Defending Public Services

Keith Vaz Excerpts

Monday 23rd May 2016 Commons Chamber

[Keith Vaz (Leicester East) (Lab)]

It is always a pleasure to follow the right hon. Member for Wokingham (John Redwood). He speaks with huge passion about these matters, and of course he has always been consistent in his opposition to being a member of the European Union. He also speaks eloquently about why he feels the way that he does.

The European debate—I say this as a former Minister for Europe—has dominated the Government’s agenda to such an extent that this Queen’s Speech is a shadow of what it should be. There is no great ideological commitment in it, so it is difficult to attack too much of it. It is important that, when we get past 23 June, we can then settle down to an intelligent legislative programme that is not dominated by people banging on about Europe —I include myself in that. Although crime has gone down in England and Wales, blue-on-blue crime has increased as far as the EU debate is concerned.

As I mentioned earlier, last Thursday the Minister for Employment was in my constituency with a very big red bus parked outside the biggest temple telling everyone that if we remained in the European Union, there would be a curry crisis and people would not be able to eat curry any more. It is important that we get the European debate into perspective.

As a fellow east midlands MP, you would expect me to say this, Madam Deputy Speaker, but I was surprised that there was no mention in the Gracious Speech of Leicester City winning the Premier league, but perhaps that will come next year.

I agree with the Government’s proposals regarding the revolution in the Ministry of Justice and our prisons. I and members of the Select Committee on Home Affairs have been very concerned about, for example, the number of people who go into prison with no interest in drugs and come out addicted to drugs. We are concerned that our prison system is not doing what it was intended to do: to punish, but also to rehabilitate. Although we expected the right hon. and learned Member for Rushcliffe (Mr Clarke), when he was Lord Chancellor, to talk about changing the way we look at prisons, we did not expect this from the current Lord Chancellor, and we are delighted that he has embraced the reform agenda. Ensuring that when people go to prison they are first punished, then rehabilitated and they do not pick up bad habits, so that when they come out of prison they do not reoffend and go back again, is one of the big issues that has confronted this Parliament for all the 29 years that I and the right hon. Member for Wokingham have been Members of it. How do we break the cycle?

I remember on a visit to a prison in the south of England speaking to a young man who was there because he had committed murder. He told me that his father had had a life sentence and he had a life sentence; he just hoped that his young son, who was then a year old, would not end up in prison. How do we break the cycle? I think we should work with the Government to make sure that our prison system does what it is intended to do.

The second issue I am interested in and concerned about is extremism. Although the Government are proposing legislation on extremism, I do not think they have gone far enough on the counter-narrative. The Select Committee is about to conclude its year-long inquiry into counter-terrorism. I am concerned, as is the rest of the House, about the number of young British citizens who decide to give up their life in this country and go and fight abroad. The current figure for those who have done so is 800, and 400 have returned so far. I cannot understand why we are not doing enough while they are still here to prevent them from going in the first place. Also, although there are programmes to detoxify those who return to this country, there is always the risk that having gone abroad to fight, whether in Syria or elsewhere, on their return they will retain the poison that was drilled into them abroad. It is important that we treat the counter-narrative seriously. We need to support our police and intelligence services in working out who is going, and work with families so that we can try to persuade people not to go.

[Norman Lamb]

Does the right hon. Gentleman agree that our prisons are a breeding ground for extremism and radicalisation, and that until we address that the flow of new extremists will continue?

[Keith Vaz]

The right hon. Gentleman is absolutely right. It is not just about preventing people without a drugs habit going to prison and coming out with one. We have been sending people to places like Belmarsh, which has been described as a place where jihadists seem to be able to influence young people. Knowing his great passion for mental health issues, the right hon. Gentleman reminds me that Simon Cole, the chief constable of Leicestershire, who is the lead on counter-terrorism in the Prevent programme, has talked about the number of jihadists who have mental health problems. These are all issues that we need to confront. We cannot necessarily do it by legislation, but we need to make sure that we have the framework in legislation to provide the resources, the time and the effort to work with people.

My final point concerns the sugar tax. I was delighted when the Chancellor of the Exchequer introduced it. We should acknowledge the fact that today is his 45th birthday. I hope he is having a sugarless cake because, as we know, a spoonful of sugar may help the medicine go down, but it is also one of the steps on the way to diabetes. As someone who suffers from type 2 diabetes and chairs the all-party parliamentary diabetes group, I believe the proposed sugar tax will send a clear message out to the retail companies. However, the manufacturers of drinks such as Coca Cola and Red Bull do not have to wait until the sugar tax comes into effect; they can start promoting sugarless drinks now.

I got into a lot of trouble because I did not want the Coca Cola van to come to Leicester at Christmas. I was accused by some people of robbing them of their Christmas. They had decided that the Coca Cola van was so strongly associated with the Christmas spirit—forget about Christianity, the birth of Christ and so on; it was the Coca Cola van that gave them Christmas—that I was severely criticised. I will make a deal with Coca Cola from the Floor of this House: if the company sends its van to promote non-sugar drinks, I will be happy to welcome it, but promoting a drink containing seven to 10 teaspoons of sugar, cannot be good for the health of our nation.

[Ian Paisley (North Antrim) (DUP)]

The right hon. Gentleman should recognise that since 2010 sales of diet drinks have increased by 33%, and in 2014 the crossover point was reached—more people purchased diet drinks than regular drinks.

[Keith Vaz]

That is a good statistic, for which I thank the hon. Gentleman. The change has come about only because of pressure from parliamentarians and from others outside Parliament, particularly clinicians, who have argued strongly that unless something is done, the health of the nation will be affected. That is why I tabled my urgent question on the obesity strategy. Unless we continue to put pressure on the manufacturers and the retailers, nothing will change.

Although we will have a sugar tax, it is still up to the supermarkets to ensure that they promote sugarless drinks. At Waitrose in Wolverhampton, which is not that far away from your constituency, Madam Deputy Speaker, there is a kiosk right in the middle of the store displaying only no-sugar products. The drinks with sugar content are put elsewhere. That is what the retailers have to do. The introduction of the sugar tax will encourage retailers and manufacturers to change their ways.

Finally, this is a hospitals and health debate—at least, it was opened by the Health Secretary. I shall not mention video games this time; I leave that to the Minister for Culture and the Digital Economy. I am very concerned about proposals from the local health authority to close the Leicester General Hospital. The possibility of reconfiguration is being considered. I have had had discussions with the chair and the chief executive of the hospital trust. I know that we have on the hospital site a world-class diabetes centre run by Professor Melanie Davies as well as Professor Kamlesh Khunti. We need to look very carefully at any plans that will diminish the services available to local people.

The general hospital site has been used by local people for years and years as a hospital site. We were promised a new hospital, accommodation for nurses and all kinds of things in the 29 years that I have represented that city. None of those promises have been realised. Although we in the community and I as the local Member of Parliament are prepared to enter into dialogue with the local health authority over its proposals, if the authority thinks it can close the hospital and give us nothing in return, there will be a bare-knuckle fight to try to preserve those services. I am not attached to the buildings—buildings are just a means of delivering services—but I am attached to the services. It is really important that we ensure that our health services remain the best in the world. I take the Secretary of State at face value: he wants our NHS to be the best in the world, and so do we. In order to achieve that, we need to make sure that it is properly resourced, keeps up with the developments in our population, and provides the expertise that is necessary for the NHS staff, to whom we pay tribute, to do their work so that it retains the best the world has to offer.

Diabetes Care

Keith Vaz Excerpts

Thursday 3rd March 2016 Commons Chamber

[Keith Vaz (Leicester East) (Lab)]

Thank you, Mr Deputy Speaker, for giving me the opportunity to debate this important matter. I begin by declaring my interests as a type 2 diabetic and chair of the all-party parliamentary group for diabetes. In 2007, I founded the diabetes charity Silver Star, and I am an active and passionate supporter of Diabetes UK and JDRF—the Juvenile Diabetes Research Foundation—both of which provide secretarial services to the APPG. I would argue that we currently have the best diabetes Minister we have ever had, and I am glad to see her on the Front Bench today. I would like to thank her and her diabetes tsar, Jonathan Valabhji, for all the work that they do.

Diabetes is one of the most important health challenges facing the NHS and indeed the world. Sometimes we get immune to the facts, even though they are so devastating: 3.5 million people in the UK have been diagnosed with diabetes; 700 people a day are diagnosed with the illness; by the end of this debate 15 more people will have been diagnosed with diabetes—that is one every 2 minutes; and it is estimated that by 2025 some 5 million people in the United Kingdom will have diabetes.

Despite the good intentions of the Government, the passion of practitioners and the interest of many Members of this House, I am worried that the prevention, diagnosis and treatment of diabetes is not high enough on the agenda. One in five hospital admissions for heart failure, heart attack and stroke are people with diabetes. Diabetes is responsible for more than 135 amputations a week, four out of five of which are avoidable. Diabetes is the leading cause of preventable sight loss and the most common cause of kidney failure. Every year, more than 24,000 people die prematurely due to diabetes.

[Mr George Howarth (Knowsley) (Lab)]

I echo my right hon. Friend’s comments about the Minister. He cites statistics, and on the amount of money that is spent on diabetes, £7 billion of the NHS budget is spent on dealing with the avoidable complications to which he has just referred. Yet Department of Health spending on research into diabetes through the UK’s Medical Research Council is just £6.5 million, which is by far the lowest level of almost any developed country. Does he think there is a connection between those two things?

[Keith Vaz]

My right hon. Friend, who is a great campaigner on this issue, is right to have raised this, because we need to spend much more on diabetes research. One way of doing that is to make sure the funds are available for the excellent researchers and academics we have in this field, because research has indicated that there is an unacceptable and unexplained disparity in diabetes care in our country. We are failing the very people we are trying to help. Secondary complications are largely avoidable through better care, and we need to ask why this is not being provided. Although the NHS currently spends approximately £10 billion on diabetes, it is estimated that 80% of these costs are spent on dealing with complications. The time for conferences, seminars and good words is over—it is time for a new deal for diabetics.

Earlier this year, the Public Accounts Committee published a report on the “Management of adult diabetes services in the NHS”, and I would like to thank those on the Committee for their very hard work. The report found that astonishing variations still exist across clinical commissioning groups: the percentage of patients receiving all the recommended care processes ranged from 30% in some areas to 76% in others; and the percentage of patients achieving three treatment targets ranged from 28% to 48% in different areas between 2012 and 2013. As well as this postcode lottery, the figures were even worse for type 1 diabetic patients.

In response to my recent written question, the Minister acknowledged that there is no specific budget allocation for public health services related to diabetes. It is up to local authorities to

“assess local needs, prioritise and deploy available resources accordingly.”

I believe that is wrong. My own health and wellbeing board was unable to tell me how much it has spent on diabetes awareness. It should be able to do so. I welcome the Government’s inclusion of diabetes in their proposed clinical commissioning group improvement and assessment framework. That is a vital step in the development of a cohesive national diabetes strategy.

There has been much discussion about how effective the framework will be, and whether it will be released on time. We are already disappointed that the publication of the childhood obesity strategy has been delayed, a pertinent issue of concern for me and many other Members, including the Chair of the Health Committee, the hon. Member for Totnes (Dr Wollaston). We need an assurance from the Minister today that both the framework and the childhood obesity strategy will be published before the start of the summer recess.

The burden of care for diabetes is currently left overwhelmingly to one group: the GPs. It is unrealistic to expect GPs alone to manage this. We acknowledge that GPs are under increasing pressure, and the demand for their services far outweighs the supply. In some places, it takes weeks to get an appointment. The financial incentives given to GPs are clearly not working. Some 16% of GPs’ contracts is supposed to be spent on incentives, with 15% of this sum being directly allocated to diabetes testing. That equates to £94 million, yet an estimated 549,000 people have type 2 diabetes, but remain undiagnosed. A recent study by Pharmacy Voice found that 40% of GPs would like more support for their patients in managing diabetes. We need an action plan from NHS England that will assess the practical support that clinical staff need to care properly for their patients.

We are often told that it takes a village to raise a child. That phrase was recently given re-emphasis by Hillary Clinton. In my view, it takes a whole town of healthcare professionals to deal with the diabetes tsunami. Instead of placing the entire burden on GPs, we need to utilise a network of different professionals to attack the diabetes epidemic on all fronts in an efficient and cost-effective way.

At an international conference organised by the all-party group last month, we heard evidence to that effect from specialist GP Dr Paul Newman, endocrinologists Dr Sam Rice and Dr Abbi Lulsegged, diabetes nurse Sara Da Costa, diabetes specialist dietician Julie Taplin and lifestyle expert Emma James. However, we did not have time to hear from other parts of the network—the podiatrists, ophthalmologists and pharmacists. Their enthusiasm knows no bounds, but they are limited by the availability of funds and the lack of specialist staff. We must mobilise our political will to give them the support that they so desperately need.

Diabetes specialist nurses are vital in the fight against diabetes. Evidence shows that these nurses are cost-effective, improve clinical outcomes and reduce the length of patient stays in hospital. I am extremely concerned that the number of trained diabetes specialist nurses has stagnated. The latest national diabetes in-patient audit stated that one third of hospital sites still have no specific diabetes in-patient specialist nurses. With the predicted increase in diabetes cases to 5 million by 2025, it is alarming that forward-thinking plans to train such nurses are not being put in place now. We need a commitment from the Minister that there will be future provision for diabetes specialist nurses.

Community pharmacies are ideally placed to provide care at a time and in a place convenient to patients. The NHS diabetes prevention programme could be a great opportunity to get community pharmacies involved in supporting GPs and other healthcare providers. Janice Perkins, the pharmacy superintendent of Well Pharmacies, advised me that this could be done as part of a care plan package, where appropriate tests are provided to the patient based on their personal need, without their having to access numerous sites.

The proposed cuts to the community pharmacy budget could see the closure of up to 3,000 sites. My local pharmacist, Rajesh Vaitha of the Medicine Chest in Leicester, informed me that up to 60 out of 227 sites could close in Leicester alone. The closure of these pharmacies will have an adverse effect on patients and will place greater pressure on our already strained health infrastructure. Pharmacies are on the high street, and no appointment is needed to see the pharmacist. Like many patients, my late mother Merlyn, a type 1 diabetic, had great faith in her local high street pharmacist. I believe that the cuts to community pharmacies could be shelved if pharmacies were properly utilised in diabetes care.

Last Friday I visited the Steno Diabetes Centre in Copenhagen. Steno is a world-leading out-patient facility that cares for 6,500 diabetics a year. It is a one-stop centre for diabetics, with the main focus on prevention and secondary complications. The Steno centre is run by a team of remarkable diabetes specialist nurses led by Professor John Nolan. This is extremely cost-effective—the centre has an annual clinical budget for 6,500 patients of £9 million. Steno has reduced avoidable blindness in its patients by 90%—a service that is provided by a team of just six nurses and one ophthalmologist. The centre’s foot clinic has reduced avoidable amputations in the past 10 years by 82%. The savings from avoiding just two amputations funds the entire foot clinic’s annual budget. The Steno centre is an ideal model of how diabetes care should be facilitated. I urge the Minister—not that I want her to spend too much time abroad—to look at the incredible work that is being done there and bring a network of such centres to the United Kingdom.

In my own constituency, we are very fortunate to have not only the best football team in the country—many thanks to West Ham, Swansea and Liverpool for what they did last night—but the Leicester Diabetes Centre, a centre of true excellence in diabetes care. It is one of the largest facilities in Europe for clinical research into diabetes. Run by the dynamic duo of Professor Melanie Davies and Professor Kamlesh Khunti, it provides an innovative partnership between the NHS and academia—the very people in whom we should put more faith and behind whom we should put more funds, as my right hon. Friend the Member for Knowsley (Mr Howarth) said. We are extremely fortunate to have such experts, but we need more centres of excellence.

We need an holistic approach to public health, tackling the medical complications of diabetes and the contributory lifestyle factors that increase the prevalence of type 2. Other countries have taken a lead on this issue. Dr Francisco George, director general for health in Portugal, told me that data sharing is one thing we can do. I have also heard from Dr Pablo Kuri Morales, the Minister responsible for health promotion in Mexico, that a sugar tax actually works. Press speculation is that the Prime Minister has shelved the sugar tax until after the European Union referendum. In my view, the two matters are entirely separate, so why can we not have a sugar tax now?

I have been vocal in my support for a sugar tax and for clearer labelling of sugar content. Industry leaders such as Waitrose and Asda have made commitments to reduce sugar in their products, but I am afraid that the Government’s responsibility deal, which pledged to do all kinds of things, has not had much effect in reality, as recent reports by Professor Graham MacGregor and Action on Sugar have shown. We are, however, fortunate to have an NHS chief executive—Simon Stevens—who has imposed his own 20% sugar tax across the NHS, and that is an important start. I call on the Minister, when she returns to Richmond House, to ban high-sugar products from the canteens in her own Department.

I recently visited a brilliant juvenile diabetes centre in Tangiers, which was based in the Centre de Santé Saïd Noussairi. I nearly wept when I saw young type 1 diabetics having to rely on charitable funding just to get their daily insulin injection—something we can get absolutely free from our NHS. Yet, astonishingly, even in our country, whose healthcare system is the envy of the world, we have stark variations in diabetes treatment and unfocused resources.

We have world-leading medical professionals, nurses, healthcare professionals and researchers who are capable of doing, and willing to do, so much more, provided they get the funding and are backed by an iron political will. That is why we need to achieve a new deal for diabetics, and now is the time to start.

--- Later in debate ---

[Keith Vaz]

I will be brief, because I know that the Minister has a lot to tell us. When Members of Parliament write to local health and wellbeing boards, it would help enormously if they were able to tell us how much they spend on diabetes awareness. They cannot do that at present.

[Jane Ellison]

Part of the challenge is because much of the effort that is put in relates to the preventive agenda and the contributory factors. That is one of the challenges in teasing such figures apart. However, I will reflect on whether we can do more in terms of health and wellbeing boards.

To incentivise improvements in the treatment and care of children and young people with diabetes, the best practice tariff for paediatric diabetes provides an annual payment for every child and young person under the age of 19 with the condition, providing that 13 standards of care are met. One of those standards relates to structured education. As the right hon. Members for Leicester East and for Knowsley know, I am passionate about making changes to the way in which we do structured education. We know that it works and that it is very good when people do it, but we also know that a lot of people are not accessing it. I am looking really hard at how we could take a new and radical approach, including whether there are any tech solutions, and I look forward to reporting back on that.

Our ambitions extend further than creating a level playing field. We want the management of and care for diabetes to be driven up right across the board in order to improve outcomes. The NHS is working with a number of other organisations to help to promote services that are integrated around patients’ needs across all settings. It is implementing a customer service platform to empower patients with diabetes to self-manage by booking their own appointments, managing their prescriptions, monitoring the care they have received and viewing their personal health records.

I fear that time will not allow me to touch on prevention in as much detail as I would have liked, but I want to emphasise just how seriously we take it. The right hon. Member for Leicester East has outlined the reasons why it is important, including the escalating figures and how much the rising tide of type 2 diabetes associated with lifestyle will cost the NHS in the future. The factors can be modified, and one of the most powerful weapons in our armoury is the NHS diabetes prevention programme, which is the first national type 2 diabetes prevention programme to be delivered at scale. Its aim is to help people identified as at the highest risk of developing type 2 diabetes to lower their weight, increase physical activity and improve their diet through intensive lifestyle intervention programmes. I am pleased to inform the House that the first providers will be announced by the NHS shortly, and the programme will move ahead.

The programme will also link to the NHS health check programme. Almost 3 million NHS health check offers were made in 2014-15 and almost 1.5 million appointments taken up. That is vital for first awareness and my constituency knows how important early diagnosis can be as a result of the checks carried out by Silver Star when it visited us.

The right hon. Gentleman talked about other important referral routes, including engagement with pharmacists, and I will pass on his concerns to the Minister for Community and Social Care, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt), who has responsibility for community pharmacies.

The right hon. Gentleman criticised the responsibility deal, but I think it has achieved a lot. We have made some important gains working in voluntary partnership with industry, such as the voluntary front-of-pack nutritional labelling scheme, which has greatly empowered consumers to know what is in their food. That accounts for about two thirds of the market for pre-packed food and drinks, but I accept that the challenge is to go further.

We will announce more about our childhood obesity strategy this summer. We will also monitor the impact of NHS England’s proposal for the introduction of a sugar tax on the NHS estate. It will be interesting to see the results of that consultation. The Sugar Smart app has empowered 1.6 million consumers to date to know more about what is in their food.

I thank the right hon. Gentleman again for bringing these important issues to the House. I am absolutely sure that we will discuss them again, because this vital agenda is right at the heart of the Government’s health programme.

Oral Answers to Questions

Keith Vaz Excerpts

Tuesday 9th February 2016 Commons Chamber

[Mr Hunt]

The hon. Lady is absolutely right that one thing that can tip hospitals into special measures is having too high a proportion of staff from agencies so that a trust cannot offer the continuity of care that other trusts can. There have been an extra 83 full-time doctors at Walsall Healthcare NHS Trust over the past five years, along with 422 full-time nurses. An improvement director started this week and we are looking to find a buddy hospital, which is what I think will help most. When it comes to turning hospitals round the fastest, we have found that having a partner hospital can have the biggest effect, as with Guy’s and St Thomas’s for the Medway.

[Keith Vaz (Leicester East) (Lab)]

Despite having a football team at the top of the premier league, the hospitals of Leicester are in need of urgent assistance. The worry for Leicester is that they will slip into special measures, particularly regarding A&E. What steps can the right hon. Gentleman take to ensure that our hospitals perform as well as Leicester City football club?

[Mr Hunt]

We want to them to be as outstanding as Leicester City football club, but we recognise that there is some way to go. There is pressure on A&E departments, as the Under-Secretary of State for Health, my hon. Friend the Member for Ipswich (Ben Gummer), has acknowledged in the House, and we are giving careful thought to what we can do to support them. Leicester will be one of the first trusts in the country to offer full seven-day services from March or April 2017 onwards, so important improvements are being made, but we will do all that we can to ensure that they happen quickly.

NHS Trusts: Finances

Keith Vaz Excerpts

Monday 1st February 2016 Commons Chamber

[Ben Gummer]

My hon. Friend is entirely right and speaks from experience. That is why, as part of the spending review settlement, £1.8 billion was set aside as a transformation fund. The principle behind the transformation fund is that the money will go to those trusts that are beginning to show transformation in the way they are running not only their finances, but their whole operations. That is for the betterment of patients as a whole. We have to see transformation; otherwise money will be wasted, as it has been in years previously.

[Keith Vaz (Leicester East) (Lab)]

What help and assistance can the Minister give to the ambulance service in Leicester? On Sunday 24 January, 10 of the 25 ambulances that serve the whole of Leicestershire were parked outside A&E at the Royal Infirmary, trying to hand over patients to the staff. On 856 occasions in the last year, ambulances had to wait between two and four hours to hand over those patients. In Leicester we need not more consultants, but a better system of management.

[Ben Gummer]

The right hon. Gentleman raises an issue that has been severe in Leicester, and I am aware of it. I am happy to have a separate meeting with him to discuss the matter and what is being done about it. Across the country, however, we are seeing a rather better performance this winter than last. That is because of the extraordinary amount of planning done by the NHS, and because we are getting better at dealing with the extraordinary pressures that are placed on the NHS in winter. In Leicester, there has been a particular issue. I am aware of it, and I reassure him that it will be fixed in time for next year.

Childhood Obesity Strategy

Keith Vaz Excerpts

Thursday 21st January 2016 Commons Chamber

[Dr Wollaston]

I thank the right hon. Gentleman for his point, which prompts me to address the issue of a sugary drinks tax. We looked at examples of where taxation can be applied across sugar more broadly, perhaps to incentivise reductions within reformulation, as some countries have done. However, we wanted to address the single biggest component of sugar in children’s diets, which is sugary drinks. The Committee recommended a sugary drinks tax rather than a wider sugar tax, and there are several reasons for doing that. First, we know that it works. Secondly, it addresses that point about health inequality.

Mexico introduced a 1 peso per litre tax on sugary drinks and by the end of the year the greatest reduction in use—17% by the end of the year—was among the highest consumers of sugary drinks. The tax drove a change in behaviour. The whole point of this sugary drinks tax is that nobody should have to pay it at all. To those who say it is regressive, I say no it is not; the regressive situation is the current one, where the greatest harms fall on the least advantaged in society. As we have seen with the plastic bag tax, the tax aims to nudge a change in behaviour among parents, with a simple price differential between a product that is full of sugar, and causes all the harms that we have heard about, including to children’s teeth, and an identical but sugar-free product—or, better still, water.

[Keith Vaz (Leicester East) (Lab)]

I congratulate the hon. Lady on securing this debate and on her work in this area. We do not really have to wait for a tax; we can take what the Mayor of London has done in City Hall as an example. He has made sugary drinks more expensive, and therefore people have that choice immediately. In the presence of the Chairman of the Administration Committee, the House’s greatest living dentist, who is participating in this debate, may I say that it is possible for this House to put up the price of sugary drinks so that those who go to the Tea Room will then have that choice?

[Dr Wollaston]

I thank the right hon. Gentleman for that and welcome what he describes. That movement is not just happening in City Hall, because it is being recommended within the NHS by Simon Stevens. I also congratulate Jamie Oliver and the many other outlets that are introducing such an approach. The other point to make is about public acceptability, because all the money raised goes towards good causes. As we have seen with the plastic bag tax, the fact that the levy is going to good causes increases its public support. That levy has been extraordinarily effective, as plastic bag usage has dropped by 78%. That is partly because we all knew we needed to change but we just needed that final nudge. That is what this is about: that final nudge to change people to a different pattern of buying. It has a halo effect, because it adds a health education message and that is part of its effectiveness.

--- Later in debate ---

[Keith Vaz (Leicester East) (Lab)]

I will stick to my eight minutes, Madam Deputy Speaker, and I will not give way, if that helps—[Interruption.] All right, I will give way.

It is a pleasure to follow the hon. Member for Colchester (Will Quince). He is hard on himself; he is not obese, just very well built. I know that his enthusiasm for curry is known throughout Colchester, so that might be a contributing factor. It is a pleasure to speak in the debate and I congratulate the hon. Member for Totnes (Dr Wollaston) not just on how she chairs the Select Committee on Health but on how she brings issues to the House, especially this critical issue of childhood obesity. I am delighted to see the Minister at the Dispatch Box, as she gets it. She is the Minister responsible for diabetes and whenever we in the all-party group on diabetes ask her to deal with these issues, she has always been very open and transparent. I think that she is on the same page as the rest of us.

That helps me put aside at least half of my speech because I do not need to repeat the statistics that Members who are experienced in these matters know all about—the cost of diabetes to the national health service, the worry that over half a million people have type 2 diabetes and are not aware of it, the need for prevention and awareness, and the importance of protecting our children. The figures given by the hon. Member for Totnes are clear. The problem gets worse as children get older and the figures are so worrying that if we just stand still, the crisis of childhood obesity will continue.

[David Rutley (Macclesfield) (Con)]

With reference to standing still, the debate today has largely focused on sugar and our intake of it. One of the key things we need to do to tackle the challenge of childhood obesity is to focus on activity—getting people to be physically active, through sport or, as I increasingly believe, outdoor recreation. The Department for Culture, Media and Sport sports strategy, which focuses more on outcomes and includes outdoor recreation, could help to tackle the crisis that we are facing. Does the right hon. Gentleman agree?

[Keith Vaz]

Absolutely. The hon. Gentleman is looking at someone who constantly tells people to move more, but prefers to go by car rather than walk. It is a wonderful thing to say, but it is a different matter to get us on to those bicycles, on to our feet and involved in physical activities. My physical activity extends to table tennis, which is not the best way of losing weight and ensuring that my type 2 diabetes is under control. The hon. Gentleman is right—those lifestyle changes are necessary and they need to happen at a very young age. Schools, teachers, kids and parents need to be involved in ensuring that there is more activity because that will help in the long run.

We should be pretty dramatic in the way we deal with the problem. As you know, Madam Deputy Speaker—as you have no doubt shown the film to your children at some stage—Mary Poppins thought that a spoonful of sugar helped the medicine go down, but a spoonful of sugar, or nine teaspoons of sugar in a can of Coca-Cola, does not help the medicine go down—it makes matters worse.

In the short time available, I shall concentrate on the need to ensure that retailers do their bit to bring down the sugar content in sugary drinks. I am full of praise for the Mayor of London, the hon. Member for Uxbridge and South Ruislip (Boris Johnson), for going one step further than waiting for a sugar tax, which I understand is still on the agenda. There was a feeling that the Government had rejected that, but there were newspaper reports that the Prime Minister was still considering the matter. Perhaps the Minister can tell us when she winds up.

The retailers, having been invited by the previous Secretary of State for Health to be part of a voluntary arrangement, did not keep their side of the bargain. Despite the great declarations that were made by the previous Secretary of State, which I am sure were well intentioned, it is difficult to control global empires to ensure that they reduce the amount of sugar in drinks. We therefore have to take drastic measures. That is why I support a sugar tax, as enunciated by the Chair and other members of the Health Committee. We need to do that. We also need to do what the Mayor has done. Putting up the price of sugary drinks in City Hall is an extremely important way of sending out a clear message. Simon Stevens has said that he would do the same thing at NHS hospitals. How many of us turn up at local hospitals and see vending machines openly trying to sell us sugary drinks such as Coca-Cola?

I recently returned from a holiday in India. Whenever I asked for water or Diet Pepsi or Diet Coke, I was told it was not available. There is an interesting read-across to other Government Departments. The big retailers may be more conscious of the fact that the British House of Commons is interested in the issue, but in countries outside western Europe and the United States, they may feel that they can dump their sugary products without offering an alternative. Before we get to the issue of the sugar tax, which, as I said, I support, there is much that retailers can do.

I recently visited a branch of Waitrose in West Bromwich. I was interested to see that all the sugar-free products had been put in one kiosk in the middle of the store, so when people walked in they were not overwhelmed by the promotion of two-litre bottles of Coca-Cola for the price of one—they looked at the kiosk, where there were only no-sugar products. That is a way of encouraging those who purchase—I am not saying dads do not do it, but in most cases mums—to go to the kiosk and try to think positively about buying products that are free of sugar.

As I said in an intervention, there are things we can do. If we go to the Tea Room to have our lunch after this great debate, what is on offer? Club biscuits, Jaffa cakes, the most fantastic Victoria sponge—marvellous stuff that the Administration Committee offers us. The fruit is at the side, between the refrigerated drinks and the till. By the time I get there, even I, with my type 2 diabetes, am sometimes tempted to go for the sugary products and the chocolate. Why do we not promote the food and drinks that are healthy?

That is why, like others, I commend what Jamie Oliver has done. We need people like that, who have captured the imagination of the British people, to ensure that the public and the press help in the efforts to reduce sugar. Finally, I lavish praise on my hon. Friend the Member for Swansea West (Geraint Davies), who has introduced a Bill to provide for better labelling. We still do not have effective product labelling. It is important that we see such information because it will enable us to make informed choices.

If we do nothing, the obesity crisis will get much worse. We are not drinking at the last-chance saloon. That is now closed. We are outside and we are ready for firm Government action. That is our request to the Minister. Because of her own commitment to these issues, I know she will react positively.

[Several hon. Members rose—]

Sugary Drinks Tax

Keith Vaz Excerpts

Monday 30th November 2015 Westminster Hall

[Keith Vaz (Leicester East) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Hamilton, and a pleasure to follow the hon. Member for Erewash (Maggie Throup) and four outstanding speeches. I could easily say I agree with everything I have heard and sit down, but this would not be Parliament if we said so few words, so I will add a couple of words.

Normally, I think Home Affairs Committee reports are stunning. However, the report that the hon. Member for Totnes (Dr Wollaston) has published today is an absolutely stunning report, which I hope will be a turning point in how the public and the Government look at the issue. I congratulate her and the members of her Committee on the work that they have done.

I also want to congratulate Jamie Oliver on the work that he has done and this amazing petition, which has managed to attract 151,782 signatures. This debate is an example of how Parliament can reflect the needs and wishes of the public. It was opened eloquently by my hon. Friend the Member for Warrington North (Helen Jones), with whom I spend many hours in the Tea Room, where we discuss food and other things of that kind. She spoke well, as did my hon. Friend the Member for Newport West (Paul Flynn).

I want to speak about various issues. I declare my interest as a type 2 diabetic. Mr Hamilton, you are also a type 2 diabetic, but you are better at taking the advice of the hon. Member for Erewash than I have been. She encourages people to cycle, and you went on a cycle ride from Leeds to Paris in support of diabetes; I walk to the tube. It is very bad. I keep saying to my wife that I want to buy an electric bicycle, and she keeps saying that I will never use it, but I use you as an example, Mr Hamilton —a paragon of what we should all follow.

[Maggie Throup]

Sky Ride is open to anybody of any age. I encourage the right hon. Gentleman to find his local Sky Ride starting point, buy a bike and go and enjoy it.

[Keith Vaz]

I will, but for me it will not be Sky Ride; it will probably be Skyfall. However, I will look up what the hon. Lady has suggested.

On the point made by hon. Members about Mexico, I met the Mexican ambassador and his amazing dog, Pepe, on Thursday last week at the Mexican embassy. The ambassador is also a diabetes campaigner, and he told me that the example of Mexico is a good one. The chair of the Health Committee, the hon. Member for Totnes, gave us the figures: consumption is down in Mexico, and the price differential provides an important nudge. The ambassador told me that Mexico is the biggest consumer of Coca-Cola in the world. That is why Mexico introduced the sugar tax, which is working, and it is important that our Government consider that tax.

However, we need to move further. I gave up sugar when my local GP diagnosed me with type 2 diabetes on an awareness day. He said, “Come along and be tested.” I was tested and he rang me the next day and said, “The good news is you’re on the front page of the Leicester Mercury, but the bad news is you’ve got type 2 diabetes.” I did not really know what it was, but I gave up sugar, which is a killer, immediately.

Whenever we talk about the sugar industry, it gets very worked up. I think we should go further and have a no sugar day. The last time I questioned the Prime Minister on the subject, about the time of World Diabetes Day last year, I suggested that the consumption of sugar should be stopped in No. 10 just for one day. Imagine if the Administration Committee, or the commissioners of this House, decided that just for one day, perhaps World Diabetes Day, there would be no sugar available in the Tea Room. When you got to the counter—I know you would resist it, Mr Hamilton—there would be no Club biscuits, no Jaffa Cakes, no Victoria sponge; just fruit and other types of food we can consume without increasing our sugar intake. There are a lot of examples of that happening. We need to take a proper course of action, apart from simply putting up taxes.

I commend the companies that have tried to do something about the issue. I went to a Waitrose store in Wolverhampton to look at what the manager had done. I am sorry, I did not tell my hon. Friend the Member for Wolverhampton North East (Emma Reynolds) about that—I was driving past and I had no time to text. The manager had taken all the no-sugar products and put them in a kiosk in the middle of the store. Rather than being shoved on the last possible shelf, they were in one kiosk with the words “no sugar”, so all the no-sugar stock was in one place. It is so much better when companies encourage their consumers to be responsible.

My hon. Friend the Member for Warrington North mentioned the responsibility deal, but I think it has failed. Voluntary codes do not work. The Government were right to introduce the deal under the previous Secretary of State for Health, but unfortunately it has not made much difference. We should get the companies in—perhaps invite them to No. 10—and get them round the table with the Health Secretary and tell them that they need to do much more to control the amount of sugar in their products.

I congratulate my hon. Friend the Member for Newport West on introducing his ten-minute rule Bill on labelling. On the point made by various hon. and right hon. Members—and Mr Jamie Oliver—if we simply put the number of teaspoons of sugar on the front of a product, that will be sufficient to allow consumers to make a proper choice. Rather that than having tiny lettering on the back of a product, which we do not always see. I would also like to see more products with the words “suitable for diabetics” on them. To give Marks & Spencer—and corporate Britain—credit, it has no-sugar chocolate. It tastes pretty awful compared with real chocolate, but at least it is there, and when you are desperate, you can reach for the drawer that says “no sugar”.

I want to ask those who produce sugary drinks to be a little less touchy and more touchy-feely. I was recently asked whether I supported the arrival of the Coca-Cola van in Leicester. I said I was against it because it would encourage young people to drink more Coca-Cola, which has seven teaspoons of sugar in each can, and there was a huge outcry. When I went to a football match two weeks ago at the King Power stadium—before Jamie Vardy scored his 11th goal—a man came up to me and said, “You are like the Grinch. You have ruined our Christmas, because you do not want the Coca-Cola van to come.” I thought Christmas was about the birth of Christ and the message of Christianity, but I now realise it is about not depriving people of their beloved Coca-Cola van, which they can go and worship on 17 December in Leicester.

We then discovered, thanks to the Mirror and the Daily Mail, that the Coca-Cola van is visiting some of the most obese cities in the country. It actually visits Coca-Cola’s best consumers. I had a very nice letter from Coca-Cola inviting me to come and meet the chairman in Atlanta, Georgia—I think I will go to the local headquarters in Reading—and I said, “All you have to do is put on the van the words ‘no-sugar Coca-Cola’, ‘Diet Coca-Cola’ or ‘Coca-Cola Lite’, and you can help change the habits of consumers.” That needs to be done, and I have an open invitation to Mr Oliver to come to Leicester on 17 December, not in an anti-Coca-Cola van, but in a van from which he can give out his good food and perhaps water instead of Coca-Cola. Perhaps he can follow the van around the country making sure we have good products given to young people.

The Under-Secretary of State for Health, the hon. Member for Battersea (Jane Ellison), the Minister with responsibility for diabetes, must feel a little alone given all the speeches that we have heard so far. I think she is committed to doing a great deal of work on diabetes. I had the pleasure of being with her in Asda on World Diabetes Day—not shopping, but raising awareness of diabetes in her constituency—along with Silver Star, a charity that I founded a few years ago. However, I think the Government as a whole are reluctant to take on the big companies. I hope that they will be bold in order to save lives and help the health of our nation, and that they will take an initiative that will encourage Health Ministers and Governments all over the world to do the same.

Oral Answers to Questions

Keith Vaz Excerpts

Tuesday 13th October 2015 Commons Chamber

[George Freeman]

I pay tribute to my hon. Friend, who has first-hand experience of this matter. It is true that people who are responsible for ensuring that they hold a certificate when claiming the exemption could be subject to genuine mistakes. That is why we responded to the feedback this summer and put measures in place so that if someone submits a valid medical exemption certificate within 60 days of a penalty charge notice, the penalty charge will be cancelled. It is also worth remembering that all patients on benefits or on the NHS low income scheme are exempt anyway, and that patients who require frequent prescriptions can enrol for a pre-payment certificate, which costs no more than £100 a year.

[Keith Vaz (Leicester East) (Lab)]

There are 3.3 million diabetics in this country, including myself, who are entitled to these certificates. This is not special pleading, but the issue is that when they come to renew they do need help. As the hon. Member for Blackpool North and Cleveleys (Paul Maynard) has said, it is difficult for them to fill in some of these forms. Will the Minister ensure that local GP practices are able to help people if they need assistance in filling in these forms?

[George Freeman]

I will happily look into that specific issue, discuss it with the right hon. Gentleman and see whether there is anything we need to do.

Oral Answers to Questions

Keith Vaz Excerpts

Tuesday 7th July 2015 Commons Chamber

[Ben Gummer]

I very much look forward to meeting my hon. Friend and his colleagues, and I have already committed to doing so. I hope that the lead he has taken with his colleagues in forging a cross-party consensus will be copied across the House.

[Keith Vaz (Leicester East) (Lab)]

Each week, 1,000 diabetics suffer hypoglycaemic attacks, which require urgent medical treatment and access to acute services. Does the Minister agree that better management of diabetes services by GPs will lessen the pressure on our A&E services?

[Ben Gummer]

I do agree with the right hon. Gentleman, who is an expert in this field. We have a diabetes and obesity strategy coming later in the year. The Under-Secretary, my hon. Friend the Member for Battersea (Jane Ellison), who is responsible for public health, will be leading that effort.

Oral Answers to Questions

Keith Vaz Excerpts

Tuesday 2nd June 2015 Commons Chamber

[Jane Ellison]

My hon. Friend raises an extremely important issue. I welcome the fact that she has so quickly got to grips with some of the key local health facts in her area. Hon. Members across the House can look at how their clinical commissioning group is performing in the national context. My hon. Friend is right to say that her CCG performs poorly when it comes to amputations. There is a huge opportunity for improving the outcomes for people if we can get the worst-performing CCGs in that context up to the standard of the best. The national diabetes prevention programme is very much about preventing people getting to the stage where those complications can cause such terrible problems.

[Keith Vaz (Leicester East) (Lab)]

13. May I join the Minister in congratulating the hon. Member for Fareham (Suella Fernandes) on her place in this House? She was a worthy opponent of mine in 2005 and I am glad she managed to get elected. On the national diabetes prevention programme, for those of us who have diabetes the issue is what is corporate Britain doing to work with the Government in order to reduce the amount of sugar and fat in food and drink? Unless we do that, we cannot tackle the diabetes crisis that we will face.

[Jane Ellison]

The right hon. Gentleman is quite right. Tackling obesity is one the great public health challenges of our age. Right across the developed world we are looking at all the things that are going on around the world—the new science and the new research. The right hon. Gentleman is right to say that industry has a role to play, as has every part of Government—national Government and local government—as well as families, GPs and the NHS. This will be a whole-nation approach to tackling obesity. We are working on our plans, which I look forward to discussing with him in due course.

UK Ebola Preparedness

Keith Vaz Excerpts

Monday 5th January 2015 Commons Chamber

[Mr Hunt]

We have learned the lessons to speed up the process so that people, I trust, will not have to wait as long. One of the lessons we learned in the Christmas period is that we do not want people to have to wait as long. I want to stress to my hon. Friend—perhaps he could stress this to his constituents—that the clinical risk of contracting Ebola from sitting next to someone who is not exhibiting feverish symptoms is very low. That is why the clinical advice was, and remains, that it is perfectly safe for someone to travel on a train if they are not displaying the symptoms. We want to go further, however. We recognise that we do not know everything about this disease and therefore want to be precautionary. That is why we have said that if people in the high-risk categories—those who have had contact with Ebola patients—say they are unwell, we will have a different protocol going forward even if their temperature is within the normal range. I hope that will reassure his constituents.

[Keith Vaz (Leicester East) (Lab)]

The Government were absolutely right to start screening on 14 October. May I urge the Secretary of State to resist calls from those who say that screening is not effective and should stop? This was not a direct flight: it went through Casablanca. Although we have put a lot of resources into Sierra Leone and we have resources at Heathrow, there appears to be no international effort in the major hubs in Africa. What steps are going to be taken to help Governments such as that in Morocco, specifically in Casablanca, which receives so many flights from other countries in Africa that end up at Heathrow airport?

[Mr Hunt]

I thank the right hon. Gentleman for raising that point; he has done so on a number of occasions. It is very important that there is not a weak link in the chain. We have been relatively satisfied with the screening procedures at Casablanca, which we have obviously inquired into in great detail because of the fact that Pauline came through Casablanca, but I will ask Public Health England to reassure me that it is satisfied with those screening procedures, and, if not, if there is any assistance we can provide to the Moroccan authorities.