Alcohol Duties

Baroness Merron Excerpts

Tuesday 2nd November 2021 Lords Chamber

[Lord Kamall (Con)]

The Office for Health Improvement and Disparities, as well as many other bodies, will continue constantly to review the impact of this change in taxation. In addition, the Government remain committed to supporting those who are most vulnerable and most at risk from alcohol misuse. Alcohol is a cross-cutting issue affecting several government departments. A strong programme of work is under way to address alcohol-related harms and their impact on life chances, including an ambitious programme to establish specialist alcohol care teams in hospitals and support for children of alcohol-dependent parents. There are a number of other alcohol harm reduction strategies that are too numerous to list now, but I am happy to write to the noble Baroness.

[Baroness Merron (Lab)]

My Lords, alcohol-misuse experts have warned that the Government’s reforms of alcohol taxes are undermined by their failure to address the issue that alcohol from high-strength beverages may remain cheaper, in many cases, because the price per unit of alcohol is lower in many of those high-strength beverages. What plans do the Government have to introduce minimum alcohol pricing? Does the Minister share my concern that the Chancellor, in the Budget, appeared to be investing more in Prosecco than in the public health budgets that we need to see to cover the cost to society of alcohol harm.

[Lord Kamall (Con)]

The World Health Organization and a number of other organisations have criticised the current system of taxation of alcohol, and urged the Government—and the EU when we were a member of it—to move toward taxation based upon the volume of alcohol. To answer the noble Baroness’s specific question, there are no current plans to implement minimum unit pricing in England, but the Government continue to monitor the impact of minimum unit pricing as evidence emerges from Scotland and Wales. It has been in place in Scotland for more than three years, and the Scottish Parliament will not consider its extension until April 2024. In all my conversations with various public health experts, one of the things that they make quite clear is that this has to be evidence-led, and we want to look at evidence from elsewhere.

Health Incentives Scheme

Baroness Merron Excerpts

Thursday 28th October 2021 Lords Chamber

[Baroness Merron (Lab)]

My Lords, I thank the Minister for answering questions on the Statement, which was first made on Friday, before the Government began press releasing new—and some not so new—spending commitments, and eventually published their full Budget yesterday. I must admit to having been somewhat bemused when I read this Statement. It felt like being taken on something of a gentle canter around the issues. To put it mildly, it is more than unusual to see the announcement of an app and wrist-worn devices making the grade for the substance of a parliamentary Statement presented to both Houses.

I make this point because it is important to say that, on any measure, the Government have decimated the budgets necessary to tackle the underlying causes of poor health and the inequalities that arise from and contribute to its incidence and effects. As we know, poor health has many costs—social, economic and personal—and I regret that the Statement is a fig leaf for inaction. Although the Prime Minister and the Secretary of State have acknowledged that stark health disparities exist, the Government repeatedly fail to face the target, let alone hit it.

The pandemic has highlighted just how important it is to have a healthy and resilient nation. Preventing and treating disease is vital for reducing further unnecessary deaths from disease and lessening the burden on the NHS as it contends with the enormous backlog in healthcare caused by the pandemic. However, the Budget presented contradictions, as funding will be mostly focused on a curative rather than preventive approach, which would have prevented obesity and non-communicable diseases happening in the first place. Public health experts and practitioners alike agree that investment in the prevention of disease could make the single biggest difference to the nation’s resilience and health, so can the Minister explain the reason for this omission from the Budget? Does he agree that failure to invest in public health will harm the Government’s levelling-up agenda?

Specifically, we were disappointed not to see any further public health funding in the Budget to allow local authorities to deliver key prevention services, such as smoking cessation and weight management. It is well documented that locally provided public health services are highly effective and cost effective. Can the Minister tell your Lordships’ House why this was ignored?

We on these Benches have campaigned for many years against this Government’s short-sighted cuts to public health funding. A reduction in spending of a quarter in this area has led to growing obesity in our population, loss of smoking cessation services, a ticking time bomb of poor sexual health, and overburdened drugs and alcohol services. Of course, any savings made by those cuts has been hoovered up by the impact on the rest of the health service.

Obesity is at a crisis level in this country. Two-thirds of adults are above a healthy weight; half are obese. A new IPPR report says that multiple disadvantages were “conspiring” to drive down health outcomes and prevent life expectancy from growing across parts of England. Hundreds of thousands of children in England are growing up overweight or obese because of widening health disparities across the country. Their excess weight means that they will face a higher risk of serious conditions, such as type 2 diabetes, heart disease or cancer, later in life. The IPPR analysis found that as many as one in 12 cases could be avoided if health outcomes in the worst parts of England were improved to match the best. This does not make pretty reading.

We are of course not going to argue against measures that attempt to help the public improve their health, but like the obesity strategy that precedes it, the latest pilot announced in the Statement is tinkering around the edges. We need to acknowledge that tackling obesity is about tackling poverty. People in the poorest communities are twice as likely to be obese as those in the best off. This scheme is about encouraging people to make healthy choices, but the cost of living crisis will make that even harder for too many people. How is someone supposed to make healthy choices if they simply cannot afford to?

According to a report by Broken Plate, the poorest fifth of UK households would need to spend 40% of their disposable income on food to meet Eatwell Guide costs, as opposed to just 7% for the richest fifth. Therefore, if poverty limits someone’s food choices, their exercise choices and their time, can the Minister tell the House why this does not feature in the heart of the Government’s plan to tackle this scourge?

Whatever this pilot achieves, and whatever their obesity strategy achieves, it will be completely undermined by the £20 a week cut to universal credit, which, despite yesterday’s announcement, will push millions on to cheaper, less healthy alternatives. Can the Minister tell the House what will happen to the health of adults and our children? Will those who are invited to join this pilot come from the communities that will benefit most? They are the people who have suffered most from the cuts to public health. Will the Minister commit that this scheme and the obesity strategy will be followed by the restoration of moneys cut from the public health grant?

[Lord Scriven (LD)]

My Lords, from these Benches I thank the Minister for coming to answer questions on the Statement. These Benches welcome anything, including innovation, that targets the poor health and loss of life years that obesity brings. However, this is really the emperor’s new clothes, because it has to be set in the wider context of the detriment of poor health, public health budgets and poverty. Public health budgets have been decimated, so that many issues connected to the determinants of health cannot be dealt with. Low pay has become the norm for so many in our country. School budgets for extra activities, such as physical activity, and timetabling have caused problems, and food and drinks industry standards also have to be addressed. Tackling obesity is about tackling the lack of opportunity and tackling poverty. Innovation with a wristband is like asking somebody to learn the Green Cross Code they have a motorway to get across. It is not going to be successful.

As a country, we have to start early: we have the second-largest child obesity problem in the whole of Europe. So what are the Government doing to ensure that daily sport as an activity is available in every state school, so that every child has some daily activity? What is the Government’s response to the report by the Association for Physical Education with regard to children’s health and, in particular, with regard to swimming?

Diet at home and in school is important. The Jamie Oliver Foundation Bite Back report basically found that healthy options in schools were more expensive. What are the Government doing to ensure that fresh, healthy food is available at an affordable price in every school in the country? How are the pilots being chosen? The correct areas are the areas of deprivation, because that is where the highest incidences of obesity are. What are the criteria? How are they being selected? How are areas being offered the chance to become part of the pilot? This must be seen as a healthy eating and exercise approach, and not a weight-loss problem. There are far too many citizens in our country who suffer with eating disorder issues. So what are the Government doing to ensure that it is this framework of healthy eating and healthy lifestyles, rather than being seen purely as weight loss?

With regard to the wristband and the data, who will have access to the data? Where will it be stored? What precisely will the data be used for? Will any private sector organisation have access to the data and its interpretation, and, if so, what conditions are in place to ensure that we do not have the problem that we had with DeepMind, where it was used for purposes over and above what was anticipated?

Finally, talking of the private sector, HeadUp Systems is noted in the Statement. This is a company that has a £30,000 turnover and made an £11,000 loss last year. So how, and on what criteria, was HeadUp Systems chosen? What role will it have? Which other private sector organisations were asked to provide the support that HeadUp Systems is doing? What Ministers or officials did members of HeadUp Systems approach or have access to? If there is a contract, what is its value and on what basis was it given to HeadUp Systems?

People with Learning Difficulties and Autism: Detention in Secure Settings

Baroness Merron Excerpts

Thursday 28th October 2021 Grand Committee

[Baroness Merron (Lab)]

My Lords, I thank the noble Baroness, Lady Hollins, for her sensitivity, her work on this crucial matter, and today for her use of her voice in giving voice to those who do not have a voice. The manner in which this debate has been conducted has spoken volumes.

When people are in the wrong environment, they suffer trauma, deep unhappiness, ill health, abuse of their human rights and lack of dignity—the list goes on. I ask myself: why is it that those who have learning disabilities and/or autism are seen to be less worthy of the right environment than those who do not? My noble friend Lord Touhig said that we should be ashamed of the years of failures and that this is a stain on British society. I agree with him because we are judged as a society on how we treat those in greatest need, to whom we owe the most.

The noble Lord, Lord Crisp, spoke of people getting stuck and their situation deteriorating because of the so-called care environment in which they have been put. This is not acceptable. It is a sorry and lengthy catalogue, which I hope the Minister will today commit to put an end to—a sorry catalogue of missed targets. Every figure that we refer to is not just a figure; each one of that number represents a person—and not just a person but their family, friends, colleagues and communities. They all carry that suffering along with the person.

I found myself shocked, as I am sure many noble Lords did too, by what I understand of the situation. The noble Baroness, Lady Bull, made a very good point that shocking though the figures are, they are actually small enough to make an impact. I hope the Minister will outline to the Committee today how he will undertake, with his colleagues, to put an end to this outrage once and for all.

The figures that shocked me were not just that there are over 2,000 people with a learning disability and/or autism in in-patient units or that there are 210 children there, but that the number of people in units has gone up by 40 from the end of September. So we have seen no sign of change. The figure that really tells the story that we are here to address is that the average length of stay for people with a learning disability and/or autism in in-patient units is 5.4 years. That is 5.4 years that no person will ever get back.

We have heard in the debate about the thousands of reported incidents of restrictive interventions—physical and chemical restraint. The most recent data show that in one month alone, July 2021, we saw over 4,000 reported incidents, 930 of which were against children. I go back to the point that has been made repeatedly in this debate, which I ask the Minister to address: much of this is because of the environment, nothing else. How can it be justifiable when we know, as the noble Baroness, Lady Hollins, said, that the costs of keeping somebody in an inappropriate environment are no less than to keep them in a caring, happy and appropriate environment? The finances do not stack up, so can the Minister address how the finances are worked out, as well as the quality?

We find ourselves in a shocking situation. We know, for example, that the mental health White Paper, issued in January 2021, took the important step that learning disabilities or autism will no longer be grounds for detention under the Act, but can the Minister update us on the timetable for bringing forward the legislation? We know that recently, in June, the Government published the results of the consultation on the White Paper, and there were positive responses on the necessity for these reforms. It would help to know, first, when that legislation will come forward but, secondly and key to this debate, when and how will there be a grip on this and by what means will the Minister measure the right progress having been made to protect and advance the interests of every individual about whom we are speaking today.

Coronavirus Act 2020

Baroness Merron Excerpts

Tuesday 26th October 2021 Grand Committee

[Baroness Merron (Lab)]

My Lords, we do not oppose the renewal of the Coronavirus Act. As the Minister himself acknowledged, the pandemic is not over and many of these measures remain necessary. These provisions include: powers around the emergency registration of healthcare workers, which is important in ensuring that we can get workers who have retired from the healthcare system back into it, and participating in the vaccination programme; provisions for sick pay from day one, rather than day four, to help those required to self-isolate; and derogations that make it possible for remote participation in court proceedings to take place.

Not opposing the extension has been made easier, I should say, given that some of the more concerning and draconian measures have been removed from the Act. This includes Schedule 21, which contained the power to detain potentially infectious persons and has been used for a number of prosecutions, every one of which was found to be unlawful by the Crown Prosecution Service. A year ago, the Joint Committee on Human Rights said that these powers “ought to be repealed”. We, too, have long called for those powers to be removed from the Act and it is right and proper that they have been. However, we would question whether some sections which are also set to be removed should be.

We are disappointed, for example, that the powers in Section 78 to enable local authority meetings to take place remotely have been removed from the Act. Surely it should be the case that local authorities should decide for themselves if they would like to continue online meetings, especially as we approach a challenging winter, with the Health Secretary warning that cases could well rise to 100,000 a day. I look forward to the comments of the Minister as to why that intervention on the organisational arrangements of councils is being made.

Nevertheless, the Coronavirus Act itself is not the legislation that put us into three national lockdowns and imposed the regime of local lockdowns, the three-tier system, travel restrictions or mask-wearing mandates. Indeed, I am sure from this debate that I am not the only one who has lost count of the number of SIs laid under the Public Health (Control of Disease) Act 1984, the legal basis for coronavirus restrictions in England. I note that no changes to the public health Act are planned. Over the past 18 months, the House has repeatedly expressed its concern, as we have heard today, about the myriad regulations that have been introduced with limited scrutiny, bypassing Parliament and leading to executive dominance. These concerns have been further exacerbated by the Government’s reliance on the “made affirmative” procedure, meaning that, all too often, Parliament has not been given the opportunity to debate or scrutinise regulations before they became law.

That includes the health protection regulations that we are also debating. They were laid on 22 September and came into effect on 27 September. We fully support the provisions to amend the definition of “fully vaccinated” to include those who have received doses of two different approved vaccines or clinical trials. We also support the extension of the requirements for those who test positive for coronavirus and who are unvaccinated to self-isolate, and the extension of local authorities’ enforcement powers to 24 March 2022. However, I do not understand why this legislation was laid under the “made affirmative” procedure. I should be grateful for the comments of the Minister when he responds. After all, the department knew that the original expiration deadline was approaching and has long acknowledged that cases could rise to 100,000 this autumn or winter, thus necessitating continued self-isolation and enforcement powers.

While this is of course a rather straightforward SI, the Minister’s predecessor—the noble Lord, Lord Bethell —failed to make the case when introducing far more onerous Covid regulations that were laid using the emergency “made affirmative” procedure to implement coronavirus policies. Many of these regulations were laid at the 11th hour—a point made by my noble friend—despite being in press releases days, even weeks, in advance. They included mask-wearing requirements and the system of mandatory quarantine backed by criminal sanction, which gave the police the power to enter people’s homes; it also allowed individuals to be detained and searched, and have their belongings seized. These are not minor changes to the law.

Although we understood the need for the Government to respond quickly in the initial phases of the pandemic because of the emergency, it is unjustifiable to continue doing so without scrutiny where pandemic management has moved from reaction to control. I hope that the Minister can assure the Committee that the Government will do much better if, or when, they reintroduce some restrictions in respect of the management and control of the spread of coronavirus.

We all know that the pandemic is not over. We see tens of hundreds of new recorded Covid infections every day. We know that there are hundreds of people in hospital, many of whom are in the ICU. We also know that, on average, over 100 people are sadly dying of this dreadful disease every single day. The Minister will be well aware that the NHS Confederation, the BMA and local councils have called on the Government to implement plan B immediately. It contains the measures that we already support and are familiar with, such as mask wearing and allowing working from home. The Prime Minister should never have abandoned these measures; it is extremely concerning to hear that he is not following the advice of SAGE. My noble friend Lord Hunt expressed concern about the downgrading of SAGE’s role. I would welcome the Minister’s comments on that.

It appears that there has been little learning in government of the lessons from the early stages of the pandemic when delays undoubtedly, regrettably and tragically cost thousands of lives. Indeed, we know that plan B will not be enough to prevent another lockdown. Let us look at some of the current practices. I refer the Minister to one particular aspect of test and trace: the messages sent to people who have been in contact with somebody who has tested positive for Covid. Can he tell the Committee what impact those messages and their wording, which I would suggest is not carefully constructed, have had on compliance? Also, what assessment has been made of the user experience of the people receiving those messages? How often is the messaging reviewed?

The noble Lord, Lord Naseby, talked about the power of communication. I suggest to the Minister that, for any of us who are in receipt of these messages, the advice on what to do is, at a minimum, confusing. It is overly directive on the matter of self-isolation and takes a considerable time to establish that self-isolation is not necessary if one has been double-vaccinated. I would be grateful for the Minister’s comments on that.

Furthermore, the Government must get a grip on the stalling vaccination programme: it has left almost 5 million people at a greater risk of catching Covid, as they are yet to receive their booster jabs and are at the mercy of waning efficacy. The Government have said that the vaccination programme will continue to be our first line of defence; yet on current trends, we will not see completion of the booster programme until spring 2022. This seems rather slow.

We note also that the rate of vaccination for children is shamefully low as well. Vaccines for 12 to 15 year-olds in the UK started on 20 September and, to date, only 15% of 12 to 15 year-olds in England have received one shot. With hardly any protective measures and delayed vaccination, the return to school last month has seen record numbers of children becoming infected. For the last three weeks, we have seen an average of 10,000 new five to 14 year-olds testing positive for Covid every single day. Thousands are missing school, and this cannot continue.

As we approach a difficult winter, it seems that Ministers have failed to put in place the necessary measures to improve ventilation in businesses, public spaces and schools, despite better ventilation having been proven to reduce transmission of Covid. They have also failed to provide for proper sick pay and to fully resource local contact tracing teams, which would also help reduce the spread of the virus. This is no time for complacency. We urge the Government to act on vaccines, ventilation, sick pay and masks.

COVID-19: Type 2 Diabetes

Baroness Merron Excerpts

Thursday 21st October 2021 Lords Chamber

Asked by

[Baroness Merron]

To ask Her Majesty’s Government what steps they are taking to support people at high risk of developing type 2 diabetes who have gained weight during the COVID-19 pandemic.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

My Lords, helping people to achieve and maintain a healthy weight is one of the most important things we can do to improve our nation’s health, as I am sure many noble Lords agree. Our world-leading strategy to meet this challenge was published in July 2020 and reflects the significant work undertaken over recent years to halve childhood obesity and create a healthier environment to help people maintain a healthy weight.

[Baroness Merron (Lab)]

My Lords, new NHS research reveals that people seeking help to lose weight are significantly heavier now compared with those who sought help pre-pandemic. With type 2 diabetes closely linked to obesity and local public health services shown to be highly cost-effective in helping people to lose weight, what assessment has the Minister made of the link between the cuts in funding and the increasing levels of obesity and diabetes, and will the NHS evidence now drive the Government to commit to reversing public health grants and properly funding services that are essential to tackling obesity?

[Lord Kamall (Con)]

I am sure that noble Lords will agree that it is really important that we tackle these issues and respond to the weight increases over the Covid-19 lockdowns. In March, the Government announced £100 million of extra funding for healthy weight programmes to support children, adults and families to maintain a healthy weight. Additionally, more effort has been put into providing access to information.

Drugs: Black Review

Baroness Merron Excerpts

Tuesday 19th October 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for her question and for her point that it is important to continue to invest in drug treatment services, but also to make sure that we stop drug users from engaging with drugs in the first place.

[Baroness Merron (Lab)]

My Lords, among some 32 recommendations, Dame Carol stressed the importance of getting more people into treatment who require it, diverting people away from the criminal justice system, and ensuring that service users are given a wider package of support for housing, employment and mental health. With drug-related deaths in England and Wales rising for the eighth year in a row in 2020, what conclusions might be drawn about the effectiveness or otherwise of the current cross-government approach to tackling addiction? Can the Minister assure the House that wisdom will prevail such that funding for substantive health support services to tackle addiction will be announced in the comprehensive spending review?

[Lord Kamall (Con)]

The Government have committed to answering in full the recommendations of Dame Carol Black’s review. In terms of joined-up thinking across government, the Government established the new Joint Combating Drugs Unit—the JCDU—in July 2021 to co-ordinate, and drive a genuinely cross-government approach to, drugs policy. The JCDU brings together different government departments, including those that the noble Baroness mentioned—the Department for Health and Social Care, the Home Office, the Department for Levelling Up, Housing and Communities, the Department for Work and Pensions, the Department for Education and the Ministry of Justice—to help tackle drugs misuse across society by adopting a cross-government approach.

HIV Action Plan

Baroness Merron Excerpts

Monday 18th October 2021 Lords Chamber

[Lord Kamall (Con)]

As noble Lords will have seen, there is agreement with the noble Lord’s point. As part of the Government’s commitment to reaching zero new HIV transmissions in England by 2030, the department is currently developing a new sexual and reproductive health strategy and an HIV action plan. Officials will continue to engage in discussions with the Department for Education during the development of these publications to relate them to how HIV is covered in the statutory curriculum in schools and as part of the intimate and sexual relationships lessons under personal health and social education.

[Baroness Merron (Lab)]

My Lords, HIV can affect anyone, as we know. Despite the success in combating it, further reducing the number of people who remain undiagnosed with HIV will become very challenging unless testing uptake is improved, as my noble friend Lord Cashman said. This is particularly the case for heterosexuals who do not consider themselves at risk of HIV. What assessment has the Minister made of why people who visit a sexual health clinic may leave without testing for HIV? Will he make it a priority to ensure that all those attending sexual health clinics are offered, and encouraged to accept, an HIV test?

Virginity Testing

Baroness Merron Excerpts

Tuesday 12th October 2021 Lords Chamber

[Lord Kamall (Con)]

I thank my noble friend for that question. I think we all agree, as he said, that conversion therapy is an awful practice and should be outlawed. The Government have made a commitment to outlaw it. There is an interesting thing, when we talk about the history of various commitments from the Front Bench and whether they were implemented: around Christmas time, we often see advertisements saying, “A dog—or a puppy—is for life, not just for Christmas”. As we know, with ministerial life, it is the opposite: a ministerial portfolio is for Christmas, not for life. However, when I look back at my time, I would ask people to judge me on my actions.

[Baroness Merron (Lab)]

My Lords, I welcome the Minister to his place and wish him well. In addition to private examinations performed by gynaecologists and other medical professionals, campaigners report that victims are often subject to extremely crude examinations performed at home by family members, involving such means as inserting fingers into the vagina to check if the hymen is intact. What steps are the Government taking to tackle such hidden forms of abuse?

[Lord Kamall (Con)]

One issue we have to think about whenever we bring in any new law or ban is the unintended consequences. One unintended consequence that has been raised is that doing so might drive this practice not only into the home but underground. If we make it illegal, it is illegal; we must make sure that, when someone subjects a woman or girl to that awful experience, everyone knows it is illegal and that they will face the full force of the law.

Health: Type 2 Diabetes

Baroness Merron Excerpts

Tuesday 12th October 2021 Lords Chamber

[Lord Kamall (Con)]

I thank my noble friend. I have done my homework and I have read a little about what has been happening up to now, especially about the NHS diabetes prevention programme, which identifies those most at high risk of developing diabetes and refers them on to behavioural change programmes and personalised education to reduce their risk of developing diabetes, including things such as bespoke exercise programmes and learning about healthy eating and lifestyle. The programme achieved full national rollout in 2018 and 2019, with services available to patients in every system in England.

As we know, tackling diabetes is multifactorial. Nevertheless, the NHS long-term plan sets out plans for increased action on diabetes and related issues. I shall mention just a few, including the healthy weight strategy launched in July 2020 to help adults and children maintain a healthy weight, and the restrictions on the promotion and advertising of foods high in fat, sugar and salt, as was mentioned earlier. It is really important with programmes such as this that we look at these studies on a longitudinal basis and look at the evidence. Some of these programmes will work, and some will not. That is just the way the world is. We have to make sure that we tackle unintended consequences first of all, and that any future policy is very heavily based on evidence rather than a wish. That will be the most effective way of tackling diabetes.

[Baroness Merron (Lab)]

My Lords, the rise in diabetes means that millions of people are at risk of devastating complications, including heart attacks. In 2009, to improve heart health, checks were introduced for the over-40s. However, by 2019, only half of those invited actually received those checks, and the checks were paused during the pandemic. Does the Minister agree that it is vital that these preventive checks are relaunched, and will he commit to putting in place a plan to ensure that people are able and willing to attend them?

[Lord Kamall (Con)]

I do not think anyone will disagree on the importance of making sure that these checks are reinitiated, or on what is being put in place to make sure either that patients are able to continue with or that new patients can start some of these programmes. Also, as noble Lords can imagine, there has been better use of technology in all fields during the Covid lockdown. For example, the NHS used Facebook to reach millions of men aged 40 or over who were at risk of developing type 2 diabetes. We also know that, in some cases, there are online consultations between patients and medical experts. Of course, with better tools, such as remote monitoring and flash blood readers, it is important that information can reach clinicians and be reviewed remotely. But there is no substitute for face-to-face meetings, and we hope very much that many of these can be resumed as soon as possible.

Calorie Labelling (Out of Home Sector) (England) Regulations 2021

Baroness Merron Excerpts

Thursday 22nd July 2021 Lords Chamber

[Baroness Merron (Lab)]

My Lords, the need to tackle obesity and to support people in so doing is crucial to the health and well-being of individuals as well as the health and well-being of the nation. Excess weight directly impacts how well—and how long a life—we live, carrying a higher risk of heart disease, diabetes and cancer. It places limits on us at work, at home and in our social lives. It is a growing challenge that exacerbates inequalities. There are nearly three times as many hospital admissions due to obesity in the poorest communities as in the better-off.

It is demonstrably not the case that everyone knows how to manage their weight or that it is simply a matter of exercising a choice as to whether we do so or not. The challenge of maintaining a healthy weight and lifestyle requires information, knowledge and support, as well as personal effort, as was illustrated by the noble Baroness, Lady Jenkin of Kennington.

The Department of Health and Social Care cites evidence that one in four children and adults is now obese and that restaurant or takeaway meals contribute to the overconsumption of calories because they contain, on average, twice as many calories as the equivalent retailer own-brand or manufacturer-branded products. We know that voluntary compliance on labelling has not worked, and the pandemic has certainly been no friend to healthy weight levels, making this an ever more pressing situation to address.

This statutory instrument offers one step along the way, with many more steps needed, matched by proper investment and a strategic approach. As the display of calorie information and the recommended daily calorie intake is required only of larger businesses—those with 250 or more employees—does the Minister agree that there is greater value to be gained from this measure through the reformulation of products and portion sizes? The sight of a 2,000-calorie meal on a menu may well drive a provider to address that. Can the Minister explain what plan is in place to lever this opportunity for a bigger prize of change?

As we heard, the Government’s impact assessment gives a best estimate of net benefits amounting to over £5.5 billion over the next 25 years. The impact assessment makes it clear that most of the benefits come from a change in personal decision-making, but it seems that the evidence base on reformulation is stronger. It is particularly important that an evidence base around personal choices is acquired, so that we can have full, informed conversations as we look forwards. I hope the Minister will take note of this.

As we have heard in this debate, calories are a very crude measure of what we put into our bodies. It is crucial that we understand the nutritional content of what we consume. Will the Minister explain what consideration was given to a model much closer to what we see on packets in supermarkets? That does not seem to have been considered in the options appraised in the impact assessment. Is extending the scope of these measures being considered and, if so, on what sort of timeline? Will the research base be grown before action is taken?

The amendment in the name of my noble friend Lord Brooke of Alverthorpe rightly highlights that obesity is also impacted by alcohol consumption. It is right that the noble Baroness, Lady Finlay, and my noble friend Lord Berkeley laid down a challenge to the food and drink industry to step up to the mark. We on these Benches will return to this during consideration of the Health and Care Bill.

I am very grateful to the noble Baroness, Lady Bull, for bringing real insight to this debate and to the noble Baronesses, Lady Parminter, Lady Wheatcroft and Lady Greengross, who all spoke movingly and personally about the reality for those living with eating disorders. To follow this through, before implementation, will the Minister continue to engage with those who have legitimate, very real concerns about the draft regulations and seek to address them?

We know that eating disorders in the UK have increased during the pandemic, while services are simply not good enough, particularly failing children and adolescents. Will the Minister commit to a national strategy, matched by proper investment? Improving access to treatment and support is crucial. We will further press this home through amendments to the Health and Care Bill.

Will the Minister also commit, as a starting point for local authorities, to reinstate the resources already lost to the improvement of public health? The evidence favours interventions that promote a life of healthy choices, while cuts to public health over the past decade have put pressure on local authorities and worked in the opposite direction. I hope these regulations can offer a step forward.