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Foresight Review of Obesity

Volume 464: debated on Wednesday 17 October 2007

The chief scientific adviser and his Foresight team have today published the report, “Tackling Obesities: Future Choices”, which pulls together the latest evidence and expertise on this vital issue and seeks to answer the question: how can we deliver a sustainable response to obesity over the next 40 years? Foresight exists to challenge existing policy, and the report is nothing if not challenging.

The report predicts that, on current trends, by 2050, 60 per cent. of men, 50 per cent. of women and 26 per cent. of children and young people will be obese. Incidents of type 2 diabetes are set to rise by 70 per cent.; attacks of stroke by 30 per cent.; and cases of coronary heart disease by 20 per cent. Obesity-related diseases will cost the nation an extra £45.5 billion a year.

The implications for those individuals who are directly affected are profound. An obese young man who remains obese, as most are likely to do, will die, on average, 13 years younger than his peer group. However, the report is based on current trends. Our destiny need not be pre-ordained, and we can buck those trends, provided that we are all prepared to take the necessary steps. Indeed, the work assembled for this project gives the UK a platform to become a global leader in tackling a problem that is challenging policy makers across the world.

In recent years, we have focused more closely on child obesity. Sure Start children’s centres provide parents with high-quality health advice in the crucial pre-school years. We now intend to start earlier still with the proposed nutritional grants for pregnant mothers. Over the past three years, the share of children on the school fruit and vegetable scheme who are eating five a day has increased from just over a quarter to just under a half. We have introduced tough new nutritional standards; we are investing almost £100 million a year to improve school food; and we have added an entitlement to cooking lessons on the national curriculum. We have established the national child measurement programme, which will provide the largest database of its kind in the world on children’s weight. In 2004, only half of all pupils did two hours of high-quality PE and sport every week; today the figure is 86 per cent. We are now raising our sights so that every child has the chance of five hours sport every week, backed by a further £100 million of additional investment.

Working with the Food Standards Agency and the food industry, we have introduced front-of-pack labelling, and we have worked with Ofcom to prohibit television advertising of foods that are high in fat, salt and sugar during children’s programmes. This was a bold measure, but we are determined to go further if the evidence supports the need to do so. We will therefore be reviewing the impact of the restrictions on the nature and balance of food promotion to all children, across all media.

The Foresight report endorses interventions such as these, but argues for an even bolder approach. The report says that although personal responsibility is a crucial determinant of our body weight, our environment also plays a vital role. The chilling reality is that modern life makes us overweight. As Sir David King puts it:

“We evolved in a world of relative food scarcity and hard physical work—now energy dense food is abundant and labour saving technologies abound”.

Modern transport systems, sedentary jobs and convenience food make life more comfortable, but also lie at the heart of this dilemma. In a sense, we are victims of our economic success. The pace of technological revolution outstrips human evolution.

Tackling this problem calls for a fundamental shift in approach. Although the report projects us forward 50 years, it does of course require action today, and many of the areas identified in the report cannot be tackled successfully by Government alone. I hope this report will trigger the national debate that is essential if we are to rise to the challenge.

The report highlights the responsibilities of employers to look after their employees’ health, which is in the interests not just of their staff, but of the business: enhancing performance and improving productivity. The report also shows how small changes to everyday routines can make a real difference. For instance, employers might look at providing loans for bikes, not just season tickets; subsidising gym membership, not just canteens; and even putting out fruit at meetings, rather than biscuits. But the report also points to more substantial measures—for instance, with the built environment. Local authorities must ensure that healthy living is built into the infrastructure of our towns and cities so that planning systems improve our health and well-being.

The report examines the availability of, and exposure to, obesogenic food and drinks. Front-of-pack labelling is now increasingly prevalent, but industry has yet fully to embrace the colour coding system. There is emerging evidence that the FSA's labelling system is more effective at informing consumers and I want to work with the industry to see this adopted, but the report underlines the expectation for change. I have also asked the FSA to conduct an immediate investigation into the use of trans fats, to examine whether there is more we should ask the food industry to do in this area.

The report talks about the importance of targeted public health interventions. There are regional disparities in the prevalence of obesity and I hope that primary care trusts will look at what more can be done through advice and training in health consumption and activity to help obese people to achieve sustainable reductions in their weight. Underpinning all this is an acknowledgment that Government must do more. We will develop a comprehensive cross-government strategy on obesity to respond to the evidence in this report. Because of the need for concerted action on a number of fronts, I will convene a cross-governmental ministerial group to guide our approach.

We will continue to focus particularly on children. More than 80 per cent. of obese 10 to 14-year-olds remain obese into adulthood. As part of the spending review, we have already set our ambition to reverse the growth in obesity so that, by 2020, we reduce the proportion of overweight and obese children to the levels in 2000. Ensuring that our health service is as focused on prevention as it is on treatment is already a priority, and obesity epitomises the need for that change.

In the past, tackling obesity has always been regarded as a matter of personal will-power, but as the report starkly demonstrates, people in the UK are not more gluttonous than previous generations and individual action alone will not be sufficient. Obesity is a consequence of abundance, convenience and underlying biology. Solutions will not be found in exhortations for greater individual responsibility, or in what the report calls the futility of isolated initiatives.

Let us begin the national debate here in Parliament today, and let us use the report to forge the consensus that will allow the UK to pioneer the new long-term integrated approach that the issue desperately requires. I commend the statement to the House.

I am grateful to the Secretary of State for advance sight of his statement. Indeed, I am grateful—I hope that the House is grateful—to all those who worked on the Foresight programme and for their report.

The Foresight programme makes a clear argument: our human biology has not much changed, but our environment and our society have. We lead less active lives; we enjoy plentiful energy-dense foods. It has become normal to be overweight. It will become normal to be obese if we do not act now. Our response to this needs to change or the slide into obesity will create an epidemic of disease and the national health service will not cope.

The public health Minister, the right hon. Member for Bristol, South (Dawn Primarolo), called this a “wake up call”. If it is, the Government have been asleep for the past decade while the alarm bells have been ringing. When the Labour Government came to office, they abolished the target on obesity that was set in the 1992 “Health of the Nation” White Paper. In 2004, the Health Committee’s report on obesity said:

“On present trends, obesity will soon surpass smoking as the greatest cause of premature loss of life.”

In 2004, the Government abandoned their previous stance and set a target to halt the rise in childhood obesity by 2010. Since then, the rates have continued to go up, and what has been the Government’s response to that? It had been to push the target back from 2010 to 2020. Frankly, we can see why they have failed. The Secretary of State talked about the child measurement programme, but what is the point of a programme that does not lead to any action? Children are measured so that there is an ability to take subsequent action. This is the way in which the Government work: targets as a substitute for achievement when what we really need is action—not gimmicks or one-off initiatives, but a sustained plan. As the Foresight programme makes clear, that plan has to tackle the whole map of factors that contribute to rising levels of obesity.

The plan must start with nutrition in pregnancy and early years. There is no evidence that the Secretary of State’s voucher scheme alone will work. The National Institute for Health and Clinical Excellence has proposed guidelines for early years nutrition and all those proposals need to be supported. The plan must include the reformulation of foods. My colleague in the European Parliament, John Bowis, earlier this year led a parliamentary initiative to ban synthetic trans fats in Europe.

As the Government said earlier this year, saturated fats are the greater public health hazard. We need a supply chain initiative that will reduce fats, sugar and salt progressively and substantially. We must also promote good diet, targeting certain junk foods—today the Prime Minister called them “unacceptable foods”. Nutrient profiling that stigmatises all cheese as a junk food just forfeits credibility.

Three years ago, when the Government published their public health White Paper, I argued for a combined traffic light and guideline daily amount system of front-pack food labelling. The Government got it wrong then, and now we have several confusing labelling systems. Will the Secretary of State today agree that the Government will back a combined traffic light and GDA labelling scheme?

Will the Secretary of State commit today to a national research centre on obesity? Will he commit to a nationwide programme to identify cardiovascular risk? Will he commit to supporting proven exercise referral schemes? Will he commit to ring-fenced public health budgets so that we cannot carry on seeing such budgets being raided to meet national health service deficits? Will he explain to the House why the number of public health staff has halved? Will he explain why primary care trusts are not on track to have trained school nurses in place by 2010, as was promised? Will he tell the House why the lottery funding for community sport has been halved, when half the population do no sport and take no active recreation?

Today, the Secretary of State said that he will develop a comprehensive cross-Government strategy on obesity. Three years ago his predecessor said at the Dispatch Box that he would develop a cross-Government campaign on obesity. The words do not change, but delivery never takes place. For a decade, the Government have presided over an escalating public health crisis. A succession of gimmicks has had little impact. There has never been the comprehensive action that is required. The issue is not just about individual choices; it is about social responsibility—our responsibility for our health. It is about stronger families that give young people the guidance and self-esteem necessary to make healthy choices and lead healthy lives, stronger communities that promote activity and sport, and corporate social responsibility to promote good diet and cuts to fats, sugar and salt, and to ensure that affordable diets are on offer in the most deprived areas.

There is an analogy to climate change. In both cases, we need a cultural shift, technological innovation, a framework of legislation, and Government action, and we need individuals to respond. My right hon. Friend the Leader of the Opposition and the Conservative party have led the argument for a greener Britain through social responsibility. I can today commit the next Conservative Government to meeting our obesity and public health challenges, through social responsibility, to ensure a safer, greener and healthier Britain.

I echo the hon. Gentleman’s words about the work of the Foresight team. The review is a comprehensive piece of work. A group of experts spent two years formulating the evidence, and the review gives us an opportunity to become world leaders in tackling the problem. I really do not want to look back—

Well, I just think that the report deserves discussion in Parliament, rather than a simple Punch and Judy show. [Interruption.] Well, I do believe that. I believe that obesity is one of the long-term issues on which politicians have an obligation to forge a consensus. I do not expect the Opposition to be in power for at least another 20 or 30 years, but undoubtedly Governments will change. Undoubtedly the Opposition will be in power at some stage over the coming years—I leave aside the Liberal Democrats. We must forge a consensus on the issue that allows the British people to believe that whatever Government come along, there is a comprehensive, integrated strategy to deal with what the Foresight report says is one of the most profound dangers and threats that the world faces.

Having said that, I will go through the points made by the hon. Member for South Cambridgeshire (Mr. Lansley) before I end my response by saying that I agree with much of what he said about the need to tackle the issue of good diet and the need to involve Ofcom more closely. Any objective look at what has happened in the past few years would suggest that, as the Foresight report recognises, the Government have taken a number of measures that are crucial to tackling the issues, and child obesity in particular. The first thing to say is that we commissioned the report. We set up the Foresight unit specifically to look at the issues long-term.

Secondly, we introduced the tough new nutritional standards that have been in place since September as regards the rubbish that was in vending machines in our schools. Over the past three years, the share of children on the school fruit and vegetable scheme who eat five a day has gone up from a quarter to just under half. Some 86 per cent. of school children now do at least two hours of high-quality sport or physical education. The Department for Transport is investing £15 million in the national cycling network, and 450 schools are due to benefit from that. We put £1 billion more into sport in this country. All of those measures and more are important, but that brings us back to the Foresight group’s comment about the futility of isolated initiatives. What we need is much greater integration, and the Government need to do more in that regard as well, but we need to forge a political consensus on the matter across the House.

The hon. Member for South Cambridgeshire (Mr. Lansley) says that we have abandoned the target for 2010. We had a fairly modest target of stopping the rise in childhood obesity by 2010. As part of a discussion of the latest round of public service agreements, and educated by the early draft of the Foresight report, we decided to be far more ambitious and say that rather than halting the rise, we should reverse it to 2000 levels. That will take longer than 2010, which is why the aim is to achieve the target by 2020.

The point that the hon. Gentleman makes about the national weighing and measuring programme is right. I agree that we need to give that a legislative push. From the early results, it looks as though we are getting about 90 per cent. compliance, but that must be properly tested.

I do not agree with the hon. Gentleman about ring-fenced budgets. I am surprised by his remarks. Opposition Members have been speaking about the need for the NHS to be separated from politicians, with no targets and with the money being handed down and local trusts allowed to get on with it. The right approach is for us to give the money out to health trusts and to make them responsible for dealing with the issue, ensuring that there are indicative measures. The proper place to put the emphasis on public health is through the operating framework. We will do that at the end of the year.

The hon. Gentleman’s other point—on public health staff—is a hardy perennial, and I was disappointed that he raised it in this debate. The number of nurses working in primary and community care settings has increased by 31,500 or 40 per cent. since 1997. That includes a 35 per cent. increase in the number of school nurses, so the number of people working on health in communities has increased enormously, as has the budget for public health and throughout the health service. All our aims are predicated on the massive increase in investment that we have put into the health service since 1997.

I agree with the hon. Gentleman about where the focus needs to be now. Indeed, I dealt with that in the statement. We need to ensure that we go further on colour coding and that we talk to the industry. We do not want to be attacked for unnecessary regulation. We want to persuade the industry, with the benefit of the report, that we all have a responsibility. Of course the Government have a huge responsibility, but so do others. If the Foresight report does not point us in the right direction, nothing will.

The humour from the Conservative Benches is wonderful, but the guffaws are slightly forced.

I thank the Secretary of State for early sight of the statement. He is right that the report must be taken seriously. Unless we take decisive action, the consequences for people’s health of obesity, such as diabetes and heart conditions, could be devastating and will bankrupt the NHS. It is important to stress that we should all take personal responsibility as individuals and as parents. Perhaps the three of us Front-Bench spokesmen should take part in the Great London run next year. I invite the Secretary of State to join me. I did it this year, and the Lib Dem health team is in pretty live condition—[Interruption]. Mr. Speaker, come to my aid. There is an awful lot of noise in the background.

It is also right that we should hold the Government to account for their action or inaction. Is this not a case of “here we go again”? In 2004 the White Paper promised a long-term strategy to tackle obesity, and Wanless urged joined-up thinking. In a high-profile announcement the Minister for Employment and Welfare Reform, the hon. Member for Don Valley (Caroline Flint), who was a Health Minister at the time, was put in charge of tackling obesity. Now, after three years of inaction, what do the Government propose? They propose a three-year comprehensive strategy on obesity. I know that the Government are famous for repeating announcements, but to take three years to repeat the announcement seems to take the biscuit.

Indeed, take the fruit.

We also have the inevitable, rather vacuous claims that the UK can be a world leader on the subject, yet in the real world the problem is getting massively worse and the UK compares badly with most other countries. Why did Derek Wanless conclude that his 2004 recommendations had effectively been ignored? Why have the public health budgets been raided to stave off financial crisis in many parts of the health service? Why have we no idea about how much we are spending on public health? How on earth can we monitor it if we do not measure how much we are spending on it in a given year? Why has the number of public health consultants and registrars declined?

Why has the take-up of school meals declined by almost 500,000 in the past two years? Schools now have to weigh their children, but why is there no follow-up action to give the schools the opportunity to do anything to tackle the problem that they uncover? Is it not right that the top priority must be to tackle child obesity, both through more exercise and through better diet?

The report highlights the risk of polarisation of society between

“the junk-food eating, less-educated poor and functional food eating, better-informed higher classes”.

It highlights the importance of education, yet the statement is silent on the horrifying potential inequality in health outcomes between rich and poor. What is the Government’s strategy to tackle that? Overall, is this not one of the worst examples of great rhetoric not being matched by action?

I do not think the report is an example of that at all. The hon. Gentleman welcomes the report, so I assume he has read it. It was not I who said that it gives us the opportunity to lead the world on the issue. The report itself states that the work assembled for the project gives the UK a platform to become a global leader in tackling a problem that is challenging policy makers across the world. It points out that nowhere across the world is there a comprehensive strategy to tackle the problem. It identifies some important community initiatives, such as the North Karelia project in Finland, which had remarkable success. The report suggests that we consider setting up a similar project in a couple of regions or cities in the UK.

The report makes it clear that no one has a magic bullet and that there is no single answer. There is no use waiting for some kind of medical technology to produce a magic pill or tackle the issue. That is not going to happen. The report concentrates our attention on the need to rise above the political fray and to accept that mistakes have been made, although I do not accept the hon. Gentleman’s point. The science has moved on and our approach has moved on. One of the reasons why we commissioned the report and sponsored it is that we recognised that we were running to catch up on the evidence that the scientists were producing on the need to tackle obesity.

We can consider various initiatives. The hon. Gentleman mentioned health inequalities. The report states that the Government’s action in tackling health inequalities and climate change could help, because energy saving could help to encourage people to exercise more. [Interruption.] The hon. Gentleman says from a sedentary position—you two are such chums, Mr. Speaker, on unhelpful comments from the back—that the statement was silent on that. In my statement to Parliament, I set out what is in the report, picking out some of the issues. The statement the day before yesterday—there does seem to be one almost daily—pointed out that we will introduce 100 GP practices into the 25 per cent. most deprived areas to try to deal with the problem of under-doctored areas. The report points to a series of measures that need to be taken, and tackling health inequalities is crucial. The hon. Gentleman talks about the day-to-day banter that we sometimes have, but the report will have an important role in tackling these problems in the longer term.

The reduction in the take-up of school meals has also been mentioned, so let me point out yet again that the city I represent followed Finland’s lead and became the first to try to tackle health inequalities and problems with educational attainment by saying that every primary school pupil should be able to have a free breakfast, free fruit and free lunch. What is more, we did that before Jamie Oliver, and it had a remarkable impact. The programme is due to be assessed by Hull university, yet the incoming Lib Dem authority cancelled the scheme this year—[Hon. Members: “Ah!”] Yes, they abolished it. So much for free school meals as a means of tackling deprivation. The Lib Dems in Hull say that we have to introduce this nationally, but it is not a problem for Kingston upon Thames; it is problem for Kingston upon Hull, so the local authority should be involved in tackling it. It is a disgrace that the programme has been abandoned.

Putting all that aside, I hope that the Liberal Democrats—whichever leader is in charge of them this week, next week or the week after—will engage fully in the debate. I believe that the Liberal Democrats have a huge contribution to make to tackling some of these long-term problems—and the Conservative party does as well. As for the Great London run, I will consult shadow spokespersons to ensure that we all give the same answer!

May I congratulate the Foresight team on its excellent report and pay particular tribute to the work of the Minister for public health, my right hon. Friend the Member for Bristol, South (Dawn Primarolo), who made an excellent speech at the launch this morning? I am sure that my right hon. Friend the Secretary of State understands the frustration of people like me, who know how difficult it is to tackle this enormously complex problem of obesity, and that, like me, he recognises that the Government cannot solve the problem on their own. A whole societal approach is necessary, involving literally everyone in the country. Will he consider my wish list of the day? First, will he consider introducing a mandatory labelling scheme that could be agreed across the board—irrespective of whether individual supermarkets like it or not? Next, will he commit to having a school nurse in every single school, which would make a huge difference to the public health of the nation? Also, can I ask him to be even tougher on food advertising to children, particularly in respect of foods high in fat, salt and sugar, as that alone could make a considerable difference?

I thank my hon. Friend for his customary constructive comments and for giving us a good lead-in during Prime Minister’s questions. I join him in congratulating our right hon. Friend the Minister for public health and, indeed, the Minister for sport and the Minister for Children, Young People and Families, all of whom were signatories to the report’s foreword. My hon. Friend makes a very important point about the inability of Governments alone to tackle the problem. The report makes that point repeatedly and eloquently, which will provide a huge boost to my hon. Friend’s other point about the need to convince those involved of the need to produce a better food labelling scheme. I am not saying that I am going to push anyone into anything, but as Bob Dylan once said,

“You don’t need a weather man to know which way the wind blows.”

As far as school nurses are concerned, we cannot commit to one for every school, but our plans relate to clusters of schools and we intend to follow our successful approach to school sport. We want the expertise to be present in order to benefit a number of schools in an area.

May I advise the Secretary of State that I believe that there is an obesity pill, so his earlier comment was perhaps ill informed? In connection with the increased hours for sport and exercise in schools, will the Secretary of State ensure that team games—not just any exercise—are provided in school? We need team games, which I believe are the best for keeping young people fit, and to have team games, we need sports fields. Will he therefore remonstrate with local authorities because, under the learning communities programme, schools are merging and selling off the sports fields? That is happening in my village of Poynton, where the Vernon infants and junior schools are combining. I am in favour of the merger, but not of selling off the sports field, which is currently part of the infants school and adjacent to the junior school. Will he contact the authority to make it clear that this must not happen? We need playing fields if we are to provide more recreation, exercise and sport in schools.

The hon. Gentleman is right that there are various pills around, but they have not proved to be particularly successful. The report points out that they have had varying degrees of success, but that no single medical solution is likely to come along and solve all the problems.

I agree with the hon. Gentleman about the need for team games and sports. There was a period in which it was felt in the education world that competitive sports were somehow bad for children. That is ludicrous and it should go back to whichever strange opinion former it stemmed from. It is essential to have sports, including team sports.

School sports field are important. This year, for the first time in many years, there was a net increase in the number of sports fields opened rather than closed. The policy that we introduced insists that no school can get rid of a sports field without the express permission of the Secretary of State, and only then if the money received for it is going to be reinvested into sport, fitness and education. I believe that the hon. Gentleman will welcome that policy, as he will welcome our extra £1 billion investment in sport.

As my right hon. Friend knows, I take a great interest in increasing the level of physical activity in response to obesity. Building on what the hon. Member for Macclesfield (Sir Nicholas Winterton) has just said, will my right hon. Friend commit to ensuring that the single delivery system for sport, physical education and activity across the country—the county sport partnerships and others—becomes more heavily involved with primary care trusts? I offer the Secretary of State the opportunity to visit Leicestershire county sports partnership, which I chair, as one example where the local PCT is heavily involved in our activity.

Will my right hon. Friend also work with the Department for Culture, Media and Sport to define clearly the roles of Sport England and the Department of Health? There are some difficulties, of which the attitude to walking is a good example. It is a great way of getting people to start to take up physical activity and then move into sport. That was demonstrated last week when it was found that 40 per cent. of people taking up sport in north-west Leicestershire did so as a consequence of walking. Will the Secretary of State try to bring those two elements together and clearly define who takes responsibility for which part of the governmental programme? That is crucial to delivering the first steps in tackling adult obesity. We can tackle child obesity if we get school sport right.

The answer to my hon. Friend is a very simple yes. What he says is crucial and the talks with the DCMS have already started. My hon. Friend has made an enormous contribution to sport in this country and I believe that he can make an important contribution to the work that is now under way. As I mentioned earlier, the Minister for sport, the Minister for Children, Young People and Families and the Minister for public health are working closely together. The new cross-Government initiative will involve everyone in government. I believe that my hon. Friend the Member for Loughborough (Mr. Reed) has a very important role to play, and we will be in touch.

I find it a bit odd that the shadow Secretary of State criticised the Government for abandoning and relaxing targets when, only an hour ago, that is exactly what the Leader of the Opposition called on the Prime Minister to do. On the question of the futility of isolated initiatives, my right hon. Friend has accepted the need for an integrated approach in central Government, but does he also accept that, in reality, it is at local authority level that the integration will have to take place? Only the local authority and the children’s trusts can seriously integrate and influence health, schools, leisure, youth services, land use planning and transport planning. Does he agree that this will be a real test of the Government’s commitment to ending simple top-down government and to decentralising more? Will it not also be a real test of the ability of children’s trusts to deliver and, indeed, of the commitment to achieving all five outcomes in the “Every Child Matters” agenda?

I do agree with my hon. Friend. I do not know whether he has had an opportunity to read the report yet, but the Foresight group says precisely what he has said—that it is at local government level, where initiatives in Finland and other parts of the world have been hugely successful, that we can establish what could be described as an embryonic facility to test measures that may well be necessary throughout the country.

The group also makes the point that planning is central, especially local authority planning. Cities must be planned on a particular basis. They should not be like Los Angeles, where people take the car to buy a pint of milk. We should look towards 2050 and the world beyond, and plan for that world now. That is why my right hon. Friend the Minister for public health and others are in touch with the Local Government Association to talk through the issue and try to identify areas—Bury might be one of them—where we can try out some of this integrated work at local level.

Is not the dismal truth that the problem has occurred on this Government’s 10-year watch? As much as anything, it is about a failure to inform effectively.

Does the Secretary of State agree with Peter Hollins, chief executive of the British Heart Foundation? He says that the report

“is hardly a wake-up call. Repeated reports like this… should have had alarm bells ringing in Whitehall long ago”.

Is it not clear that we must now consider not just the level of calories, but the degree to which food is processed? Will the Secretary of State take that into account when he considers labelling?

Finally, what advice is the Secretary of State taking from the United States, which has an even larger problem than we have? Will he examine that problem very carefully?

I do not accept what the hon. Gentleman says. I do not blame earlier Governments. The Foresight report looks back at many, many years. A useful section considers the approach to smoking over the years and notes that although there has been a big public health success in that regard under Governments of different persuasions, it was preceded by a long route that began in the early 1960s with information, proceeded to more intervention, and concluded with regulation providing for smoke-free areas. It would not have been possible to implement such regulation back in the 1960s: there would have been public outrage. The Foresight group’s point is that obesity is a long-term issue which has not arisen under any particular Government’s watch. Indeed, it is a global problem.

I was disappointed by the hon. Gentleman’s quotation from the British Heart Foundation—it may have been taken out of context—because the report adopts the most comprehensive approach possible. Scientists have examined the matter scientifically. I did not have a chance to reply to a question from the shadow Secretary of State, who asked whether we would put together a team of experts or something of the kind—

We plan to keep the same team together to work on the project, although I do not know whether the building in which they are housed will be called a research centre.

The way in which food is processed is central. We can learn lessons from the United States, which does indeed have a far greater problem, although we will soon have as great a problem here if we do not do something about it. My right hon. Friend the Minister will talk to her opposite numbers in the United States during her visit, which will take place shortly.

Will the Secretary of State stress the importance of personal responsibility to the campaign? Information about diet, nutrition and the importance of exercise is available wherever we turn, and it is difficult to understand how the message has not already reached everyone in the country. No adult in this country is force-fed, and adults must take responsibility for what they choose to eat, but parents must take responsibility for what their children eat. They cannot transfer the responsibility to schools. Our schools are doing a very good job with the meals and exercise that they provide, but parents can give their children exercise in the form of sporting activities at the weekend, and they must take responsibility for that.

If the campaign is to succeed, we cannot constantly provide excuses for people. Obesity is not the fault of Government, the advertising industry, the food industry, schools or the health service. People must take personal responsibility.

I could not agree more with the hon. Lady on one very important point. The Foresight report says that this is not just a question of individual responsibility, although it does not suggest that it is not an element. What the authors want to tackle is the view that the problem is merely about people who eat too much, and has nothing to do with the way in which society is organised. They point out that because our biology has not kept pace with technological advances, the amount of energy that we take in is not matched by the amount that we expend. That is an important point, particularly because obesity gives rise to bullying, which affects youngsters in this position.

The hon. Lady is, however, absolutely right about the amount of information that is available. What we must ask is why, if all that information is there, people are not acting on it. She is also right about the need for parental responsibility. The fact that mothers were passing fish and chips through the railings at that school in Yorkshire is thoroughly depressing. Ensuring that youngsters become used to a healthy diet from a young age depends on their having that healthy diet at home as well. There is a two-way education process, involving parents as well as others. I think that the hon. Lady’s question, which will be encapsulated in Hansard, is the very first important contribution to the debate.

May I pursue what was said by my hon. Friend the Member for Upminster (Angela Watkinson)? Does the Secretary of State accept that one reason why children eat more fast food and ready meals than they should is the increasing time pressure on ever busier parents? If he does accept that, what steps will the Government take to implement flexible working and other family-friendly policies so that parents can go home and cook more wholesome food for their children?

That is precisely why I personally took legislation through the House introducing the right to request flexible working, which at the time was attacked by the trade unions because it did not give a right to demand flexible working, and by some, although not all, sectors of business on the grounds that it imposed a burden on business. In fact, it has been remarkably successful: 80 per cent. of requests are accepted without the need for any process, while a further 10 per cent. are accepted following discussion about how more flexible working can be accommodated.

The first six months of a child’s life are crucial. The report mentions breastfeeding in that context. Paid maternity leave has been increased to 26 weeks and more recently to nine months, and eventually it will be increased to a year. Men now have paid paternity leave. All that is essential to the debate. The hon. Gentleman ought to look at the record. I do not want to make a political point, but I will in the sense of reminding him that the Conservative party opposed those proposals.

We need to expand that flexibility. We have already extended it to carers, but I believe that we should now extend the right to request flexible working much more widely, perhaps as part of the debate on obesity.

I was heartened by the Secretary of State’s answer to my hon. Friend the Member for Upminster (Angela Watkinson). He appeared to downgrade the role of personal responsibility in his statement when he said, “In the past, tackling obesity has always been regarded as a matter of personal will-power”. Is it not clear that we all learn and that we do not need a red light on a packet of crisps to tell us that they are fattening? There is no reason why we should not have the occasional packet of crisps, but if a parent gives a child a packet of crisps at breakfast, morning break, lunch, tea and supper, the child will clearly have an obesity problem. Is the Secretary of State perhaps a little nervous of making it clearer to the public that it is first and foremost up to them, not Governments, to change their personal behaviour?

We are trying to make clear the role of personal responsibility. The report speaks of an obesogenic environment, suggesting that modern life and the way in which the world now works make people fat, and that that must be tackled on a much wider basis than individual personal responsibility.

I am sorry if I downplayed personal responsibility. I am merely drawing attention to the report’s observation that in the past, when Governments wanted to tread on this territory, the first response was always “nanny state” and the second was that it was up to individuals to deal with the problem. According to the report, if Governments proceed along those lines, the issue will never be tackled successfully. Personal and parental responsibility are an essential part of tackling it, but there is a much wider issue that must be addressed by all elements of society, with Government taking the lead.

As someone who used to work in marketing for a supermarket chain, may I tell the Secretary of State that proposals to ban so-called junk food advertising on television and to introduce a state labelling system will not make any difference to childhood obesity? They will simply be another triumph for the nanny state. May I suggest that he stops those measures that make it sound as though the Government are doing something but that will make no difference whatever, and instead promote the individual responsibility line outlined by my hon. Friend the Member for Upminster (Angela Watkinson)?

It is not either/or, and individual responsibility alone will not work. If the hon. Gentleman has a chance to read the report, which was written by eminent scientists, he will see that it makes it clear that food labelling and advertising form a crucial part of tackling the problem. In my view, the reason why advertising restrictions should go much further is that about 70 per cent. of children watch television programmes outside the traditional children’s viewing times. I think that that is making a big contribution and will make a bigger contribution, but it is just part of the answer. The hon. Gentleman says that it is either/or, but that does not take us any further forward in the debate.

Is the Secretary of State aware that many hard-working local general practitioners have been trying to run programmes to tackle obesity in their local areas for many years? In fact, my local GP, Dr. Andrew Brewster, who is an excellent GP, recognised the problem some years ago and developed an innovative and successful programme in my area. However, the big problem was that he could not get the funding from the NHS or the primary care trusts to run the programme, so he had to get the money from drugs companies. Does the Secretary of State agree that, for real change to happen, local GPs must be properly funded and supported to tackle obesity?

The GP the hon. Gentleman mentions could make a contribution to the debate. Of course primary care is essential to tackling the problem. I am not sure when the GP had problems with funding. An enormous amount of funding is going to GPs—indeed, we are often criticised for too much funding going to GPs, so I will be surprised if there is a problem at the moment in accessing money.

The hon. Gentleman is right, however, that GPs and primary care have as big a responsibility for prevention of disease as they do for tackling it. That is why we announced that there would be 100 new GP practices in the 25 per cent. poorest areas and 150 GP-led health centres around the country. As well as providing greater access, they will all have a responsibility on prevention as well as cure. I am sure that the GP the hon. Gentleman mentions would welcome that. It seems that he has been doing that work for many years. We want to see that replicated throughout the country.