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Childhood Obesity Strategy: Chapter 2

Volume 643: debated on Monday 25 June 2018

Today the Government published the second chapter of our childhood obesity plan. The plan is informed by the latest evidence. It sets a new national ambition to halve childhood obesity and significantly reduce the gap in obesity between children from the most and least deprived areas by 2030.

Childhood obesity is one of the biggest health problems that the country faces. Nearly a quarter of children are overweight or obese before they start school, and the proportion rises to more than a third by the time they leave. The burden is being felt hardest in the most deprived areas, with children growing up in low-income households more likely to be overweight or obese than more affluent children.

Childhood obesity has profound effects, which are compromising children’s physical and mental health both now and in the future. We know that obese children are more likely to experience bullying, stigma and low self-esteem. They are also more likely to become obese adults, and face an increased risk of developing some forms of cancer, type 2 diabetes, and heart and liver disease. Obesity is placing unsustainable costs on the national health service and our UK taxpayers, which are currently estimated to be about £6.1 billion per year. The total costs to society are higher and are estimated to be about £27 billion per year, although some estimates are even higher than that.

The measures that we outline today are intended to address the heavy promotion and advertising of food and drink products that are high in fat, salt and sugar, on television, online and in shops, and to equip parents with the information that they need in order to make healthy, informed decisions about the food that they and their children eat when they are out and about. We are also promoting a new national ambition for all primary schools to adopt an “active mile” initiative, like the Daily Mile. We will be launching a trailblazer programme, working closely with local authorities to show what can be achieved and to find solutions to problems created by barriers at a local level.

Childhood obesity is a complex issue that has been decades in the making, and we recognise that no single action or plan will help us to solve the challenge on its own. Our ambition requires a concerted effort and a united approach by businesses, local authorities, schools, health professionals, and families up and down the country. I look forward to working with them all.

We have a childhood obesity crisis, and we need action.

Of course, many of the policies announced today seem familiar. That is because they are actually our policies. Supporting the Daily Mile initiative is a Labour policy. Supporting a ban on the sale of energy drinks to under-16s is a Labour policy. Proper food labelling is a Labour policy. A target of halving childhood obesity is a Labour policy. The Minister should not be commending his statement to the House; he should be commending the Labour party manifesto to the House.

But what was not in the Minister’s response? There were no mandatory guidelines on school food standards, and no powers for councils to limit the expansion of takeaway outlets near schools. There was nothing about billboards near schools, there was no extension of the sugar tax to milky drinks, and there was no commitment to increasing the number of health visitors—and what about television advertising? We were told action was coming:

“the Health Secretary, is planning a wave of new legislation...including a 9 pm watershed”

said the Telegraph.

“Barring a last-minute change of heart, advertising for products high in sugar, salt and fat will be banned before the 9 pm watershed”

insisted The Times. But what did the Secretary of State announce yesterday? He is

“calling on industry to recognise the harm that constant adverts for foods high in fat, sugar and salt can cause, and will consult”.

So not even an “intention” to ban advertising of junk food—just a consultation. Surely this former Culture Secretary has not given in yet again to big vested interests?

We would bring forward legislation to ban the advertising of junk food on television. We have a childhood obesity crisis; the Government should be introducing restrictions on the advertising of fudge, not serving more up of it.

The Government talk of the role of local authorities. We agree, so will council public health budget allocations still have to wait until the spending review? Does that not mean new money will not be available for councils until 2020?

The Government have today announced 13 consultations and reviews; that hardly suggests the Government are gripped with a sense of urgency to tackle this crisis. Yet the evidence is clear: we need determined action now. I can assure the Minister that we would co-operate on the timely passage of legislation, so rather than stalling further, will he take us up on our offer? Our children depend on it.

I have been doing this job for just over a year now and I had yet to find the party politics in child obesity, but I have to say that the hon. Gentleman has just managed to land that one correctly, if nothing else. He seems to be suggesting that everything in the plan is a Labour idea and that the last two years have been in some way a wasted opportunity since the 2016 plan. I would suggest that that is not true, and it is not even close, actually. Over half of the products in the scope of the soft drinks industry levy that we brought in under Chancellor Osborne have been reformulated, with many important manufacturers leading the way. Our comprehensive sugar reduction programme has reduced sugar in some products that children eat the most. We have also made a number of significant investments, including doubling the primary PE and sport premium to £320 million a year, transforming children’s physical activity, as well as investing about £100 million this year in the healthy pupils capital fund and £26 million over three years to expand the breakfast clubs, with a focus on the Department for Education’s opportunity areas.

But we were always clear that chapter 1 was the start of the conversation—the clue is in the name—and we are very clear that more needs to be done; that is why I said what I said in my opening remarks. That is why we are introducing the bold new measures outlined in chapter 2. I am sorry that the hon. Gentleman does not like consultations, but what could be described as delay through consultations I would describe as getting it right, and I expect that we will come on to discuss some of these measures in the coming minutes. But we must get these measures right and make sure people cannot duck underneath them.

Finally, the hon. Gentleman spoke about public health. We are spending £16 billion in the ring-fenced public health budget during this spending review. There are many good examples of local councils doing excellent things with that money, and we will probably hear about some of them as well.

Order It is unsurprising that there is significant interest in this matter, but in order to facilitate timely progress to the ministerial statement, and indeed to the subsequent debate which I can advise the House is heavily subscribed, there will need to be a premium on economy from Back and Front Benches alike, as will now be brilliantly exemplified by the Chair of the Select Committee on Health, Dr Sarah Wollaston.

I warmly welcome the second chapter of the childhood obesity plan, which takes us so much further in a number of areas. Can my hon. Friend the Minister set out the timescale for these consultations and confirm that the responses will be considered in a timely manner, treating this with the urgency it deserves?

Yes, and may I thank the Chair of the Select Committee for the work she has done on this? Ever since we came into Parliament together she has been championing this issue—long before it was fashionable, I might add—and she has really led the line with her Select Committee inquiry on it, to which I and other Ministers joining me on the Front Bench today, including the Minister for Digital and the Creative Industries, my hon. Friend the Member for Stourbridge (Margot James), gave evidence. With most, if not all, of the consultations we are not hanging about; they will be getting under way this year.

This is a ticking time bomb that needs to be dealt with properly. We know that children from deprived backgrounds are twice as likely to suffer from obesity, so I first want to ask the Minister how this ties in with his plans to tackle poverty. The Scottish Government’s ambition to halve obesity in Scotland by 2030 and initiatives such as the Daily Mile are extremely important in addressing this. Those initiatives have received the backing of Jamie Oliver, who has stated that Scotland

“has picked up the baton that Westminster dropped”.

The Scottish Government will support small and medium-sized enterprises that have innovative ideas for junk food alternatives. What support will the UK Government be giving to companies founded to offer alternatives to fatty foods? Does the Minister agree that restricting the powers of the Scottish Parliament to lead the way on legislation on food safety, labelling and health claims could severely restrict Scotland’s ability to lead the way in this area?

I thank the hon. Lady for what I think was her welcome for this. Looking at the letter on the comprehensive strategy to tackle child obesity that was sent to the Prime Minister on 25 April and signed by her leader, the First Minister of Scotland, I have ticked alongside the bullet points and I reckon that 80% or possibly 90% of the things that her leader has asked for are in this plan. She has asked about inequality, for example, and we have the lowest levels of inequality in 30 years. I am not going to get into the devolution arguments, but I will say that we welcome the North Star policy that the Scottish Government have announced, with the support of Jamie Oliver—who, I might add, has been very supportive and helpful throughout this process. We matched that, but the difference is that we have a plan for how we are going to get there.

Is my hon. Friend aware that Hinckley and Bosworth Borough Council is already leading in Leicestershire in the areas of prevention strategy and tackling obesity? Chapter 2 will be widely welcomed. Has he considered talking to supermarkets about healthy shopping strategies?

I cannot say that I have considered that personally, but I know about lots of the technology solutions that supermarkets are bringing in. I am not surprised to hear the news about my hon. Friend’s local council, and yes, this is absolutely about prevention. Last week, the Prime Minister announced a record investment of new money in the NHS, alongside our new long-term plan, of £20.5 billion a year, but that must go hand in hand with prevention. Investment and prevention are always better than cure.

I also warmly welcome these proposals. These have been asks of the all-party parliamentary group on diabetes and of Diabetes UK for a number of years. There is a clear link between childhood obesity and diabetes, and 4.1 million people in the UK suffer from diabetes. Does the Minister agree that retailers do not have to wait for the consultation? As with the sugar tax, they can start to make the changes now to prevent diabetes in the future.

Yes, and I thank the right hon. Gentleman for his support for this. Diabetes UK has said:

“Diabetes UK welcomes the ambitious range of measures outlined by the government in their commitment to tackling the childhood obesity crisis facing the UK.”

Its brilliant chief executive, Chris Askew, has been very supportive of this plan. This is one of the drivers of the need to tackle this issue, and no, nobody has to wait for this. There have been many examples, and I am happy to name-check Waitrose, which took the lead on not selling energy drinks to children. Its example was followed by all the other mainline supermarkets.

I welcome the Government’s multi-pronged approach, but will the Minister bear in mind the fact that, when it comes to calls for banning advertising before 9 o’clock, such a measure would do huge damage to the economics of the commercial broadcasters, just at a time when fewer and fewer young people are watching scheduled television? Instead, they are now watching the on-demand services that are the direct competitors of commercial TV stations.

I take my right hon. Friend’s views very seriously, but we want to protect children from the advertising of products that are high in saturated fat, salt and sugar, and we are going to consult on introducing a 9 pm watershed. He mentions online, catch-up and social media, and that is one of the reasons that this is an important area for us to consult on. We want to ensure that we get this right, and it is not about punishing the industry. The people who work in the industry and in advertising are also parents, members of society and taxpayers. They also have a stake in this and in the reason for it all to succeed.

I am really glad to hear the Minister talk about tackling the health inequalities of obesity among children, because we know that the gap between the least deprived and the most deprived children has become more pronounced over the past eight years. Will he go into a bit more detail about what he is going to ask local authorities to do to close that gap?

I will work with local authorities on a new pathfinders programme, which the hon. Lady may not have had a chance to look at as it was published only this morning. We want to work with them to model solutions and barriers to action through the pathfinders programme. There are already some good examples, some of which are set out in the plan, including in Blackpool and at Derbyshire County Council, which are doing good things. Many local authorities already have a number of substantial levers and powers. We want to model the best so that others, such as Liverpool, can follow.

Why are the poorest children disproportionately among the fattest? It is not because they watch more adverts, is it?

It could be that, but it is a job of education and about helping their parents make sensible choices, because it is the poorest in society who miss out when we get this wrong. It is about what the Prime Minister described as a “burning injustice” when she was first elected, and I agree with her.

Breastfeeding is a protective factor against childhood obesity. Although initial rates are about 75%, fewer than 45% of mothers continue to breastfeed by six to eight weeks. There is no mention of breastfeeding in the childhood obesity plan. With health visiting services being cut, what are the Government doing to promote this important part of a child’s nourishment?

There is no mention of breastfeeding in the plan, but that does not mean that I and my colleagues do not see it as a very important part of the early years programme. In areas that I represent, as well as, I am sure, in other areas represented by colleagues, local authorities are often actively engaged in making sure that breastfeeding is a very important part of a child’s start in life.

It was the drive and passion of Alderman Eric van der Burg, a right-wing politician, that led to results in bringing down child obesity in Amsterdam. What more do we need to do to get local authority leaders here to see that this is actually part of their core business, not a fringe activity?

As my hon. Friend will remember from my speaking to the Health Committee, I have also been to Amsterdam, but unfortunately not for as long as the Committee members were. The whole-systems approach taken by Mayor van der Burg and Amsterdam is very impressive and has resulted in a 13% reduction in child obesity. Local authorities can learn from their attempts to market their cities, areas and regions, and I would suggest that having a good, healthy community and a good, healthy look when people walk out of the airport and do not see massive adverts for unhealthy fast food is an important part of that.

I welcome the Minister’s statement. Will he encourage supermarkets to offer free fruit to kids coming into the store? Nothing has changed my supermarket shop more than my local store doing so; when kids go in, they now ask for their free clementine rather than their chocolate.

That is an easy one to agree with. Tesco has been doing that for years, and my children regularly avail themselves of the opportunity.

May I urge the Minister not to get into some nanny state, socialist claptrap arms race with the Opposition parties, which will never be satisfied, as we heard earlier from the shadow Secretary of State? May I remind the Minister that he is actually supposed to be a Conservative and urge him to think about this from a Conservative standpoint, which focuses on things like parental responsibility and not seeking to ban anything that moves?

I am very pleased that my hon. Friend made that very helpful contribution. I am a Conservative—I said so in my opening remarks—but at the end of the day this is a publicly funded health service that we all believe in and all love. If we want it to celebrate its 140th birthday, we need to protect it, and that means getting serious about prevention and stopping people coming into the service and getting sick. Everyone in the House—Conservative, Labour and everyone in between—should get behind that.

As I understand it, a six-year-old will be 18 before the Minister’s proposed ban on the promotion of unhealthy food at supermarket checkouts will come into effect. Surely this is meant to be a crisis, not a long-term plan.

I thought for one fleeting moment that the hon. Lady and I were going to agree. I do not recognise that that six-year-old will have to wait another 12 years for the measure to be consulted on and put in place, so I think the hon. Lady might need to check her math.

I think the Minister said that one quarter of children are obese by the time they go into primary school. The figures are shocking. Surely that must mean that nought to five-year-olds have far too much refined sugar in their diet. Can we please have an emphasis on parental responsibility for those young children?

Yes. I am absolutely clear that there are three parts to this particular puzzle: there is Government, and using the power of Government for things like a sugar tax, which clearly only the Government can do; there is business, and the reformulation we are seeing from many, many businesses is impressive and helpful; and there are parents. Parental responsibility is central to this—we cannot do it without them—but we are going to give them information to help them do it.

The Minister’s Conservative Government introduced a tax on sugary drinks, which worked because, as we know, manufacturers have reformulated their drinks. Why does he not accept that the voluntary approach to high-sugar food is not working? Why does he not introduce regulation to cut sugar in the high-sugar foods marketed at families?

The hon. Lady and I went through this at oral questions just last Tuesday. There is a two-part approach: the stick and the carrot. As a carrot, we have a sugar-reduction programme on fizzy drinks, and my colleagues at Public Health England are doing a calorie-reduction programme—working closely with the industry, and with great success, to reduce calories through changes to recipes and portion sizes, for instance. Yes, sometimes the Government need to wave a stick, but there are also times when they need to encourage and to help along the way. We are going to do both.

At a time when families are struggling with the cost of living, I urge my hon. Friend to make sure that these measures do not increase prices, which hit those on the lowest incomes the most.

I have been very aware of that throughout the drawing together of this plan. For instance, we do not propose to ban “children eat free” offers. We are talking about food and drink price promotions, such as two-for-one multi-buy deals in the retail and the out-of-home sector, to prevent needless consumption and to help parents with pester power—with which I am incredibly familiar, as I have a 10-year-old and a seven-year-old.

The challenge is about both prevention and cure. We need to act now to help the growing numbers of children who are already obese, but in its recent inquiry the Health and Social Care Committee heard that provision of tier-3 and tier-4 services is bare. It concluded:

“Addressing health inequalities must include providing help for those children who are already obese.”

What is the Minister going to do about the commissioning of tier-3 and tier-4 services?

The hon. Gentleman is absolutely right. This is not just about some future generation; it is about the generation now that is already too big. It is about helping people through a sugar-reduction programme, a calorie-reduction programme and—something we have not yet talked about—the Daily Mile and the activity programme we see in so many schools in my constituency, and I am sure in the hon. Gentleman’s constituency. That will help children in the future, and it will certainly help children now. It is never too late.

I welcome my hon. Friend’s proposals, and I am grateful for his recent visit to Bexley to see our local plans for coping and dealing with childhood obesity. Chapter 2 is a good plan. Does he agree that targeting sedentary lifestyles is a top priority, and that to do so we need parental involvement?

It was a pleasure to visit my right hon. Friend’s constituency to see how Bexley Council is using its power, money and public health grant—the council made it very clear to me that it would like more, and my right hon. Friend is a very good advocate on the council’s behalf—to bring forward a whole community response like the one I saw in Amsterdam. I would like to see much more of that in England.

We have heard that obesity is caused not only by the wrong food but by a lack of exercise. Far too few children walk or cycle to school. Will the Minister engage with all our schools to make sure we have proper, realistic travel plans in place so that many more children walk or cycle to school?

Yes. The Daily Mile happens when children are in school, but getting to school is important. I work with Sustrans, a charity, quite a lot in my constituency, as I am sure many Members do. It works to help children to cycle and scoot to school. That is very important, and the hon. Lady is right to raise it.

The hon. Member for Witney (Robert Courts) is starting to resemble a runner who is literally itching to get out of the starting blocks.

As the father of a two-year-old, I am increasingly concerned about the sedentary lifestyles that children lead. Will the Minister join me in praising Middle Barton, Great Rollright, Queen Emma’s, Clanfield and Stanton Harcourt primary schools in West Oxfordshire, which have signed up to the Daily Mile programme? Will he encourage others to do the same?

My hon. Friend will have enjoyed that contribution; I suspect his office are clipping it as we speak. We have a national ambition for every primary school to adopt an active mile initiative, such as the Daily Mile, as a result of this plan. I visited Western Church of England Primary School in my constituency recently, which has good plans to do that. This week is National School Sport Week. I will be at my sports day on Friday, taking part—as I am sure you will be at some point, Mr Speaker.

The Minister’s virtue is boundless; he is truly a person of the people. I am sure he is a very popular parent at the school—I have no reason to doubt it.

On Friday, I met Councillor Hazel Malcolm, Wolverhampton’s cabinet member for public health. We discussed this challenge for the city, where, unfortunately and sadly, the child obesity problem is often worst in the lowest income wards. The Minister has mentioned the Daily Mile a few times during this statement. What can he do to make this more than something there are warm words about and to roll it out in schools so that children get the benefit?

The education team are working very closely on this, and the Minister for School Standards wrote a very good piece in The Sunday Times about it. [Interruption.] Indeed, the children’s Minister, the Under-Secretary of State for Education, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), is right here on the Bench with us. We are encouraging all schools to take part in the initiative and we have a national ambition for it. There is no reason why schools in the right hon. Gentleman’s constituency cannot do it, as is the case for schools in my constituency and those of other Members.

I, too, want to welcome the Daily Mile initiative. We should not be arguing about who was first to introduce it; I know we are competitive, but this is competitive for the schools. Does the Minister agree that any sporting activity in schools should be encouraged? Does he also agree that the social prescribing of sporting activities could also play its part in tackling this obesity crisis?

Especially tennis, Mr Speaker. I know my hon. Friend is keen on social prescribing, as am I. I recently signed an accord between National Parks England and Public Health England to use the brilliant natural resource of our national parks. They are clearly part of the social prescribing mix that we increasingly see across our country, and I want to see more of it. She is right to raise that.

I, too, thank the Minister for his statement. With 25% of children overweight in Northern Ireland, will he confirm how he intends to work cross-departmentally there in the absence of a working devolved Assembly? We need a strategy that works for all of the United Kingdom of Great Britain and Northern Ireland.

Yes. Some of the measures in this strategy relate to reserved matters, such as the advertising proposals that I have spoken about. I have been speaking to my officials, who are already talking to officials in Stormont and will be helping them to develop their own plans. I know they have been very interested in what we are doing, and I hope they can copy and follow some of this locally.

Community sports clubs, such as the Cary Park tennis club in Torquay, play a large role in making children active and encouraging them to participate in activity. Will the Minister confirm that looking at these sorts of groups will be part of the strategy—to get people active, not just to tackle what they are eating?

Yes, that is part of the strategy, in so much as we want local authorities to be involved, and upper tier authorities in England are all now public health authorities in their own right. There is absolutely no reason why sports clubs, which are plentiful in all of our constituencies, should not be a key part of the active lives agenda. Not just children need to do more activity in our country; all of us do.

I thank the Minister for the inclusion of both physical exercise and diet in this. Of course physical exercise is vital for mental health as well as physical health. Is the ambition to halve childhood obesity by 2030 ambitious enough, given that this is such an important issue for the future of not only the children, but our health service?

I think it is very ambitious. Our first plan was world-leading and I outlined some of the things it has achieved. I think this plan is ambitious enough at the moment. We say in the plan that it is chapter 2 and that there will be a chapter 3—and no doubt there will be.

As 80% of children are not doing the recommended minimum of exercise, we owe it to them to do better than make political gestures. In stark contrast to when the Labour Government devastated school sport, will the Minister commit to making it an absolute priority to work with the Department for Education to unlock school sports facilities for free after school and in the school holidays for sports groups and parents, in order to provide opportunities?

I spoke earlier about the Government’s doubling of the primary PE and sport premium to £320 million per year, which is very important. My hon. Friend is absolutely right to raise the issue. I will of course work with all my colleagues across Government to implement the plan and to do even better than we currently are.

Obesity harms the life chances of too many children. Given the Minister’s encouragement earlier, will he join me in praising schools such as Lytchett Matravers Primary School, which has already set up a Daily Mile scheme, and encourage others to follow suit?