he feels that it provides better patient care than just issuing antibiotic prescription after prescription. Things must change for the sake of the patient, to reduce the number of prescriptions, to contribute to the battle against antimicrobial resistance, and ultimately to save the NHS millions of pounds.

The recently launched review of antimicrobial resistance, chaired by Jim O’Neill, is entitled “Rapid diagnostics: stopping unnecessary use of antibiotics” and states that

“rapid point-of-care diagnostic tests are a central part of the solution to this demand problem, which results currently in enormous unnecessary antibiotic use.”

That is why I am asking the Minister to do whatever she can to break down the silos, create the funding streams for C-reactive protein point-of-care tests in primary care, play her part in implementing our national antimicrobial strategy and save the NHS millions of pounds that could be redirected to disease areas that would really benefit from an injection of funds. This is a win-win-win situation and it must be addressed as quickly as possible.

Oral Answers to Questions

Maggie Throup Excerpts

Tuesday 17th November 2015 Commons Chamber

[Mr Hunt]

I commend the extraordinary contribution made by NHS front-line workers of Indian origin. I have met the Indian doctors association, the British Association of Physicians of Indian Origin, and have had many discussions on that front. It is very important, however, that people speak good English if they are providing care in the NHS. There are real issues for clinical safety when the standard of English is not high enough. We have a lot of fantastic support from immigrants who do a great job on the NHS frontline, but good English is an absolute pre-requisite.

[Maggie Throup (Erewash) (Con)]

3. What steps the Government are taking to improve diagnostic testing in primary care.

[The Parliamentary Under-Secretary of State for Life Sciences (George Freeman)]

The Government are determined to improve and invest in diagnostic testing in primary care. Diagnostics and breakthroughs in innovative diagnostics are key to a 21st-century NHS. That is why we have set up the medical technology strategy group, which I chair, to look at accelerating diagnostics into the system; the cancer strategy taskforce; the Prime Minister’s GP access fund; the new models of care programme; and the accelerated access review, which is looking to accelerate those diagnostics with particular value to patients and the system. We have also introduced the new guidelines for the National Institute for Health and Care Excellence, and, through the genomics programme, we are investing in 21st-century molecular diagnostics, which will come to shape the future.

[Maggie Throup]

C-reactive protein point-of-care testing could reduce the number of prescriptions for antibiotics, contribute to the UK’s anti-microbial resistance strategy, and save the NHS millions of pounds each year. Ahead of my Adjournment debate on this issue next Monday, will the Minister agree to look at this type of testing as a way of saving the NHS money and providing appropriate patient treatments?

[George Freeman]

My hon. Friend makes an excellent point. We are completely committed to tackling anti-microbial resistance, and reducing the volume of antibiotics prescribing is vital to that. We are a world leader in this field in tackling AMR. We have an expert group looking at how to improve diagnostic services in relation to AMR, and it has already identified what diagnostics are currently in use and what new technologies are on the horizon, including C-reactive protein point-of-care testing. The group is currently formulating conclusions. The public health Minister, my hon. Friend the Member for Battersea (Jane Ellison), is looking forward to responding to my hon. Friend’s debate on Monday to set out more of the detail.

NHS (Charitable Trusts Etc.) Bill

Maggie Throup Excerpts

Friday 6th November 2015 Commons Chamber

[Wendy Morton]

My hon. Friend makes a valid point. I shall explain that a little more later, but the Bill is about creating independence while maintaining accountability. I believe that we are looking for a route to enable these charities to move forward and to be on a more level playing field with some of the big charities operating across the country. Let us not forget that this is something that they have been asking for.

Collectively, across the country, about 260 charities exist to receive and manage charitable funds on behalf of NHS bodies. I am sure that everyone in the House would agree that they do fantastic work and that many Members are aware of local hospital charities in their constituencies. My preparation for this Bill made me think back to when my sister, who was five or six at the time, spent six weeks in the local NHS hospital and my mum was able to stay near the hospital thanks to accommodation that was provided either by a “friends of” organisation or a local charity that provided that sort of sheltered accommodation. Without that, she would have had to make the long journey to and fro every day. I am sure it made a huge difference, not only to her, but to the whole family.

Hon. Members will be interested to learn that just over £345 million was raised by these charities in the past financial year, supporting patients and staff right across the country. I am sure everyone in this House would agree that they make an outstanding contribution and are deserving of our support. Members may be asking why it is necessary to legislate, and that is a perfectly good question. It is one that I have asked, and I now wish to answer it. In simple terms, the Bill is good housekeeping; it is a matter of follow through. The charitable environment has moved on and there is a need to provide certainty in an already complex world and a complex structure. The Bill seeks to remove the Secretary of State for Health’s powers to appoint trustees, so it will draw that process to a conclusion. The Bill is overdue and it makes sense.

Currently, 16 NHS charities have trustees appointed by the Secretary of State for Health and are directly affected by the Bill. They are bound by charity law and NHS legislation. They are currently unincorporated and their trustees have unlimited liability. This means that the 16 NHS charities will choose either to revert to a corporate trustee model, meaning that the board of the NHS body for which the trustees were appointed acts as trustee of the charitable funds, which is how many NHS charities already successfully operate today, or, as many of the 16 have indicated they would like to do, they can convert to become independent charities without Secretary of State-appointed trustees.

[Maggie Throup (Erewash) (Con)]

As I understand it, some NHS charities have already converted to independent status. Will my hon. Friend expand on what benefits they have gained from doing that?

[Wendy Morton]

I will come on to deal with some of those benefits later. Anyone would think my hon. Friend had read my speech, because the next words on it are “six charities”. I can assure you, Mr Speaker, that no one has seen it. Six charities have already completed the transition to independence. They include Barts Charity, which raises money for Barts Health NHS Trust, including St Bart’s hospital. That was the first to convert to an independent model. The others are Alder Hey in Liverpool; Birmingham Children’s Hospital Charity, which is close to my constituency; and Guy’s and St Thomas’. The Royal Brompton & Harefield Hospital Charitable Fund has also become an independent charity. They are all able to benefit from greater independence and less bureaucracy.

--- Later in debate ---

[Wendy Morton]

When it comes to hospitals, we all have our own personal stories on which to draw and our own personal experiences. The British public are very generous in donating to many different causes, and certainly to local hospitals. The move to independence will help to attract some of the bigger corporate donations, and enable the hospital to work and compete alongside other charities. It makes them operate more independently and less bureaucratically in today’s world, which is very different from that which existed when the trusts were first formed.

On my visit to Great Ormond Street, it was clear to me that the legacy of J.M. Barrie lives on. Where else in the world could we find a boardroom named after a fairy, Tinker Bell? No one can fail to be touched by the commitment and dedication of the staff there. Great Ormond Street hospital has been constantly evolving since opening in a Georgian townhouse in 1852. Today, it is halfway through an ambitious, 20-year redevelopment programme to rebuild two thirds of the hospital site. The charity is working to deliver new facilities appropriate to world-class paediatric care, research and education. It is the largest dedicated funder of paediatric research in the UK, and that is something of which we should all be proud.

[Maggie Throup]

How much does the charity raise each year? Obviously, it does fantastic work, as we have been hearing, and I wonder what the total figure is.

[Wendy Morton]

In a nutshell, the figure is significant, and I will come on to that shortly.

The charity funds vital support services that care for the child and often the whole family: financial advice, parental accommodation, as well as spiritual support and helping families to stay together and manage their lives during what can be very difficult and trying times.

The Great Ormond Street hospital charity has a large number of donors, individual companies and, I am told, celebrities who support their work. On fundraising, Members will be interested to know that the charity raised £80,981,000 in the financial year 2014-15—an increase on the previous financial year—so the figure is indeed significant.

One of the most generous donors in its history is, of course, J.M. Barrie. As the Great Ormond Street Hospital Children’s Charity is keen to take advantage of the opportunity to move to independent status, specific legislation is required to provide for the rights to the “Peter Pan” royalties to be given to the new charity. The idea of royalties being paid to a charity is not unusual in itself. As we approach the run-up to Christmas, I am reminded of songs recorded for charity where royalties go into charitable trusts, but the relationship between Great Ormond Street hospital and “Peter Pan” is different. It is already a unique situation, and a unique solution is required to enable the rights to the crucial royalties to be given to the Great Ormond Street Hospital Children’s Charity, so that Great Ormond Street hospital can continue to benefit from the generous J.M. Barrie bequest.

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[Anne Marie Morris]

Mr Speaker, this is such a fascinating subject that I want to ensure it gets the air time it deserves. I know that my hon. Friends also have a lot to say. I am sure that we will manage to have an interesting and long debate.

[Maggie Throup]

Does my hon. Friend agree that we must get things right not just because of the financial implications for the charity, but because of the charity’s reputation?

[Anne Marie Morris]

My hon. Friend makes a crucial point. Reputation is critical. The changes that we are making today will add to the charity’s reputation and help it to raise further funds for what is a worthwhile cause.

If I may, I will continue to explain the fascinating history of Great Ormond Street hospital, the contribution it has made to our country, and why the Bill is so important and valuable and has my support and that of the Government, despite the hospital’s humble beginnings. Just as you arrived, Madam Deputy Speaker, I was explaining that the hospital originally had just 10 beds and two doctors, and was situated in a 17th-century townhouse. It has constantly redeveloped itself to ensure that it is suitable for the treatment of modern illnesses as medicine develops.

Before the inception of the NHS in 1948, Great Ormond Street was a voluntary hospital that ran fundraising campaigns to expand its size from the 1850s onwards. Because private fundraising was strongly regulated, it was owing to the support of people such as Barrie who left legacies to the hospital that it was able to develop the highest standards.

Throughout its history, the hospital has been at the forefront of numerous breakthroughs in paediatric healthcare, such as appointing the first consultant paediatric surgeon, Denis Browne, in 1928; opening the UK’s first heart and lung unit in 1947; opening the UK’s first leukaemia research unit in 1961; pioneering the first heart and lung bypass machine for children in 1961; performing the first successful bone marrow transplant in Britain in 1979; undertaking the world’s first stem cell-supported trachea transplant in a child in 2010; becoming Europe’s first children’s hospital to offer a portable haemodialysis service in 2010; and opening the Newlife birth defects research centre in 2012, which is Europe’s first research centre to tackle birth defects.

Great Ormond Street hospital would not be able to make such advances without the relevant and up-to-date equipment it has. Thanks to its supporters, it is able to provide its patients with leading-edge equipment, so that its exceptional doctors and nurses can improve diagnosis and treatment, and continue to provide children with the world-class care they need. In one notable instance, a 15-year-old machine developed an unrepairable fault and had to be replaced in 2012. If the funds to upgrade it had not been available, the hospital would have had to continue to refer patients elsewhere for imaging, which would have been inconvenient for families and costly to the hospital.

The equipment owned by the hospital includes specialist X-ray equipment, such as cone beam CT technology, which can take high-quality 3D images with less radiation than a standard CT scanner. The ultrasound equipment in the Dubowitz neuromuscular centre is used to assess about 350 patients each year and helps clinicians to make a faster and more accurate diagnosis of conditions such as muscular dystrophies, myopathies and motor neurone disease. Nutritional equipment includes equipment that can help patients, such as premature babies, those in intensive care, or those receiving treatment for gastrointestinal conditions or cancer. Because those patients are in a fragile state or receiving strong medication, they need a precise recipe with the right balance of fluids and nutrients, and the hospital is able to provide it.

[Maggie Throup]

My hon. Friend has explained precisely why Great Ormond Street hospital needs extra charitable money. It carries out fantastic work that is over and above the work found in so many other hospitals, and it is renowned across the world for its work. Whatever money it can raise through charitable donations is important.

[Anne Marie Morris]

As ever, my hon. Friend makes an important point. It is right that the money goes towards new, far-reaching, novel pieces of equipment and medical solutions, which are exactly what we need in this country. We should be proud of that and do everything we can to enable the hospital to gain as much funding as possible.

The hospital is able to facilitate a number of different wards for a number of different treatments, and that is due to the continued contribution from donations and legacies. Barrie’s contribution has been so significant over the years that, fittingly, there is a Peter Pan ward—I am sorry that there is not yet a Wendy ward, but I am sure we can do something about that.

--- Later in debate ---

[Maggie Throup (Erewash) (Con)]

I am delighted to contribute to today’s debate on such an important issue, and I congratulate my hon. Friend the Member for Aldridge-Brownhills (Wendy Morton) on deciding to raise it in this place and to make these changes, which I am pleased to support.

Our nation would be a poorer place without the thousands of charities and their trustees who contribute their time and their expertise without fear or favour. As we have heard, this is trustees’ week, so it is appropriate to debate this issue today. Close to my heart are the many hospital-related charities that play such an important role in supporting our free-at-the-point-of-care national health service that has served us so well. It is vital that such charities are allowed to conduct their good work with as few barriers as possible.

The current structure of NHS charitable trust status has three main disadvantages. First, potential donors may perceive that the charities lack independence from government. Secondly, being bound by legislation prevents the charities from adopting different legal forms specific to their needs, particularly those offering limited liability. Thirdly, the Charity Commission believes that dual regulation under both NHS and charity legislation makes it difficult for NHS charities to achieve and demonstrate independence. It is therefore vital that NHS charities have the opportunity to move to independent charity status.

In my constituency, I have many charities that support the work of the NHS in some way, but today I want to highlight just two of them. First, Ilkeston community hospital league of friends is a dedicated group of people who do everything from making cups of tea for visitors and taking the newspaper trolley around the wards to holding extremely successful spring, summer and Christmas fairs. A recent bed push up Ilkeston’s main street, Bath street—and when I say up, I mean up the hill—raised over £1,400. These events raise valuable additional funding providing for those added extras that make such a difference to my community hospital. This has included a scanner for the Val Jackson scanner suite at Ilkeston hospital, and the list goes on and on.

Secondly, I have an amazing hospice, Treetops Hospice Care, located at Risley, but serving the wider community across Derbyshire and parts of Nottinghamshire. Only the other day, we heard a very powerful speech in this place by my hon. Friend the Member for Lewes (Maria Caulfield)about the importance of palliative care. Treetops Hospice Care is a bit unusual as it does not have any beds, but provides all its end-of-life care and support in the community. As we heard on Wednesday, up to 70% of people want to die in their own homes, yet only 30% manage to have their wishes fulfilled. The invaluable care in the community that Treetops provides is helping my constituents to fulfil their wishes, which must be comforting for their families at such a difficult time. Treetops is innovative in its fund raising, too, holding everything from dog shows and vintage fairs to car boot sales and a sponsored bike ride taking in all the different charity shops that make a contribution—and I am pleased to say that I took part on a tandem.

My constituents and the wider population give generously and freely to both Ilkeston community hospital league of friends and to Treetops Hospice Care. These two charities are not bound by the legislation that the NHS charities in question are today.

As previously mentioned, the Bill takes away one of the barriers to maximising donations for the NHS charities in question. It removes the Government’s involvement, as it removes the role of the Secretary of State in appointing trustees. This move will enable potential donors to know that the NHS charity is truly independent from the Government.

I now wish to talk specifically about Great Ormond Street hospital. I have visited this amazing hospital on numerous occasions in a professional capacity, so I felt touched by the descriptions that my hon. Friend the Member for Aldridge-Brownhills and the hon. and learned Member for Holborn and St Pancras (Keir Starmer) provided of their visits to this amazing hospital. Like them, I felt very privileged to have seen a small part of its ground-breaking work and the care that is given there. Only yesterday, we heard about the one-year old girl, Layla Richards, now in remission from leukaemia as the result of innovative gene editing, creating designer white blood cell treatment. That really was fantastic news—both for Layla and her family.

[Bob Stewart]

I have to declare an interest, as my wonderful daughter-in-law, Nicola Stewart, is a nurse at Great Ormond Street. I just want to confirm and support everything my hon. Friend is saying about the dedication of the nurses and doctors at Great Ormond Street hospital.

[Maggie Throup]

I thank my hon. Friend, and I completely agree that every doctor and nurse, and every NHS worker goes beyond the call of duty—not just at Great Ormond Street, but in hospitals throughout the country. We owe a great debt of gratitude to them for the work they do.

J. M. Barrie made a very generous and powerful donation when he gifted the rights from “Peter Pan” to Great Ormond Street Hospital Children’s Charity. I am sure the renowned author would be cheering from the Gallery, if he could, to hear that his wishes are to be continued through the mechanisms of this Bill.

[Mr Jacob Rees-Mogg (North East Somerset) (Con)]

Mr Barrie had better not cheer from the Gallery; if he did, he would be ruled out of order.

[Maggie Throup]

I bow to my hon. Friend’s greater knowledge of this place.

It is only right that every effort is made to ensure that the moneys available through the rights are used for the original intended purpose. I am sure that the parents and patients at this world-leading hospital will be backing this Bill, as they can see and experience first-hand how important additional charitable donations are to the workings of this hospital. The Bill provides for much-needed changes to legislation, and I will support it in the Lobby today.

--- Later in debate ---

[Simon Hoare]

I am grateful for your ruling, Madam Deputy Speaker—and I am drawing my remarks to a close.

I also think that the Bill is helpful in terms of general governance. As has been noted, Great Ormond Street currently operates two charities side by side. That requires two reports to the Charity Commission, two sets of audited accounts, and a duplication of arrangements involving busy people who could, quite properly, be engaging in other activities to raise funds.

[Maggie Throup]

It is not just about the duplication of effort but about the fact that money that has been spent on creating the accounts and on the bureaucracy could have been spent on the work that the charities carry out.

[Simon Hoare]

My hon. Friend is an energetic champion of deregulation and trying to cut away as much red tape as possible. I am sure that the electorate of Erewash are delighted by that. I agree with her entirely that this could free up not just time but valuable funds for a more health-related purpose.

My hon. Friend the Member for Aldridge-Brownhills has delivered the Bill with great clarity. In this day and age, it is interesting and unusual when any Secretary of State is prepared to see power taken away from them. The Bill champions the cause of localism and local involvement, which is a good thing. Although the Bill cannot prove this of itself, there might well be opportunities to raise additional funds from trusts if potential donors understand that the trust is separate from, and not appointed by, Whitehall and Westminster, and that they can donate with confidence and comfort because the Charity Commission’s rules of governance for charitable trusts are writ large within the Bill as safeguards to ensure that any moneys raised are used for their proper purpose. I support the Bill entirely.

--- Later in debate ---

[Maggie Throup]

Does my right hon. Friend agree that we are richer as a nation because of the unique combination of our free-at-the-point-of-care NHS and all the charities that support it, which all come together to make us bigger and better?

[Alistair Burt]

Yes. I do not think I am trespassing on any party political ground in saying that we should recognise that people’s desire to give is built on more than just paying their taxes; it is built on an innate desire to help their communities and their neighbours. That is an instinct that cannot and should not be stopped, and it will always find its way into other areas where there are services funded by the state, but it adds a dimension that is very special. Each is valuable in its own way, and my hon. Friend is right to draw attention to that.

My hon. Friend the Member for Yeovil (Marcus Fysh) spoke of his young days visiting hospitals as the son of a paediatrician. My dad, who might be watching this debate, is a retired general practitioner and I also remember visiting hospitals with him. Perhaps, like me, the sight of needles and machines that go “ping” were sufficient to put my hon. Friend off going into medicine, which means he has ended up in the same place as me. Those days, however, were valuable and we are grateful to all those who work in the health service and have made a contribution. As a senior paediatrician, my hon. Friend’s father will have certainly done a lot of good throughout his career.

My hon. Friend the Member for North Dorset (Simon Hoare) also supported the change in the law and invited us to comprehend the risks involved in various trustees supporting Lucky Lad at Uttoxeter. Unfortunately, my brief does not extend to whether that is common practice among trustees or whether it was a major inspiration for the Bill, but my hon. Friend made his point well and it is covered by what we will go on to do.

My hon. Friend the Member for Torbay (Kevin Foster) spoke of the importance—he has also just mentioned this in his intervention—of recognising that Great Ormond Street hospital serves so many of us. He also spoke of the Torbay Hospital League of Friends and its “This is critical” campaign, which is a perfect example, as my hon. Friend the Member for Erewash has said, of a combination of people who recognise that funds are available through the national health service, but who want to make an extra contribution on top of that. We wish that and similar campaigns well.

Junior Doctors’ Contracts

Maggie Throup Excerpts

Wednesday 28th October 2015 Commons Chamber

[Maggie Throup (Erewash) (Con)]

At the election, the Conservative party promised to deliver a seven-day a week NHS, and my right hon. Friend the Health Secretary is working hard to deliver a package of reforms, including the contractual changes under debate. As a former NHS worker, I know that junior doctors, like all those who work in the NHS, are dedicated to the service of patients. We owe them a great debt, and it is only right that they are rewarded fairly—something that I believe this new contract seeks to achieve.

It is time to dispel some of the mistruths about the updated terms and conditions that have been peddled by the Labour party and its lobbyist allies outside the Chamber. On pay, the facts are now clear. I am delighted that the Secretary of State has made it clear today that no junior doctor will be worse off as a result of the new contracts.

In terms of pay progression, the move away from an automatic rise for years served and towards increases linked to career progression through training grades and levels of responsibility must be welcomed. This will help to bring doctors in line with the industry standards of almost all other professions and see pay increases awarded fairly and on merit, rather than simply on how long a person has been in post.

Some plain time working will increase because of the changes, but there will be a new maximum working week of 72 hours, down from the current maximum of 91 hours. In addition, no junior doctor working full time will be expected to work on average more than 48 hours a week, and new limits on the number of nights and long shifts worked will be introduced. Surely these measures will provide a better work-life balance for our junior doctors and allow them to plan their time off with some certainty.

It is deeply concerning that the BMA has refused to negotiate on contract reform and has instead turned to the threat of strike action. Strikes, especially in vital public services such as health, are never in the public interest and serve only to detract from the valid points made by trade union members. I therefore urge the BMA to suspend the imminent strike ballot, get back around the negotiating table and start making some real progress with the Heath Secretary to secure a fair deal for their members, while securing patient safety.

A Government who take the difficult decisions rather than what is politically popular are, by their very nature, a responsible Government. As a Conservative Government, we are taking those difficult decisions so we can build a stronger and more sustainable NHS for the future.