Physical Inactivity (Public Health)

Nick Smith Excerpts

Tuesday 18th November 2014 Westminster Hall

[Nick Smith (Blaenau Gwent) (Lab)]

It is a pleasure both to serve under your chairmanship, Mr Weir, and to introduce today’s debate. I would like to put my thanks on the record to the Backbench Business Committee for allocating us this time, and I particularly thank the hon. Members for Chatham and Aylesford (Tracey Crouch) and for Canterbury (Mr Brazier), my right hon. Friend the Member for Rother Valley (Kevin Barron), my hon. Friend the Member for Bradford South (Mr Sutcliffe) and the right hon. and learned Member for North East Fife (Sir Menzies Campbell) for their support in applying for this debate. It is great to have cross-party interest, and I am looking forward to hearing colleagues’ contributions today on how we can best get Britain active.

I note that the hon. Member for Chatham and Aylesford has sent her apologies to us today; I understand that she is being kept busy in a bunker in Rochester and Stroud. Fair do’s—she is a tireless campaigner on public health and I pay tribute to the work that she has done in this area.

There is a physical inactivity epidemic and a growing obesity problem. If we want to make south Wales and the UK healthy again, we must help people to enjoy the simple activities that can save their lives. We need to walk, dance and play our way to well-being.

Tredegar in my constituency is the home of Nye Bevan and the NHS, and promoting physical activity is an issue that beats at the heart of our nation’s health. Although health is a devolved matter in Wales, I take an interest in the wider issues of public health, and during my time in the House I have spoken in favour of minimum pricing for alcohol and plain packaging for cigarettes, and taken an interest in the drivers of long-term conditions, such as diabetes, heart disease and obesity.

Britain, including Wales, is a great sporting nation. Governments of both colours have made huge efforts to showcase Britain as a home to sports. In recent years, we have celebrated the 2012 Olympics and this year’s Glasgow Commonwealth games, and next year there will be the rugby union world cup. However, for all that we are a successful sporting nation, we are not an active nation.

This debate is conveniently timed, as ukactive has just published its latest report into what it calls an “epidemic” of inactivity. Ukactive aims to get

“more people more active, more often”

and the stats that it has to show are really quite shocking.

Inactivity is the fourth largest cause of disease and disability in the UK, and physical inactivity directly contributes to one in every six deaths in the UK. That makes it as dangerous as smoking. Those who are completely inactive are at a much greater risk of a wide range of chronic diseases, such as diabetes, heart disease, cancers, obesity and mental health conditions, including dementia. Last week, the Welsh Minister for Health and Social Services reported that Wales is suffering from an “obesity epidemic”.

In the most recent Wales health survey, 58% of adults were classed as overweight, with 22% classed as obese. In my constituency of Blaenau Gwent that was higher, with 27% of adults being classified as obese. Meanwhile, Public Health England reports that obesity in adults has increased from 15% in 1993 to 25% in 2012. Obesity for children under 10 has increased to 13% and for 11 to 15-year-olds, it has increased to a shocking 18.7%. The answer to that is not just diet, of course, and it is certainly not to do nothing. We need to get Britain moving. How do we do that? I am careful at least to try and practise what I preach. Although I am often guilty of flopping down by the telly and watching sport instead of doing it, over the summer one of my tech-savvy daughters downloaded a pedometer app on to my phone for me. I now take care to get in my 10,000 steps a day, although sometimes it is a struggle. I am also a keen hiker; my part of the world, which includes the Brecon Beacons, is very good for that.

One of the key messages that we need to get across in this debate is that physical activity can be as simple as just going for a walk. This is not a debate on how to increase participation in sport, although sport is a cracking pastime for those who want to do it. Physical activity can be anything from taking the dog for a walk, to a Zumba class, to kids flying around on a skateboard. Not every kid in a class will be sporty, just as not every adult has fond memories of playing rugby in freezing cold PE lessons. We risk putting people off and making them think it is not for them if we make this solely a “sports” agenda, not a “get active” agenda. It is important that we make it easy, natural and normal for people to fit activity into their day.

In Blaenau Gwent in south Wales we have some fantastic, varied activity going on. There is a great tradition of bowling, with many teams from different valley villages and towns. That also helps address problems of loneliness and supports good mental health for older people. There are lots of dance groups, too. Places such as the Llanhilleth institute, built from the contributions of miners and steelworkers, positively bubbles with the sounds and energy of Zumba and body combat sessions. It is fantastic to see these places.

Having said that, in times of cutbacks to councils we need to promote more and more of such provision in deprived boroughs such as mine. I would like to see promotion of what I see as more accessible sports too, which require less space and less kit and caboodle, and which can be played indoors, such as table tennis and basketball.

Across Britain, the most deprived areas on average suffer more from inactivity and have higher rates of obesity than less deprived boroughs. There are practical concerns that we need to take into consideration. We can encourage somebody to take more exercise, but if we do, we need to make it easy, affordable and safe for them to do so. In order to make a meaningful difference, we need to be serious about reaching those hardest-to- reach groups.

The biggest health benefit is earned by getting someone to move from no activity to some activity. What are the Government doing specifically to encourage participation in physical activity in the most deprived areas? The next important factor is profile, and there is still lots to do to raise the profile of physical activity to improve public health. There have been some real success stories over the past year, of local government pushing this issue up the list of priorities. Ukactive found that over 70% of local authorities have increased spending on physical activity in the last year. In Wales, the Welsh Assembly Government have set the pace for leadership on this issue. Last year, Wales launched the Active Travel (Wales) Act 2013—Europe’s first piece of active travel legislation—which puts safe cycling and walking at the heart of Wales’s plans for the future.

We must not underestimate the achievements that there have been, but we must also not underestimate how far we still have left to travel. Despite the increases and the good work and good will that we have seen, spending on physical activity represents just 4% of the ring-fenced public health grant. We need all Governments, of all colours, to take leadership on the issues—just look at the national campaign on smoking, which has made such a huge difference. Before 1998, smoking levels were rising year on year, as inactivity and obesity levels are rising now, yet since 1998, 1.5 million people have quit smoking. The tide has turned. Important factors include the 10-year strategy, which has been long-term and, crucially, supported by all major parties across the aisle, so it is important that this issue is not politicised, and that is why it is great today that there is good cross- party debate. Pleasingly, the momentum has continued —and fair do’s, in 2011, the Government set specific targets to reduce smoking further by 2015. That needs to be applauded.

However, that leads me to a final but really key point. Action on smoking is about shifting the narrative to prevention rather than cure, and that is what we need to do now for physical inactivity. Individually, we all need to be concerned with physical activity for the sake of our personal health, and nationally, we all need to be concerned about physical inactivity for the sake of our national health service.

The new chief executive of NHS England put that in no uncertain terms last week, when he told the annual conference of Public Health England to get serious about obesity or bankrupt the NHS. We cannot afford to keep flooding our NHS with avoidable illness and disability. Diabetes UK estimates that type 2 diabetes already costs the NHS about £9 billion a year. If we are to protect our NHS and the excellent service that it gives us and our constituents, we need to prevent these problems from arising in the first place. The NHS is the national health service, not the national sickness service or the national pharmaceutical service. Prevention is better than cure. We need to start seriously looking at shifting to a service that promotes health and prevents illness wherever possible.

I am pleased that a future Labour Government would be committed to allowing GPs to give out exercise on prescription. That is a step that the medical profession is ready to take. A recent poll of GPs reported that 95% of GPs without access to exercise referral programmes said they would use one if it were available. The success of initiatives such as Let’s Get Moving, which encouraged more than 500 previously inactive patients to amass a total of 164 million steps—is that not brilliant?—shows how valuable GP surgery-led interventions can be.

This is an important debate and there are important questions to put to the Minister. First, how can the Government and others improve on what is being done? Secondly, where is the Olympic legacy for deprived areas such as Newham, which hosted the Olympics and is the least active borough in the country? Thirdly, what can be done to ensure that best practice is being shared, and that our efforts are being properly monitored so that we have data on what works, what is needed and, importantly, where?

Credit needs to be given where it is due. Some ships are moving in the right direction. For example, in England, the NHS’s “Five Year Forward View” makes a strong reference to this topic. We must applaud that, but the tide has not yet turned and inactivity is still set to rise.

Like smoking cessation, what can the Minister offer that will really make a difference in this regard? Labour has given a commitment to put physical activity at the heart of its future health plans, but the current Government and all future Governments, of any colour, need to do the same. I look forward to hearing from colleagues and to the Minister’s reply.

[Several hon. Members]

rose—

--- Later in debate ---

[Nick Smith]

I have little time to respond, so I unfortunately cannot comment on all the cracking contributions made in the debate, but I did particularly like the point raised by my hon. Friend the Member for Inverclyde (Mr McKenzie), who talked about our spending all day in front of a screen and then going home to spend our evening in front of a screen. We should all be mindful of that. I also laughed at his story about being a Zumba orphan, because that is where his mum spends all her time these days.

I want to highlight a few points that were made in today’s debate. It is important that we reduce obesity and improve health in areas of deprivation. The costs of being unhealthy are high, particularly for clinical conditions such as heart disease and diabetes. The financial costs of obesity are also high, and we need to promote physical activity. The NHS’s chief executive has spoken of the NHS being bankrupted by the high costs of physical inactivity.

I thank everybody for participating in today’s debate. We must place as much emphasis on promoting physical activity as we placed on reducing smoking in the past in order to see a successful campaign.