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Dietary Advice and Childhood Obesity Strategy

Volume 611: debated on Monday 23 May 2016

(Urgent Question): To ask the Secretary of State for Health to provide an answer to the urgent question of which I have given him notice.

I thank the right hon. Gentleman for the question. The Under-Secretary of State for Health, my hon. Friend the Member for Battersea (Jane Ellison), is principally responsible for this issue, but as she is on Government business in Geneva—a cruel twist of fate— I am pleased to respond to his question.

Tackling the unacceptable level of childhood obesity in this country is a major priority for all of us in this House and for the Government. We know that obese children are much more likely to become obese adults. In adulthood, obesity is a leading cause of serious diseases, such as type 2 diabetes, heart disease and some cancers. Tackling obesity and improving diet, especially in children, is therefore one of our major priorities and an issue that we made a commitment to tackle in our manifesto.

Evidence shows that obesity is a complex issue to which there is no single solution. Tackling childhood obesity requires a full package of bold measures and collective action by Government, businesses, health professionals and individuals. Our comprehensive childhood obesity strategy, which is being launched this summer, will be a key step forward in helping our children to live healthier lives. It will look at the range of factors that contributes to a child becoming overweight and obese, and it will also set out what more can be done by all. Our cross-Government approach, led by the Department of Health, is based on the latest scientific evidence from Public Health England and the Scientific Advisory Committee on Nutrition.

As for the views expressed today by the National Obesity Forum on how to prevent obesity and type 2 diabetes, Public Health England has described them as irresponsible, as they do not reflect the totality of the evidence base. By contrast, Public Health England’s dietary advice is based on advice from independent experts on the Scientific Advisory Committee on Nutrition, which, in turn, is based on all available evidence. SACN conducts full-scale consultations on draft reports and goes to great lengths to ensure no bias. International health organisations agree that too much saturated fat raises cholesterol, increasing the risk of heart disease, and that obesity is caused by consistently consuming too many calories.

Order. It should now have become clear, but for the avoidance of doubt, in particular for the benefit of those attending our proceedings who are not within the Chamber, that these matters should be self-contained and readily intelligible. The request from the right hon. Member for Leicester East (Keith Vaz) was to the Minister to provide a statement on dietary advice and the childhood obesity strategy. All is now magnificently clear.

May I thank you, Mr Speaker, for granting this urgent debate and the Minister for his answer to the question?

The National Obesity Forum’s report published today has led to a public outcry and confusion. Indeed, the conclusions of this report contradict much of the health and lifestyle advice issued by the Government and the NHS over the past decade. Ordinary people are now caught in a whirlwind of conflicting advice at a time when they desperately need clarity, consistency and straight talk. Quite simply, they do not know where to turn. The Royal College of Physicians, the Faculty of Public Health and the British Heart Foundation have all raised concerns about this report. Some have claimed that local authorities, schools and the NHS are receiving guidance from organisations whose funding and motivations are not known. I welcome the use by the Minister of the word “irresponsible” in respect of this report.

The critical issue, however, is the delayed publication of the childhood obesity strategy. We were first told that this would be published in December 2015. We were then told that it would be February 2016. It is now expected at the end of the summer. No doubt you will confirm, Mr Speaker, that there is no clear indication from the Government as to when the end of the summer will be. Amid the delays, other voices are filling the vacuum. Clearly, a strategy is required on what steps are needed to prevent and tackle the growing levels of obesity, which, at current rates, are expected to reach 60% of the adult population by 2025. We need a definitive date for the publication of the strategy. Will the Minister give us a date today? In the Queen’s Speech last week, the introduction of a sugar tax was confirmed, which I warmly welcome. That could prevent 2.7 million people from being obese, by 2025.

Finally, obesity is a leading cause of type 2 diabetes, as the Minister has said. Just as the rates of obesity are set to increase, the number of people with diabetes is expected to rise to 5 million by 2025. As a type 2 diabetic and chair of the all-party group for diabetes, I live with how stark the situation is. Sadly, today’s information tsunami has demonstrated a lack of leadership in public health. Although the Public Health Minister should be commended for all the work she has done, the Government must go further. Failure to act now will jeopardise the future of our nation’s health and the solvency of our national health service.

I thank the right hon. Gentleman for taking the opportunity of the report’s publication to give the Government the chance to respond and, hopefully, to put in the public realm a degree of concern about the report to back up the comments that he has made. I can do no better at this stage than quote what the chief knowledge officer of Public Health England, Professor John Newton, said today:

“Suggesting people should eat more fat, cut out carbs and ignore calories conflicts with the broad evidence base and internationally agreed interpretations of it.”

He continued:

“This opinion paper from the National Obesity Forum and Public Health Collaboration is not a systematic review of all the relevant evidence. It does not include an assessment of the methodological quality of the studies and should not be confused with the comprehensive reviews of the evidence that are produced by our process. For example, this paper highlights one trial suggesting high dairy intake reduced the risk of obesity, while ignoring a systematic review and meta-analysis of 29 trials which concluded that increasing dairy did not reduce the risk of weight gain.”

I am pleased that the right hon. Gentleman has given us the opportunity to agree with him and others who have said the report is irresponsible.

To respond to the right hon. Gentleman’s questions for the Government, it is clear that the childhood obesity strategy will be much welcomed, but it has to be soundly based. Much though I would like to give a date, I have to say that its launch will indeed be “in the summer”, and the summer is in parliamentary terms a flexible period. In saying that, I do not in any way minimise its importance.

The presence of my hon. Friend the Minister for Children and Families demonstrates that this is a cross-Government strategy. We know it will be scrutinised by many different parties, so it has to be right to give the guidance the right hon. Gentleman talks about. One can look at any national newspaper—one in particular—any day of the week and read conflicting advice on what is good and what is bad. Whereas that might be a source of amusement to the news programmes, for parents looking for what is right for their children, it is vital that they have advice they can trust. That is why the childhood obesity strategy, much commented on in this place, is so important.

The right hon. Gentleman is an important voice in dealing with diabetes. “Healthier You”, the national diabetes prevention programme based on international evidence, will start this year in 27 areas covering approximately 45% of the population and making up to 10,000 places available to people at high risk of developing diabetes, and will roll out to the whole country by 2020. The right hon. Gentleman is right to emphasise the importance of diabetes. I hope he acknowledges that that is recognised by the Government.

Does my right hon. Friend not agree that instead of all this complex and conflicting nanny state advice, it would be far better simply to advise children to move about more and eat less?

I am delighted to welcome the question from my hon. Friend the Member for Bury North—may God bless all who live there. I had a small bet with the Secretary of State on how long it would be before the words “nanny state” were uttered, and I was not disappointed.

My hon. Friend is right to ask the question, and we still want to encourage children to move more and eat less—there is nothing contradictory about that. However, a Government who take children’s health seriously, whether in relation to dentistry, deprivation and the environment, or indeed their physical health, weight and wellbeing, are as entitled to comment on this issue as anyone else. The childhood obesity strategy will not contradict efforts to encourage physical activity, but it will, I hope, have elements that my hon. Friend and everyone in his constituency welcomes.

Obesity, and in particular childhood obesity, is one of the biggest public health challenges facing our country. Today’s report not only questions official Government advice, but says that it may have had disastrous consequences. Whether that is right or wrong is a matter for debate.

Let me start by asking the Minister about today’s report. It makes a number of recommendations, but perhaps the most controversial has been the call to stop recommending the avoidance of foods with a high saturated fat content. I am pleased that the Minister has reaffirmed that he has no plans to review the Government’s official advice in the light of that call, and has also reaffirmed that the evidence on the current dietary advice remains valid, but does he share the views of experts, including the British Heart Foundation, who have today stressed the importance of official guidance being informed by robust evidence, free from interference by industry?

On the childhood obesity strategy, as my right hon. Friend the Member for Leicester East (Keith Vaz) said, in September we were told that it would be published before Christmas. Then at Christmas we were told that it would be published in the new year. In the new year we were told that it would be published in the spring, and now we are told that it will not be published until the summer, so can the Minister explain this delay? May we now have a cast-iron guarantee that the strategy will be published before the House rises for the summer recess, so that Members will have the chance to question Ministers on the contents of that strategy?

We welcome the recent announcement of a sugar levy, but does the Minister agree that alongside action on cost, we need action on advertising and labelling? Perhaps the real cause of rising childhood obesity has been not the Government’s dietary guidance, but their failure to take tough action on the marketing and packaging of unhealthy products. Will the Minister confirm that the strategy will contain comprehensive and co-ordinated action to tackle this growing public health challenge? Some of the best advances in public health have come about because past Ministers have shown leadership and vision, so may I say politely to this Minister: “Enough of the delay. It is now time to act”?

I am sure the Under-Secretary, my hon. Friend the Member for Battersea, will be able to pick up a number of issues that the hon. Gentleman has raised, but let me respond to some.

First, in relation to the report, as I emphasised by quoting the remarks from Public Health England, any advice that goes into the public domain which is to have credibility and upon which people should want to rely must be fully evidence based and as thoroughly researched as possible. If there is any doubt about that—if the evidence appears to be scant—it is right that such advice should be dismissed as irresponsible. We should continue to urge people to look at far more in-depth studies and internationally accepted views on health, diet and wellbeing. I made that point and I am pleased that the hon. Gentleman agrees.

In relation to the Government’s activity, the childhood obesity strategy will come forward in due course, but it cannot be said that nothing has been done in the meantime. The sugary drinks tax has been taken forward, and I can assure the hon. Gentleman that advertising, labelling and promotion definitely come into the strategy and will be looked at. Having spoken to my right hon. Friend the Secretary of State for Health, I am sure that the intention is to get the report out at a time when the House will be able to consider it. There is little likelihood of the House not having an opportunity to discuss and debate such an important matter, but it is important to get the report right. It is important that it meet exactly the challenges that the hon. Gentleman made from across the Dispatch Box. If it is not seen to be thorough, well researched and well evidenced, it will fall foul of the concerns raised by the irresponsible report today. I am grateful for his support. The outcome is something we all want to see, and I can assure him that my hon. Friend the Minister will be studying his remarks carefully.

In the hope that the Minister has doubled up his bets with the Secretary of State, may I join my hon. Friend the Member for Bury North (Mr Nuttall) in urging him to curb the Department of Health’s natural nanny state instincts when it comes to a childhood obesity strategy? If the sugar tax is part of that childhood obesity strategy, can he explain why the tax is being directed at a certain number of products, when other products with far more sugar in them will not be covered by the tax? Will he abandon this policy and encourage the Chancellor to abandon it before it becomes the new pasty tax policy?

Tempting though it is to use my temporary position for a whole range of announcements in relation to this area, I think that would be unwise. I can inform my hon. Friend that I have him on an accumulator with my hon. Friend the Member for Bury North (Mr Nuttall); I am not saying who is the final part of it. No, the Government will stick to their declared policy in relation to sugary drinks. Perhaps my hon. Friend might welcome the fact that all the money from that is going into physical activity through sports in schools, which I know he is really keen on as well. Perhaps that mitigates any concern he might have.

We have heard about the evidence base and the importance of looking at that evidence as we move the strategy forward. May I ask, as I did when this was last debated on 21 January, that the childhood obesity strategy look at the evidence that breastfeeding can contribute to reducing childhood obesity? The evidence is there, and it makes a significant contribution, so will the Minister ensure that it gets prominence in the report when it comes to be published?

Yes, I am very conscious of the issues surrounding this. The hon. Lady already has a meeting with the Under-Secretary, my hon. Friend the Member for Battersea, when these issues can be taken further.

I welcome the Government’s words on the national child obesity strategy and the necessity of making sure that it is authoritative when it is published. However, in the light of today’s unhelpful reports, is not the real point that it is absolutely critical that that strategy deals with many of the myths out there and is truly authoritative and conclusive in the advice that it relays?

My hon. Friend is absolutely right—that is important. The strategy has been awaited, and if it is to do the job we all want it to do, it should deal with the myths and concerns that have been raised, and do so in a proper evidential manner.

May I join in a partial, and rather surprising, alliance with the hon. Member for Shipley (Philip Davies) in questioning the sense in taxing just one particular type of product? Would not the Government instead—this is where I part company with him—consider taxing sugar as an ingredient to create an incentive for reformulation of products to reduce sugar content across the board, rather than just picking on one type of product?

I thank the right hon. Gentleman. He was not on my accumulator, so it has gone down. What he is calling for is exactly what the strategy does. It is designed to be quite wide and to take into account the possibility of other action in other places. He is absolutely correct about that.

Far from raising the nanny state, I welcome the Government’s proposals regarding sugar. There is a difficult issue not only about childhood obesity but about dentistry and the shocking evidence showing that young children today are having to go through procedures that should not be necessary. Will the Minister reissue that guidance and warning to all parents? I have a son who is 19; I know many people will be shocked to hear that. When he was 16, he had not had a fizzy pop; by the age of 18, after he had had fizzy pop from 16 to 18, he had 12 fillings. Will the Minister reiterate the dangers of fizzy pop?

Now we are back on home territory, as I am the Minister responsible for dentistry and can thoroughly concur with what the hon. Lady has said, while sharing the House’s astonishment at her news. The issue of dental clearances and young children’s teeth is a scandal. I will be speaking about this because on Friday I am going to a British Dental Association conference in Manchester and it will form part of my speech. The question is how to reach the parents and carers who have charge of their children to make sure they have access to the sort of treatments that are available, and how we work through schools, and through dentistry itself, to try to make more provision available for those who can be reached so that we deal with this terrible problem. There are some good experiments going on, not least in Nottingham; I think that the hon. Member for Nottingham North (Mr Allen) is partly responsible for those. The hon. Lady is right: dental issues are a serious matter to be dealt with in the overall health strategy.

May I first declare that I am a believer in the nanny state? It was the nanny state that stopped children being sent down mines and up chimneys, and much more besides. May I applaud my right hon. Friend the Member for Leicester East (Keith Vaz) for raising this very important issue? Last week when I had a peanut butter sandwich, it tasted rather sweet, so I checked the jar and found it had sugar in it. May I suggest to the Minister that we go well beyond a sugar tax and have some means of stopping sugar being put wrongly into foodstuffs?

We now have a sugar app, which means that the next time the hon. Gentleman goes down to the supermarket and wants to check how much sugar there is in a product, he can use the app by placing a device against the barcode. My family have used it and they have found, to their astonishment, how much sugar is contained in products that they never expected to contain it. This is not only about making sure that there is a reduction in sugar content where that is possible and appropriate, but about alerting consumers to the amount of sugar, which is really important. I shall ensure that the Under-Secretary, my hon. Friend the Member for Battersea, gives him details about the app he can use.

I know the Minister is a very reasonable man, so will he explain to my constituents how it can be reasonable for the public health budget in Hull to be cut by £1.56 million in-year? That means a reduction of £300,000 in the obesity strategy, and local authorities of course lead on obesity public health issues, do they not?

They do. I just have to tell the hon. Lady that all parts of Government are making the sorts of efficiencies they need to make in relation to such matters, and that can be no different for her area.

Prior to the reported publication date in the summer, will the Minister make sure that he discusses the co-ordination of the strategy very carefully with the Welsh Assembly? In border areas such as mine—advertising crosses the border and labelling crosses the border—people from my constituency who buy sugary drinks in Chester will find that their resources are put into sport in England, but not necessarily in Wales. It is important to consult the Assembly.

In accordance with the last answer I made to the last question when I was last at the Dispatch Box, the answer is yes.

Order. We now come to an urgent question to be asked by Mr Bernard Jenkin. Not here. Where is the fella?

I find it very hard to believe that the hon. Gentleman is in Brussels. [Interruption.] Order. Given that I have granted the hon. Gentleman’s application for an urgent question, it is a considerable discourtesy for him not to be here at once. He should have been in the Chamber. This must not happen again. The hon. Gentleman is a very serious and conscientious parliamentarian. If you put a question in, man—be here. Let us hear it. I am sorry to be annoyed, but I am annoyed, because the House’s interests are involved. This is not just about the hon. Gentleman; it is about all the other Members who have bothered to be here on time and about the interests of the House. The Minister was here well in time, which is good, and the shadow Minister has toddled in—the hon. Member for Wolverhampton South West (Rob Marris) beetled into the Chamber just in time. Let us hear from the hon. Member for Harwich and North Essex (Mr Jenkin).