Diabetes: Tailored Prevention Messaging

Debate between Jim Shannon and Keith Vaz

Thursday 24th October 2019 Westminster Hall

[Keith Vaz (Leicester East) (Lab)]

It is a pleasure and honour to serve under your chairmanship, Ms Buck—for the first time, I think. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate, not only as vice-chair of the all-party parliamentary group on diabetes, but as a fellow Fox—a supporter of Leicester City Football Club. As we heard from the hon. Member for South Antrim (Paul Girvan), he is also probably one of the most assiduous Members of this House.

I am pleased to see the Minister in her place and congratulate her on her appointment. I hope she will last longer than the last three diabetes Ministers—I am not one of those who wants a general election tomorrow, and we would like to see her build herself into her portfolio. I hope she will last as long as the shadow Minister, who has been there a while and so has been through many Ministers. We hope they will be able to share information. Let us keep the Minister in her place for some time—until the election, of course.

I declare my interest as a type 2 diabetic and chair of the all-party parliamentary group on diabetes. I have a family history: my mother, Merlyn, and my maternal grandmother both had diabetes, which gave me a 4% higher than average chance of getting diabetes. Added to my south Asian heritage, that makes me six times more likely than my European counterparts to be someone who would get type 2.

We have heard some amazing statistics. We should all just sit down, as if we were sitting in the Supreme Court, and say, “We agree with the hon. Member for Strangford,” because we agree with practically everything that he and my hon. Friend the Member for Heywood and Middleton (Liz McInnes) have said. However, it would not, of course, be the nature of Parliament if we all just agreed with the speech of the person before us, so I will plough on; I apologise if I repeat some of the things already mentioned.

As we know, every two minutes someone is diagnosed with diabetes. In my own city of Leicester, a higher than average number of people have diabetes—8.9% compared with 6.4% nationally—and that is expected to rise to 12% of the city’s population by 2025. That is due to the higher proportion of black and minority ethnic residents compared with the UK national average—BAME communities are genetically more likely to get diabetes.

In the time that I have spent as a type 2 diabetic, which is about 10 years, and as the chair of the APPG, I have come to the conclusion that there are five pillars of diabetes care, and I want to talk briefly about each one. The first is putting consumers first: we must put diabetics at the heart of diabetes care. There are meetings, seminars and events—a whole industry around diabetes care. We need new technology, experts and so forth, but we must never forget that it is the consumers—the diabetics—who should be put at the forefront of the debate on diabetes. Sometimes we forget the user: the people at the end of the process.

As we have heard, we need better technology. Members of the APPG and I visited the Abbott site in Witney in July 2019. I was first invited to go there by the former Prime Minister, in whose former constituency Abbott is based, because we wanted to look at the company that produced flash glucose monitoring devices, which have transformed the lives of so many people with type 1 diabetes. We went there because there are shortages of the equipment. In the past, one could go on the website and take one’s own device. There has been a shortage since the Government very kindly decided that everyone with type 1 diabetes would be able to get a machine on World Diabetes Day last year, so we went to talk to the chief executive about it. I know the company is working hard to ensure that the situation is reversed—I suppose we win the lottery by being able to provide the machines, but then we find that we do not have enough machines. I hope that this is going to improve.

I would like to show you my fingers, Ms Buck, so you can see the holes from my twice-daily finger pricking—I am surprised that I have any blood left. I use my GlucoRX device in the morning and am shocked at the reading in the evening, but I just carry on. I would love to have a flash glucose monitoring device—I cannot get it on prescription, because it would probably bankrupt the NHS if all type 2 diabetics received it, but it is a very important device.

My hon. Friend the Member for Heywood and Middleton, who is an assiduous member of the APPG, reminds us of the importance of diabetes specialist nurses such as Debbie Hicks in Enfield and Jill Hill, who have both given evidence to the APPG at one of our meetings. They have an incredible amount of knowledge. To go back to what the hon. Member for South Antrim said, we know that doctors are gods—they have a better reputation than MPs, anyway. Who wants to listen to an MP when they can listen to their local GP? However, they do not have the time. From our constituents, we all know that doctors are unable to see all their patients and spend sufficient time with them talking about diabetes. The point that has been made about diabetes specialist nurses is very important: we need to ensure that we have more of them.

The second pillar of diabetes care, after the need to put consumers first, is awareness. We all know that diabetes is a ticking timebomb. There are 4.6 million people with diabetes in the country, but an additional 1.1 million people, which is equivalent to the entire population of Birmingham—imagine the whole of Birmingham suddenly getting diabetes overnight—are undiagnosed. We therefore need to support awareness campaigns, which have been led very much by the private sector but supported by the Government, because that is the best way to tell whether people have type 2 diabetes and whether they can change their lifestyle.

We have heard from the former Chinese-meal eating, lemonade and fizzy drink-drinking hon. Member for Strangford how he changed his lifestyle. If only he had been told before, he might have changed it earlier. I remember that when my mother had type 2 diabetes, I had just been appointed Minister for Europe by Tony Blair and had no time to look after my mother. I was flying around Europe trying to enlarge the European Union by bringing in Poland and Hungary—as we are about to leave the European Union, I will not start another debate about that. The fact is that I did not spend enough time with my mum, which is a source of great guilt for me personally—finding out about diabetes, how she got it, what she was doing about it, and why she was still eating chocolate when she was a type 1 diabetic. Looking back at it, it seems amazing. It is important that we diagnose earlier, because then we can take our medication.

[Jim Shannon]

The right hon. Gentleman is absolutely right, and I thank him for putting forward his own personal story. The Government have taken some steps in the right direction on the sugar tax. Does he think we should be looking at things such as a soft drinks levy; trying obesity reduction through sugar in schools, in food and in the standards that are put forward; addressing the issue of takeaway food and restaurants, where the level of sugar in meals is incredibly high; introducing a 9 pm watershed for junk food advertising; banning multibuy offers; and providing clearer labelling? Those six things would be a step in the right direction.

[Keith Vaz]

I say yes to the hon. Gentleman on all those points—I agree with them all. I will come to the sugar tax later, but I can take a chunk out of my speech by saying that I agree with all those six points. His shopping list is fine with me, and I will happily copy it.

However, campaigns are extremely important. Very soon, we will have World Diabetes Day. Diabetes UK writes to everyone, asking them to turn buildings in their constituency blue. That is in just 26 days’ time. As chair of the APPG, I have written to mayors across the country, asking them to turn their landmark buildings blue. I ask the Minister to turn the Department of Health and Social Care blue on the outside—it may well be blue on the inside—on World Diabetes Day. I say to the hon. Member for Strangford that he should turn the Castle Ward or the statue of St Patrick blue in his constituency to raise awareness. Of course, one day we will have a statue to the hon. Gentleman himself in Strangford, next to the one of Jamie Vardy, and we will turn them both blue.

We in the all-party parliamentary group, of which we have so many members here—one could call them the usual suspects, but I call them the all-stars—meet every month. We produce reports, one of the most important of which is on mental health and diabetes, something that diabetics are simply not aware of when they get diabetes. I certainly was not aware of it. Support for mental health and wellbeing is critically important to people who have type 2 diabetes. It is an ongoing thing; people do not know why they have depression or why their lifestyle has changed, but it is to do with diabetes. I pay tribute to Diabetes UK, to Chris Askew, and to Nycolle Diniz for the work she does for the APPG.

It is not only specialist nurses who can help us, but other professionals, such as pharmacists. Everyone knows that pharmacies and pharmacists have great expertise in diabetes. My mum—I go back to talking about my mum—could spend more time with her pharmacist in Evington in Leicester talking about her condition than she ever did with her doctor. Maybe the Government should run the awareness campaigns through the pharmacies. That would mean reducing the money going to the doctors a little, and they will quaff around and complain—but if we fund pharmacies to do the testing, we will save so much money in the end. Pharmacists such as our APPG ambassador, Jimmy Desai in Ilford, have done an amazing job. Let us empower them to do things.

The third pillar is prevention, which we have all talked about, and reversal if possible. The hon. Member for Strangford has changed in terms of his weight; we have heard from people such as Dr David Unwin, another of our ambassadors at the all-party parliamentary group, that around 60% of cases of type 2 diabetes can be delayed or prevented by making those lifestyle changes and having a healthy, balanced diet.

At the Health Hub in Doha, which I recommend the Minister visits—although obviously not if there is a crucial vote, as the Government will need her here; I am happy to pair with her and we can go together—if a doctor says, “You are borderline diabetic,” they do not give the patient tablets. Rather, they say, “Here is a prescription to go to the gym downstairs. Start doing your gym work, and don’t see me again until you get your lifestyle sorted out,” because lifestyle makes a great deal of difference. Some of us have our watches connected to our phones—I do not know whether my right hon. Friend the Member for Knowsley (Sir George Howarth) does—so we know about our steps. I very rarely hit 10,000, but at least there is a willingness to try to do more exercise, and walking round the Palace is a way to make sure we do that.

As we have heard, obesity is a killer. Obesity-related conditions cost the NHS—cost the Minister—£6.1 billion a year. I adopt as my own the shopping list of the hon. Member for Strangford: the six things he has asked for, from the watershed to multiple offers in supermarkets. We should all do that and say, “Let’s do it.” The private sector has done its bit. Kellogg’s has put traffic light labelling on most of its cereal packs sold in the United Kingdom since 2018—well done to it!

--- Later in debate ---

[Jim Shannon]

Will the right hon. Gentleman give way?

[Keith Vaz]

I think Ms Buck might object.

[Keith Vaz]

No, she will allow it.

[Jim Shannon]

In my GP surgery, and I think across the whole of Northern Ireland, GPs have classes for diabetics. They bring them in and do all those things: they do their feet, check their blood, check their eyes, talk about their health and check them over physically. They send those tests away, and they are brought back to make sure they are clear. Things are often done in other parts of the United Kingdom of Great Britain and Northern Ireland that could be used as examples here. The right hon. Gentleman is talking about what is happening in Leicester, and it is good to hear that, but we are very fortunate to have that in my clinic and other clinics across Northern Ireland, where we get those checks twice a year.

[Keith Vaz]

Could I have just one minute, Ms Buck, given that the hon. Gentleman intervened?

Summer Adjournment

Debate between Jim Shannon and Keith Vaz

Thursday 20th July 2017 Commons Chamber

[Keith Vaz (Leicester East) (Lab)]

It is a pleasure to follow the hon. Member for Bridgwater and West Somerset (Mr Liddell-Grainger) and I eagerly want to visit his constituency to meet all these house builders with whom he is in dispute. I do not think they stand much of a chance, being up against the hon. Gentleman.

I welcome the presence on the Labour Front Bench of the new shadow Deputy Leader of the House, my hon. Friend the Member for Bristol South (Karin Smyth), who will be making her maiden contribution in this debate, and, of course, the ever-present Deputy Leader of the House, who will be winding up. I have to apologise for the fact that, unfortunately, I have an unbreakable commitment in Leicester and might not be able to be here for the winding-up speeches. However, I will read Hansard with great care. I also had no idea I was going to be called so early.

I make no apology for starting this debate by talking about the situation in Yemen. Despite the catastrophic situation within the state, we are currently experiencing an even worse crisis. In the course of Yemen’s civil war there have been well over 10,000 civilian deaths, 19.4 million Yemenis are without access to healthcare, 3 million are now suffering from acute malnutrition, and over 3 million are internally displaced. One child dies every 10 minutes.

Last week the United Nations announced that there were 300,000 cholera cases in Yemen countrywide, in 22 of Yemen’s 23 provinces. If current rates of cholera stay the same, from the time we enter recess to when this House returns on 5 September, up to 225,000 extra cases will be added to that number. The United Nations calls this the worst cholera crisis in the world.

Along with the spread of the disease, there has been the chronic destruction of medical infrastructure caused by the civil war, which has exacerbated the crisis. Despite the assistance given by organisations such as Médecins sans Frontières, Islamic Relief, the Yemen Safe Passage Group, the UNHCR, and the Red Cross, the situation in Yemen is getting much worse. We heard only today that a number of journalists had been prevented from landing in Sana’a.

While we go to our constituencies to do the work that all Members have to do during the recess, we must not forget what is happening in Yemen. I hope that a message from the Front Bench will go back to the Foreign Office that we expect to see Ministers fully engaged in the crisis that continues to unfold.

This week I was elected chair of the new all-party group on immigration and visas, and I am delighted to see the vice-chair of the group here, the hon. Member for Harrow East (Bob Blackman). I am also very pleased that the hon. Member for Linlithgow and East Falkirk (Martyn Day) was elected as the secretary. The group’s purpose is to raise, on an all-party basis, issues of concern about the way in which our immigration and visa system operates. We all have critical constituency cases involving people who wish to travel, or whose relatives are not allowed to come into the country. For instance, the wedding of a constituent of mine is taking place at the end of August, but the best man is not being allowed to come here. Trying to convince officials who are thousands of miles away is extremely difficult.

I hope this group will, in a measured way, explore these circumstances, especially the role of the account managers and the issue of same-day service. I have a case of somebody who applied for a same-day visa, paid the fee of £500 on top of the fee of £1,000 for their visa, and six months later the situation has not been resolved. It is important that we look at these issues in a constructive way.

I hope that, over the summer, Ministers in the Department for Exiting the European Union and the Home Office will be trying to fashion a plan for the 3.2 million EU citizens living in the United Kingdom. We have heard the Prime Minister’s welcome assurance that they will be allowed to stay, but the process of issuing the necessary documentation could take a long time. There is now a backlog of 100,000 cases at the Home Office. Some of those citizens arrived here without passports because they could enter the UK with identity cards from EU countries. Getting them processed will be extremely difficult.

I hope that those Ministers will also look into the suggestion of a pilot scheme for allowing EU citizens to register at local level. They could take their passports along to the local authority and get themselves checked and registered. That information could then be handed on to the Home Office. The Deputy Leader of the House of Commons, the hon. Member for Northampton North (Michael Ellis), is a former member of the Home Affairs Committee, and he will be well aware of these issues. I hope that he will pass that suggestion on.

I want to make two quick constituency points before I end. The first concerns the continuing campaign being led by Amy Morgan, a young mother in Leicester whose son, Tyler, was stabbed to death a year and a half ago. Another of my constituents, Isaac Williams, was stabbed to death in April this year. We need to do more to tackle knife crime. I introduced a Bill to increase the length of time people spend in prison for carrying a knife. Statistics show a 24% rise in the incidence of knife crime. That is a huge increase, with 12,074 offences and 2,381 detentions last year. Secondly, I am hoping to organise a meeting in my constituency involving those who have control of our theme parks, following the death earlier this year of my 11-year-old constituent, Evha Jannath. It is extremely important that families who visit theme parks should be as safe as possible.

Speaking as the chair of the all-party parliamentary group on diabetes, and as someone who has type 2 diabetes, let me end by issuing a challenge to Members. I want to commend the Pioppi diet, and I will write to the 100 Members who have the most diabetics in their constituencies about this. Of course, we all have diabetics in our constituencies, but the Library has provided me with statistics for the top 100. I think that Doncaster might be on that list, Madam Deputy Speaker. I shall ask those Members to take up the challenge of the Pioppi diet, which is named after a village in Italy where people live on average to the age of 97 as a result of their Mediterranean diet. It involves getting rid of sugar, which is a killer, keeping away from potatoes—and, for me, rice—and concentrating instead on the good food that is available around the Mediterranean. We have wonderful farms and food makers in this country, but we do not spend enough time looking at what we eat.

We have a diabetes epidemic in the United Kingdom. There are 4 million people with type 2 diabetes in this country, and 500,000 more—some of whom are in this House today—who do not know that they have the condition. My hon. Friend the Member for Strangford (Jim Shannon) is an officer of the APPG, and I am sure that he will be taking up the Pioppi diet challenge—

[Jim Shannon (Strangford) (DUP)]

If it helps me to live to 97, I definitely will.

[Keith Vaz]

I know that all Democratic Unionist party Members would like to live to be 97, especially in the current climate.

I will be writing to those 100 Members, urging them to take up that challenge. I want to thank Dr Aseem Malhotra, the world-famous cardiologist, and Donal O’Neill, a renowned film-maker from Ireland, for writing the incredible book, “The Pioppi Diet”. I want everyone to take it up for 28 days in August and to see, when they come back, whether it has made a difference. With that, Madam Deputy Speaker, I should like to wish you, the Leader of the House, the shadow Leader of the House, all Members and all Officers of the House a happy and peaceful recess. We hope that nothing will bring us back during the recess, as has happened in the past. We want a bit of political stability so that we can enjoy our summer.

Theme Parks: Child Safety

Debate between Jim Shannon and Keith Vaz

Monday 3rd July 2017 Commons Chamber

[Keith Vaz (Leicester East) (Lab)]

I am grateful to you, Mr Speaker, for allowing me this opportunity to raise the issue of child safety in theme parks. We in Leicester were deeply affected by the death of one of our own, Evha Jannath of Belgrave, at Drayton Manor park in Staffordshire. On the morning of Tuesday 9 May 2017, Evha woke up excited at the prospect of visiting Drayton Manor park with her school, the Jameah girls academy, which is in Rolleston Street, Leicester. She had been given £10 by her family to spend at the park. Just four days before, she had celebrated her 11th birthday. What Evha’s mother, Mussamth, did not know, when she waved Evha off that morning thinking that she would be safe and would have an enjoyable trip, was that that would be the last time she would see her. Tonight, we need to begin the process of addressing some of the issues surrounding Evha’s death, and I am grateful to see the Minister for Disabled People, Health and Work in the Chamber. This is not just for the family or for the 1.5 million people who visit Drayton Manor each year, but for the millions of theme park-goers worldwide.

[Jim Shannon (Strangford) (DUP)]

I have sought permission from the right hon. Gentleman to make an intervention. Like many in the House, I enjoy theme parks. When we go to Florida, for example, we notice that wherever there is a level of fun, there is also a need for strict regulations. Does he agree that, when it comes to regulations that work, we should perhaps take some lessons from the Americans when we deal with our own regulations back home?

[Keith Vaz]

This is certainly something that I hope the Government will look at, once they have had an opportunity to see the reports that have been prepared by the police and the Health and Safety Executive.

On that tragic day, Evha got on the Splash Canyon ride at just after 2 pm with her school friends. According to eye witness accounts, as the Splash Canyon ride went around its circuit, Evha fell into the water as the vessels bumped into one of the sides of the ride. Having fallen into the water, Evha began walking towards her friends who were in the vessel as it was pulled away by the water current. For a few minutes, Evha followed the vessel trying to get back to safety and to rejoin the vessel, because her friends were still in it. Sadly, at that stage she received no help and was eventually sucked under the water. In his initial report, the coroner, Andrew Haigh, has suggested that Evha suffered blunt chest trauma which led to her death. In his communications with the family and with me, and especially in allowing Evha’s family to see the body for a second time—which was of particular benefit to Evha’s mother—Mr Haigh has been exceptional.

Issues of theme park safety are critical at all times, but especially as we head towards the school summer holidays. These parks across the United Kingdom earn millions of pounds, and whether it is at Disney in the United States or at Drayton Manor, adults and children must be safe to visit them. According to Health and Safety Executive data, there were 420 non-fatal injuries at theme parks in 2015-2016, with 249 of them involving children under 16. There have been three deaths since 2005. That is three too many.

All theme parks have television screens that are monitored by staff. The family want to know who was watching these screens and how Evha was left in the water for several minutes without anyone coming to rescue her. The House may recall the horrific accident at Alton Towers in June 2015 when passengers on a ride crashed into an empty carriage and many suffered appalling injuries. The fact that this tragedy could happen so soon afterwards means that certain issues were not addressed, and it is in the public interest that they are addressed immediately. Following the tragedy, a feature of this case has been how the agencies involved have gone to great lengths to help the family. I thank the Health and Safety Executive for the work that it has done so far in investigating the issue, particularly the work carried out by Catherine Cottam under the leadership of head of operations Neil Craig.

The vessels on the Splash Canyon ride have no seatbelts and a number of vessels had their

“stay in your seat signs obscured.”

Unfortunately, this incident was not the first time that somebody had fallen out of a vessel at Drayton Manor. In 2013, Patrick Treacy also fell off the Splash Canyon ride. In an interview with BBC Radio 5 live following Evha’s death, Patrick’s mother Vicky called for lap bands on the seats to ensure children or adults do not stand up on the ride. If there is a threat that children may fall out of such rides and into the water, certain safety procedures should be adopted. I fear that that was not the case at Drayton Manor after the Patrick Treacy incident and in Evha’s case the same thing happened again.

In the immediate aftermath of the incident, other major theme parks, including Alton Towers, Legoland and Thorpe Park, closed their water rides. However, the rides have since reopened without waiting for the Health and Safety Executive report. The presence of lap bands that would ensure that participants sit in their seat, but would not impede escape if the vessel capsized, must be seen as a potential solution. That would not affect their enjoyment. Clear public announcements regarding seating on rides at all parks, a member of staff escorting people to their vessels and informing them that they must remain in their seats, and clear signage are all vital, but the family feel that all that was lacking on that day at Drayton Manor. According to the children who were interviewed afterwards, they called out for help to the guards, but nothing was immediately done for them. Making sure that such rides are adequately staffed is also a priority. Perhaps it would have been better if there had been two members of staff at the start of the ride assisting children to board the vessels.

I accompanied the family, including Evha’s father Muhammed Islam, her brother Muhammed, and her uncle Mohammed, to Drayton Manor where the ride and the circumstances were explained carefully to us by the police. On behalf of the family, I thank Superintendent Steve Morray and DCI John Quilty and his colleagues for their work and for the relationship that they have built with the family. Of particular benefit was showing the family the CCTV footage of Evha’s last moments. The police investigation continues.

Evha was only 11 years old and got on the boat with five other children of the same age or younger. Children under-12 should be accompanied by an adult at all times on such rides.

I also want to raise the issue of bereavement damages for the death of a child, which are currently capped at only £15,000. That is woefully low. Although of course no amount of money can compensate for the loss of a child, we must look again at the issue of fair compensation for families. There is no cap on such payments in the United States. Legislation should be introduced to remove the cap to allow proper compensation to be given to families.

The owners of Drayton Manor have been deeply affected by the tragedy, and William Bryan wrote to me:

“the whole Drayton Manor community remains deeply saddened and upset by the terrible incident last week. I cannot comprehend the pain and anguish that the family and wider community feel right now”.

His letter was deeply appreciated. There are so many heroes and heroines who acted swiftly after Evha was discovered. I personally pay tribute to the air ambulance service for its reaction to the incident and its efforts in trying to save Evha’s life, and to the staff, who must have been horrified by what they saw.

Hundreds of people attended the funeral in Leicester, even though many of them did not know Evha personally. The Darus Salam mosque and its director, Moj Mohammed, have also been exceptional and have established a JustGiving page to support Evha’s family. Evha’s school, and particularly its headmistress Erfana Bora, provided great comfort to the family after Evha’s death.

Many legal issues remain outstanding, and I have been careful not to cross into them while the inquest is pending. The family have appointed Hilary Meredith, of Hilary Meredith Solicitors, and her legal team to deal with legal measures, and they have taken up the challenge forcefully, for which I thank them.

By themselves, even though I am sure they will be extremely thorough, the police and Health and Safety Executive inquiries will never bring Evha back. However, it is hoped that their recommendations will change how the system works. The hon. Member for Strangford (Jim Shannon) is absolutely right that there are theme parks in other countries. Theme parks do not exist only in the United Kingdom; they exist all over the world. Millions of children enjoy going to them, and if there is an example of better practice, I hope we will be able to follow it.

Throughout May I spent a great deal of time with the family, who remain shocked and in mourning. As one would imagine, Evha’s mother is still devastated by the death of her young child. Muhammed, Evha’s brother, has taken on so much after this tragedy and has handled himself in a way that most 18-year-olds could not, and should not be asked to do. Muhammed and the family are concerned about potential negligence leading to his sister’s death.

To lose a child is horrific, but to use that loss as a means of achieving positive change, so that things can be improved for others, is nothing short of heroic. Having spoken to Evha’s father, Muhammed Islam, I know he is set on ensuring that no other family is hit by such a tragic event. No Member of this House wants to be in the position of calling for change after such a tragedy, which is why we need to ensure there is change.

The House will inevitably move on to debate other tragic events—indeed, earlier today we heard more about Grenfell Tower. However, for this close-knit and loving family, no minute will go past, no day will go by and no birthday will fail to be acknowledged without longing for their daughter, sister and niece. They will never again hear little Evha chatting and laughing, and they will never see her lovely face, which is why they want to get to the truth of what happened. They deserve nothing less.