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Obesity

Volume 470: debated on Wednesday 23 January 2008

The first ever cross-government strategy to tackle obesity is being published today. The House last discussed this subject in October, when the then chief scientific adviser, Sir David King, and his foresight team published the report “Tackling Obesities: Future Choices”—the result of two years’ work by some of our most eminent scientists and academics, seeking to determine how we can deliver a sustainable response to obesity over the next 40 years.

I shall just remind the House of the challenges identified in that report. Foresight said that with 23 per cent. of men, 24 per cent. of women and 18 per cent. of children clinically obese, and with no expectation of any spontaneous reversal of obesity trends, those figures will rise to 60 per cent. of men, 50 per cent. of women and 25 per cent. of children by 2050. That will have a severe impact on the health of individuals, increasing the risk of diabetes, cancer, and heart and liver disease. The cost will be felt in every part of society, not just in headline financial or health terms, but in personal ways, by affecting the lives and opportunities of millions of people.

The overall cost to society is forecast to reach £50 billion over the next 40 years based on current trends, including a sevenfold increase to the NHS. However, as foresight said, such outcomes are not inevitable, and if we take action now the trends can be reversed. Halting the obesity epidemic is primarily about individual behaviour and responsibility—how people choose to live their lives, what they eat and how much physical activity they take. It is also, as I shall outline, a matter of the commitment of the private and voluntary sectors. However, the Government have the most significant role in expanding people’s opportunities to make the right choices for themselves and their families, in ensuring that people have clear and effective information about food, exercise and individual well-being, and in ensuring that policies in a wide range of areas promote an environment that supports people in their desire to maintain a healthy weight.

The Government have set themselves a new ambition of being the first major country to reverse the rising tide of obesity in the population by ensuring that all individuals are able to maintain a healthy weight. Our initial focus is on children: by 2020, we intend to reduce the proportion of overweight and obese children to 2000 levels. To help to fulfil that ambition, foresight suggested that the Government should focus their action on five main policy areas. I should like to set out the initiatives that the Government are announcing today in each of the five policy areas. They will be financed with £372 million of extra funding between 2008 and 2011.

The first initiative concerns the healthy growth and development of children. The strategy begins from the start of a child’s life, with early identification of at-risk families, and plans to make breastfeeding the default option for mothers. For school-age children, as my right hon. Friend the Secretary of State for Children, Schools and Families, who has worked closely with me, set out yesterday, the Government will continue to invest in healthy schools, including making cooking a compulsory part of the national curriculum. We will also take measures to increase participation in physical activity by the least active children, and develop policies to ensure that the lunches that children bring to school are as healthy as those now provided as school meals. To support and empower parents to make changes to their children’s diet and physical activity at all ages, we will invest £75 million in an integrated marketing campaign.

The second strategy is promoting healthier food choices. It sets out a healthy food code of good practice, which we will develop in partnership with the food and drink industry and other relevant stakeholders. The code will challenge the industry to adopt voluntary practices to reduce consumption of saturated fat, salt and sugar. We will also ask Ofcom to bring forward its review of the restrictions on advertising unhealthy foods to children and report early findings by September. On the broader environment, we will promote the flexibilities already contained in planning regulations, so that local authorities can limit the spread of fast food outlets in specific areas, such as those close to schools or parks.

The third policy is building physical activity into our lives. The initiatives range from those focused on the individual—for example, a Walking into Health campaign, which aims to get 30 per cent. of the population walking at least 1,000 more steps every day—to those directed at whole communities and businesses. For example, we will invest £30 million in Healthy Towns, which means working with selected towns and cities to learn from the successful EPODE model used in France through a whole-town approach to promoting physical activity.

We will also set up a working group with the entertainment technology industry to incorporate devices that allow parents to manage the time that their children spend watching TV or playing sedentary games online much more widely. We will review our overall approach to physical activity, including the role of Sport England to ensure a clear legacy of increased physical activity up to and beyond the 2012 Olympic games.

The fourth policy area is creating incentives for better health. Individuals, employers and the NHS need to have stronger incentives to prioritise the long-term work of improving health. In that strategy, we lay out plans for working with employers and employer organisations to explore the way in which companies can best promote good health among their staff and make healthy workplaces part of their core business model. We will pilot and evaluate a range of different approaches to using personal financial incentives to encourage healthy living.

The fifth and final strand is personalised advice and support. When people are overweight or obese, they need access to personalised services that are tailored to their needs and support them in achieving real and sustained weight loss. We will support the commissioning of more weight management services by providing increased funding in the next three years. Our intention is that people have easy access to highly personalised feedback and advice on their diet, weight, physical activity and health, providing them with the information to encourage healthy behaviour. We will explore the potential to develop further the NHS Choices website so that it provides advice on diet and activity, with clear and consistent information on how to maintain a healthy weight.

The measures in those five policy areas are only the first steps towards our objectives. We will continue to examine not only the best emerging evidence of what works, but whether everyone in society—employers, communities and individuals—can participate fully in the programme. Our research will be part of wider efforts to develop our knowledge through the newly established obesity observatory. We will publish an annual assessment of the progress being made and use that to develop and intensify our policy focus as we acquire evidence on what works best.

Foresight pointed out that there was at that time no concerted strategy or policy model that adequately addressed the problem of obesity anywhere in the world. It added that the work assembled for the project gives the UK a platform from which to become a global leader in tackling a problem that is challenging policy makers across the world. The report has been produced with the full participation of the interim expert group of distinguished scientists and academics, which was created from the foresight project and contains many of the leading scientists and nutritionists who worked on it. The expert group will continue to guide us, placing science at the heart of our policy response, so that we are better able to grasp this opportunity to tackle the most profound public health risk that this country faces. I commend this statement to the House.

I thank the Secretary of State for supplying a copy of his statement during the past hour. I apologise for the absence of my hon. Friend the Member for South Cambridgeshire (Mr. Lansley), who was already on a tour in the north of England when the Secretary of State said that he planned to make this statement.

Reversing the trend of rising obesity is a social responsibility in which everyone has a role to play. The UK now has more obesity than anywhere in the Organisation for Economic Co-operation and Development except for Mexico and the US. England has a higher rate of obesity than anywhere else in the European Union, with a rate of 22.6 per cent. in the UK compared to 10 per cent. in France. Obesity could also cost £60 billion by 2050, on the Government’s own forecast figures.

With the rising tide of obesity, hospital treatments for the condition have spiralled on Labour’s watch, across all age groups and both sexes, with grave inequalities increasing among socio-economic groups. Most alarmingly, obesity among children is sharply on the increase, rising from 10 to 17 per cent. among children aged between two and 10 in the decade to 2005, with 31 per cent. of children in that age range in England now either overweight or obese. We therefore agree that there is a public health crisis in obesity, which is something that we have been urging the Government to prioritise for years.

The question is: how do we tackle it? Does the Secretary of State agree that we cannot leave the problem to doctors, thus recognising what Dr. Colin Guthrie has said:

“The GP’s role has changed so much over the past 10 years. We have so much else to do in our practices. We are swimming under targets to meet so many things”?

Does the Secretary of State also recognise what Dr. David Haslam, the medical director of the National Obesity Forum, has said:

“I am rewarded”—

by the quality and outcomes framework—

“for identifying an obese person. I then make a list, put it in a draw, close it and forget about it. It is good that obesity has made it into the GMS contract as a disease in its own right, but it is a catastrophic failure—a complete and utter waste of time—that it has done so in its present incarnation”?

There is no question but that obesity is a crisis that needs tackling, but what needs to happen without more overweening, nanny state, maddening lifestyle diktats?

We certainly agree that the Government have a duty to ensure that people have the information they need to make informed choices about the food they eat. The Government have so far failed in that duty, and the information is simply not available. At last we now have a commitment to cross-party working—again, something for which we have called for years. Indeed, my hon. Friend the Member for South Cambridgeshire wrote to the Secretary of State only yesterday, building on the many representations that he has made on the issue over the years.

Does the Secretary of State agree that current food labelling practices are fragmented and confusing, with different manufacturers using different systems and some using none at all? The traffic light labelling system, which the Government advocated in 2004, added to that confusion because it is based on the concept of good or bad food, when what matters is whether a person’s diet is good or bad. The system does not work in practice, either. If a wholemeal bread roll is low in sugar, moderate in fats and high in salt, would it merit a green, amber or red light? If fruit juices, cheese or fish have red traffic lights, how will people understand that they can form part of a healthy diet? How does a crude traffic light system deal with the major differences between the diets of adults and children?

Since 2004, we have been calling for food labelling that is based on information about food’s nutritional value and its contribution to a good diet. That means that people should be given information about the recommended daily amounts of calories, fats, sugar and salt. Such a system would be well understood by the public and would help people to put together a good diet. That is why for more than three years we have argued for a combined multiple traffic lights and guideline daily amounts system. In its food and health action plan in 2005, however, the Department of Health said that by early 2006 there would be

“a clear, straightforward coding system that is in common use, and that busy people can understand at a glance, to find out which foods can make a positive contribution to a healthy diet”.

Does the Secretary of State accept, however, that little progress has been made?

Does the Secretary of State also accept that we should jointly advocate the traffic light GDA front-of-pack labelling system, making Britain a leader in the European debate on the issue? The matter has been handed over completely to the European Parliament to dictate directives on food labelling. As the Secretary of State well knows, I, on two occasions, and two of my colleagues, have introduced private Members’ Bills that would have given the Government the opportunity to pick up the issues of both country of origin labelling and standards of production. The question now is whether we can lead in that debate and ensure a common European position, given that the trade in foods requires standards that are recognised across Europe.

In 2005, the Government promised that they would take simple steps to clarify food labelling. They have not delivered. The Food Standards Agency has been strongly pushing the traffic light model, which the Department of Health strongly supported. As the Secretary of State well knows, food labelling is only a matter of voluntary practice.

The Secretary of State’s statement is a series of repackaged announcements, which were in Labour’s last obesity strategy but have not been delivered. Labour did not even attempt to tackle obesity until 2004, with its public health White Paper “Choosing Health: Making Healthy Choices Easier”. A comparison between the 2005 report setting out delivery dates for the commitments in that White Paper, and today’s strategy, shows that little progress has been made.

What of cooking in schools? Who could object to increased teaching of cooking in schools? We do not. But at what point does the curriculum allow teachers the discretion to balance cooking with enough physical education and sport? It is not the fault of teachers, but sport has been squeezed out by an emphasis on the core curriculum, obsessive health and safety rules and a mass sell-off of playing fields under this Government, especially in the late 1990s.

On the issue of junk food—

Order. The hon. Gentleman has gone over the time allocated to the Opposition. In fact, I have given him a minute over. Rather than being overweight, he is over time. [Interruption.] I am watching the clock as well. Back Benchers must get a chance to speak.

The hon. Gentleman can be described as Confused of Eddisbury, because on the one hand we are castigated for introducing an overweening nanny state, while on the other we are told that we have not taken enough action in this regard. I listened to him saying that we have made a commitment to cross-government working on the issue. I have looked through the document carefully, and I find that I have made no such commitment. Given the response from Conservative Members, I think that it would be a bit futile.

Let us deal with the questions raised. The constructive part of the hon. Gentleman’s speech was his recognition that the issue is a real public health threat, and his acceptance that everyone has a role to play. That was absolutely right. As for the reference to GPs, this country now has 18 per cent. more than it had in 1997, and it will have yet more—we are creating 250 GP-led health centres across the country. When I talk to GPs, they do not tell me that they have to be incentivised to deal with someone who is overweight. Given that an overweight person who loses half a stone becomes half as likely to develop type 2 diabetes, GPs need no incentivising. I also remind Conservative Members that GPs now spend on average 10 minutes more with every patient than they did in 2000, so there is more time being devoted to this issue at primary care level.

The hon. Gentleman spent a large part of his contribution talking about food labelling, which is one aspect of a very wide-ranging debate. Let me pick up on the points that he raised. Yes, we have championed the traffic light system, and we have done so because consumers regularly tell the FSA that that is the system they prefer. It is clear, it requires no translation, and it is very accessible. However, we say in the report that we would like to move to a single system.

Incidentally, we are leading the world in that our food retailers and manufacturers have, to a large degree, accepted the need to put information on packets. We should congratulate them on that. The problem is that there are three different methods, and I think that we would all like a uniform system. Our view is that the expert independent group that we set up should look at the three systems and at all the evidence, and make a recommendation on which system we should adopt, whether it be the traffic lights, the monochrome system or the hybrid system. When we get that recommendation, we will work with the industry to try to establish a single system. That is the most constructive way forward.

The hon. Gentleman said that this strategy was a repackaging of old initiatives, and that there was nothing new in it. Let me remind Opposition Members that we are putting more than £100 million into cycling—

To the huge admiration of my hon. Friend the Minister. Cycling England has received about £14 million, and it is now going to receive something like £120 million, which will do an enormous amount to increase cycling levels.

Cooking has never been a compulsory part of the national curriculum at key stage 3. For the very first time, in this strategy we are announcing that it will become compulsory, and we are recruiting 800 extra teachers to ensure that it is properly taught. That is an enormous step forward. I also want to mention Healthy Towns. When we debated the foresight report, the hon. Member for South Cambridgeshire (Mr. Lansley) rightly looked at what was happening in France and Finland to see whether we could reproduce the kind of model that exists in those countries. The Thames Gateway presents a perfect opportunity for us to do that, by taking a whole-town approach. Such approaches have had startling results in France, using the EPODE model. That is just one of many new, fully funded initiatives in this proposal.

I want to make a final point to the hon. Gentleman about school sports and the myth about playing fields being closed. Playing fields closed under the previous Conservative Government. To close a playing field now, a school has to get the authority of the Secretary of State and prove that it will put the money back into new resources for sports and physical activity. Twenty-two per cent. of children in this country were doing four hours of high-quality sport and physical activity each week when we first measured it after coming into government; now, the figure is 86 per cent. We have a good record on this, and if we are going to take a cross-government approach to tackling this issue, I would ask for a less miserablist approach from those on the Conservative Front Bench.

I congratulate my right hon. Friend on this very constructive set of proposals. Experience shows that, provided we take the public along with us at a speed they are happy with, we shall make much better progress, especially in areas such as smoking and environmental issues, where the public can be educated in order to improve the situation for the future.

May I ask the Secretary of State to concentrate on two issues? One is that we need yet tougher regulations on advertising to children foods that are high in fat, salt and sugar. I still believe that that is a major part of the problem. Secondly, will he see what he can do to help GPs to help people with weight problems by making more interventionist strategies available? At the moment, GPs can monitor people’s weight but there are not enough interventions available to them to help people to manage their weight and obesity problems.

My hon. Friend is right to raise those two issues. This month, we have introduced the first restrictions on advertising to children. Ofcom said that it would review the situation after a year, but it has now agreed, as part of this strategy, to use just six months’ information. We therefore have the prospect of having an evidence base for whether to move further by September. This is a delicate issue, and there are different views on all sides, but I think that that is the right way to proceed.

My hon. Friend asked about GPs. This is more than an obesity strategy; it is a public health strategy. The body set up to tackle obesity is very much a cross-government public health body. All the issues involved—from breastfeeding through to taking more exercise and having a healthy diet—apply right across the public health spectrum. We therefore need more interventions, and GPs need more resources for that. That is why we have announced £372 million over the next three years as part of this package.

I thank the Secretary of State for giving me early sight of his statement. Last time we discussed this subject, I challenged him to join me in taking part in the 10 km London run. He has not come back to me on that yet. Perhaps the enthusiasm of the Minister of State, Department of Health, the hon. Member for Exeter (Mr. Bradshaw), for physical exercise in the form of cycling suggests that he might be more up for it. However, I am still waiting to hear from the Secretary of State and, indeed, from the Conservative spokesman.

We all agree about the scale of this problem. It is growing at a much faster rate than anyone anticipated, and this country has the worst rates of obesity anywhere in Europe. By 2010, there will be 1 million obese children, which is a pretty frightening statistic, and we are now seeing the onset of type 2 diabetes among children, which had previously not been the case. We must also consider the knock-on health consequences—including heart and liver disease, as well as the mental health problems and low self-esteem that go with obesity—as well as the cost to the NHS and the economy.

I welcome the statement’s commitment to placing science and evidence at the heart of policy making in this area. It is always welcome when the Government are prepared to change the habits of a lifetime by moving away from gimmicky, headline-driven policy making to policy making that is based on science. I also welcome the focus on physical activity.

Is it not the case, however, that the Government are their own worst enemy? Their record so far has clearly been woeful. Of course it is absurd to suggest that they are responsible for all of these problems, but they over-promise and under-deliver. The 2004 White Paper made a grand spending commitment, but the Faculty of Public Health Medicine said today that only half the money that was promised has been put forward. Why should we believe the spending commitment that has been made today, when that previous commitment has not been met? Furthermore, the target of eradicating childhood obesity by 2010 has been quietly dropped in favour of a much vaguer commitment to achieving a target by 2020.

The main issue that I want to raise is the fact that the statement says absolutely nothing about growing health inequalities. That is more relevant in the area of obesity than in any other, and there is clear evidence of a growing divide in regard to weight. The foresight report was clear in raising that concern. Will resources be targeted at those disadvantaged groups in which the problem is the greatest? Low levels of breastfeeding are particularly prevalent in disadvantaged groups. Will resources be targeted at that problem as well, as there is a clear link with obesity?

The statement makes reference to tackling fast food premises, which hit the headlines over the weekend. What is the substance behind that proposal? The statement also talks a lot about the efforts to be made in schools, but the fact is that, since the Government’s introduction of the healthy eating strategy, 425,000 fewer children are eating school meals. What are the Government doing to address that concern and to encourage more children to eat school meals? The statement then lurched into nanny state mode, when it proposed to

“develop policies to ensure that the lunches children bring to school are as healthy as those now provided as school meals.”

How on earth are we going to do that? Will it involve the introduction of the lunch box police? How on earth can we dictate to people in that way?

The food industry clearly has a big part to play in all this, and it would be sensible to arrive at one system for food labelling. Will the Secretary of State assure the House that such a decision will be based on evidence? Different systems are being considered at the moment; will the decision be based on evidence—

That was a bit confused as well. The hon. Gentleman is trying to have it all ways. On his first point, I am tempted to say that my comments on whether I enter the cycling marathon will be delivered through a spokes person—

Yes, but that would not have made such a good joke.

At least we are agreed on the scale. I noticed that the Liberal Democrats very quietly dropped their commitment to free adult social care yesterday. If we had put resources into that, we would not have had enough money to invest properly in public health.

I welcome the hon. Gentleman’s commitment to using the relevant science. Let me mention Professor Susan Jebb from Cambridge university, who played an exceptional role in the foresight review and is now the chair of our expert group. She has looked at all these proposals in great depth and approved them.

Let me deal with the more negative aspects—for example, the hon. Gentleman’s comment that the Government’s record was “woeful”. We can always have a knockabout and say that we have not done all that we should have done. I accept that, but woeful? Let me just clarify on school sport that when I mentioned four hours, I meant to say two hours of high-quality PE in schools—[Interruption.] Well, the record has been put straight. Back in 2002, the first time it was measured, the figure for such provision was 22 per cent., but it is now at 86 per cent.—a massive increase, well ahead of our target.

For the first time ever, we have introduced restrictions on advertising to children. I accept that some would have liked us to go further, but this is the first time that it has been done. We have introduced front-of-pack labelling. Yes, there is confusion about the different systems, but we are far ahead of the rest of Europe in that respect. Furthermore, an enormous revolution has taken place in school food. As my hon. Friend the Member for Dartford (Dr. Stoate) said a few moments ago, we need to take the public with us. Pictures of parents putting fish and chips through school gates are depressing, but we are moving forward on all those fronts.

The hon. Member for North Norfolk (Norman Lamb) asks what we are doing to encourage take-up of healthy school meals, so let me remind him that Hull had three healthy school meal projects being run under a Labour administration; the incoming Liberal Democrat council cancelled them, setting us back in tackling obesity—yet here we have Liberal Democrat Members demanding to know what more we are doing to counter obesity.

The hon. Gentleman is also wrong to say that we have a more lax public service agreement target. In fact, we have a tighter target because instead of simply seeking to halt the increase, we want to reverse the trend in child obesity—a much more difficult task—by 2020.

The hon. Gentleman asked two further questions. On fast food outlets, there are restrictions, but there is flexibility in the current planning rules. We do not want to introduce unnecessary rules; we need to use existing regulations to allow local authorities to stem the increase in those outlets near schools and parks. As for lunch boxes, my right hon. Friend the Secretary of State for Children, Schools and Families is not suggesting that we need lunch box police. What we are talking about are the sorts of ideas that we saw working in the Green Dragon school in Brentford today. The head teacher and other teaching staff take responsibility for looking in a child’s lunch box—it is much easier in a primary than in a secondary school—and if they find that the child has just a bag of crisps and a chocolate bar, they send a message back home. Some schools actually use a traffic light system, putting on a red, green or amber sticker to send an appropriate message to parents.

The hon. Gentleman’s final point was about health inequalities—a crucial issue. Obesity is a health inequality issue, as well as a public health and prevention issue, so the most intense activity should be focused on the poorest areas. We announced a £72 million investment in a public information system that we will want to use throughout the country, but it will be targeted where the problems are the most serious. I accept that obesity is a health inequality issue, and I believe that we need to use this strategy to tackle the broader health inequality problems we face.

I very much welcome my right hon. Friend’s positive statement, particularly his encouragement of breastfeeding and compulsory cooking lessons. How would he build on the very successful GP exercise on prescription programme, particularly its extension to younger patients? Also, how does he intend to build on the successful school cycling initiatives, which have done very well in some parts of the country but have not been taken up as enthusiastically as I would like in other parts?

My hon. Friend has hit on two really important aspects of the problem. Exercise on prescription is being looked into further as we speak; it is a very important part of our plans to encourage more exercise. On school cycling, we have a very good relationship with the Department for Children, Schools and Families and the Department for Transport and have sought to increase the number of children participating through Bikeability. Some of the extra resources we are putting in will be invested in that.

It is obviously sensible to try to bring together the different systems of nutritional labelling and I am sure that the Secretary of State would accept that, in view of the food trade, it makes sense to attempt to achieve that on a Europe-wide basis. Does he also accept, however, that if we want to guide people’s choice and help them to make informed decisions about what to eat, they need to know about the nutritional qualities of food as well as about its drawbacks? Should we not move towards a system of information that is about more than just deterrence, as that could make a contribution to people sustaining a healthy diet?

The right hon. Gentleman makes two important points, the first of which is the significance of European competency, which was, incidentally, given by the Conservative Government, who I believe took the right decision. Nestlé, for example, is based in Switzerland and distributes its goods across the world, not just in Europe, so we need an international approach to the issue. I would try to convince the Commission that we should have a derogation to do our own thing in this country rather than be held back by the slowest countries in the European Union—but that is a debate for another day.

The right hon. Gentleman’s other important point was about deterrence and how to secure the best system. I believe that we should be looking into not only how a system of food labelling gives information to consumers, but how it encourages changed habits, so we need to highlight healthy food options. When items are labelled red under a traffic light system, it is not saying that people should never eat them, but that they should take into account the fact that if they are to maintain a balanced diet, they should not eat items such as chips every day. I am sure that a system can be devised that the food industry will buy into and that will take account of the right hon. Gentleman’s very important points.

My right hon. Friend’s statement was welcome, but does he agree that one thing that the Government can do to fight obesity, particularly in children, is to provide modern and inspiring sports facilities? Will he work with colleagues across Government to ensure that that happens so that an excellent school—albeit one that is some way down the list in Building Schools for the Future—such as Sir John Nelthorpe school in Brigg, that has no sports hall now, could gain funding for one? Government-inspired renaissance projects such as the one in Goole, which has an excellent sports village concept, could also gain funding. May I assure my right hon. Friend that should he be able to help with the Goole project—

My hon. Friend is an expert in covert lobbying for schools in his constituency. I know from my experience in education and the work carried on by my right hon. Friend the Secretary of State for Children, Schools and Families that the school sport partnership is one of the Government’s great success stories. Although Building Schools for the Future is an important element in replenishing all school facilities, including sports, it is not as if there is inactivity in the meantime. The school sport partnership is already an important part of what has happened and will be an important part of what happens in the future. On the matter of the school in my hon. Friend’s constituency, my right hon. Friend the Secretary of State for Children, Schools and Families suggests that my hon. Friend meet the Minister for Schools and Learners.

Does the right hon. Gentleman agree that it is a sad reflection on this Government that one of their key objectives is to get the number of obese children by 2020 back to 2000 levels, yet they have been in power for 10 years and the problem has got progressively worse during this Labour Administration? Notwithstanding the importance of food inputs, is it not a fact that getting people to exercise every day is the most important issue? What is the Secretary of State doing to ensure that schools provide compulsory physical training and that people are made aware of the different exercise options—the relative merits of cycling, walking 5,000 steps and running, for example? What is he doing to introduce advertising—

Obesity, as foresight pointed out, has trebled over 30 years. I am perfectly willing, representing the party of Government, to take whatever responsibility we have in that matter. However, as the hon. Gentleman seems to recognise, there is a much wider responsibility in society. In his final comments, he came close to expressing the overweening nanny state argument.

We have made huge advances in the provision of high-quality sport and physical exercise. There will be two hours a week in 100 per cent. of schools by 2010, and we will then progress to five hours a week.

As one who, 15 years ago, presented a Bill to introduce a harmonised system of nutritional labelling using the traffic light system, I warmly welcome my right hon. Friend’s statement and the drive towards a single scheme. I am afraid my Bill received no support from the Government of the day, but it is good that it has received support from our Government. May I urge my right hon. Friend to ensure that he puts the health of our children above the health of the advertising industry?

Yes, we will put the health of our children before the interests of any group that is acting in a way contrary to the health of our children, but the advertising industry has worked with us to introduce the system that Ofcom implemented this year. It is the first time that we have had any legislation at all. If we are to move further, we would like to do so with the full commitment and continued co-operation of the advertising industry, although obviously the health of our children comes first.

Does the Minister accept that in recent days, for good or ill, we have developed a celebrity culture, particularly among the youth of the nation? Would it not be appropriate for those in the public eye who have a particularly healthy and good lifestyle to offer their support, so that young people can look up to them as role models and take the exercise that they need?

We are considering using as role models people who had serious obesity problems when they were very young. At the weekend, there was a story in the papers about a male model who has shed about 10 stone and now appears in the kind of magazines that interest youngsters. The hon. Gentleman is absolutely right: we need such role models—including many Labour Members, I might add—as part of a national campaign to get the message home to young people.

I welcome my right hon. Friend’s statement, but will he think again about the possibility of providing more space in the national curriculum? The progress made in providing two hours of sport a week is significant, but two hours in a whole week is not a huge amount. Should we not give sport the same status that we give to maths, English and science? Should schools not be assessed on achievements in running, swimming and cycling in exactly the same way as they are assessed on achievements at level 4 in key stage 2, or the gaining of five A-C grades at GCSE?

This is an important issue, but I remind my hon. Friend that we will progress from two hours in every school to four hours and then five. Furthermore, every school will be an extended school by 2010. That will provide huge opportunities for extra-curricular activities, not just in dance and drama but in sport.

I entirely agree with my hon. Friend about cycling. The extra money for Bikeablity will enable it to help us in a number of ways, as it has wished to do for many years, and I am sure that its contribution will be enormous.

Does the Secretary of State recognise that the Treasury is a key ally in his Department’s campaign to improve the nation’s health through, for example, the taxation of alcohol and tobacco? In the context of his statement about obesity, will he contact his colleagues in the Treasury and find out why those who join fitness centres in order to reduce their weight must now pay VAT on their membership fees?

I am sure that the Treasury will be aware of points made by Members throughout the House about how we can use the taxation system in our drive to tackle obesity. The Budget traditionally deals with that, and I think that the example given to the rest of us by the right hon. Gentleman—a distinguished cyclist in the House—will be taken into account when it is presented in a few weeks’ time.

I welcome my right hon. Friend’s statement. Will he join me in commending head teachers such as Anthony Edkins of Harrop Fold school in my constituency? He has focused on the three issues of obesity, under-age drinking and teenage pregnancy among his pupils. As part of the focus on obesity, he has brought in a celebrity chef to teach young people about food values and to make the subject enjoyable. Is that not a great example?

I agree, and there are other great examples throughout the country. We have picked up some of that best practice. Only this morning I was with young Lizzy Butler, a 14-year-old from Leeds. In her school, the Watch It campaign has been remarkably sensitive in dealing with youngsters who have Lizzy’s problem of being overweight, and changing their lives completely. That initiative was launched jointly by the NHS and the school, and we can spread it much more widely with the resources that we are investing in the programme.

I commend the expansion of cycling through a very successful network in Bedfordshire. May I also draw the Secretary of State’s attention to the work of the Kids’ Cookery School, a charity based in west London which for some years has been working with children from a variety of backgrounds to introduce them to cooking and eating healthy food? Will he assure me that the work of charities of that sort will be made available across Government, so that their expertise and success in bringing good food to the notice of children will not be lost in what might otherwise be a top-down state-run scheme?

I will give the hon. Gentleman that assurance. The Minister of State responsible for public health, my right hon. Friend the Member for Bristol, South (Dawn Primarolo), visited the Kids’ Cookery School recently, and tells me that the Department learnt an awful lot from what is happening there. Indeed, organisations across large swathes of the voluntary sector are crucial allies in our strategy.

I welcome the statement, but may I pursue the point about taxation? Given that incentives will be needed to get couch potatoes to the gym, is there not a case for tax relief on gym membership?

If I may, I will leave such questions to the Treasury. We have a Budget coming up. Representations can be made and questions can be asked of Treasury Ministers, and I am sure that my hon. Friend is as adept as any on these Benches at putting his view across.

Does the Secretary of State agree that healthy minds are as important as healthy bodies, and that access to high-quality United Kingdom-produced children’s programmes contributes to that? Will he bear in mind the damaging impact that restrictions on advertising have already had on the UK children’s programming sector, and will he resist any moves to extend the advertising ban further? That would do little to tackle obesity, and would do more damage to an important part of the broadcasting landscape.

What we have there is the balance of the argument. The covert point made by my hon. Friend the Member for Edinburgh, South (Nigel Griffiths), who has now left the Chamber, is that whatever the effect on the advertising industry, we should plough on regardless in the interests of children’s health. Now, the hon. Member for Maldon and East Chelmsford (Mr. Whittingdale) has made a point about the effect on the industry. We do not believe that there is currently any proof of such dire effects, but we must listen to the industry. We do not want there to be fewer high-quality children’s programmes because we have taken certain measures. In that event, children might watch programmes made overseas and tune into channels on which there are no restrictions.

I understand the argument entirely, and so does my right hon. Friend the Secretary of State for Culture, Media and Sport. He is part of the ministerial team examining the issue, and will remain part of it. The voice of the DCMS will be an essential element of where we go next, after we have had the review in the summer.

I warmly welcome the determination to increase the promotion of breastfeeding. Evidence is becoming stronger all the time that babies who are breastfed are not just healthier, but protected from harmful weight gain in childhood and from obesity in later life. Is my right hon. Friend aware of the work of the Breastfeeding Manifesto Coalition, and will he consider implementing the seven points in the manifesto, which are consistent with his strategy?

As my right hon. Friend the Minister responsible for public health mentioned at a meeting last week, we are considering that seven-point manifesto. There is no difference between us on the importance of encouraging breastfeeding. We introduced the 26-week period of maternity leave so that we could be consistent with the World Health Organisation’s drive in favour of six months of breastfeeding. Whatever we decide in relation to the manifesto, the coalition is crucial in helping us to implement the strategy. Breastfeeding is an essential part of beginning the process of good, healthy nutrition and tackling the problems of obesity.

The Secretary of State’s third action point was to build physical activity into our lives, and I entirely endorse that; it is one of the crucial planks of the strategy. Why then did the Minister for Schools and Learners confirm in a written answer that this Government are cutting the number of places for physical education teachers from 1,450 in 2005-06 to 1,180 in 2007-08—a cut of 25 per cent. in the very people needed to tackle the problem?

If the hon. Gentleman will forgive me, let me say that he can ask that question when he has the relevant Secretary of State in front of him. My recollection from when I was doing that job is that we had a large increase in the number of PE teachers. [Interruption.] Well, I would have to look at that in detail. I will not take it as read from the hon. Gentleman. [Interruption.] I mean no disrespect to the hon. Gentleman—[Interruption.]

Order. Let the Secretary of State reply. The hon. Gentleman might not be satisfied with the reply, but it is the reply he is going to get.

My recollection is that we had increased the number of PE teachers and people dealing with sports in our schools, although I do no know whether they come under the heading of “PE teacher”. The situation might be similar to that in public health, where we have a huge increase in the number of people dealing with that but they are not categorised in our staff census in the same way as they were before. I think that the hon. Gentleman might be usefully be present for Department for Children, Schools and Families questions.

I welcome the statement, especially as there is currently a debate about the role of Sport England, and therefore probably about the role of primary care trusts and others working with the county sports partnerships. In view of the fact that there is a tight timeline for that—it is expected to have a broad strategy very soon and to have its business plan in place by April—can the Secretary of State give an assurance that the policy review he mentioned in his statement will be implemented in parallel with it rather than at a later stage, especially as the National Institute for Health and Clinical Excellence recognises that physical activity is one of the most cost-effective ways of tackling the obesity problem?

We will try to do it in parallel, but there is some work to do. The basic discussion we are having is about whether Sport England should focus on sport alone. We could use its network and, importantly, its reach into local communities to focus on activity that might not be sport-related, such as more walking and healthier lifestyles. There is a lengthy debate to be had and many issues for us to address, such as finance. If we can go through that process in time to introduce the policies in parallel, it would obviously make sense to do so.

We have already heard how, sadly, the Jamie Oliver revolution has resulted in an exodus from school dinner tables, as children either bring in unhealthy pack-ups or leave the school premises to buy their favourite food: chips. In an effort to reverse this trend, will the Secretary of State discuss with Ministers responsible for school menus whether the status of oven chips in school meals should be reviewed? Although Scarborough’s most famous product qualifies for three green traffic lights and is less than 5 per cent. fat, it is lumped into the same category as the unhealthy deep-fried alternative, which is why it is not served up more regularly in school meals.

It is chips with everything in this debate. That is a matter for the School Food Trust to look at. On the point about declining numbers, that always happens: in such circumstances, there is always an initial decline in the number of children eating school dinners. The SFT believes that although schools must pay more attention to whether their menus are attractive, the figures will gradually increase and things will eventually improve. That is certainly our experience in Hull, where we introduced the policy on school meals pre-Jamie Oliver. There should not be a counsel of despair because of the initial reaction of some children and some parents. If we keep at it, we can turn things around. I was at Green Dragon primary school in Brentford this morning. One big issue is that primary school children are much more receptive to these messages, and we need to ensure that the good habits continue when they go on to secondary school.

Those of us who are overweight already get enough stick at home without having to come to work for another beating. What we need are some carrots and some incentives. If the Secretary of State will give an undertaking to come to Banbury to listen to concerns about the future of local NHS services, I will give an undertaking to lose a couple of stone by Easter.

The hon. Gentleman draws attention to the importance of carrots in this policy. The five-a-day campaign is important. He has started with carrots; there are another four to go. I am sure we will see a svelte Member for Banbury very soon.

I sympathise with my hon. Friend the Member for Banbury (Tony Baldry), because the last time I dared to mention having lost a stone and a half, I was taken to task by one of the more delectable parliamentary sketchwriters, who disputed that at great length in her column. Having said that, I am a little puzzled by the idea of inspecting children’s lunch boxes to remove forbidden fruits—or, rather, forbidden chocolates. Given that children, for good reasons, now have more disposable income than 30 years ago, how will that solve the problem of them simply going out afterwards and buying whatever unsuitable food they wish to purchase?

I am afraid that that suggests that if we cannot do everything, we should do nothing. Schools across the country are already doing what we seek to do on school lunch boxes: work with parents to ensure that they have information and advice. The hon. Gentleman will have seen what children in his constituency have in their lunch boxes. Some of them come to school, probably having had no breakfast, with only a packet of Hula Hoops and a chocolate bar in their lunch box. Irrespective of what they might eat outside the school, our responsibility is what happens inside the school. Having put, with all-party support, a lot of effort into getting school meals right, we should use—without introducing the lunch box police or being heavy-handed—the initiatives that teachers themselves are introducing and spread best practice. At all stages, we should work with parents rather than against them.