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House of Lords Hansard
20 July 2017
Volume 783

    Question

    Asked by

  • To ask Her Majesty’s Government to what extent they attribute the slowing in the growth of life expectancy identified by Sir Michael Marmot to health issues related to obesity, such as type 2 diabetes.

  • My Lords, we agree with Sir Michael that it is difficult to draw conclusions about the causes of the slowing of growth in life expectancy at this stage. We will follow further research with interest. A number of factors contribute to the length of people’s lives, including having and maintaining a healthy weight. We know that obesity is a leading cause of serious diseases such as type 2 diabetes, heart disease and some cancers.

  • My Lords, in the United States life expectancy is now declining. Where America leads, we often follow. There, there are no party political points made about this but rather a general acceptance that the major factor, among others, is obesity and linked conditions such as type 2 diabetes and heart disease. Will Her Majesty’s Government please redouble their efforts to educate the population, especially in schools and the NHS where they have authority, about the benefits of healthy eating and taking exercise in an attempt to avert the innumerable individual tragedies this will lead to and the terrible consequences for our health service and society?

  • We take obesity extremely seriously and have a lot of initiatives going forward such as introducing a soft drinks industry levy, which will come into effect in April. The important thing could be harnessing new technology. We need to make sure that we can get to people, particularly young people. We will work with Public Health England on good initiative ideas, and with commercial players to investigate opportunities to bring forward a suite of applications that enable consumers to make the best use of technology and data to inform their eating decisions.

  • My Lords, in the SACN report, the variation between different groups was seen to be quite unacceptable. For example, in the Borough of Kensington and Chelsea, the difference between different demographic groups for men was 16 years. To what does the Minister attribute this inequality and what do the Government intend to do about it?

  • It is definitely true that inequality has a part to play but it is interesting that it is due not only to funding. While I was researching this, I noticed comparative statistics on life expectancy at birth across the G7 nations. Those show no direct correlation between GDP expenditure and health outcomes. For instance, the USA spent 16.6% of its GDP on healthcare but has the lowest life expectancy at 78 years. Italy spends the least at only 9.1% of its GDP and has the second highest life expectancy at 82 years. Diet and lifestyle—which everybody has a responsibility for—go a long way in playing a part in this.

  • Surely the Minister agrees that the point the noble Baroness, Lady Walmsley, is making is not a comparison between how much is spent per head on healthcare but about the poverty that gives rise to the inequalities that lead to disparities in life expectancy. She is drawing attention to that basic poverty, aside from the need to have well-funded health services.

  • That is exactly why the NHS is spending an increase of £8 billion in real terms between 2020 and 2021, and why public health funding has been ring-fenced and the grant will remain in place for 2017 and 2018. We have also been committed to the Healthy Start scheme and provided an estimated £60 million-worth of vouchers to families on low incomes across England in 2015-16. These can be exchanged for fresh or frozen fruit, veg and milk, and provide free vitamins that support intake during pregnancy and early years. An average of 480,000 children benefited from the issue of these vouchers every four weeks last year.

  • My Lords, does the noble Baroness accept Public Health England’s view that sugar in alcohol is a major contributor to obesity? I welcome the Government’s announcement this week of a drugs strategy. When will they turn their attention to the alcohol strategy, which is now well out of date and badly in need of attention?

  • We have taken forward initiatives, and public information about the guidelines is included in Public Health England’s “One You” campaign, which aims to motivate people to take steps to improve their health through action on the main risk factors such as smoking, inactivity and alcohol consumption. It includes a drinks tracker app to help drinkers identify risky behaviour and lower their alcohol consumption. Spending on alcohol services for adults has gone up from £200 million in 2014-15 to £230 million in 2015-16.

  • My Lords, if poverty is a factor in diabetes, how are we to deal with the matter in the north-east, which was the subject of the first Question? We have pumped in money there but seen in last week’s figures that the north/south divide in prosperity is still as strong as ever.

  • That is why we confirmed before the election that the ring-fenced grant would remain in place for this year and next, transferring responsibility to local government. It has created an opportunity to join up public health with the funding streams for local services such as housing and economic regeneration, in the interests of improving the health of the local population. Local authority public health spend is in addition to the money the NHS spends on prevention.

  • My Lords, Michael Marmot’s report emphasises the important role that dementia has played in the near halving of the increase in life-expectancy levels since 2010, because of the sudden and sustained increase in older deaths. Dementia and Alzheimer’s are now the leading cause of death among women aged over 80 and men aged over 85. How does the Government’s insistence that money is going into the system to tackle this square with the evidence in the report that health and social care spending is going down, at a time of rising health needs linked to the ageing population, and Sir Michael’s own comments that financial settlements have been “miserly”? What will the Government do to address the Alzheimer’s Society’s comments on the report? It said that,

    “the chronic lack of funding to the social care system … is devastating people with dementia”,

    and that action is needed,

    “before the care system collapses entirely”.

  • Dementia is such a depressing disease for anybody to have. It affects not only those who have it, who are incredibly frightened, but their loved ones, who have to care for someone who becomes a completely different person in front of them.

    The Challenge on Dementia 2020 Implementation Plan, which was published in March 2016, sets out the actions that the Government and key stakeholders will be taking in order to implement the 2020 challenge. It sets out how the Government will put the views and lived experience of people with dementia and their carers at the heart of our delivery strategy by establishing a new dementia 2020 citizens engagement programme. The Government have already invested an additional £2 billion to put social care on a more stable footing and alleviate short-term pressures across the healthcare system.

    Every department has to take responsibility for what is going on with obesity in this country. It affects all departments—the Department for Digital, Culture, Media and Sport, the Department of Health and every other department—and we need to make a joined-up effort to ensure that we tackle the crisis of obesity in this country.