Childhood Obesity and Diabetes

Debate between Pauline Latham and Keith Vaz

Wednesday 24th April 2013 Westminster Hall

[Keith Vaz]

My hon. Friend is absolutely right. I hope that by securing the debate and by hearing the contributions of hon. Members, we can get a pathway to try and show that complacency will actually help people to get diabetes. That is why I hope that hon. Members will join me today in a war on sugar, a fight against fat, and a battle against the bulge.

We must address three key areas. The first is the role of Government in facing the obesity epidemic head on. That is closely linked to the second key area, which is the role of food and drink manufacturers. The responsibility deal was a flagship of the previous Secretary of State for Health, who is currently Leader of the House. It was launched in March 2011, but I am sorry to say, it appears to have failed. Voluntary agreements with industry have made little impact. The headline pledge to cut 5 billion calories a day is simply incalculable, arbitrary and misleading.

The Department of Health, in response to a parliamentary question of mine, said:

“It is not possible to measure the exact contribution of business’ actions to changes in consumers’ calorie consumption.”—[Official Report, 6 February 2013; Vol. 558, c. 339W.]

By February 2013, 122 companies had signed up to one or more of the responsibility deal’s six pledges, but it is what happens afterwards that really matters. Those pledges, sadly, in my view—I am ready to be convinced otherwise when the Minister replies—have, at best, paid lip service to the Government’s aim of getting the nation to eat more healthily, drink less, be more active, and have healthier working lifestyles.

[Pauline Latham (Mid Derbyshire) (Con)]

Does the right hon. Gentleman agree not only that parents have a huge responsibility to feed their children appropriately and ensure that they get adequate exercise, but that schools have a huge responsibility to give children nutritious, non-fattening and not sweet foods—healthy foods—and through sports, encourage them to take the exercise that will make them healthy and set in train for their whole lives the habits of exercising and eating healthily? It is not only about parents, because schools should help too, as well as the industry that he is talking about.

--- Later in debate ---

[Keith Vaz]

I thank my hon. Friend for her intervention. I did not know that that was the case, but if it is, it should be put right. All teaching establishments should be treated on the same basis and should all get the same message from Government.

Let us consider the issue of where schools are situated and the ability of fast-food chains to mushroom around schools. Many children purchase fast food on their way home from school. For many, fast food is readily available. For example, in my constituency, there are 61 fast-food outlets within a 1-mile radius of Rushey Mead primary school. Positive action has been taken by some local authorities. Waltham Forest council, for example, banned fast-food outlets near schools in 2008. However, more must be done to address the issue. Since 1 April 2013 and the creation of health and wellbeing boards, the onus has surely been on local councils to consider sensible planning restrictions to tackle childhood obesity.

Schools need to do more to educate pupils about the benefits of eating a healthy diet. I commend the excellent report by Ella’s Kitchen, “Averting A Recipe For Disaster”, which urges the Department for Education to address poor nutrition for children by making cooking in schools compulsory and by giving free breakfasts to every child. We currently have an epidemic of childhood obesity, which in 20 years’ time will turn into an epidemic of type 2 diabetes.

The incidence of diabetes is truly alarming. Sometimes we repeat these statistics so often that they lose their impact, but I have to repeat them again today. There are an estimated 3 million people in the UK with the condition, and a further 850,000 are thought to have the condition but are not aware of it. The complications from poorly managed and poorly treated diabetes are shocking. It is the leading cause of blindness, kidney failure and lower-limb amputations. Each week, there are 100 diabetes-related amputations; and each year, 24,000 people die earlier than expected due to complications from the condition. Not only are the health risks extreme, but the cost to the NHS is enormous. It is astonishing. The NHS spends roughly £9.8 billion a year and 10% of its budget treating the condition and its associated complications.

[Pauline Latham]

The right hon. Gentleman talks about amputations. My father had his leg amputated because of diabetic complications, but his problem was that he never stuck to his diet. People must be given more help to understand the complications that they can and probably will incur if they do not take the prognosis seriously and control their diet, because if they do not do so, they will have those long-term problems.

[Keith Vaz]

The hon. Lady is absolutely right. I do not want to steal lines from the Minister’s speech, but when she recently addressed a forum on diabetes, that was exactly what she said: diet is extremely important. We are all busy people and when we walk into the Tea Room for our cup of tea, we are faced with Club biscuits, Jaffa Cakes, Victoria sponges—plural—and all kinds of other things that entice us, so even if I go in saying that I must have a banana or an apple, I end up, as the hon. Member for Strangford has seen, picking up a Club biscuit. The hon. Member for Mid Derbyshire is absolutely right: diet is crucial. That is why I wish the newly appointed diabetes tsar, Dr Jonathan Valabhji, the best of luck in dealing with those figures.

How do we cope with this situation? There are practical steps that health care providers, local authorities and the general public can take, but the key is prevention. The new NHS health checks will offer those aged between 40 and 74 a check to assess their risk of heart disease, stroke, kidney disease and diabetes. If only I had had that check when I was 40, I would have discovered six years earlier that I had diabetes. However, new research revealed by the university of Leicester on Friday suggests that the checks could detect at least 158,000 new cases of diabetes or kidney disease, but they are not being taken up. I pay tribute to the work of Professor Kamlesh Khunti of Leicester university, who was behind the research that revealed the number of cases that could be discovered. The health check has enormous potential to find those in the early stages of diabetes or even with symptoms of pre-diabetes.

health

Debate between Pauline Latham and Keith Vaz

Tuesday 18th September 2012 Commons Chamber

[Pauline Latham (Mid Derbyshire) (Con)]

May I take this opportunity to welcome the new Health Minister, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), to his post and wish him every success in his new role?

I want to draw the attention of the House and, in particular, the Minister to two key issues in relation to type 1 diabetes. Some Members may be aware that I spoke on this issue last week in a Westminster Hall debate, but today I want specifically to urge the new health ministerial team to support the artificial pancreas project that is being funded by the charity JDRF. If the Department can find any funding to assist the research, that would be very welcome.

I wish to ask the Department of Health to end the postcode lottery that exists in the NHS on access to insulin pumps. At present, there are no answers on what causes or how to cure type 1 diabetes. The only way to find a cure for type 1 is through greater investment in medical research. If additional funding can be made available to cure, treat and prevent type 1 diabetes, it will result in long-term cost efficiencies for the NHS. It will also help the UK to retain its position as a world leader in this type of medical research.

Type 1 diabetes is a chronic, life-threatening condition that has a life-long impact on those diagnosed and their families. It strikes children and adults, staying with them for the rest of their lives. It is usually diagnosed in childhood between the ages of 10 and 14, but more and more children are being diagnosed much earlier, from 18 months onwards. It is an auto-immune condition; it causes the body’s own immune system to turn on itself and destroy the beta cells in the pancreas, leaving the body unable to produce the life-essential hormone, insulin. Insulin pumps cost between £1,000 and £3,000. There are additional costs for the consumable attachments, infusion sets, batteries and pump reservoirs, for which patients might have to pay themselves. The cost of those consumables could amount to between £1,000 and £2,000 per annum for each patient.

By contrast, the Scottish Government announced in February 2012 that all eligible under-18s with type 1 diabetes in Scotland will now have access to insulin pumps. They have also said that the Government are committing funding of at least £1 million to help NHS boards deliver pumps to under-18s who need them, as well as tripling the amount of pumps available to all people with the condition in Scotland. That has been followed by a further boost of £1.5 million this April in Scotland to provide more young people with insulin pumps.

Type 1 diabetes is a very different, distinct condition from type 2 diabetes, as it is not linked to lifestyle issues, such as diet and exercise. People with the condition rely on a programme of finger-prick blood sugar tests and insulin pump infusions or injections up to 10 times a day to stay alive. Although these prolong life, they are not the cure. A child diagnosed with type 1 diabetes when they are five faces 19,000 injections by the time they are 18. People with the condition are at risk of devastating complications, including blindness, heart disease, amputation, strokes and kidney failure, to name but a few.

Type 1 diabetes reduces life expectancy by about 20 years and there is a small but very real chance of sudden death. The short-term complications include debilitating hypoglycaemia, which, if left untreated, can lead to unconsciousness, coma and occasionally even death. Children never escape the responsibility of checking their blood sugar level and parents never have a day off from worrying about their children, even at night, as the blood sugar level has to be checked. Parents cannot relax because one of them must get up at night to check that their child is okay—or even still alive.

JDRF has told me that about 500 people in each constituency have type 1 diabetes. Therefore, more than 26,000 children in the UK have type 1 diabetes, which is as many as one in every 700. Some 98.6% of the children and young people who have diabetes will have type 1. The incidence of type 1 diabetes is increasing by about 5% year on year.

[Keith Vaz (Leicester East) (Lab)]

The hon. Lady is making an excellent and powerful speech. I declare my interest as a sufferer of type 2 diabetes. I wish to emphasise the importance of prevention work. She has talked about type 1, which is difficult to prevent; but in general, the more money that is spent on preventing diabetes, the less money that will need to be spent by the NHS in the future.

[Pauline Latham]

I thank the right hon. Gentleman for that intervention, because he is a big champion of tackling diabetes, particularly type 2, and he will speak up at every opportunity. Good care for not only the young with type 1, but for older people who can try to prevent themselves from getting type 2 diabetes will, of course, save the health service a huge amount of money.

As I mentioned, JDRF funds a large research programme to develop a closed-loop artificial pancreas, to help children with type 1 diabetes to live a life without the constant need for painful finger-prick tests and multiple insulin injections every day just to stay alive. It would give people with type 1 diabetes the freedom from those injections every day and has the potential to prevent some of the devastating complications that can arise from the condition. It would also give parents peace of mind that their children are much more likely to have stable blood sugar results, thus keeping them out of hospital.

The project involves two pieces of equipment that are already available to people with type 1 diabetes: a continuous glucose monitor that measures blood glucose levels regularly; and an insulin pump, such as the one I am holding, that painlessly administers insulin. The main task is to develop a computer that can talk to the two components and calculate exactly how the insulin pump should react and when to administer the insulin. That would close the loop to make the device a functioning artificial pancreas. This artificial pancreas is not yet commercially available, although the research team have already completed trials of the artificial pancreas in a hospital setting and are now beginning trials where children take the artificial pancreas home to see how well it works in a real-life situation.

Will the Minister please give an undertaking to monitor this research carefully and, if possible, lend his full support to this piece of groundbreaking research, which could improve the quality of life for so many young people in my constituency and many thousands across the country—it could do more than that; it could transform their quality of life.

The second issue that I would like to raise briefly this afternoon is the inequality that exists in our NHS in getting access to an insulin pump. The Minister may be aware that the Medical Technology Group recently carried out a freedom of information survey of every primary care trust in England, publishing its findings in “Pump Action—A Review of Insulin Pump Uptake and NICE Guidance in English Primary Care Trusts”. The report shows significant inequality in the provision of insulin pumps across England and a lack of adherence to National Institute for Health and Clinical Excellence guidance, with low insulin pump usage compared to the NICE benchmark. The average rate of insulin pump provision for people with type 1 diabetes is 3.9%, compared with the 12% benchmark recommended by NICE; it is nowhere near the 33% recommended for children younger than 12.

There is, without doubt, a postcode lottery on insulin pump access. The percentage of people with type 1 diabetes using an insulin pump falls as low as 0.25% in Medway and 0.3% in Croydon. In my county of Derbyshire, the rate is 4.4%, with 120 people using an insulin pump out of the 2,746 people with type 1 diabetes in the area—that is well below the NICE guidelines. May I request that the Minister take urgent action as soon as possible to address this issue? It simply is not fair that people can be denied treatment just because they live in the wrong part of the country.