Obesity

Lord O'Shaughnessy Excerpts

Wednesday 18th July 2018 Lords Chamber

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

My Lords, first, I congratulate my noble friend Lord McColl on calling this debate and showing his usual enthusiasm and tenacity in doing so. I have a feeling that, given his injunction to us is to eat less, the timing of this debate, which means speaking between 6.49 pm and 8.02 pm, is perfect as we have all missed dinner. I also congratulate the noble Baroness, Lady Boycott, on a very passionate and persuasive speech; she will obviously bring many strengths to this House. I note that in 1984 she wrote a book called The Fastest Diet. I think she might have been one of the first people to promote the idea of fasting. I skipped breakfast this morning in her honour as I am on currently going through the fad of the 16:8 diet. I do not know whether it is helping; I generally just feel a bit tired, but that could be something else.

This is a topic we talk about a lot, but I think we are making progress and getting good ideas from it. I think we are making progress in government policy, too, and I will talk more about that. We know the level of the problem: a quarter of children aged five are overweight or obese, rising to a third by the age of 11, and six out of ten adults are overweight or obese. I am, however, mindful of my noble friend Lord Balfe’s point about accuracy. Strictly speaking, of the adults who are overweight or obese, a quarter are obese so most are overweight, and there are question marks about that. Nevertheless, that is a lot of people—a significant part of the population.

As many noble Lords pointed out, including my noble friend Lady Neville-Rolfe, there is not only a poverty dimension but an age dimension, so there are all sorts of social justice issues at work here. There are also huge economic costs: £6 billion a year to the NHS and about £27 billion to the economy at large, as the noble Baroness, Lady Massey, pointed out, endorsed by my noble friend Lady Neville-Rolfe. There are health costs linked to cancer, cardiovascular disease and diabetes—I thought the Vietnam example was terrifying. Though, as my noble friend Lady Jenkin pointed out, there is cause for hope about type 2 diabetes being a reversible condition, and I will return to that. There are other costs, too, including worklessness, oral health and the emotional and mental health costs, as the noble Baroness, Lady Walmsley, and my noble friend Lord Kirkham pointed out. I think it constitutes a crisis, and as the noble Baroness, Lady Walmsley, pointed out, it should be thought of as a disease, if not an epidemic, because it appears to be catching. It appears that if your peers are overweight, you are more likely to be overweight—that is a catching thing. Whether it is a meme rather than a disease, it is something that can be spread.

As has been said today, it is not simply as easy as saying you should eat less and exercise more, especially in what my noble friend Lady Jenkin evocatively called an obesogenic environment. It is a phrase I had not heard before, but I thought it was very evocative. Ultimately, we need to help people build up good habits of personal responsibility.

Lots of noble Lords talked about the role of schools, and I will return to that, but it is notable that Ofsted has said today that we cannot lump all this on to schools and every part of society needs to take responsibility. I could not agree more. As the noble Baroness, Lady Massey, pointed out, families and parents need to be equipped to give good advice and good parenting. As the noble Baroness, Lady Grey-Thompson, and my noble friend Lady Neville-Rolfe pointed out, corporates need to play a role in this, as of course do the Government. We all agree with that. We need to be guided by evidence and research, although, as my noble friend Lord Blencathra pointed out, sometimes the evidence and research, and all the advice that is based on it, can change.

We are trying to do something about that. We have made a significant investment in a policy research unit to help make sure there is more consistent advice. I think there is generally a better understanding of the causes of obesity now.

My noble friend Lord McColl talked about the fat versus sugar debate. That still rages on and views still differ. Noble Lords also talked about calories versus exercise or inputs versus outputs, as I always think about it. The noble Lord, Lord McColl was firmly on one side of that debate, with the noble Lord, Lord Addington, firmly on the other, and other noble Lords, such as my noble friends Lord Blencathra, Lady Neville-Rolfe and Lord Kirkham and the noble Baroness, Lady Grey-Thompson, somewhere in between. I think of it in physics terms, as the law of conservation of energy: what comes in either goes out or stays. It is simply the case that in an isolated system, energy is conserved.

We need to look at this holistically, and that is what the Government have been trying to do. Noble Lords will know about what we call chapter one of the obesity strategy. The centrepiece of that is the sugar levy, which my noble friend Lord Balfe called a popular tax. There you go—they do exist. That has had a really big impact for everybody, children and adults, with 45 million kilograms of sugar being taken out of circulation as a consequence. As well as this, there have been big investments in school sports, breakfast clubs and food tech being in the national curriculum, which the noble Baroness, Lady Grey-Thompson, and my noble friend Lady Neville-Rolfe asked about.

We also know that chapter 1 did not have the full effect that we wanted, especially on reformulation, which is the point that my noble friend Lord Blencathra was making about the kinds of food everybody eats, not just one category or the other. This is what led to chapter 2, announced on 25 June. I was glad to see noble Lords welcoming that. There were really big moves forward, including a watershed for advertising unhealthy food, which the noble Baronesses, Lady Massey and Lady Walmsley, asked about. Also, there was a ban on price promotions of high-salt and high-sugar foods—trying to take the fun out of processed food, as the noble Baroness, Lady Boycott, said, which is a really good way to think about it. We ended the sale of energy drinks to children, which was one of the things that really worries me. If you look at the impact on school life, teachers will tell you that is a really big problem. It includes consistent calorie labelling outside the home, although, as my noble friend Lord Blencathra pointed out, it might not always help to know how many calories are in that Starbucks chocolate muffin. But it does help to provide a nudge. We are also introducing stronger government standards for food and catering services, something raised by my noble friend Lady Neville-Rolfe. And, of course, there is the Daily Mile, which has proved very popular—so popular that I wonder whether we, as an institution, should do it before Prayers. We might be able to show genuine leadership on that.

The point that the noble Lord, Lord Addington, and the noble Baroness, Lady Grey-Thompson, made is critical. I hope that noble Lords will see in chapter 2 that this is a cross-government effort. These are not just health things but encompass different departments, although I appreciate that we can always do more.

The noble Lord, Lord Brooke, asked about the consultations; I do not have a date by which they will be instigated, but they will be launched by the end of 2018. I absolutely salute the work he is doing to try to drive that campaign with national broadcasters, and I have brought that to the attention of my colleagues in the department.

The noble Baroness, Lady Walmsley, asked about prevention. It is interesting that our new Secretary of State has an interest in that whole agenda, and I think we will see more of that from him. Given the department he has run, he also understands the media and how you influence people’s behaviour when you do not have lots of money to spend—which the DCMS rarely has. We therefore also now have quite an interesting ally in the new Secretary of State.

We are trying to do other things. The noble Baroness, Lady Grey-Thompson, knows better than all of us in this Chamber about the importance of exercise. She has done it—she is a Paralympic champion herself. We are encouraging walking to school—there is a good joint project with Living Streets—more money is going into the Bikeability scheme, and there is the Sport England strategy and the CMO’s daily physical activity deadline. A lot is going on, but I agree that perhaps there is a need to wrap all this together, not just to talk about the food and health bits of it.

My noble friends Lord McColl, Lord Blencathra and Lord Kirkham emphasised different eating habits. There is a successful public health campaign called Change4Life, which has some quantifiable impacts on the way people eat food—the quantity as well as the quality—and there is more emphasis on preparing food from scratch rather than eating processed food. I encourage noble Lords to look at that, because it has been quite effective, and it uses public campaigns as well as other ways of promoting good eating habits.

My noble friend Lady Jenkin talked about the potential of fasting. The ancients understood this but we now have an evidence base, as she described, which means that we should probably put more emphasis on fasting as a technique, not just for losing weight but for better health as a whole. The department as a whole will need to take that forward.

On tackling other causes of obesity, my noble friend Lord McColl talked about stress and abuse, which was an incisive point. That goes hand in hand with what the noble Baroness, Lady Massey, said about building self-esteem, which in a way sometimes corrects the consequences of stress and abuse. She will know very well that some important steps forward have been taken in schools in this country to try to increase well-being and build character—I tried to do that in the schools I set up—which will have benefits for both mental and physical health.

Finally, on a few other issues which noble Lords raised, my noble friend Lord Balfe and the noble Lord, Lord Brooke, asked about weighing people. There is an issue about weighing teenagers forcibly, but clearly we need ways to sample age cohorts. I will investigate that further and see exactly how we do it. My noble friend Lady Neville-Rolfe talked about sleep, which we have touched on before. I am increasingly of the view that there may be a need for some government work on promoting good sleep—not that I am the Public Health Minister.

The noble Baronesses, Lady Walmsley and Lady Massey, asked about breast-feeding. We are absolutely promoting it and we recognise the advice of the Scientific Advisory Committee on Nutrition. It is also a part of the maternal health strategy. The noble Baroness, Lady Walmsley, mentioned bariatric surgery. There are NICE guidelines for that, so if people meet certain criteria it should be available to them.

Once again, we have had an interesting and wide-ranging debate, although obviously there are some areas of disagreement among us. I will end on the point the noble Baroness, Lady Thornton, made. I will certainly speak to the Secretary of State about it, and I think he is open-minded on this. You can look at the attitude he has taken to the role of social media, for example, which goes beyond what most pro-business Governments would be prepared to do. I think he will be sympathetic to this. In the end, this is about helping people to develop a healthy relationship with food. It brings to mind a book I read a few years ago, which is not about food at all, called The Case for Working with Your Hands, by Matthew Crawford. He talked about the alienation that comes from working in an office environment, such as in bureaucracies, because you are unable to feel what you have produced—you cannot touch it. He ends up, having done a philosophy degree, becoming a motorcycle mechanic—so it is a bit like Zen and the Art of Motorcycle Maintenance. It is about something physical. There is something about growing food or foraging for it—it is about going out to experience it, and knowing what it feels like. If we want to develop those good habits and a sense of personal responsibility, we have to get people involved—children, but adults as well—in the experience of growing food. That is not easy to do in cities, but we could discover that and do more of it.

Finally, these debates are incredibly helpful, because this is an iterative process. We have had chapter 1 and chapter 2, and I dearly hope that we will have chapter 3. I am sure that many of the ideas that noble Lords have suggested tonight will feature in it. Long may it continue, and I look forward to the next debate on obesity, which I am sure will take place before long. Once again I thank my noble friend Lord McColl for instigating this debate, and I congratulate the noble Baroness, Lady Boycott, on a superb speech.