Childhood Obesity Strategy: Chapter 2

Paul Blomfield Excerpts

Monday 25th June 2018 Commons Chamber

[Steve Brine]

I have been very aware of that throughout the drawing together of this plan. For instance, we do not propose to ban “children eat free” offers. We are talking about food and drink price promotions, such as two-for-one multi-buy deals in the retail and the out-of-home sector, to prevent needless consumption and to help parents with pester power—with which I am incredibly familiar, as I have a 10-year-old and a seven-year-old.

[Paul Blomfield (Sheffield Central) (Lab)]

The challenge is about both prevention and cure. We need to act now to help the growing numbers of children who are already obese, but in its recent inquiry the Health and Social Care Committee heard that provision of tier-3 and tier-4 services is bare. It concluded:

“Addressing health inequalities must include providing help for those children who are already obese.”

What is the Minister going to do about the commissioning of tier-3 and tier-4 services?

NHS Long-Term Plan

Paul Blomfield Excerpts

Monday 18th June 2018 Commons Chamber

[Mr Hunt]

I want to reassure the hon. Lady that, in all our discussions about core social care funding and the funding accessed by local councils, we discuss working-age disabled adults every bit as much as the frail elderly. They are central. Many councils actually spend more on that group than on older people. We will not crack the social care problem unless we take that group of people extremely seriously.

[Paul Blomfield (Sheffield Central) (Lab)]

The Secretary of State talked about mental health funding without mentioning the crisis facing our young people. He knows that across the country there are appalling waiting times to access child and adolescent mental health services. How significant is today’s announcement to tackling that issue?

[Mr Hunt]

It is very significant, first, because we have been clear that a transformation in mental health is central to our ambition for the new 10-year plan, and secondly, because, as the hon. Gentleman knows, the Green Paper will over that period see the number of people employed in looking after young people with mental health problems increase from 9,000 by an additional 8,000—a near doubling in the size of the workforce. This financial plan gives us the confidence to say we can deliver that.

Education (Student Support)

Paul Blomfield Excerpts

Wednesday 9th May 2018 Commons Chamber

[Stephen Barclay]

As a medic, my hon. Friend alights on an important point that I am happy to pick up. A number of the professions are degree entry, which precludes the further education college sector, so I will be happy to discuss that with him.

It is worth drawing to the House’s attention that it is not just universities that have been pushing for a change. Professor Dame Jessica Corner, the chair of the Council of Deans of Health, said:

“Our members report receiving a high number of good quality applications for most courses and they will continue to recruit through to the summer. Where courses have historically had a large number of applicants, fewer applicants might well not affect eventual student numbers”.

The key issue is not just how many people apply; it is ensuring that there are sufficient applicants for the places and then increasing the number of places on offer.

[Paul Blomfield (Sheffield Central) (Lab)]

Will the Minister give way?

[Stephen Barclay]

I have given way quite a lot, so I will make a little progress.

In addressing the Opposition’s points, we have moved slightly outside the scope of the SI before the House, which concerns postgraduates, into a discussion about undergraduates, and the Chair of the Health Committee, my hon. Friend the Member for Totnes (Dr Wollaston), made the point that the postgraduate market has certain features that are distinct from the undergraduate market. In certain disciplines, such as mental health and learning and disability, some older applicants may be more risk averse about taking on a student loan, depending on when they did their first degree. If it was before 1998, they probably will not have a student loan, but let us not forget that the Labour party introduced tuition fees, so many who studied after 1998 will have a loan.

Working in conjunction with colleagues in the Department for Education, and taking some of the lessons about targeted support that have been learned in teaching, we intend to offer £10,000 golden hellos to postgraduate students in specific hard-to-recruit disciplines—mental health, learning and disability, and district nursing—to reflect the fact that those disciplines often have particular recruitment difficulties. That £9.1 million package will be supplemented by a further £900,000 to mitigate a particular challenge with recruiting in any geographical areas. For example, if an area such as Cornwall suddenly found itself having difficulty in recruiting speech and language therapy recruits, a targeted measure—perhaps at a different quantum from £10,000—could be implemented in order to reflect those geographical issues.

PACE Trial: People with ME

Paul Blomfield Excerpts

Tuesday 20th February 2018 Westminster Hall

[Caroline Dinenage]

I am sure that will be part of the NICE guidance. Where there is significant evidence that alternatives deserve greater investigation, I am sure NICE will look at that. I will talk about that a little more in a second.

On conflicts of interest, it is obviously important that researchers and scientists with particular expertise in one area will have worked and shared their expertise in related fields and industries, but transparency regarding conflicts of interests is vital to the integrity of the research. The NHS Health Research Authority already issues guidance on conflicting interests and I understand it will consider whether any further clarity is needed.

Clearly, the controversy around the trial is problematic for researchers, but it is most of all distressing for patients with CFS/ME, who deserve the most appropriate treatment from the NHS and to have confidence in the treatment that is being provided. That is why we welcome the NICE decision to undertake a full review of the guidance, which will examine the concerns around the PACE trial and any implications for its current recommendations. NICE develops its guidance independently to support NHS organisations and clinicians to deliver services in line with the best available evidence. It welcomes the input of stakeholders and more than 10 CFS/ME charities and organisations are already registered to support the guideline development process. All other parties who are interested can comment on the draft scope and draft guidelines at the appropriate time during the development process. Final guidance is expected in October 2020.

[Paul Blomfield (Sheffield Central) (Lab)]

The Minister makes the point that final guidance is expected in October 2020, but given the significant doubt over CBT and GET and their impact now, does she recognise the strong case for NICE to suspend the current guidance, which points people towards those potentially damaging treatments?

[Caroline Dinenage]

As an independent organisation, that will of course be a matter for NICE, taking into consideration the evidence.

I know it is a priority for the CFS/ME community that more research into identifying the underlying causes of the condition be undertaken. I would like to reassure those affected that both the MRC and the National Institute for Health Research welcome high-quality applications for research into CFS/ME, including studies to investigate its biological causes, and it will come as welcome news that the MRC is currently funding a project to examine the relationship between abnormal brain structures and symptoms of CFS/ME.

I again thank the hon. Member for Glasgow North West for raising this important issue on behalf of those affected by the condition in her own constituency and up and down the country. I hope the debate has been helpful.

Question put and agreed to.

Junk Food Advertising and Childhood Obesity

Paul Blomfield Excerpts

Tuesday 16th January 2018 Westminster Hall

[Maggie Throup (Erewash) (Con)]

I beg to move,

That this House has considered the effect of junk food advertising on obesity in children.

It is a pleasure to serve under your chairmanship, Ms Dorries, for what I think is the first time. I thank colleagues across all parties for supporting my bid for this debate to the Backbench Business Committee, and I thank the Backbench Business Committee for understanding the importance of junk food advertising and its impact on childhood obesity and for granting this debate.

If hon. Members will excuse the pun, the size of the issue is getting bigger. Some 23% of children in reception are overweight or obese, rising to 34% of children in year 6, and the prevalence is higher for boys than girls in both age groups. Over the last 30 years, there has been a substantial increase in average weight in the UK and, at the same time, a decline in the quality of diets. It is predicted that if current trends continue, half of all children will be obese or overweight by 2020, which is just two years away.

Obese children are about five times more likely to remain obese in adulthood, so acting early can protect them from a lifetime of avoidable ill-health and disease. Obesity can lead to a number of serious and potentially life-threatening conditions, such as type 2 diabetes, heart disease and cancer. Recently, cases of type 2 diabetes have been reported in teenagers, although until now it has been recognised as a disease of older age. Obesity costs the national health service an estimated £5.1 billion and the UK economy £27 billion each year, so it is of the utmost economic importance that the obesity epidemic is addressed. I fear that those costs are grossly underestimated.

Obesity is strongly linked to socioeconomic deprivation. Findings from the most recent national child measurement programme show that inequalities in obesity prevalence between the most and least deprived quintiles of children in reception are widening faster than expected. Obesity is also twice as prevalent among children living in the most deprived parts of England than among those in the least, and patterns are similar across Scotland and Wales. That reflects the fact that families from lower socioeconomic backgrounds across the UK have the poorest diets, high in saturated fat and low in fruit, vegetable and fibre consumption.

Research also shows that the poorest UK households are exposed to twice as many television food adverts than the most affluent viewers. That exposure is problematic. Food advertising in the UK disproportionately features unhealthy food items, and young children are especially vulnerable to marketing techniques that promote unhealthy food. The pervasive harms of adverts place untold pressures on the poorest in society. Children with low nutritional knowledge are more likely than those with higher literacy to select unhealthy meals after seeing junk food adverts. Junk food marketing exacerbates health inequalities, especially among very young children and adolescents.

Over the last couple of years, there has been much focus on the impact of sugar on children’s health and the growing problem of obesity. However, we must not lose sight of the role that foods high in fats and salt play in the epidemic of obesity sweeping our nation. I am sure that Jamie Oliver’s visualisation of the amount of sugar in fizzy drinks in teaspoons helped the public to understand the issue, but we need to go further. The salt content of processed food has decreased over the past decade, mainly as a result of successful campaigning, and it is now common to find low-fat alternatives on supermarket shelves, but there is more still to do. As we focus our minds on trying to rid ourselves of those few extra pounds we mysteriously gained over the festive season, it is the right time to focus the Government’s mind on continuing measures to continue to tackle the obesity epidemic.

[Paul Blomfield (Sheffield Central) (Lab)]

I congratulate the hon. Lady on securing this debate, and she is making a powerful contribution about the scale of the crisis. Prevention is clearly more important than cure, but given where we are now, does she acknowledge that we also need to focus on cure? Does she share my concern that too few clinical commissioning groups are commissioning tier 3 services, which can make positive interventions to support seriously obese children?

[Maggie Throup]

I agree completely. We need to consider prevention, cure and treatment. It is a huge problem, and it will not go away unless we tackle every aspect of it. The hon. Gentleman makes a good point.

The debate in Parliament on the impact of junk food, by which I mean food high in fats, salt and sugar, is not new. I talked to somebody just last week who gave me the insight that we have been discussing it for getting on for 15 years—probably more than that, if we backtrack even further—and we still do not have the courage to ban the advertising of products with such a major impact on the health of our nation and our future generations.

Recently, the Select Committee on Health held an inquiry and produced a report, “Childhood obesity—brave and bold action”, followed up in a short report early last year. Both reports contained a strong call for a ban on junk food advertising before the 9 o’clock watershed, yet that was sadly missing from the Government publication “Childhood obesity: a plan for action”, introduced in August 2016.

I am delighted that new rules on advertising were introduced by the Committee of Advertising Practice in July 2017—their impact is still being analysed. The rules banned the advertising in children’s media of food or drink products high in fat, salt or sugar. The restrictions now apply across all non-broadcast media, including print, cinema, online and social media, but that does not solve the problem. In 2015, Public Health England recommended extending current restrictions to apply across the full range of programmes that children are likely to watch, rather than limiting them to children-specific programming. Yes, restrictions apply to advertising high fat, salt and sugar products during prime time, but only when the audience is made up of 20% children or more.

A recent study commissioned by the Obesity Health Alliance found that 59% of food and drink adverts shown during family viewing time would be banned from children’s TV, yet hundreds of thousands of children are exposed to them every week. In the worst-case example, children were bombarded with nine adverts for products high in fat, salt and sugar in one 30-minute period. Adverts for fast food and takeaways appeared more than twice as often as any other type of food and drink advert, while adverts for fruit and vegetables made up just over 1% of food and drink adverts shown during family viewing times. The study also showed that the number of children watching TV peaks between 7 pm and 8 pm, definitely not when children-only programmes are shown.

Although I recognise that advertising restrictions in the UK on high fat, salt or sugar products are among the toughest in the world, we need to be even tougher. The childhood obesity plan published by the Government in August 2016 states that it is only the start of the conversation. This debate aims to help continue that conversation and focus on other measures that the Government can take to stop and reverse the obesity epidemic.

Health and Social Care Budgets

Paul Blomfield Excerpts

Tuesday 14th March 2017 Westminster Hall

[Mr Clive Betts (Sheffield South East) (Lab)]

It is a pleasure to follow the two Select Committee Chairs, my hon. Friend the Member for Hackney South and Shoreditch (Meg Hillier) and the hon. Member for Totnes (Dr Wollaston); we have worked very closely on these issues. It is also a great pleasure to see so many other colleagues in the Chamber today. It is obvious that social care and health issues are now coming very high up the agenda, which is absolutely right.

I will refer to the report that the Communities and Local Government Committee has just produced, “Adult social care: a pre-Budget report”. In the next few weeks, we will produce a longer report about longer-term issues in social care. To begin in the here and now, the Committee welcomed the fact that the Government have allowed local authorities to increase the precept in the next two years and have encouraged local authorities to take up that offer, while still recognising that there are challenges around the fact that the precept raises very different amounts of money in different local authority areas. We asked for an immediate further injection of £1.5 billion, so it is welcome that the Chancellor announced an increase of £1 billion, even though £1.5 billion would have been more welcome—I think that is how the Committee will look at that.

Recognising that that would not be a permanent solution for this Parliament, however, we asked for the National Audit Office to be given the responsibility to look at what is required for the rest of this Parliament—the further two years of the spending rounds—to address the issues in social care. Those issues are very real, with an increase by a third in the number of people in their 80s or 90s over a 10-year period, with local authority spending on social care down by 7% since 2010 in real terms, with the increase in the minimum wage, with the Care Act 2014 and with all these other pressures.

[Paul Blomfield (Sheffield Central) (Lab)]

Does my hon. Friend recognise that there are two groups of victims of the crisis in social care? They are not only those who depend on the services, but those who work in the sector and who face, for example, widespread non-compliance with national minimum wage legislation, which the Government are aware of but not acting on. Does he agree that needs to be recognised in a future settlement? We need a paradigm shift in how we view care work.

[Mr Betts]

We will return to the proper training, long-term commitment and pay of staff in the care sector in our Committee’s further report, but we certainly had evidence to that effect.

We need another way of dealing with the funding gap for the rest of this Parliament. For the longer term, I very much welcome the announcement of the Green Paper, but I echo the comments of the two previous speakers. We need to get cross-party agreement on a sustainable, long-term settlement that will last not merely for the next Parliament, but for several Parliaments after that. There are major challenges. I agree that we should look at health and social care together, but there are fundamental differences in governance and accountability between the two systems, so how do we resolve that?

We should certainly look closely at what is happening in Manchester, to learn about the devolution deal there and how the two can work together within the same governance structure. Personally, I feel that losing the local accountability that the social care system currently has and simply centralising the whole system would be a mistake. That would take us in the wrong direction, so it is important to look at what is happening in Manchester. We have two very different funding systems. We have the health system, which is free at the point of use, but I do not think that anyone suggested in evidence that we could fund social care on exactly the same basis. We will have to consider something slightly different to fund social care, but how the two systems fit together will be a challenge.

If we are considering the future for social care funding, we should bear in mind that currently we have a mixture of funding. We have some central Government funding, local authority funding and the personal contributions that come through people paying for their care, particularly in residential homes, and what happens to their estate when they die. Will that mean a bit extra from those different elements—a bit more from central Government, local Government and personal contributions—so that the total whole grows? However, the Government have said that they will introduce the Dilnot proposals in the next Parliament—that is what the Minister said to us—which will cap and reduce the contributions that may come in from people’s private estates when they die, so does that mean more money from somewhere else?

I am sorry that the Chancellor did this, because everything should be on the table, but he ruled out a different way of taxing or receiving contributions from people’s personal estates when they die: taking a percentage of everyone’s estate. Currently, people contribute their estate if they end up with dementia and go into a care home, but if they have a heart attack, they tend to contribute nothing. Is that system fair? Is that a challenge we must look at? Even with Dilnot, the £72,000 limit would take most of the estate from a small house sold when someone in my constituency dies, but it would be only a fraction of the value of a property sold in the more expensive parts of London. Is that fair either? Do we simply scrap the whole thing and go on to a German system of social insurance?

The Communities and Local Government Committee went to Germany to have a look at its model. There are pros and cons to it, but we really need to put everything on the table and not rule out any possibilities. We need something that we can, in the end, reach cross-party agreement on, recognising that the social care system will probably be different in its funding from the health system. How they can fit together and be governed together will be absolutely crucial to the success of a long-term settlement, when we eventually reach one.

Oral Answers to Questions

Paul Blomfield Excerpts

Tuesday 7th February 2017 Commons Chamber

[David Mowat]

Conservative Members very much respect Sir David Dalton. I remind the hon. Lady that she stood for election on a slogan of not a penny more for local government, so it is entirely inappropriate for her to say different things now. There is now an opportunity in Manchester, through the devolution deal, to integrate care and the NHS more effectively, and I expect that to happen.

[Paul Blomfield (Sheffield Central) (Lab)]

8. What assessment he has made of trends in the availability of GP appointments.

[The Parliamentary Under-Secretary of State for Health (David Mowat)]

Best trend data come from the GP patient survey, which collates feedback from more than 2 million patients biannually. The most recent results show that 92% of patients found their appointment to be convenient—a slight increase on previous results—and that 86% of respondents rated their overall experience of their GP’s surgery as good.

[Paul Blomfield]

The Minister knows that there was a 30% rise in waiting times in 2016—that is one of the key concerns that constituents raise with me. Local GPs tell me that one of the main pressures they face is the failing social care system. The Minister knows that the answers he gave a moment ago do not address the problem, so will he commit to doing something meaningful?

[David Mowat]

The answer I gave a moment ago was the results of the GP patient survey. The Government and I accept that the country needs more GPs. GPs are the fulcrum of the NHS, and we have plans for a further 5,000 doctors working in primary care by 2020. We intend to add pharmacists, clinical pharmacists and mental health therapists as part of the solution.

Mental Health and NHS Performance

Paul Blomfield Excerpts

Monday 9th January 2017 Commons Chamber

[Mr Hunt]

May I reassure the hon. Lady that we will not be kicking the issue into the long grass? The Prime Minister has made a statement that we will have a Green Paper. There is a very specific reason why we need a bit of time: we want to ensure that the changes that we make—[Interruption.] We are getting a bit of chuntering from the Labour Front-Bench team. They might want to listen to the answer. The reason why we need to take some time is that a number of pilots concerning the improvement of mental health provision are taking place in schools at the moment, and we want to see them go through and evaluate them to inform what we do in the Green Paper. That will take a bit of time, but, at the end of it, we will get a better evidence base for the right way forward.

[Paul Blomfield (Sheffield Central) (Lab)]

Young people in Sheffield have for some time now been telling me that they are waiting 25 weeks for an appointment with CAMHS after referral. Headteachers are telling me that they are digging into their budgets to buy in support for pupils in crisis, because they cannot access NHS services. Is it not deeply cynical for the Prime Minister to be raising hopes that we will be tackling the mental health crisis of our young people when the measures and the money that have been announced fall so desperately short of what we need?

[Mr Hunt]

It would be cynical if we raised hopes and had no intention of doing anything about the matter. What the Prime Minister said this morning in her speech was that this was the start of a process. She pointed to those problems and said that we will have a Green Paper to look at how we deal with them in detail, which does take some time. I hope that we will get to a position when we can deal with those problems. The hon. Gentleman is lucky to have Professor Tim Kendall working in Sheffield, as he is the NHS lead mental health psychiatrist and a specialist in homelessness, and he is helping us to shape the strategy.

Social Care

Paul Blomfield Excerpts

Wednesday 16th November 2016 Commons Chamber

[Mr Hunt]

I absolutely agree with the hon. Gentleman. It is the hallmark of a civilised society that we treat all older citizens with dignity and respect. I totally disapprove of 15-minute visits. I find it impossible to understand how anyone could really look after someone’s needs in a 15-minute visit. I hope that, like us, he is proud of the introduction of the national living wage, which is helping the people who do this very important work. It will help 900,000 people working in the social care system by paying all over-25s a minimum hourly rate of £7.20 from this April.

[Paul Blomfield (Sheffield Central) (Lab)]

The Secretary of State will know that Ministers have acknowledged that illegal non-payment of the national minimum wage is rife in the care sector. Does he agree that Her Majesty’s Revenue and Customs should publish the results of the investigations it launched two years ago into the six big providers? Where employers are found to be non-compliant in relation to an individual care worker, does he agree that HMRC should carry out a full investigation into that employer to see how widespread that non-compliance is?

[Mr Hunt]

We are absolutely determined to clamp down on employers who do not pay the national living wage. If the hon. Gentleman or any other hon. Member has any evidence at all of that happening, they should let HMRC know. HMRC has a policy of naming and shaming employers who do not do the right thing and rightly so.

Oral Answers to Questions

Paul Blomfield Excerpts

Tuesday 15th November 2016 Commons Chamber

[Mr Speaker]

The right hon. Member for Orkney and Shetland (Mr Carmichael) is in line for an award.

[Paul Blomfield (Sheffield Central) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health (Mr Jeremy Hunt)]

I am pleased to report to the House something I was not sure I would ever be able to say: last week, the British Medical Association called off its industrial action and committed to working with the Government on the implementation of new contracts for junior doctors. This will make a significant contribution to our commitment to a safer, seven-day NHS, and the Government will work constructively with junior doctors to address their concerns, because they are a vital and valued part of our NHS.

[Paul Blomfield]

The South Yorkshire and Bassetlaw STP sets out some very positive ambitions, but it warns that there will be a financial shortfall for health and social care services in our area of £571 million by 2020-21. Those ambitions are unachievable unless the Government address the shortfall. What is the Secretary of State going to do about it?

[Mr Hunt]

We are working very carefully with all STP areas to make sure that their plans are balanced so that we can live within the extra funding we are putting into the NHS—an extra £10 billion—by 2020-21. We will look at that plan and do everything we can to help to make sure that it works out.