(11 years ago)
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Philip Davies (in the Chair)
Before I call Mr Keith Vaz, Members should be aware that although things are quiet at the moment, we have been advised that there is a possibility of lots of noise outside, due to the work being carried out to try and get the visitors’ entrance up and running. If the noise reaches an unacceptable level and people are struggling to hear, we can ask them to stop. Things are all quiet at the moment, but if that happens, please let me know and we can do something about it.
Keith Vaz (Leicester East) (Lab)
It is a huge pleasure for me both to serve under your chairmanship during this important debate, Mr Davies, and to raise the issue of childhood obesity and type 2 diabetes. In 2007, after a chance testing by my local GP, Professor Azhar Farooqi, who is now the clinical commissioning group lead in Leicester, I was diagnosed with type 2 diabetes. Before I discovered that I had diabetes, it was not really a subject that I was aware of. Since then, it has become my passion inside and outside Parliament.
I begin by paying tribute to the Minister, who has truly revitalised the debate on obesity and diabetes since becoming a Minister. I agree with what she said, in her interview with Total Politics this week, about the public health Minister’s job. I have deleted one or two words, but she said that
“this is not a soft…girly option, it is a…serious job”,
and she is absolutely right. That is why I am delighted to see, on the Opposition Front Bench, the shadow Minister for public health, my hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott), who entered the House with me in 1987.
I am also delighted to see so many other Members of Parliament who have either raised the issue of diabetes or have been involved in campaigns. There is the hon. Member for Strangford (Jim Shannon), who, like me, is a type 2 diabetes sufferer; the hon. Member for Mid Derbyshire (Pauline Latham), who has raised the matter many times in the House; and my hon. Friend the Member for Inverclyde (Mr McKenzie), who was in the Chamber, but has popped out. There is also the hon. Member for Southport (John Pugh), the hon. Member for Morecambe and Lunesdale (David Morris), who is my next-door neighbour in Norman Shaw North, and last but not least, the hon. Member for Torbay (Mr Sanders), who is the chairman of the all-party parliamentary group on diabetes and who, for many years, has raised the issue with such passion.
Childhood obesity has become an important political issue. The NHS report, “Statistics on Obesity, Physical Activity and Diet”, of February 2012, stated that in 2010, about 30% of boys and girls were classified as either overweight or obese. The study found that 17% of boys and 15% of girls were obese, which is an increase from 11% and 12% respectively in only 15 years. The factors that cause childhood obesity are a major part of the debate. A recent study by University college London found that 30% of the difference between the bodyweight of one child and another can be explained by their genes. However, genes alone cannot explain the rapidly increasing incidence of childhood obesity.
The ever-increasing numbers of overweight children must be addressed, or we will have a generation of obese children growing into obese adults. It will be a generation at risk from the associated dangers of being overweight, including having type 2 diabetes. Unless we do something about that trend now, the twin epidemics of obesity and diabetes will overwhelm the NHS.
Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)
Does my right hon. Friend agree that whereas a generation ago, if a child was overweight, adults used to say, “They will grow out of it”, we cannot afford that type of complacency now?
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.
Keith Vaz
I thank the hon. Lady for her intervention. I fear that she may have seen a copy of my speech, because she has mentioned the very issues that I intend to raise. All three areas are extremely important. It is not one area alone that can deal with the issue; it is a combination of all three factors.
The first factor is the manufacturers. Coca-Cola pledged to reformulate its best-selling drinks to reduce calorie content by at least 30%, but it has chosen not to reformulate its classic, full-fat Coca-Cola, the world’s most popular drink. A can of full-fat Coca-Cola has eight teaspoons of sugar. If the responsibility deal is to be truly believed, it has to be more robust. The pace of change among food and drink companies must be dramatically increased. The only alternative to the responsibility deal, in my view, is legislation.
Last year, I introduced a private Member’s Bill, the Diabetes Prevention (Soft Drinks) Bill, to reduce sugar content in soft drinks by 4% and to establish a programme of research by requiring manufacturers of soft drinks to reinvest part of their profits in diabetes research. In 2010, 14.5 billion litres of soft drinks were consumed in the United Kingdom. According to research by Professor Naveed Sattar of the university of Glasgow, the average person in the UK consumes between a fifth and a quarter of their daily calorie allowance through non-alcoholic drinks. Those are somewhat hidden calories. Professor Sattar said:
“This analysis confirms that many people are perhaps not aware of the high calorie levels in many commonly consumed drinks.”
The consumption of sweetened soft drinks clearly has a part to play in the increasing waistline of the nation.
Attempts to legislate on the issue have been rather unsuccessful. In September 2012, New York’s mayor, Michael Bloomberg, introduced a ban on super-size fizzy drinks to tackle the city’s obesity problem. The ban was overturned in the New York supreme court by a coalition of drinks companies and industry groups.
Legislation has not been limited to sugary drinks. In October 2011, the Danish Parliament passed a so-called fat tax on foods containing more than 2.3% saturated fat. The tax was scrapped after concerns were raised about its adverse effect on the economy as increasing numbers of Danes crossed the border to purchase food in Germany. Clearly, that would be less easy if we did such a thing in England, because of the ability to go to Scotland and Wales.
The hon. Member for Mid Derbyshire mentioned schools. She is absolutely right. The third key area is the role of schools in childhood obesity. Healthy eating in schools has been given a real boost by initiatives such as Jamie Oliver’s “Feed Me Better” campaign, which successfully attempted to transform lunch-time menus. However, many schools still have vending machines offering fizzy drinks and sugary snacks. We should issue an ultimatum: schools should remove all vending machines by 31 December this year. That would go some way towards addressing the problem of bad nutrition in schools.
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.
The Parliamentary Under-Secretary of State for Health (Anna Soubry)
I apologise, Mr Davies, for what may become something of a love-in. I will probably pinch some of the right hon. Gentleman’s speech, and I pay tribute to the great work that he has done. Does he agree that great work has been done in Leicester with the health checks that are being rolled out there? The approach is forward-thinking. Anyone who registers with a doctor and is in the right age group automatically gets a health check. The work is also being driven by the excellent charity with which the right hon. Gentleman is associated. Does he agree that real, positive work is being done in Leicester from which the rest of the country can learn?
Keith Vaz
Absolutely. I thank the Minister for her kind words. I know that she has to pass Leicester in order to get to London and I know that she has made a number of visits to the city; she was there recently. I thank her for the compliment that she has paid to Leicester and to Silver Star. The Government must not miss this opportunity to set targets for GPs, because it is only through setting targets that we can secure real change.
Another avenue that could be explored is the role of pharmacies in testing for diabetes. According to the Royal Pharmaceutical Society, there are more than 10,000 community pharmacies in the UK. I believe that those pharmacies are under-utilised. My mother, before she died, had absolute faith in her local pharmacist. Of course she listened to her doctor and she got her prescription. On occasion, she would listen to her son and her daughters. However, the person she really respected was the pharmacist, and because pharmacies are on the high street, they are available to local people, so they can get their tests. The benefits of testing for diabetes in pharmacies are twofold. Bringing testing into the community because the pharmacies are there means that hundreds of thousands of people who have not been diagnosed with the condition can discover whether or not they have it and, more importantly, it would reduce the pressure on already over-burdened GPs.
Finally, I want to talk about the new landscape of health care and its role in tackling diabetes. The Health and Social Care Act 2012 offers an unparalleled opportunity to revolutionise diabetes care and prevention. I warmly welcome the introduction of health and wellbeing boards, which will put local councils firmly in the driving seat to address public health. I have always believed that local authorities have a role in providing those services. Importantly, the boards will be able to work with charities, such as Diabetes UK, which have done outstanding work over many years and provided so much help to so many people. The first thing I did when I discovered I had diabetes was become a member of Diabetes UK. I receive constant updates about what I should do and a little loyalty card, which I have not used yet, but it has the telephone number.
It would be remiss of me not to bring up Silver Star, which the Minister mentioned and with which I am privileged to be associated. It targets at-risk communities. Indeed, having been established in Leicester, sent buses to Mumbai and Goa, and supported charitable work in Yemen, the charity opened its first London diabetes centre in Edgware only two weeks ago with the help of Mr Speaker, in the place he was born—not quite the hospital, because Edgware general is down the road. He was born in Edgware however, and it was great to have him back to open the new unit.
The charity has sought—this takes us back to the point made by the hon. Member for Mid Derbyshire—to deal with issues relating to children and sport; the importance of diet; and the role of parents and professionals. On Friday, the charity and I will unveil the winners of a painting competition held by Silver Star in association with Leicester City football club. All the school children of Leicester were asked to paint a picture showing the importance of a healthy lifestyle. I thank the football club’s chairman, Mr Raksriaksorn, and his son Top for naming the charity as one of their charities of the year and for working with it to ensure that children realise the importance of sport. I hope that on Friday not only will the winner of the competition be announced, but Leicester City football club will at last get into the play-offs where we belong, as it is one of the last games of the season.
The health clock on diabetes has reached 11.59 pm. We need either to toughen the responsibility deal or to pass legislation. Schools need to take immediate action to remove vending machines that sell sugary drinks. We need local councils to give fewer planning permissions for fast-food outlets near schools, or, better still, no planning permissions. We need a radically different approach to ensure that everyone at risk is tested for diabetes. If we do not do so, the NHS will be overwhelmed and it will not only affect our generation, but our children’s generation. That is why we must act now.
Mr Adrian Sanders (Torbay) (LD)
It is a pleasure to serve under your chairmanship, Mr Davies, for the first time. I congratulate the right hon. Member for Leicester East (Keith Vaz) on securing this important debate.
I would like to highlight the clear distinction between type 1 and type 2 diabetes. The vast majority of children with diabetes have type 1, which is not preventable and needs daily treatment with insulin. That is not to say that diet is not important; some believe that one can put off presenting with type 1 by adopting a very sensible diet and exercise regime, but that is not proven. The fact is that there is not a lot that most people can do to stop it happening, myself—a type 1 diabetic—included. It is going to happen; it is a question of when.
The vast majority of people with diabetes have type 2, which is explicitly linked to lifestyle. Other risk factors include ethnicity and family history. Type 2 usually manifests later in life, but lifestyle in a person’s early years has a considerable bearing on later risk. Just to confuse the situation, rather worryingly, we now see cases of children developing type 2 diabetes, with about 500 cases diagnosed in the UK to date. It is therefore extremely worrying to hear that a quarter of children entering reception classes are overweight or obese—the proportion rising to one third at age 11.
How significant a public health disaster obesity is likely to become cannot be overstated. On current trends, it is estimated that direct costs to the NHS will be £10 billion a year by 2050 and the wider social costs will be many times that once issues such as early incapacity, lack of productivity and so on are factored in. An obese man is five times more likely to develop diabetes than a healthy man. Obese women are 13 times more likely to develop it than their healthy counterparts. Diabetes is one of the more costly long-term conditions for the NHS to deal with, so higher levels of obesity will clearly lead to greater problems for the NHS, and I am not sure anyone has yet figured out how to address the human and financial costs.
I am happy to welcome the work that the Government have undertaken so far on diabetes and wider public health issues. We have made significant progress in identifying where the problems are and what is causing them, and the national diabetes audits have been a great help in that regard. For all its controversies, the Health and Social Care Act 2012 should allow health care professionals to integrate what they do with local authorities, public health services, schools and so on—whether it happens in practice has yet to be seen.
The overarching problems are clear: a more sedentary lifestyle, and, in childhood, the attraction of TV and video games; the lack of structured sport and exercise—especially in schools—and an increased perception among parents of the heightened dangers of playing outside. Coupled with those is an increasingly unhealthy diet, exacerbated by excessively sugary, salty and fatty foods. A difficulty arises when we consider how to tackle what is at root a cultural problem. France, for example, experiences the same commercial challenges, with the availability of unhealthy food and the growth of electronic entertainment, but has only half the UK’s rate of childhood obesity. A lot of voices call for quick, and sometimes superficial, Government interventions, such as banning or regulating sugary cereals, a tax on particularly unhealthy products and so on. Such policies might have some value as part of a wider strategy, but on their own they will not effect the cultural shift we need.
We need to improve the ability of consumers, especially parents, to make informed decisions about what food to buy and prepare. To me, that implies a two-pronged approach, with better food labelling at the point of sale—whether at a supermarket, restaurant or even fast-food outlet—and better education, particularly in schools, both playing a role. We need to look at promoting alternatives to sugar, especially in soft drinks, which contribute a great deal to childhood obesity.
I spoke at a diabetes conference yesterday. A concern that came up, which has been coming up for years, is that previous strategies to improve outcomes have often failed due to silo working or a lack of integration between services. In Torbay at least, the health care system has recognised the serious problems that causes and has integrated primary and social care services, which gives it a head start when tackling public health issues. We now need that principle extended to the policies and services that impact on child health, specifically obesity. In Whitehall, there has always been a chasm between the Department of Health and the Department for Education, and it needs bridging at national and local levels. We would do well to recognise that prevention works best the earlier it starts.
Statistics show that children are already in trouble before they get to school, so there is a role for early- years services as well. Whether we like it or not, public services are driven by financial imperatives and we will need to address the problems at the funding level, by giving schools, GPs and all the other interested parties a shared duty to tackle public health issues and rewarding those that show innovation in their curriculums. Change4Life is a good start. It rightly highlights that strategies and solutions are best designed and delivered at a local level.
I conclude by praising the right hon. Member for Leicester East for securing the debate and for the work he does. I also thank the other hon. Members here today who are tireless campaigners in the field, and the Minister for her fresh approach to the subject. Any strategy we use must bring local stakeholders together. Whatever we do, it needs to be more ambitious than what we are doing.
Mr Iain McKenzie (Inverclyde) (Lab)
It is a pleasure, Mr Davies, to serve under your chairmanship. I also thank my right hon. Friend the Member for Leicester East (Keith Vaz) for securing this important and timely debate. Across the UK, childhood obesity is soaring and, with it, diabetes. We need to deal with childhood obesity sensitively and robustly, and we must not make the mistake of thinking that one solution will fit all children. Obesity in childhood is a complicated condition and can have many different causes. Childhood obesity often persists into adult life, and adults who are obese as children have a higher risk of diseases associated with obesity, particularly type 2 diabetes, hypertension, cardiovascular diseases and, yes, even cancer.
The UK has one of the highest levels of childhood obesity among developed countries. I will take a moment to discuss what has been happening in Scotland, because we share that problem. In fact, it is probably multiplied. In common with most of the developed world, Scotland is experiencing an obesity epidemic, and the west of Scotland heads up all the wrong health leagues in Europe. Scotland has one of the highest levels of obesity among OECD countries. Only the USA and Mexico have higher levels. Recent figures show that 26% of adults in Scotland are obese and 65% are overweight. For children, the corresponding rates are 15% and 31%.
Worryingly, the prevalence of type 2 diabetes is increasing rapidly in Scotland, as well as across the UK, with the largest part of the increase likely to be due to poor diet and low levels of physical activity, resulting in increased levels of obesity. Our diet in Scotland was a response to a life spent in the heavy industries, but it is totally unsuitable for a career spent in front of a computer screen. Activity levels are far too low to burn off our daily calorie intake. To give children the best start in life, early-life interventions need to begin before and during pregnancy, continue through infancy into early years settings, such as nurseries and childminders, and carry on into primary school.
In my constituency of Inverclyde, we have had to take steps to address the growing problem. Many years ago, we started to educate children and parents about healthy eating. In primary schools, our classes are in competition to see who the healthiest eaters are and which are the most active classes in their school. Our schools have sports co-ordinators, who introduce and encourage kids to participate in a wide variety of sports. It is not only that—our schools link up with local sports clubs to encourage kids to continue to be active after school and at weekends.
As we heard from my right hon. Friend the Member for Leicester East, we continue to have vending machines in our schools, but in Inverclyde we have put healthy foods in them. Fizzy drinks are no longer available in our schools; the only thing that can be bought from vending machines is water. Granted, it is difficult to get companies to participate in that, but our schools have been encouraged to do it off their own bat, if need be. Fast food and mobile vans have been banned from within a one-mile radius of our schools, so that if a child—especially those in secondary schools—wishes to partake in fast food outlets, at least they have to walk a distance to get there and back.
The early years offer the best opportunity to put in place healthy behaviours around food and physical activity, which will hopefully be sustained into adulthood. Central to that is the involvement of families. Encouragement must start within families to adopt a healthy lifestyle and eat healthier foods. Today, 15 out of every 100 primary school children in Scotland aged between four and a half and five and a half are dangerously overweight. Diabetes is a serious condition that causes heart disease, stroke, amputations, kidney failure and blindness, and more deaths than breast and prostate cancer combined.
Almost a quarter of a million people in Scotland have diabetes. New statistics in the annual Scottish diabetes survey show that the number of people with the condition has continued to increase alarmingly by about 10,000 a year. The majority of those people will have type 2 diabetes, a form of the disease that can be caused by an unhealthy lifestyle and can be so easily prevented. Across all four nations in the UK, we have seen a huge rise in childhood obesity.
We know that losing weight is about more than just altering your diet, but people are different. There are burners and storers. Storers find it difficult to lose weight, but love food—and love the wrong food—and do not take to exercise too keenly. Those additional factors lead to their heading in the wrong direction with their weight, and that can subsequently lead to diabetes. Let us not assume, however, that all is well with the thin people whom we meet, because poor diet can cause problems. We clearly need an approach that combines diet, exercise, the education of children—and, crucially, the education of parents—and psychological support. We need to increase physical activity at primary school and carry that on into secondary school. We need to encourage leisure activities for children to get them involved in sports and away from their computers and TV screens.
Ms Abbott
Does my hon. Friend agree that, while all the things he said are important, it is also important that children take an intelligent interest in what they are eating? In that respect, Martha, the young woman in Scotland who photographed and blogged about her school lunch, is an example of a young person who is engaged in food quality.
Mr McKenzie
I absolutely agree with my hon. Friend and I will give her an example. During my time in local government, I took the opportunity of taking a few school meals with the kids. Was the message getting across? Yes, because they told the teacher that I had only two pieces of fruit and had not taken my five pieces of fruit. The message gets across if it is emphasised time and again.
As I said, we need to increase physical activity at primary school and carry that on into secondary school. The competition for young people’s leisure time has never been greater. Many prefer to play a sport on the Wii than try it for real. The issue is not only with the young, but with the elderly. A unique group called the Globetrotters has recently been set up in my area. It encourages the elderly to be more active and its members have, in their actions—their steps are counted and their trips are mapped out— walked to the moon and are on their way back. “Walking to the moon and back” is the group’s most ambitious trip to date. The Globetrotters is a fantastic example of what can be done from a perspective of physical exercise not needing to be that challenging.
The food industry, as we have heard, needs to take responsibility for the fizzy drinks and sweet foods targeted at children. Healthy eating patterns, as we know, are formed in childhood and taken into adulthood, and new research has warned that suffering obesity as a child may take a bigger toll on health in adulthood than was previously thought. If we do not put in place a varied approach to tackling obesity, a major and irreversible time bomb will be ticking away at our children’s and our nation’s health. Obesity will cost the NHS billions. Obesity-related illnesses already cost the NHS an estimated £5.1 billion a year. If we are to get to grips with it, we need to do a lot more together, starting right now, before the problem becomes worse and the NHS can no longer cope.
John Pugh (Southport) (LD)
I pay tribute to the right hon. Member for Leicester East (Keith Vaz), who introduced the debate, for his characteristic generosity in congratulating all the other Members present; that is very much a feature of his style.
Let me start with the assumption that an obese child is an abnormality in some sense or other. It is not normal in nature for children to be obese; what is rather more normal is for people, as they get older, to find it difficult to stop being obese. If we think of portraits of obesity in literature, we think of Billy Bunter in the ’40s. Then, obesity was seen, in a very naive way, as a consequence of childhood greed, because it was a rare and not well-understood phenomenon. An earlier example is the plump lad in Dickens—I think he was called the fat boy—who was actually a thyroid victim. However, such children were unusual enough in those days to be pointed out; they were not at all a standard thing. Now, as all of us have recorded, the phenomenon of obese children is no longer a rarity in an advanced society.
Last week, the Minister and I attended an event organised by the all-party group on obesity, although I do not think she was aware I was there. A very earnest man told us we need to be careful about every extra Mars bar we eat every day; otherwise, we would increase our weight exponentially and eventually end up with serious problems. He was particularly horrid about egg custards and the like. Although what he said was probably broadly correct, I could not help thinking that it was not really sensible for any of us constantly to calculate exactly how much we had eaten, whether we had eaten too much or too little and by how much. I was slightly reassured by some research that came out after that event, which said, as the hon. Member for Inverclyde (Mr McKenzie) has just done, that there is more to this issue than meets the eye. If people become plump, it is not just a question of over-supply; it is sometimes to do with their glands and their endocrinology—whether they are burners or storers.
I recognise that this is a complex problem, but the fact of the matter is that the nations that have an obesity problem, as many advanced nations do, always have three principal characteristics: a relatively unlimited supply of food, easy access to that food—in other words, it does not have to be cooked or prepared in a long, elaborate way and can simply be grabbed—and a sedentary lifestyle. I do not see any of those changing any time soon. All three are probably necessary before nations have an obesity problem, and all three are, in many respects, here to stay.
I am therefore a little sceptical about claims that there is an easy solution to this problem. While other Members were speaking, I wrote down some of the solutions that were advocated, and every one can be faulted in some way. School dinners were mentioned. I used to be a teacher, and I used to see children walk past pictures of big, rosy apples, lettuces and things like that, before going straight for the pizza and chips. I was sometimes aware of how futile and ineffectual healthy eating programmes can be. The reality is that school dinners—many of us have experienced them—have never been notably healthy or low in calories, because it is assumed that children need lots of energy to get through the day. Working hard on school dinners and children’s choices is not, therefore, necessarily an easy solution.
A tax on fattening food was mentioned, and I am sure you would not warm to one at all, Mr Davies. The reality is that most food, if we eat enough of it, is fattening, with the possible exception of lettuce and something else, which requires more calories to eat it than we get from it—[Hon. Members: “Celery.”]
On education, the British public are not particularly lacking in knowledge about the things that make them fat and the things that are likely to have a less adverse effect. They are probably not quite as acutely aware as they should be about the calories in individual things. One of the easier ways of addressing some of the problems we have with alcohol is reminding people what the calorie intake from a glass of wine or a pint of beer actually is. However, that is not an automatic or a simple solution either.
Changes in family lifestyle were mentioned. Parental responsibility is important, but, at the same time, people’s lifestyles will be under increasing pressure in many ways—there is no evidence they will be under less pressure.
Ms Abbott
I am listening with interest to what the hon. Gentleman is saying, and I will respond to some of it in my remarks. He does not think the general public are ignorant of what food contains or the calorific value of food. However, people are often shocked to find that there is sugar in things such as baked beans and tomato ketchup; they often do not know how much sugar and fat there is in processed food. People who want to do right by their child will feed them these so-called breakfast cereal bars, but they do not understand how much sugar and fat there is in them.
John Pugh
There are benefits to the approach I outlined, although the people who are most acutely aware of the calorific content and the quality of their food are those who are already halfway to solving the problem. However, many people do not get even to that first base, and that is where public health messages have an impact.
Mr Sanders
Does my hon. Friend not think there would be an enormous benefit in having a simple traffic-light system so that parents buying children food understand that red means danger? Similarly, people queuing up at a fast-food restaurant will know which items on the menu contain the most sugar.
John Pugh
I hope hon. Members do not misunderstand me. I am not saying that the bits of the jigsaw cannot be put together and cannot ultimately constitute a perfectly satisfactory solution. I am saying that every one of the solutions so far advocated must come with a caveat, because it is not likely to be the magic bullet that will transform things. There is no magic bullet, and I will return to that theme when I conclude.
On sport, it is unquestionably the case that one reason why children acquire the extra pounds is that they move around far less than they ever did. When I was at school, the dinners were intensely fattening, but children moved far more, so the obesity problem was not that marked. One issue, however, is that if the problem starts early, as my hon. Friend the Member for Torbay (Mr Sanders) suggested, and the child is already overweight, he or she will be more reluctant to engage in sport and likely to look for excuses to avoid sport, so offering them a wider menu of sporting opportunities, by itself, will not help.
Pressure on producers and the responsibility deal were mentioned, and a lot can be achieved through such measures. The Minister will confirm that we have, almost without noticing, reduced the amount of salt in our food by agreement with the producers, and nobody has really minded. Clearly, similar results can be achieved by agreement with sugar producers, and there is no reason why that should not happen. Again, however, people tend to deceive themselves. We are all familiar with the phenomenon of people who sit there with a beefburger and chips, but who have a diet coke by their side. The assumption is that if they drink the diet coke, the effect of the chips and the beefburger will somehow be negligible.
The right hon. Member for Leicester East mentioned the issue of access. Access to fast food is one of the principal reasons why society has the difficulties it does. When we go to railway stations or other places where we are in a hurry to buy things to take on our journey, it is noticeable that we are presented with larger snacks than we would want, such as grab bags and extra-large chocolate bars. There is no explanation for that, other than that the producers are being blatantly irresponsible and trying to shift more of their product.
I must make a confession that may shock many Members present. As a student, I once worked as an ice cream salesman, driving an ice cream van. Our strategy was always to turn up at schools around lunch time, although my ice cream was of such low grade that the children would walk past my van. Instead, they would go to the Mr Whippy van, even if it got there later, so our strategy did not entirely work. However, Members can see that having food near lots of ravenous children is attractive to commercial interests, even if it is irresponsible of them to pursue such a strategy.
All those solutions have merit, but most of them have limitations. It is tempting simply to say there are a lot of issues—I have said as much myself—and that we have to press all the buttons to get the effect we want. I am quite happy to go along with that, I would like us to concentrate on what works and on what there is clear evidence to support; that is what I think needs to happen. One serious problem that concerns me, and which has been mentioned, is tokenism. I have seen tokenism in action; I have seen schools go through the motions of telling the children a bit about food and sticking up the appropriate pictures, but nothing really changes, so the phenomenon persists because it has not been properly addressed. There is irrevocably an element of personal and family responsibility. We cannot take that out of the equation. However, the most successful methods of making it easier for people to make the right choices must be evidenced, supported, endorsed and spread. We should not put into practice a mechanism that might or might not work.
A concern that results indirectly from concentration on the problem in question is the increasing incidence among children of not diabetes but eating disorders. However we pursue the agenda, we must do so in a way that makes it less likely that increasing numbers of children will, because of a legitimate concentration on their health and weight, become obsessed with their body shape and develop problems with eating behaviour that they would not have if they grew up naturally and in a satisfactory way.
Jim Shannon (Strangford) (DUP)
It is a pleasure to take part in the debate. I have several things in common with the right hon. Member for Leicester East (Keith Vaz), not least that we support the same football team. I have done so since 1969, and I hope we shall be in the premier league next year. The second thing is that we are type 2 diabetics, as a result of our lifestyle—from about the same time, as I became a diabetic some five years ago.
I acknowledge that I am a diabetic because of the lifestyle I had. Hon. Members may know the experience of being offered a well man check by the doctor, who always says there is good news and bad news; we say, “Tell me the bad news first.” The doctor five years ago told me, “The bad news is you are diabetic. The good news is you can manage it if you really want to.” That was the thrust of it. He said “You can ignore this, and shortly you will be on tablets, and then on injections.” He was not scaremongering, but just wanted me to know exactly what the condition meant. He said, “Your diabetes will not kill you, but what will kill you will be all the things that come from it: your blood pressure and heart, or amputations and stress levels.” I know fine rightly that I became a diabetic because of my lifestyle five years ago. The fact is I love Chinese food; five days a week I had a sweet and sour pork and two bottles of Coke. It never changed—I like it, and so that was what happened. As well as that there was all the stress of the job—previously I was an Assembly Member in Northern Ireland, and a councillor. I love long hours, and they do not bother me at all—and that probably applies to every other hon. Member; the hours were not an issue, but the stress is.
Clearly I had to make changes. Looking back into my ancestry, no one—not my mother, father or grandparents—had diabetes. I was the first in my family, so the cause was clearly my lifestyle. I make that point because of the question of heredity and the hope that I would not pass on my difficulties to my children or my wee granddaughter, four-year-old Katie-Lee. The question is how to instil in children and grandchildren the necessary control, so that they eat the right food, in the right way. I was on diet control in January, and am now on two Metformin tablets in the morning, and two at night; there is nothing graceful about growing old. We may need tablets to keep us going, and probably most of us in the Chamber are of that ilk. The question for me is what I can do as a grandfather, and as an MP, to protect my granddaughter and children, and everyone else, from becoming diabetic.
The UK has the fifth highest rate in the world for type 1 diabetes in children. That can lead to serious health problems such as blindness and strokes, to name but two. Some 24.5 children in every 100,000 aged 14 and under are diagnosed with the condition every year in the UK. Statistics are real to those of us who are focused on the disease and how to deal with it. The UK’s rate is about twice as high as the rate in Spain, which is 13 in every 100,000, and in France, which is 12.2 in every 100,000. The league table covers only 88 countries where the rate of incidence of type 1 diabetes is recorded. There are around 1,038 children under the age of 17 living with type 1 diabetes in Northern Ireland, and almost one in four of those reached diabetic ketoacidosis before a diagnosis was made. DKA can develop quickly and occurs when a lack of insulin upsets the body’s normal chemical balance and causes it to produce poisonous chemicals known as ketones. If undetected, those ketones can result in serious illness, coma and death. We all know people who have come through that, and I am aware of people who have succumbed to diabetes.
The number of people living with types 1 and 2 diabetes has increased by 33% in Northern Ireland during the last five years; that is the largest increase in the United Kingdom, compared with 25% in England, 20% in Wales and 18% in Scotland. The total number of adults with diabetes—those aged 17 and over—registered with GPs in our small part of the UK is just shy of 76,000, and 1,038 young people under 17 are known to have type 1 diabetes, which is another significant rise. Prevalence in the Northern Ireland population is now more than 4%. Some 10,000 people have diabetes without having been diagnosed with the condition. It is scary stuff, when we realise what is happening in our region. I had occasion to speak about that with the right hon. Member for Leicester East before the debate.
Through my colleague, the Northern Ireland Health Minister, I encouraged the purchase of insulin pumps for type 1 diabetics, which was done last year; we have also encouraged the provision of training for family members, guardians and health staff in the use of the pumps. When a Minister is committed to the issue, things can happen.
I have every confidence in the Minister who is present for the debate. In my short time here I have witnessed her contribution in her role, and her commitment to change and to taking hard decisions. I do not agree with everything that she does, but I admire her commitment to the job, and many things that she has done have not gone unnoticed.
Approximately 90% of the 3.7 million people in the UK diagnosed with diabetes have type 2. I have brought that issue to the attention of the Northern Ireland Health Minister, as I am very aware of the ticking time bomb that diabetes is, and the key initiatives in operation in Northern Ireland. He is clearly doing a great job, including setting aside funding to employ additional diabetes staff—specialists, nurses, dieticians and podiatrists: all help that a diabetic needs, but perhaps not enough. All the hon. Members who have spoken have done so with honesty; if we put all the ideas together in a big pot, perhaps we will find a way forward. We need to instil good eating habits in children that will not lead to diabetes later in life.
Rates of obesity—because that is the twin thrust of the debate—tend to rise with increasing disadvantage across developed countries, particularly among women. In 2006 in Northern Ireland, 18% of children aged between two and 15 years were reported to be obese. In 2008-09, the child health system reported that 5.3% of primary 1 children surveyed were obese. The hon. Member for Southport (John Pugh) said that when we were young, many years ago, for someone to be of a certain size was unusual. It is not any more. In the survey I mentioned, 22.5% of the children were described as overweight or obese. That is a massive number.
We need to educate parents on what they are teaching their children through their lunches and dinners. Some schools in my area implemented a healthy snack policy, where twice a week children were not allowed to bring in crisps or chocolate, but had to bring in fruit or a healthy option. That is fantastic, and it is good that it happens, but some parents pointed out how much more expensive it was. We should consider how to make healthy food more affordable for young families in the present economic difficulties.
Mr McKenzie
On that issue, is the hon. Gentleman concerned, as I am, about supermarkets that employ the tactic of making their fruit ripen as early as possible, so that families have to make several trips to purchase healthy options for their child’s lunch box?
Jim Shannon
Many parents have made me aware of that. There is a key role for supermarkets and how they do things. When we go to the supermarket—let us be honest—we can always find a multipack of crisps or chocolate. By the way, there is nothing wrong with that as long as it is done, like anything in this world, in moderation. Children love a treat, and why should they not have one if it does them no harm?
Unfortunately, it is more difficult to find a multipack of fruit juice, or bags of fruit on offer or sliced up. It is much handier for parents to pick up a bag of crisps for their child’s break than to take the time to cut up fruit when they cannot afford to buy the pre-cut fruit that they want. I believe that we need to change that by encouraging supermarkets to put regular offers on healthy options, and perhaps by looking at tax incentives to make such options a realistic lifestyle choice, and not just a fad to go for for a wee while.
One of the community groups in my area, the East End residents association, has put on a cooking class for its ladies group, which showed them how to cook healthily for the family in a quick and cheap way. Women of all ages learned how they could cook on a budget, but still provide a healthy and satisfying meal. That is also key, and I suggest that funding might be set aside for community groups and churches to put on such classes, which could make real lifestyle changes to entire households.
Unfortunately, at the moment there are few homes that can afford to have only one parent in work, with the mother at home cooking and cleaning—that now has to be fitted around another job—but we must educate people and teach them that short cuts can be made so that healthy meals and snacks for families are still provided. Will the Minister kindly address that and explain what can be done to educate and help those who simply do not know how to do the best for their families? A surprising number of families cannot do so, so we should try to achieve that if we can.
In conclusion, it is clear that something needs to be done. If there is one message from every speaker, it is that we all agree that something needs to be done; the question is how best to deliver that. Many children and adults will not be able to live a healthy life because of something that they could have made small changes to prevent. I congratulate the right hon. Member for Leicester East on bringing this matter to the Chamber. Many more hon. Members would like to make a contribution, but I can say one thing—every one of us, as elected representatives, has constituents for whom this issue is key. We look forward to hearing the response from the Minister, as well as the speech from the shadow Minister, the hon. Member for Hackney North and Stoke Newington (Ms Abbott).
Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)
I congratulate my right hon. Friend the Member for Leicester East (Keith Vaz) on securing this important debate on childhood obesity and diabetes. We know the parameters of the problem: on current trends in childhood obesity, more than half of British children will be obese or overweight by 2020. A particular concern of mine, as the representative of an inner-city constituency, is that children in the poorest decile are more than twice as likely to be obese compared with those in a more affluent or middle-class decile. It is curious that, generations ago, obesity was a challenge faced by the well-off. We now live in a society, both here and in north America, where obesity is often a disease of poverty. I will return to that point.
We also know that diabetes is the No. 1 health threat in the UK, where 3.7 million people live with the disease, and as the Royal College of Paediatrics and Child Health has told us, care processes and outcomes for children with diabetes in England and Wales remain significantly worse than those for adults, which is what makes this debate so important. Thinking on the issue has changed. When I was a child, people said of a child who was a bit chubby, “Oh, they’ll grow out of it.” It was not seen as anything to worry about. We now know that overweight children become overweight adults, with all the associated health problems.
As always, the hon. Member for Southport (John Pugh) made an interesting speech, but he said a few things that perhaps need amplification. He seemed to say that it was inevitable that there would be a problem of obesity in advanced societies. I was in Finland last week, and Scandinavian countries—Finland, Sweden, Denmark—do not have our problems with obesity. That is for all sorts of reasons, one of which is that Governments have taken the issue seriously and made what were sometimes hard decisions to try to change public health outcomes.
The hon. Gentleman seemed to imply that school dinners are not necessarily part of the solution. I believe that, certainly for primary school age children, being exposed to a range of healthy foods and having healthy school dinners makes a difference to outcomes for diet. I also believe that it is worth educating school children about diet. There has been a complete turnaround of public attitudes to smoking over the past 30 years. Many things contributed to that, including Government action, but it was also due to the role of education and public heath campaigns. I believe that, in the medium term, we can do that for healthy eating and diet issues.
We therefore know the parameters of the problem and that, as has been said, it cannot be fully accounted for by genetics; it is due to a mix of a more sedentary lifestyle and the consumption of far too many calories through the eating of more fatty, salty and sugary products. We should note, however, that one reason why people eat more fatty, salty, sugary and processed foods than they did when we were children is that they are marketed aggressively at families and children. I want to talk about pester power. If a child sees endless advertisements for Ronald McDonald, the parents, even if they know better, find themselves under great pressure when they are out to purchase foods that they know in their hearts are probably not the best for their children. An occasional treat is one thing, but the problem relates to when such foods are not just an occasional treat, but have become the mainstay of a child’s diet.
Government Members have talked about parental responsibility. I believe in that, but we must bear it in mind that childhood obesity and related conditions, such as diabetes, are issues not just for the child and their family, but for us as a wider society that is concerned about the health and well-being of all our people. To be blunt, there is also the cost of childhood obesity and of diabetes, hypertension and all the related conditions. I think that fully 20% of the NHS drugs budget currently goes on drugs for diabetes. It is all very well to talk about parental responsibility, and about the nanny state as opposed to the Pontius Pilate state, but I think that the state owes its people a philosophical responsibility, and we certainly owe the taxpayer a practical responsibility to do something about the financial consequences of the growing wave of childhood obesity and diabetes.
John Pugh
I want to take the shadow Minister back to her remarks about marketing. I genuinely accept much of what she said, but there is this phenomenon: firms such as Waitrose tell us that it spends a lot of time promoting healthy options, presumably to customers who can afford to shop there, but nevertheless records that people buy more convenience food from it. The fact that we go for convenience food is not just a direct result of marketing.
Ms Abbott
The hon. Gentleman has to understand that the problem is multifaceted and needs multifaceted solutions, one of which is more parental responsibility. The role of supermarkets, and what and how they market, is part of the problem. I live in east London, which is very varied demographically, and I can go half a mile to one supermarket that largely serves working class people—at the front and centre it has unhealthy foods—and half a mile in the other direction to Waitrose, which has fruit and wine. Supermarkets are part of the issue.
Hon. Members may remember the case last year of what The Sun newspaper described as the fattest girl in the UK. She became so obese that the back wall of her house had to be knocked down, and she had to be taken out of the house with a crane and taken to hospital. The point about her is that she had been obese all along, but had been sent to a health farm in America and had lost a considerable amount of weight. She and her mother were reported as saying that the day she came back after several months in the US on a healthy diet, her mother somehow did not have any healthy food in and sent out for fish and chips. With some obese children, it is almost an issue of co-dependency. If we are to work effectively with childhood obesity, we have to work with the family—whatever that family unit constitutes. Will the Minister tell us what action her Department is taking on marketing and promotions, and how it intends to encourage the reformulation of food products, because we need to reduce the high salt and sugar content of breakfast cereals and other items that are marketed at children online?
On the role of local authorities, we should—and I have said this more than once—move public health to local authorities. There are challenges to such a move, but also great opportunities. Potentially, it could mean an end to silo working, because in an ideal world, the education, environmental and leisure services departments work alongside public health professionals to achieve better public health outcomes. We must not forget that for every pound that is spent on things that affect our health, only 10%, I think, is spent by the NHS. The rest is spent by housing and leisure departments. Moving public health to local authorities represents a tremendous opportunity to deal with diabetes and obesity-related issues.
This has been a friendly debate, and people have fallen over themselves to be nice to each other, but let me perhaps insert a slightly cautious note. The great Professor Terence Stephenson, chair of the Academy of Medical Royal Colleges and of the Royal College of Paediatrics and Child Health, said this in relation to responsibility deals:
“The food industry cannot be relied upon to help lead the policy response to obesity. This is not a criticism of the food industry. It would be extraordinary if an industry with a duty to make profits for shareholders should act against its mission to push products and sell as much of them as possible. Asking the food industry to solve the problem is counter-intuitive; you would not put Dracula in charge of a blood bank.”
Of course it is fine to co-operate with industry, but industry must know that the Government are serious and that, in end they will legislate if it does not co-operate. Responsibility deals are fine in principle, but if industry thinks that it is all carrot and no stick, we will not get the results that we all want.
Ms Abbott
That is my exact point. Of course we want co-operation with industry, but there must be teeth—sanctions or at least the possibility of legislation—and, above all, there must be a timetable.
When it comes to childhood obesity, the most important thing is early intervention. Medical evidence shows that overweight children have, in proportional terms, gained most of that weight before they start school, so what we do in the very early years is absolutely key. Will the Minister tell us whether the Government plan to take action on training health professionals in weight management in accordance with the National Institute for Health and Care Excellence guidelines as well as emphasising the importance of parenting style and parents’ lifestyle when children’s weight is considered? Interesting research shows us that 70% of boys who have overweight fathers are overweight themselves, and 90% of girls who have overweight mothers are also overweight, which is why we stress the importance of early intervention and working with the family in an holistic way. We are talking about not any one measure but holistic working. Will the Minister tell us whether she is working with her colleagues in the Department for Education on these matters? In particular, is she following the example of Finland, where there is a high uptake of healthy free school meals, which means that children are getting accustomed to what is a proper balanced meal?
Furthermore, will the Minister tell us what she will do about the situation in academies and free schools, because they are exempt from the nutritional standards that apply to other schools? They can have machines selling fizzy drinks. Is the Minister looking at planning legislation and making public health a criteria in planning, which would make it much simpler to ban fast food shops around schools?
We appreciate the energy and enthusiasm of this Minister, but, partly because of the reliance on responsibility deals, not everyone is swept away with what the Government are doing around health, nutrition and obesity. A few months ago, Jamie Oliver said:
“This whole strategy is just worthless, regurgitated, patronising rubbish.”
Does the Minister agree that firmer and more comprehensive proposals are needed to encourage active travel and make the built environment more accessible for young pedestrians and cyclists, and that we need to take action on junk food advertising and promotions of such foods in stores?
Finally, the Public Accounts Committee report into the management of diabetes services in the NHS recently highlighted the need for action from central Government on reducing the rising numbers developing type 2 diabetes. It said:
“The Department of Health and Public Health England should set out the steps they will take to minimise the growth in numbers through well-resourced public health campaigns and action on the risk factors for diabetes”.
I understand that campaigners such as Diabetes UK have expressed their disappointment that the Government have rejected that proposal. Will the Minister tell us today why the Government chose to reject such sound recommendations made by a highly respected Committee of this House? Does she not agree that the rejection of the Committee’s recommendation might lead some observers to think that the Government will listen only to the food industry on obesity?
It is clear to me, and to all those who have campaigned for years on these issues, that self-regulation and voluntary targets alone will not work. Diabetes UK, the royal colleges and others are all coming together to call for a more robust approach to the regulation of the food and drink industry. However the Government appear a little reluctant about such a move.
Once again, I congratulate my right hon. Friend the Member for Leicester East on securing this important debate. I do not believe that there is any one measure that can impact on the matter of childhood obesity and diabetes. I have touched on some of the practical issues, but there are many others, such as culture and ideas of parenting. There is a generation of young women whose notions of parenting are limited. They hear advertisers say, “Give your child this healthy bar and that makes you a good mother,” and they do not have the information to think beyond that. Diabetes is the No. 1 public health issue facing us now, and childhood obesity gives a premonition of even worse public health problems to come. I wait with interest to hear what the Minister has to say about the points that I and some of my colleagues have raised in this interesting debate.
The Parliamentary Under-Secretary of State for Health (Anna Soubry)
It is a pleasure to serve under your chairmanship, Mr Davies. I congratulate the right hon. Member for Leicester East (Keith Vaz) on securing this debate and pay tribute to him for all the work that he has done over the years on the issue of diabetes and the subsequent work that flows from that in relation to obesity. It has been a pleasure to have his Silver Star van come in to my constituency, and I know that it has gone into many other constituencies as well.
I congratulate the right hon. Gentleman on the work of his charity not just in this country but in India. It was a great pleasure earlier this year to go to India for the first ever Anglo-Indian conference on diabetes. Unfortunately, there is a higher prevalence of diabetes in the south Asian community. It is one of the subjects that I will touch on in what will inevitably be a short speech, notwithstanding the fact that this is a large topic.
If I do not answer all the questions that have been raised in the debate today, I will reply to hon. Members in writing. I agree with the right hon. Gentleman that we must wage a war on sugar, fight fat and that we must all engage in the battle of the bulge. In relation to Ella’s Kitchen, I have seen its excellent report and have asked to meet the group. The right hon. Gentleman is absolutely right about the role that pharmacies can play. I pay full credit to Boots, which is already beginning to do that work, and to Diabetes UK—it is a great charity—which is the chosen charity of Tesco.
I want to talk about the great work that Silver Star and Diabetes UK have done with Boots testing people for diabetes, weighing and measuring them and finding out their blood sugar levels. Following that, we want to ensure that there are then referrals to dieticians, nurses and even GPs where that is necessary. We want to make sure that it all flows and works together.
I pay full tribute to my hon. Friend the Member for Torbay (Mr Sanders), who chairs the all-party group on diabetes. I will not repeat all the statistics that he gave. He rightly made the point about the difference between type 1 and type 2 diabetes; type 2 diabetes has a clear link to being overweight or obese, and I pay tribute to all the fine work that he has done.
The hon. Member for Inverclyde (Mr McKenzie) made a fine point about vending machines in schools. I completely take the point, if I may say so, that he made about academies. I have already spoken to the Secretary of State for Education on that issue. He knows my views on it, but equally I understand why he wants to ensure that our academies are free from—if I can put it this way—central control. Nevertheless, I have made that very valid point.
The hon. Gentleman made a compelling comparison between our statistics on diabetes and our statistics on cancer. We do not flinch—none of us—from talking about how we can prevent cancer. We do not flinch from talking about the fact that cancer is something that kills many people. Of course, many people live with cancer and there are great success stories. Obesity, as everyone attending this debate knows, is effectively a killer. If we were absolutely honest about it, if obesity were a disease, Governments of whatever political colour would have taken action many, many years ago to tackle the growing problem—no pun intended—of obesity and being overweight, notably in our children.
I could use up most of the remainder of my speech effectively debating with my hon. Friend the Member for Southport (John Pugh). Having listened to the hon. Member for Hackney North and Stoke Newington (Ms Abbott), there is a great danger of this “love-in” extending to my shadow as it were, because I absolutely agree with many of the things that she said in response to my hon. Friend. However, we need to take these points away.
Let us talk about something that did not exist when I was young—the concept of snacking. I was positively told not to eat between meals. If we now look in the real world at how young people live and at what they feel is acceptable, it includes going into the many coffee shops that exist. I have no problem with coffee shops, but young people go in and have a large coffee—not a small one, and we could talk endlessly about portion control; I absolutely get that point and think that it is valid—which has syrup in it. It might have marshmallows on top, and then perhaps another little dollop of cream, because it is just a snack, a treat or elevenses. “And by the way”, they say, “I think I’ll have one of those very nice muffins.” They do not know how many calories that is. I absolutely agree that they do not understand that, and there was a great outbreak of nodding at the point made by my hon. Friend the Member for Southport. That is why I absolutely congratulate all those places that have put up on their boards the number of calories in different foods.
The hon. Member for Hackney North and Stoke Newington is right that it is a surprise to people—even to supposedly intelligent, grown-up people such as ourselves—when they find out the calorific content of foods that we see and perceive as treats and snacks. Equally, I want to make it clear that we should never demonise any food. There is nothing wrong with chips, or burgers; what is important is that it is all good food in moderation.
I thank the hon. Member for Strangford (Jim Shannon) for his very kind words, and I will only say this in relation to the team he supports: come on Nottingham Forest. Moving on to more serious matters, I thank him and other hon. Members for raising the profile of diabetes and accordingly raising the issue of obesity. It is a difficult subject, because when we start to talk about people’s weight, they take it personally, and rightly and understandably so. There are many people who say, “Well, it’s not the role of Government to tell people what they should or shouldn’t eat”. They are absolutely right; it is not my role to tell people what they should or should not eat. However, it is the role of the Government, as stewards of the NHS, to make sure that the NHS budget is spent as responsibly and sensibly as possible. We know that obesity costs, not just in human terms but in NHS terms; it costs billions of pounds.
It costs in human terms as well, and many of us who see children who are overweight or obese are upset and concerned about that, because we know that many of those children will not only suffer from health issues—that is one of the things that I learned when I went to see a project in Rotherham, and I will discuss that project in a moment—but will be bullied. Many of them are unhappy that they cannot, as they perceive it, join in the sport or physical activity enjoyed by their friends. There is a real human cost to overweightness and obesity.
I will not repeat the many facts and figures that have quite properly been given in this debate. However, 1.3 million children are obese, which is one in six children. According to the national child measurement programme, which is the programme in England whereby we measure 1 million children—so, if I may say so, we know what we are talking about—4.1% of boys and 2.9% of girls are morbidly obese. That is serious stuff; 17,400 children are morbidly obese.
As has been identified, there is a clear link between obesity prevalence and deprivation. That is why this is a health and equalities issue; not just because citizens from south Asian backgrounds and indeed, I believe, from Afro-Caribbean and African backgrounds have a higher prevalence of type 2 diabetes. We know that 12.3% of reception children who are overweight or obese are from the most deprived backgrounds, as opposed to 6.8% who are from the least deprived backgrounds. I do not know why, but we cannot use the word “poor” anymore. By year 6, 24.3% of overweight and obese children are from the most deprived backgrounds, compared with 13.7% from the least deprived backgrounds.
I perhaps used the wrong language some months ago when I talked about the responsibility that falls upon us all as individuals, because we all take responsibility for our own health and, most importantly, for the health of our children. I was talking to the Food and Drink Federation about the responsibility that I believe it, too, bears, for reasons that I will not go into in too much detail. However, I put forward the fact that those who are overweight and obese as children are more likely to come from the most deprived backgrounds. There was much criticism, misreporting and all the rest of it, and, if I may say so, some political cheap shots were aimed at me. However, I hope that those facts speak loudly, and I also hope that everybody takes this away: the reason why I feel this way with such a passion is that if someone comes from a poor, deprived background, they have enough problems as a child, and enough bad things going against them to prevent them from having a great start in life, without the burden of being overweight or obese.
Ms Abbott
The Minister referred to fat children being bullied. Does she agree that being fat as a child can be the beginning of a downward spiral? They feel fat and ungainly; they are unwilling to take their clothes off for PE, particularly girls, so they take less and less exercise, so they get even fatter. It is a downward spiral.
Anna Soubry
Yes, I agree, and I also think that there is no doubt that there is a link between being overweight or obesity and mental health. Which comes first, I do not know, but it is certainly all connected.
The call for action on obesity set out the steps that we are taking to help people to make healthy choices. That is what we aim to do: provide people with the education and knowledge they need, then ensure that they have the opportunities and options to make healthy choices. We have the national child measurement programme; we have change for life. The hon. Member for Strangford may like to know that 1 million families have joined change for life, and 684,000 people have downloaded the “Be food smart” application.
There is much more that we can do, and obesity in children is one of my absolute top priorities. I want to know why we have stopped weighing pregnant women. It seems absolutely bonkers. I am looking at the advice that we give to new mothers on how to feed their babies, and I am also looking at the role of health visitors, midwives and our great NHS workers. As I have said, in Rotherham there is a wonderful project, which anyone who has an interest in this subject really needs to go and see, because one of the things that is happening there is that everything is integrated. The project has been up and running for three to four years, and the NHS, dieticians, GPs, nurses and health visitors all work with schools, teachers and the local authority—in many ways, it is driven by the local authority. It is a wonderful experience, where the project workers do not demonise food, but look with kindness and care at the causes of problems. They help people, not only with their diet through the information that they provide, but by helping them to exercise.
I have completely run out of time. In no way have I completed my speech, and I apologise profusely for that. However, I pay credit and tribute to everybody who has signed up for the responsibility deal. There is much more that we can do; I completely accept that. Nevertheless, I would say that the labelling on packaging is something that we are particularly proud of. We are getting a standardised system that will enable people to make healthy choices and take responsibility. I could talk about schools and the great work that they are doing, but that will have to be the subject of a letter.